Publisher's Synopsis
This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1879 edition. Excerpt: ... in some cases, bronchophonic and pectoriloquous in others. In these cases the heart must be carefully examined for signs of pressure on the right side, pulsation in the lower sternal region, the apex beat being obscured. bronchiectasis, or dilatation of the bronchi, occurs as a result of chronic bronchitis and asthma, where the tubal structure has suffered from atrophy of the mucous coat and thickening of the fibrous layers. It is produced by inhalation of irritating particles of dust, fluff, wool, iron, clay, and stone; and it gives rise to forms of disease named according to the special trade by which it is induced--as knife-grinder's rot, filer's phthisis, &c. Symptoms.--Much dyspnoea and expectoration, the sputa being plentiful, opaque and purulent; cyanosis is usually present, the right ventricle of the heart being eccentrically enlarged. Pathology.--The bronchial tubes are found much thickened, irregularly pouched and dilated; alveolar walls thick, white and emphysematous. Sometimes the upper lobe is in a condition of alveolar thickening, the air-sacs irregularly dilated; while in the lower parts may be found old congestive patches of pigmented thick fibroid tissue, indicative of partial lobular congestions and haemorrhage. Occasionally dilatation of the tubes is observed in compressed portions of the lungs, in empyema or pleuritic effusions. It happens especially in those chronic cases where the fluid has been evacuated by natural or artificial means. A compressed lung is very loth to expand, and if the external pressure be removed the tubes will yield to the internal force of the atmosphere, and it is common to find this pouching near an empyema. Signs.--Inspection observes depression of the intercostal spaces with fixity, and...
