Principles of pathological anatomy : adapted to the Cyclopedia of practical medicine and Andral's elements / by J. Hope.

  • Hope, James, 1801-1841.
Date:
1845
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Licence: Public Domain Mark

Credit: Principles of pathological anatomy : adapted to the Cyclopedia of practical medicine and Andral's elements / by J. Hope. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    sputum be viewed as pathognomonic of pneumonitis when it is present; the tinge may be imparted by congestions and pulmonary apoplexy, unconnected with inflammation. Dr. Williams states that he has seen the rusty expectoration in bronchitis depending on congestion from organic disease of the heart. It is true, however, that the rusty colored expectora- tion is most commonly met with in pnemonitis, but at the same time it cannot be received as always characteristic of that disease.] The crepitant ronchus, also a pathognomonic phenomenon in engorgement, depends on the bursting of mi- nute bubbles formed by the passage of air through the gluti- nous secretion. [Dr. Williams is of opinion that the crepi- tant ronchus depends on the narrowing of the extreme air- tubes, produced by the engorged vessels pressing upon them; and the air forcing itself through the viscid mucous that lines the contracted tubes, forming minute bubbles and bursting, causes the crackling sound, or crepitant ronchus.] The seat of the phenomenon is confined to the vesicles and capillary bronchi. It differs from the mucous ronchus only in its superior fineness, the latter ronchus being seated in larger bronchial tubes. The sub-crepitant ronchus is a mixture of the crepitant with the finest mucous. [The physical signs of pneumonitis afford the clearest evi- dence, as a general rule, of the progress of the disease through its various stages. In the most incipient state, when the vas- cular engorgement is but slight, the signs are not very dis- tinctly marked; but Dr. Stokes is of opinion, that intense puerility of respiration in the affected part, evinces the change that has taken place, and is the precursor of the crepitating rale. He is of opinion, therefore, that the earliest stage of pneumonitis may be diagnosticated by the local puerility of respiration, accompanied by fever, and general disturbance of the respiratory function. In the second stage the signs are well marked. The crepitating rale becomes distinct, while the vesicular murmur is diminished in the same proportion. The chest, upon percussion, will yield some degree of dulness proportioned to the extent of engorgement and infiltration.