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

  • Hope, James, 1801-1841.
Date:
1845
Catalogue details

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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    Although the physical signs of pneumonitis are usually very distinct, cases nevertheless occasionally occur in which they afford but little evidence of the diseased action. Andral details a number of cases of undoubted pneumonitis, some of which were verified by post mortem inspections, in which the physical signs were almost entirely absent. These facts ad- monish us not to rely exclusively on physical signs, but to bring them to our aid, in connection with general symptoms, as aux- iliaries, usually indispensable in diagnosticating pneumonia.] Degree 2.—Hepatization {ramollissement rouge of Andral) is represented in Fig. 4, extending from &, c, to the opposite side, and occupying the lower half of the upper lobe. It is perfectly formed, and well characterised. It sinks in water, feels firm and heavy like liver, and does not crepitate. It is very lacerable, breaking up under moderate pressure with the fingers, and a section is followed by exudation of a very spa- ring quantity of bloody serum, without the slightest inter- mixture of air. The color is a dull red with a leaden inter- mixture. This is variegated and made to assume a marbled aspect by dark blue spots of pulmonary matter, and by pale yellow streaks and clouds, formed by the bronchial tubes, the blood-vessels, and the hypertrophous interlobular partitions. The surface is granular,—a remarkable character, and de- pendent on tumefaction of the walls of the air-vesicles caus- ing obliteration of their cavities. An extreme degree of this tumefaction destroys the granular appearance, by pressing together, and thus confounding the vesicles. A hepatized lung looks larger than natural; yet it is not, the appearance being occasioned by its retaining the size of the thoracic cavity, instead of collapsing when the chest is opened. The color of hepatization is not always similar to that delineated. Where there is less black pulmonary matter to form a contrast, the marbled appearance is less striking, and the general tint partakes more of light pink, as in Fig. 7, c and g. In Fig. 4 the greyer portion of b, c, near the vessels, is in its passage into the stage of purulent infiltration, the red giving