Status thymo-lymphaticus and its relation to sudden death / by Gerhard Hutchison Cocks.

  • Cocks, Gerhard Hutchison.
Date:
1910
Catalogue details

Licence: In copyright

Credit: Status thymo-lymphaticus and its relation to sudden death / by Gerhard Hutchison Cocks. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    of the external lymphatic glands, axillary, cervical and inguinal, accompanied by hyperplasia of the faucial, pharyngeal and lingual tonsils. The spleen may also be enlarged and palpable. McCardie states that “signs of low blood-pressure may be asso- ciated, e. g., pupils comparatively large, a low tension pulse, heart sounds thin and flabby, giving one the idea of thin-walled, dilated cavities and of small muscular power.” If the blood-pressure is low, it can be detected by the sphygmomanometer. A finding of a lymphocytosis or diminution of the hemoglobin of the blood would aid in the diagnosis. Inspection of the chest may possibly show a pulsating tumor above the sternum, when the thymus is greatly enlarged, or this tumor may be palpated by the finger of the ex- aminer. Percussion. Light percussion with the finger should be em- ployed. Warthin says: “The area of thymic dullness is triangular, with unequal sides, the base at the level of the sterno-clavicular articulations, and the blunt apex is behind the second intercostal space or the upper part of the third rib. The side boundaries ex- tend somewhat beyond the sternal lines, usually more to the left than to the right. An area of dullness extending more than one centimeter beyond the sternal lines may be taken as evidence of an enlarged thymus.” , In a case of thymic asthma, during the attack, we have the pic- ture of a child suffering from inspiratory dyspnea. Thq respiration is noisy and stridorous in character. There is retraction of the supra-clavicular and intercostal spaces. The child is very restless and perhaps cyanosed. No history of a diphtheritic infection is ob- tainable. Examination of the larynx is negative, but tracheal steno- sis is demonstrable by a long tracheoscopic tube (Jackson). The most certain and only reliable method of diagnosis is radio- graphy. Warthin states “that the radiogram of the normal thorax of an infant shows in the median line a flask-shaped shadow having a narrow neck and plump body, the neck portion of the shadow reaching from the first or second dorsal vertebra to the fifth or sixth. The body of the flask corresponds to the cardiac shadow, while the neck shadow—the lateral boundaries of which only slightly exceed those of the vertebrae—is the shadow of the thymus and great vessels. Under pathological conditions, i. e., with hyper- trophy of the thymus, the neck portion of the shadow broadens.” Warthin has well shown this by radiograms. Resume, i. The thymus gland is probably an epithelial organ with an internal secretion.
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