Pulmonary tuberculosis : a clinical lecture delivered at the Philadelphia Hospital / by Solomon Solis-Cohen.

  • Solomon Solis-Cohen
Date:
1894
Catalogue details

Licence: Public Domain Mark

Credit: Pulmonary tuberculosis : a clinical lecture delivered at the Philadelphia Hospital / by Solomon Solis-Cohen. 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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    in these patients is confined to a limited area, principally at the apices of the lungs, and extends very slowly, but yet endures. It has endured, under our own observa- tion, for five years in the one case, for three years in the other, notwithstanding the fact that the patients' resist- ance has been increased by treatment. In Henry's case there are two large cavities, one in each lung, in which from time to time we detect signs of activity, which, however, subside under treatment, and even without treatment. In another group of patients we will have an exactly opposite tendency. ' General reaction is good when aroused, but there is little local resistance. The lesions are but feebly limited in space, but there is a strong tendency to Umitation of the morbid process in time ; that is to say, so long as it lasts it spreads more or less rapidly, and may involve a considerable extent of pulmonary tissue, yet it comes to an end in a comparatively short time. An illustration is shown by the patient G., in whom at present all active manifestations of the disease have ceased, but who has in a few months lost so much pulmonary tissue that a cavity in the middle of the right lung is easily demonstrated. The question, in a patient of this kind, is : Will the time-limitation come into play before the destruction of tissue has gone too far ? Nature has been bountiful to us in the matter of lungs and other organs, and a total loss of half the normal amount of pulmonary structure is not incompatible with good health, as is shown by a remarkable case of Till- mann's, in which disease and surgery had practically removed the whole of one lung, the other lung remaining healthy. And then we have, unfortunately, another group of patients, those in whom there is no tendency to limita- tion either in space or time, and they form the type of what is termed galloping consumption. The morbid process extends rapidly, and is not limited, except by the death of the patient. I have never seen cases of that
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