Watson abridged : synopsis of the Lectures on the principles and practice of physic, delivered at King's College, London / by Thomas Watson.

  • Sir Thomas Watson, 1st Baronet
Date:
1867
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Licence: Public Domain Mark

Credit: Watson abridged : synopsis of the Lectures on the principles and practice of physic, delivered at King's College, London / by Thomas Watson. 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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    dition iu which it is impermeable to air and at the same time diminished in bulk. Some consider it occasionally congenital and idiopathic. It is ]>rogressii>e, the dyspnea gets worse as it advances. Pressure on the lungs, tumors in the thorax, crooked spine, tight-lacing, tubercles, may produce or aggravate the disease. When its capillaries are effaced, the lung cannot admit its due amount of blood through the pulmonary artery, and then the increased action of the right ventricle leads to permanent dilatation of the right cavities, to palpitation, oedema. Simple vesicular emphysema is seldom very dangerous. It is a very common cause of asthma, but of a less dangerous form than that proceeding from certain other organic changes. _ Treatment.—There is scarcely any cure. Guard against aggravating circumstances. Remove or mitigate other co-existing disorders. Order change of air, warm clothing. Keep the feet dry and warm. Advise cold shower-baths. During the extreme dyspnea, loud and protracted expiratory wheezing is heard; and if, withal, small crepitations indicative of pneu- monia are heard, cup between the shoulders. The great assuager of the dyspnea in this disorder is opium, especially combined with tether. Hoff- man's anodyne 3 ss, acetate or muriate of morphia gr. g, in camphor julep, often acts like a charm. The blueness, which is temporary, of the lips and countenance should not deter from giving a full dose of opium. lNTERLOBn.AU Emphysema.—In interlobular and sub-pleural emphysema, which is true emphysema, the bulla? between the pleura and lung may be moved about by pressure. The bulla may be as large as a hen's egg. The air likely gets through a ruptured air-vesicle. It may rupture the pleura sometimes and enter the cavity of the thorax. Sometimes the air may blow the lobules of the lung asunder, even an inch. If it reach the root of the lung, it passes to the areolar tissue of the mediastinum, neck, and chest. Interlobular emphysema may take place in a few minutes or sec- onds. The cause is violent straining. Some say there exist dry crepitations and friction sound. Treatment. — Under favorable circumstances, the disease soon cures itself; the air will be reabsorbed, and the dyspnea cease. Relieve extreme dyspnea by blood-letting. If the air be felt crackling beneath the skin, let it out by a tew punctures with a lancet. This form is more common in infancy. (Edema op the Lungs is that state in which their interstitial tissue and air-cells are filled with serous fluid. It is common, and generally a part of general anasarca. The lung is generally pale gray or yellowish, is heavier, less crepitant, than natural, pits on pressure, is doughy, and does not collapse. It is attended by dyspnea, and larsre crepitations at the bottom only of the lung, because thither the liquid gravitates. Percussion gives a hollow sound. Sometimes there is but little expectoration ; some- times more, with a piece or two of mucus in it, and foamy. This oedema is symptomatic of other diseases, generally of the heart or great blood- vessels. Treat the original disorder. Pulmonary Consumption—Tubercular Phthisis.—Phthisis means a wasting away. This term is generally confined to tubercular disease in the lungs, though this disease may be situated in other organs. Tubercles are of the consistence of cheese. They are deposited from the blood often into areolar tissue. If the tubercular matter is deposited in the vesicles of the lungs, it is round ; if in the smaller bronchial branches, cylindrical. The small, more firm, semi-transparent, and bluish gray, granules, are likely the yellow opaque tubercles in a nascent state. The softening of tubercles does not begin in their centres. When the tubercles are few, they, in more than nineteen-twentieths of the cases, are found in the upper, and back parts of the upper, lobes. There also are they found the largest and
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