On the principal varieties of pulmonary consumption with practical comments on diagnosis, prognosis and treatment / by R. Douglas Powell.

  • Powell, R. Douglas (Richard Douglas), Sir.
Date:
1872
Catalogue details

Licence: Public Domain Mark

Credit: On the principal varieties of pulmonary consumption with practical comments on diagnosis, prognosis and treatment / by R. Douglas Powell. Source: Wellcome Collection.

    80/118 page 68
    present is the result of the hamoptysis; and these two facts are sufficient to mark the case clinically as one of HcEmorrhagic Phthisis. It is obvious that it is impossible to draw the line between those cases in which the acute congestion— whether of vicarious or mechanical24 origin or aris- ing from a chill or other cause—results in hae- morrhage in a lung previously sound, or determines what is often the first sign of consumption, hae- moptysis, from a lung whose vessels are frail from previous error of nutrition or disease at one portion. The distinction is mainly drawn from the clinical history of the case; and there is perhaps no true pathological difference, since we cannot on present evidence admit the haemorrhage to be bronchial. The chief fact upon which those who attribute early haemoptysis to haemorrhage from the bronchial tubes rely, is the extreme difficulty often experienced by the ablest auscultators in detecting any physical signs (but those, perhaps, of bronchial irritation) a short time after even very copious haemoptysis. A man comes for examination a day or two after bringing up a large quantity of blood, and absolutely no signs which one could definitely pronounce as^ in- 24 The term mechanical source is meant to include those cases in which the excited action of the heart and pulmonary engorge- ment connected with violent muscular exertion—excessive danc- ing, rowing, etc.—lead to hajmoptysis. I do not know of any well-authenticated case of the Idnd. In Dr. Weber's first case (C/m. Trans., vol. ii., p. 143), dancing evidently caused a recur- rence of the haemoptysis.
    digitised image 1
    digitised image 2
    digitised image 3