Licence: Public Domain Mark
Credit: Outlines of human pathology / by Herbert Mayo. Source: Wellcome Collection.
Provider: This material has been provided by the Francis A. Countway Library of Medicine, through the Medical Heritage Library. The original may be consulted at the Francis A. Countway Library of Medicine, Harvard Medical School.
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![as is commonly the case in adults and old persons, both the pus and the pulmonary substance assume an ash-grey colour. These different stages are frequently found in the same lung, dividing it into as many zones, that are strongly con- trasted, although insensibly shading into one another. The lower parts of the lungs are the most frequent seat of pneumonia; and when the disease involves the whole viscus, it is almost always in the inferior part that it com- mences. Such is the observation of Laennec, with which the impression of several of our most scientific London phy- sicians concur. Dr. Forbes, however, in his valuable notes to his translation of Laennec's immortal work, brings a body of evidence from Andral and Cruveilhier, to show that the upper lobes are very frequently the seat of pneumonia. The formation of abscess in the lungs, as a consequence of pneumonia, is of rare occurrence, [w. 60. 61.] The lining membrane of the bronchi is commonly red, and occasionally swollen. When near the surface, the first stage of pneumonia is recognized by a peculiar crepitation or crackling, as of salt thrown into the fire, resulting from the air bubbling through the liquid in the cells and minute bronchial tubes. In the second stage, the chest over the inflamed lung is dull on percussion : no crepitation is heard ; but the motion of the air and mucus in the large bronchi is distinctly audible, being conveyed through the solidified lung. The disease is characterized by obtuse and deep-seated pain in the chest, quick respiration, dyspnoea, cough; the sputa are viscid, tenacious, glutinous, and contain some diffused shade of red, being either tawny or rusty. An abscess of the lungs is attended with definite physical signs. When great part empty of fluid, it gives rise to pec- toriloquy ; or, in speaking (if the stethoscope is applied over the cavity), the voice seems to issue directly from the chest of the speaker. When air and liquid are present together, metallic tinkling or amphoric resonance is heard,—-just as when air and liquid are mingled in the pleura. The combination of pneumonia and pleurisy with large](https://iiif.wellcomecollection.org/image/b21066735_0531.jp2/full/800%2C/0/default.jpg)
