Pediatrics : the hygienic and medical treatment of children / by Thomas Morgan Rotch.

  • Thomas Morgan Rotch
Date:
1896
Catalogue details

Licence: Public Domain Mark

Credit: Pediatrics : the hygienic and medical treatment of children / by Thomas Morgan Rotch. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

    1139/1220 (page 1053)
    from effusion at this point, while the rest of the dulness is produced by the effusion. On examining also the hardened cacao-butter cast of this eifusion, it was found that the layer of fluid was very thin all over the upper por- tion of the effusion in the region of the fourth rib and fourth interspace, while the mass of the eifusion, as shown by the greatest thickness of the cacao butter, was, as would be expected from the laws of gravity and the shape of the pericardium, in the lower part of the sac on each side of the sternum in the fifth interspaces, the cast riding the arched diaphragm like a saddle, and the larger part of the mass being on the left side. These points should be carefully noted, as they are significant for diagnosis and treatment. The same result as to the area of dulness was obtained with a propor- tionately small amount of fluid in an infant about two weeks old ; and of sixteen injections, of infants of various ages, the areas of dulness were identical in all, and in all the lungs were normal and there were no pulmo- nary or other adhesions. This next diagram (Diagram 17) represents the position assumed by the Diagram 17. A large amount of liquid has been introduced into the sac (Rotch). ||||| B, liver; jjj]} B', that por- tion of the liver which is covered by the right lung ; jSj c, lung ; i| D, the area of absolute dulness caused by a large effusion ; S. sternum ; (U, nipple ; 1, 2, 3, 4, 5, 6, ribs; - - - (broken line), border of lung. margins of the lungs and the resulting area of absolute dulness where the pericardium was distended with a large amount of fluid so as to cover the entire heart. Here the transverse area of dulness produced by the much distended N