An investigation into the etiology of phthisis / by Heneage Gibbes and E.L. Shurly. II., On the clinical history of phthisis pulmonalis / by E.L. Shurly.

  • Shurly, Ernest Lorenzo.
Date:
1890
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Credit: An investigation into the etiology of phthisis / by Heneage Gibbes and E.L. Shurly. II., On the clinical history of phthisis pulmonalis / by E.L. Shurly. 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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    Exlnicted from The American Journal of the Medical Sciences for May, 1890. AN INVESTIGATION INTO THE ETIOLOGY OF PHTIj By Heneage Gibbes, M.D., /i^; PROFESSOR OF PATHOLOGY IN THE UNIVEESITY OF MICHIGAN AND E. L. Shurly, M.D., PROFESSOR OF LARYNGOLOGY AND CLINICAL MEDICINE IN THE DETROIT COLLEGE II. On the Clinical History of Phthisis Pulmonalis. By E. L. Shurly, M.D. To present the following remarks upon the clinical history of phthisis pulmonalis, without reference to its etiology, would seem to be a disre- gard of established notions of order. But, as the subject of etiology involves pathology, and as the pathology has not yet been entirely pre- sented by my colleague (Dr. Gibbes), it is deemed proper to leave all etiological considerations to a future time. A typical classification of the subject upon a purely clinical basis, of course, is well-nigh impossible, since a given group of symptoms or signs will embrace two or more com- monly recognized varieties. I shall, therefore, present the following classification, having in mind the course only : 1st, acute ; 2d, subacute ; and -Sd, chronic phthisis pulmonalis, leaving out of the category so-called miliary tuberculosis, which, for reasons afterward to be given, seems to be a disease of the lungs coincidently only with other organs ; although, as we are aware, generally embraced under the title of pulmonary tuber- culosis. Acute Phthisis Pulmonalis, like the other classes indicated, has its period of accession, its symptomatology, and its physical signs, all of which are, in the majority of cases, quite similar to each other. The stage of accession involves antecedent injury or disease, such as an essen- tial fever, dysentery, syphilis, rheumatism, previous acute pulmonary or bronchial attacks, etc., congenital defects of structure or function, bad habits or food, unsalubrious surroundings, over-work, over-worry, or other abnormal demands upon the economy. The symptomatology, in the rough, presents about the same features as the other varieties, except in the order or intensity of occurrence. It .includes cough and expec- toration, haemoptysis, pyrexia, with rapid and small pulse, anorexia, indi-