Tuberculosis : its nature, prevention and treatment with special reference to the open air treatment of phthisis / by Alfred Hillier.
- Date:
- 1900
Licence: In copyright
Credit: Tuberculosis : its nature, prevention and treatment with special reference to the open air treatment of phthisis / by Alfred Hillier. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![Circalaturi/ S//dem.—The association of endo- carditis with ])hthisis may occur, but is not common. A diffuse pulsation in the region of the prfccordia from retraction of the left lung is often noticed. Over a consolidated apex the cardiac sounds may be intensified. Adventitious murmurs accompanying the heart’s systole are frequently heard; for tliese the pulmonary area is the most common seat, but they may at times be heard over the subclavian artery and the mitral and aortic areas. The pulse in phthisis, though full, is usually soft, owing to a diminished arterial tension aud a relaxed condition of the capillaries. Integumentary System.—A malar or hectic flush is common. Pigmentivtion of the skin (chloasma phthisicorum), very similar to the chloasma seen in cancer, and development of pityriasis versicolor, a skin disease characterised by brownisli and branny patches of the skin, due to the “ microsporon furfur,” are often met with, especially in the later stages of the disease. The subject of sw'eating in phthisis has already been discus.sed. The occurrence of clubbing of the finger- and toe-tips in all forms of chronic lung disease is well recognised. Sudamina in children and swelling of the ankles from anasarca are not uncommon. Genlto-Urinavy System.—Waxy or amyloid dis- ease of the kidneys may be characterised by polyuria, the urine being clear and of low specific gravity, and containing much albumen. Tubercular pyelitis, or cystitis from jiyuria and a degree of luematuria, with frequency of micturition, may occur. The presence of uacilli in centrifuged urine is sometimes de- tected. Tubercular orchitis, the epididymis being primarily involved and enlarged and the cord thickened, may](https://iiif.wellcomecollection.org/image/b21988614_0076.jp2/full/800%2C/0/default.jpg)
