A treatise on the diseases of the chest : being a course of lectures delivered at the New York Hospital / by John A. Swett.

  • Swett, John A. (John Appleton), 1808-1854
Date:
1856
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the chest : being a course of lectures delivered at the New York Hospital / by John A. Swett. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    more marked, with the Bame listlessness, loss of appetite, and in- disposition to play, and oneasy sleep at night, yon tnusl examine the lungs; for pneumonia or pleurisy is forming there. On ex- amination, you may detect dulness on percussion, bronchia] respiration, and other unequivocal evidences of pulmonary ob- struction ; and the child may die In a few days with these for- midable complications. It is worthy of particular notice, that when these complications occur, either in the head or in the lungs, the whoop may very much diminish in intensity, or en- tirely disappear, and thus load a careless observer to suppose that the disease was improving, while, in truth, the apparent re- lief is actual danger. The examination of the chest in most cases of bronchitis, estab- lishes the absence of physical signs rather than their existence. In all cases of simple bronchitis, however severe, there is always undiminished clearness od percussion. In some of the compli- cated cases, as in emphysema of the lungs, the sound on percus- sion may be unnaturally clear. In many cases, even when the disease assumes a suffocative character, the same clearness on percussion may be noticed ; when a principal bronchus is ob- structed for a time, dulness does not exist. The truth is, that, even with marked dyspnoea,there is air enough in the cells; the difficulty is, that it does not escape from them readily during the feeble act of expiration, and is not so rapidly changed as the wants of the Bystem require. When, therefore, von find the slightest dulness on percussion, yon may he certain that some- thing else besides bronchitis is present. If it he slight, limited in extent, and situated under the clavicles, it probably depends on tuberculous deposits in the lungs. If it be more extended, it may he dependent on the existence of dilatation of the bronchi, on pulmonary oedema, on pneumonia, on pleurisy, or hydrotho- rax. This simple fact, the absence of dulness on percussion, is often of the greatest value, both in the diagnosis and the prog- nosis of pulmonary disease. A chest that sounds clearly on percussion is seldom in a very serious condition, unless, indeed, it i- unnaturally resonant, as in emphysema,or in pneumothorax. The absence of physical sign- in bronchitis, is still further illus-
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