Pulmonary consumption, pneumonia, and allied diseases of the lungs : their etiology, pathology and treatment, with a chapter on physical diagnosis / by Thomas J. Mays.

  • Thomas Jefferson Mays
Date:
1901
Catalogue details

Licence: Public Domain Mark

Credit: Pulmonary consumption, pneumonia, and allied diseases of the lungs : their etiology, pathology and treatment, with a chapter on physical diagnosis / by Thomas J. Mays. 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.

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    Auscultation'. Uwing to the dryness, swelling, and nar- rowing of the bronchial mucous membrane in the early stage of bronchitis, the breathing sounds are rough and harsh during this period. In the course of twenty-four or thirty- six hours the secretion of mucus and muco-pus appears, which gives rise to moist rales. These rales when pro- duced in the large tubes are large in volume, are called large mucous rales, and when produced in the bronchioles are of small size, and are called subcrepitant rales. Mi.xed with these are the musical, or so-called dry rales. These are named sonorous and sibilant rales—the former being pro- duced in the larger and the latter in the smaller tubes. .\11 these rales may be heard during inspiration and expiration, and may always be displaced or at least modified by the act of coughing, and so be distinguished from the gurgling rales of small cavities and of dilated bronchial tubes, which are also audible during inspiration and expiration. The rt)ughness and unevenness of the respiratory sounds are heard more distinctly after the rales have disappeared, and remain until full convalescence is established. DiKi'icRic.N'Ti.vL Di.VGNOSis. llronchitis may be mistaken for emphysema, ])neumonia, and acute phthisis, and the fol- lowing tabular view in which the salient differential points between these diseases are indicated by numbers, will serve as a means of discriminating between them. Asthma and bronchitis mav also be cunfnunded one for the other, but a careful inquiry into the family and personal history of the patient will helj) to overcome this difficulty. Bronchitis is the inevitable product of asthma and. therefore, asthma can- not exist without some degree of bronchitis. Acute Bronchitis. 1. No well-defined chill at onset. 2. Hoarseness, at the beginning usually. 3. Coug'h. severe from the first. 4. Expectoration, copious and yellow.