Home >> Manual Of Medical Diagnosis >> Added Sounds In Their to Diseases Of The Skin >> Diseases of the Respiratory_P1

Diseases of the Respiratory Organs

patient, chronic, breathing, hoarse, character, difficulty and hoarseness

Page: 1 2 3 4 5 6 7 8 9 10 | Next

DISEASES OF THE RESPIRATORY ORGANS - in the previous chapters attempted to analyze the va rious auscultatory phenomena which are to be met with in exa mining the chest, let us now take into consideration the diseases to which they owe their origin, in order that we may compare with the facts elicited by percussion and auscultation, the history and general symptoms, and ascertain what influence each of them ought to have upon any hypothesis which may be suggested for their explanation. In this chapter will be included the subject of ihthisis pulmonalis, although it be not properly a local dis ease, and claimed a passing notice in the earlier part of the vo lume as one of the depraved constitutional states; it was then found impossible to enter on a consideration of the indications which auscultation affords, and it has been thought better to it in contrast with bronchitis, to which, in many respects, it a close resemblance. Here, too, we must refer to aneurism of the aorta and its subdivisions, as one very common form of tumor in the chest, although diseases of bloodvessels belong to another division of the subject. Hooping-cough and croup, while they have each some claim to be regarded as epidemic, and popu lar belief runs strongly in favor of the infectious character of the former, are yet neither of them sufficiently understood, in a sci entific point of view, to enable us to Classify them, except as affec tions of the respiratory organs.

§ 1. Laryngitis.—This affection occurs in two very distinct forms, the acute and the chronic, which differ from each other very greatly in severity, and even in character, so that it is only when some fresh accession of inflammation has occurred, that the chronic disorder assumes any practical importance.

In most cases of acute laryngitis the attention is at once arrested by a hoarse, prolonged, rather laborious inspiration, interrupting the speech, and causing the patient to stop and take breath, while the voice is hoarse, or there is complete aphonia. The history may generally be summed up in a few words : after some expo sure, the patient has " caught cold," sorethroat being the promi nent symptom, and difficulty of breathing having come on early.

The sorethroat, the painful deglutition which usually excites coughing; and the hoarseness in the early stage, are very import ant, as indications of the serious malady impending, as well as valuable guides when it is more completely developed ; because the amount of redness of the fauces bears no proportion to the pain and difficulty of swallowing which the patient complains of. We are thus at once enabled to exclude common quinsy, which gives rise to the same symptoms, unaccompanied, however, by either hoarseness or dyspncea, in any marked degree ; the disco loration in laryngitis, too, has generally a livid hue.

The progress of the disease is very characteristic : at intervals the difficulty of inspiration is much increased, and then a period of comparative quiet probably follows ; but these spasmodic at tacks rapidly increase in frequency-and urgency, till each inspira tory effort assumes a convulsive character, the face grows dusky and is covered with clammy perspiration, the shoulders and cla vicles are heaved upwards in laborious breathing, the larynx moves up and down in a tumultuous manner, and instant suffoca tion seems impending; the patient can scarcely make the attempt to speak, or if he do, it is only in a short, hoarse whisper.

At the commencement of the attack there is usually a _good deal of febrile excitement, a hot skin, quick, firm pulse, and flushed face: as the insufficient aeration of the blood goes on, and begins to tell on the constitution, the pulse fails in power and increases in rapidity, the skin tends to coldness, the flush on the cheeks is changed to a dusky tint. All this bears upon correct diagnosis, although what it teaches be simply that there is some obstruction to the entrance of air into the lungs : the consciousness of the patient, indeed, points out that it is in the larynx ; but we know that any cause might have the same effect upon the breathing, which opposed a similar obstacle to the inflation of the lung: such circumstances, we shall find, perplex the diagnosis of the chronic affection.

Page: 1 2 3 4 5 6 7 8 9 10 | Next