Phthisis; its morbid anatomy, etiology, symptomatic events and complications, fatality and prognosis, treatment and physical diagnosis : in a series of clinical studies.

  • Flint, Austin, 1812-1886.
Date:
1875
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Licence: Public Domain Mark

Credit: Phthisis; its morbid anatomy, etiology, symptomatic events and complications, fatality and prognosis, treatment and physical diagnosis : in a series of clinical studies. 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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    pulmonary disease. The cough and expectoration are increased; the respirations are more frequent; the pulse is more accelerated, and the temperature of the body rises. My histories contain illustrations of this fact. As regards the pathological import of the hemorrhage, the views first presented are, of course, measurably applicable to these cases. I have stated that two well-marked specimens of clots formed in the bronchial tubes have fallen under my observation. In one of these there was extensive obstruction of the tubes, and death took place, but I did not see the patient, and I am unable to state any details of the history. The other case has occurred since the greater part of this chapter was written, and the facts are as follows: Dr. P., a practitioner of medicine in Canada, consulted me in June, 1873. He had had two attacks of haemop- tysis, the last of recent occurrence. He had slight cough, but his aspect was healthy. On an examination of the chest I found dulness at the right summit, with relatively feeble respiration and an abnormal transmission of the heart-sounds. The diag- nosis was a slight phthisical affection. Shortly afterward he had another small hemorrhage. There was no recurrence until the following October, when he raised daily for six successive days a few ounces of blood. Up to this time his general health had improved, and he had gained ten pounds in weight. About a month afterward he had a copious hemorrhage which con- tinued at intervals for ten days. On the third day he began to expectorate bronchial casts. lie continued to expectorate these for twenty-four hours, together with fluid blood in abundance, the latter amounting to sixty ounces in the twenty-four hours. These casts represented tubes of the size of the second or third subdivisions with branches of extremely small size. He sent me a specimen which I exhibited at a meeting of the New York Pathological Society, November 26, 1873.' The casts presented the appearance of fibrin, and on microscopical examination, made by Prof. Janeway, showed fibrillary fibrin, with deformed and shrunken red blood globules, a small quantity of haematoidin and a few white blood globules. Prior to the expectoration the patient experienced dyspnoea; but afterward this disappeared, and after recovering from the weakness caused by the loss of 1 Vide New York Medical Record, Jan. 15, 1874.