A Practical treatise on the diseases of the lungs

Vide p. 267.

Since the description of pleurisy was printed, I have observed two points in its physical diagnosis to me altogether novel: perfect cracked-metal note, in the first and second interspaces, during the height of effusion and subsequently (case of J. Denly, U. C. H., Females, vol. vi., p. 85;) and loud rubbing redux friction sound, with four or five jerks in inspiration and expiration, above the clavicle (case of G. Whiles, U. C. H., Males, vol. vi., p. 122.)

Vide p. 364.

John Stoner, ætat. 25, admitted U. C. H. for second time, third stage of phthisis, April 10, 1849. The chest-disease gradually advancing.-June 2. Loss of power of speaking, semi-stupor, with difficulty roused, dysphagia, drink pouring back through mouth, (not nose,) pupils sluggish, no distinct convulsion, lower extremities drawn up, no paralysis, sensibility blunted, fixed frontal cephalalgia; seems conscious of all that is passing around him; P. 102, R.44.-June 4. Since this seizure cough almost gone, scarcely any expectoration; alternate pallor and flushing of cheeks; no rigidity or convulsions, no screams, no strabismus; complete insensibility of dorsum of hands: tendency to rigidity of knee-joints; fingers firmly clenched, when unclenched by bystander contract again; P. 142, R. 44.-June 8. Sensibility returned, still speechless.-June 9. Spoke as usual for first time. This man was treated with mercurials, but not to ptyalism. Discharged on July 13th, he was readmitted August 18th, and died of his pectoral disease, the cerebral functions being perfectly natural, on October 11th, 1849. Post mortem: No morbid appearance at fissures of Sylvius; over both anterior lobes fine florid injection: numerous granules, opaque, grayish-white, size from pin's point to pin's head, lie under cerebral arachnoid of these lobes; convolutions here appear drawn together, as if from deep-seated contraction in the sulci; membranes here generally opalescent; dura-matral arachnoid adherent posteriorly to cerebral arachnoid of left hemisphere: membranes thicker than natural; anterior convolutions at the curve forwards, especially at left side, somewhat opaque; those of left side not materially softened, those of right firmer than natural.

INDEX.

ABSCESS of lung, signs of, 294.
Accentuation of heart-sounds
wanting, 198; falling on second
at apex, 197.
Egophony, 137; mechanism of,
141; in hydropericarditis, 224.
Age, influence on percussion, 72;
on respiration-sounds, 91.
Amphoric percussion sound, 77;
respiration, 106; echo, 144; re
sonance in pleurisy, 263; crack-
ed metal, note in Appendix.
Aneurism of the heart, 478. See

Aorta.

Aneurisms, classified, 480.
Angina pectoris, symptoms of, 387;
nature of, 388; diagnosis of, 388;
treatment of, 389; causes of, 390.
Aorta, percussion of, 227; ausculta-
tion of, 228; atheroma of, 475;
obliteration of, 475; arch of,aneu-
risms of, sacculated, 480; effects
of, 480; signs of, 481; symptoms,
487; progress of, 494; diagnosis
of, 498; fusiform dilatation, 498;
mixed aneurism, 498; descend-
ing aorta, aneurism of, 498; treat-
ment, 500; abdominal aorta,
aneurism of, 503; dissecting
aneurism, 503.

Aortic constriction, murmur of,
214; signs of, 447; regurgitation
murmur of, 215; signs of, 449;
pulsation, 469.

Aortitis, acute, 472; chronic, 474.
Apex-beat of heart, in health, 162;

in disease, 164; depressed, 164;
raised, 164; as felt, 166; altered

by non-cardiac states, 166; by
cardiac states, 168; direction of,
169; character of, 169; rhythm
of, 170.

Apoplexy, cerebral, and heart dis-
ease, 419, 447; pulmonary, 315.
Arterial thrill, 227; sounds, 229;
murmurs, organic, 230; inorga-
nic, 231.

Arteries, auscultation of, 228.
Asthma, spasmodic, 372; symp-
toms of, 372; treatment, 373;
paralytic, 374.
Atheroma of aorta, 475.
Atrophy of heart, 413.
Auricular, knocking sound, 202.
Auscultation, mediate and imme-
diate, 82; rules for, 168.
Autophonia, 144.

BLOOD in phthisis, 350.
Blood-murmurs, cardiac, 208.
Blowing respiration, 102.
Bronchi, dilatation of, 248; diag-

nosis of, 249; narrowing of, 259.
Bronchial respiration in health, 93;
in disease, 101; theory of, 104.
Bronchitis, acute, symptoms of,
240; capillary, 241; physical
signs of, 241; treatment of, 244;
chronic, symptoms of, 246; squill
247; bronchorrhoeal, 247; dry,
247; physical signs of, 247; treat-
ment of, 250; plastic, 252; me-
chanical, 254; syphilitic, 258.
Bronchophony, natural, 94; mor-
bid, 128; mechanism of, 129.

Bronchorrhoea, 247.
Bulging, 36.

CALCIFICATION in heart, 436; or
aorta, 467.
Cancer of lung, 369; primary,
symptoms of, 369; latent, 370;
diagnosis of, 370; treatment of,
371; of heart, 440.

Cardiac regions, deep and super-
ficial, 160; form of, in health,
162; in disease, 163.

Carditis, 409.
Catarrh, dry, 247.

Cava vena, situation of, 161.
Cavernous respiration, 106; rhon-
chus, 108.
Chest-measurer, 52.
Chloroform in asthma, 373; inad-
missible in dilatation of heart,
432; in softening, 436.
Chorea, mitral murmur in, 210;
in pericarditis, 397.
Cirrhosis of lung, 308.
Clearness of sound, 57.
Climate in chronic bronchitis,
251; in phthisis, 361.
Clicking, pericardial, 218.
Cod-liver oil in phthisis, 358.
Cogged-wheel rhythm of respira-
tion, 100.

Collapse of lung, 242, 259, 307.
Concretions, polypoid,in heart,467.
Consonance and bronchophony,

Diastolic sound in health, 184;
causes of, 189.

Digitalis in valve disease, 456.
Dilatation of the heart, 424, how
connected with dropsy,424; signs
of, 427; symptoms of, 428; diag
nosis of, 431; treatment of, 432.
Divided respiration, 99.
Dropsy, cardiac, mechanism of,

425.
Dulness of percussion-sound, 57;
caused by what diseases, 74.
Dynamic cardiac murmurs, 210.

ECHо and bronchophony, 134;
amphoric, 144.

Elevation of the heart, 153.
Emaciation, affects percussion, 72;
in phthisis, 348.

Emphysema, symptoms of, 328;
effects of, 330; signs of, 330; of
interlobular, 333; diagnosis of,
333; treatment of, 334.
Empyema, pulsatile, 288. See
Pleurisy.

Encephaloid of lung pedunculated,

75.

Endocardial murmurs, new and
old, 407.
Endocarditis acute, signs of, 404;
symptoms of, 405; terminations
of, 407; diagnosis of, 407; treat-
ment, 409; chronic, 409.
Entozoa in heart, 440.
Exaggerated respiration, 96.
Exercise in heart-diseases, 435.
Expansion of side, 35.
Expiratory murmur, 88.

FATTY diseases of the heart, 438.
Fecundity in phthisis, 350.
Fluctuation, varieties of, 46.
Form of chest, in health and in
disease, 35.

Fremitus, vocal, in health, 43; in
disease, 44; affected by heart,
44, 172; rhonchal, 45; tussive,
45.

Friction-fremitus, 46.

Friction, pleural, 121; pericardial,
215; properties of, 219; redux,
222; diagnosis of, 222; pleural,
of cardiac rhythm, 223; by what
quantity of fluid annulled, 374.

GANGRENE of lung, 310; diagnosis
of, 311; treatment of, 312.
Gastritis simulated by pericardi-
tis, 316.

Gurgling rhonchus, 118.

HEMOPERICARDIUM, 411.
Hæmoptysis in plastic bronchitis,
253; causes of, 316; diagnosis of,
317; treatment of, 320; phthisi-
cal, laws of, 345; influence of,

346.
Hæmothorax, 278.
Harsh respiration, 101.
Hay asthma, 255.
Heart, seat of, 159; apex of, raised
in pericardial effusion, 373; per-
cussion of, 175; dulness of, super-
ficial and deep, 176; diminished,
177; increased, 179; sideward,
180; pyramidal, 181; quality of,
182; positions of, after pleurisy,
267; sounds of, as transmitted
through lungs, 148; sounds of,
in health, 183; vary in different

Hepatization, signs of, 290.
Hooping-Cough, symptoms of, 374;
treatment of, 376.
Hydropericardium, 411.
Hydropneumothorax, 325.
Hydrothorax, 325.

Hypertrophy, of the lung, 335; of
the left ventricle, signs of, 415;
symptoms of, 417; prognosis of,
419; treatment of, 421; of the
right ventricle, 422; of auricles,
423.

IMPULSE of heart, as seen in health,
162; in disease, 163.
Induration of the heart, 436.
Influenza, 256.

Inspection of lungs, 33.
Inspiration and expiration move-
ments, relative length of, 39.
Inspiratory murmur, 89.
Interlobular emphysema, 334; in-
flammation, 307.

Intermittent respiration, 98.
Interspaces, cardiac, widened, 171.

J.
JERKING respiration, 99.
Jugular vein, pulsation of, 232;
causes of, 232.

spots, 184; symbols of, 186; KNIFE-GRINDERS' rot, 254.

theory of, 186; how modified Knocking sound, with systole,
physiologically, 191; by displace-

ment of heat, 191, 264; audible
away from chest, 192; intensity
of increase, 192; weakened, 193;

196; from auricle, 202.

duration of, changed, 194; dis- LARYNGOPHONY, 94.
tance from surface, 195; quality
of, 195; murmurish, 196; how
related to pulse, 198; number
of, 200; reduplications of, 201.
Hemiplegia, effect on expansion
of chest, 54.
Hemorrhage, bronchial, 313; of
heart, 410.

MALPOSITIONS of heart, 457.
Measurement of chest, circular,
47; transverse, 50; antero-pos-
terior, 50; vertical, 51; partial,

51.

Mediastinal pseudo-rhoncus, 127.
Mediastinum, displaced, 154.
Meningitis, tuberculous, 353, 364,

506.

Mensuration, in motion, 52.
Mercury, in pericarditis, 401.
Metallic tinkling, 144.
Miliary tuberculization, 366.
Mind, state of, in phthisis, 348.
Mitral constriction, murmur of,
214; signs of, 445; regurgita-
tion, murmur of, 211; signs of,
442; symptoms of, 444.
Motions of chest, in health, 38-
42; in disease, 40-41.
Moveableness of dull percussion,

75.

Mucous rhoncus, 118.
Murmurish heart sounds, 196.
Murmurs, endocardial, 203; cha-
racter, pitch, 203; maximum of,
204; rhythm of, 204; effect on
sounds, 205; organic mechanism
of, 205; modified by various con-
ditions, 206; inorganic, 208;
from blood, 208; dynamic, 210;
of blood origin, never diastolic,
507; arterial, 230; venous, 235;
valvular, conditions modifying,
449; aneurismal, 497.
Mutism in tuberculous meningitis,

354.

NEURALGIA, of lung, 238; intercos-
tal, 239.

OBLITERATION of aorta, 478.
Edema of the lung, 322.
Organic heat, murmurs, mechan-

ism of, 206; relative frequency
of, 217; combinations of, 217.
Orifices of heart, diseases of, 441;
symptoms of, 452; duration of,
452; relative danger of, 453;
treatment of, 453.
Orthopnoea in pericarditis, 395.

PALPITATION, dynamic signs of,
382; treatment of, 383; with
perverted rhythm, 384.
Paracentesis, in pneumothorax,
327; pericardii, 403.
Pectoriloquy, 135.

Percussion, immediate, 59; me-
diate, 61.
Percussion-sound, properties of,
57; of lungs in health, 66; in
disease, 73; in various chest-
regions, 66; affected by force of
blow, 69; by inspiration and ex-
piration, 70; unequal in the two
infra-clavicular regions, 70; con-
ditions modifying, in health, 72;
in disease, 73; dulness of, move-
able, 74; signs in disease, stati-
cal, 73; dynamic, 79; of aorta,
227.

Pericardial adhesions, signs of,402;
Pericarditis, acute, physical signs
fremitus, 173; murmurs, 217.
of, 392; symptoms of, 395; ter-
minations of, 397; causes of, 397;
diagnosis of, 397; treatment of,
400; chronic, signs of, 402; treat-
ment of, 403.

Peritoneal friction, 272.
Periphonic fluctuation, 46.
Peritonitis, phthisical, 352.
Periosteitis, costal, causes dulness,

258.

Phthisis, chronic, signs of first
stage, 336; of second, 340; of
third, 341; of arrested, 342;
symptoms, local of, 344; general
of, 347; incidental of, 351; la-
tent, 353; diagnosis of, 354;
treatment of, general results of,
357; specifics in, 358; hygienic
treatment, 361; palliative, 362;
secondary conditions in, 363;
diet in, 364; acute, three va-
rieties of, 367; symptoms of,
366; diagnosis of, 367; treat-
ment of, 368.

Pitch of sounds of percussion, 57;

of endocardial murmurs, 203,208.
Plastic bronchitis, 252.

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