Clinical lectures on pulmonary tuberculosis.

  • Thompson, Theophilus, 1807-1860.
Date:
1854
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lectures on pulmonary tuberculosis. 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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    that the cause of these conditions is contraction from ' pleurisy, and further observation confirms the correct- ness of the suspicion conveyed through the eye. If the heart were displaced by existing effusion, you would, probably, see bulging rather than depression. You put your hand on the flattened portion of the chest as the man speaks, and the vibration of the voice is distinctly perceived; effusion therefore does not ex- ist, for that would interrupt the communication of the vocal thrill. You make percussion, and find dulness greater than the false membrane on the pleura alone would produce, but the dulness lessens as you proceed upwards to the apex of the chest. The cardiac dul- ness is displaced, but not extended; that from the liver extends too much on the left. Accompanying the first sound of the heart, a loud murmur is heard near the apex, but not in the epigastrium, nor to the right of the sternum above the cartilage of the fourth rib. This patient, Thomas C , a sign painter, aged nineteen years, was admitted on the 23d of December, 1850; height, five feet, two inches, and three quarters; weight, seven stone, thirteen pounds; vital capacity by spirometer, 114. He has always lived well till lately, and has usually resided in London; has no he- reditary tendency to phthisis; his father died of dropsy at the age of sixty-two, and his mother of jaundice at sixty. He enjoyed good health till three years and a half ago, during a voyage, when he received a se- vere blow on the right side of the chest, after which he expectorated about four ounces of blood. Six months afterwards he had rheumatic fever, and inflammation of the lungs, and his sputa were streaked with blood.