Chronic Bronchitis; Its Forms and Treatment

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1882 Excerpt: ...secretion in the bronchia, in chronic bronchitis, gives rhonchi; local or general, according to the nature of the cases. In the emphysematous form of chronic bronchitis the tendency to death does not lie in malnutrition, as in the cirrhotic form. Indeed the sufferer may remain well nourished, even rather stout. There is the venosity which is antagonistic to tubercle (Rokitanski and others). (Sir Thomas Watson is happily facetious on the folly of attempting to avert phthisis by the artificial production of emphysema.) The changes here to be averted, so far as possible, are those which arise from venous fulness (see p. 29). But a few words as to the pulse may not be out of place. When there exists obstruction to the blood-flow in the pulmonic circulation, a small quantity of blood only reaches the left ventricle, and so the radial pulse is small and compressible, often slow. The veins are full, as seen in the dusky hue of the countenance, the deep-coloured, dark lips, and the thick, coarse nostrils. But when there is also the gouty heart and tense arteries, the blood-pressure within the arteries being abnormally high (of which the.copious flow of urine is the best gauge), then the radial pulse is firm and incompressible; still slow, however. When there is venous fulness, with unfilled arteries, there is congestion of the viscera, and scanty urine, laden with lithates, resembling the urine of cardiac dropsy. This venous congestion of the viscera leads to much impaired assimilation in advanced cases. The liver, as has been said before, is displaced downwards; and this leads to modifications of its functional utility. As normally located, the liver occupies a warm nook, safe from exposure to cold. But when driven down, and still more when enlarged from venous fu...