Respiratory exercises in the treatment of disease : notably of the heart, lungs, nervous and digestive systems / by Harry Campbell.

  • Campbell, Harry, 1860-1938.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: Respiratory exercises in the treatment of disease : notably of the heart, lungs, nervous and digestive systems / by Harry Campbell. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    the so-called ' atrophous ' variety—because it does not come on until the chest has acquired the iSixity peculiar to old age ; but when the disorder begins in early or middle life, ■while the thorax is still mobile, considerable thoracic expansion may occur. Similarly, expansion tends to be more pronounced the more muscular the individual. It is therefore apt to be small in those with feeble muscles. Hence an additional reason why the chest should not expand in senile emphysema. On the other hand, those of powerful muscular build are apt to get very large chests if they develop emphysema, and it is not therefore surprising that the most pronounced cases of large-lunged emphysema are generally met with in those following laborious occupa- tions. The expansion of the chest is usually most marked in its upper part. This may be explained by the effect during cough of the sudden contraction of the abdominal muscles and uplifting of the diaphragm in driving the air from the lower regions of the lungs into their apical portions, which thus tend to thrust the upper part of the chest outwards. The powerful contraction of the abdominal muscles that then takes place leads to an actual contraction Wilson Fox, who gives the most masterly account of emphysema that I have met with, supports Budd and Jenner, aiid supplies, as I think, a most important link in the chain of argument, viz., the tendency of dyspnoea to excite the inspiratory muscles more than the expiratory. He observes that the emphysematous chest, ' especially vmder exertion, is expanded to its fullest limits by the muscles of in- spiration, while the subsequent retraction necessary for the proper performance of respiration is hindered by the want of elasticity in these structures. As a consequence, a potential dyspnoea is produced, the immediate reflex effect of which is to create a tendency to further deep inspirations, and the inspiratory muscles become as a consequence hypertrophied.' (Op. cit., p. 158.) Neither Budd, Jenner, nor Wilson Fox, however, explain satisfac- torily why the chest is kept jyermanently expanded and fixed.