On chronic bronchitis : especially as connected with gout, emphysema, and diseases of the heart, being clinical lectures delivered at the Middlesex Hospital / by E. Headlam Greenhow.

  • Greenhow, Edward Headlam.
Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: On chronic bronchitis : especially as connected with gout, emphysema, and diseases of the heart, being clinical lectures delivered at the Middlesex Hospital / by E. Headlam Greenhow. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    Dr. Garrod Rheumatoid Arthritis, but more com- monly known as rheumatic gout. On the wrist and knuckles of the right hand there were also several movable, roundish, hard nodules, which were evi- dently gouty deposits ; and there was, also, one similar nodule on the pinna of the left ear. The chest was abnormally resonant on percussion over the anterior walls, excepting over the prsecordium; the resonance posteriorly was also clear, excepting over the base of the right lung, where it was slightly deficient. The respiration was laboured, and the upper intercostal spaces were depressed, as if drawn inwards, during the act of inspiration. The breath-sounds were dry, harsh and sibilant; rhonchus was here and there audible in both lungs, and dry crepitation of slightly metallic tone was occasionally heard near the middle of the right scapula. The heart's impulse was feeble, and the apex was felt beating below the sixth rib in a line with the nipple. The heart-sounds were free from murmur. The liver was enlarged and ex- tended a.n inch and a half below the margin of the ribs ; it was exceedingly tender on pressure. The cough was frequent, prolonged and wheezing, often producing retching and vomiting; the sputum was scanty, tenacious and opaque. Pulse 80; respira- tions 20 in a minute ; temperature in the axilla 99°. Urine copious, acid, specific gravity 1015 ; showing no trace of albumen, whether treated with heat or nitric acid. For some days after admission, there was little