Clinical lecture on dysnoea, especially on the dyspnoea of asthma and bronchitis, and the effects of nitrites upon it / by Thos. R. Fraser.

  • Fraser Thomas R. (Thomas Richard), Sir, 1841-1920.
Date:
[1887?]
Catalogue details

Licence: Public Domain Mark

Credit: Clinical lecture on dysnoea, especially on the dyspnoea of asthma and bronchitis, and the effects of nitrites upon it / by Thos. R. Fraser. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    in the region of the heart or extending into the shoulders and arms is often one of its superadded miseries. In disease of the larger air passages, such as oedema or spasm of the glottis, constriction of the trachea, or paralysis of the vocal cords, vve have several times observed that the great difficulty in respiration seems to occur during inspi- ration, which is laboured and prolonged, while the expira- tion is relatively brief and without effort. In thoracic pain of pleuritic or neuralgic origin, the attitude of the patient, and especially the modifications in posture and movement adopted by him, are almost sufficient to characterise the dyspnoea apart from the readily discoverable conditions by which the pain is induced. In asthma, the opportunities for investigating the phenomena have not been altogether favourable, as our cases have presented the peculiarity, which so frequently occurs in this disease, that the dyspnoea has made its appearance only during the night or early morning. Most of you, however, are familiar with the circumstances that in asthma the dyspnoea is characterized by loud wheezing sounds and great prolongation of expi- ration, that it is paroxysmal in its manifestation, leaving the patient free or nearly so from all symptoms of breath- lessness in the intervals, and that no structural alterations have as yet been discovered to account for the intense distress which marks each paroxysm. On the other hand, examples of the dyspnoea of bronchitis have been abun- dantly presented to you for consideration. You have seen that it is associated sometimes with acute, sometimes with chronic, inflammation of the bronchial tubes, that it very frequently occurs in patients suffering from emphysema, that it is often paroxysmal, and that it is accompanied with pain or uneasiness over the front of the chest, with a sputum that may be tenacious or frothy and watery, and with such auscultatory phenomena as rhonchi and sibila- tions, crepitations, and prolonged expiration.