The diseases of the chest : including the principal affections of the pleurae, lungs, pericardium, heart, and aorta / by Vincent D. Harris.

  • Harris, Vincent Dormer.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The diseases of the chest : including the principal affections of the pleurae, lungs, pericardium, heart, and aorta / by Vincent D. Harris. Source: Wellcome Collection.

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

    261/456 (page 245)
    HEREDITAET PREDISPOSITION are unable to ignore tlie part played by hereditary tendency iu tbe predisposition to the disease. Green, for examj^le, says tliat spealdng generally it is simply a tendency to disease wbicli may be said to consist in some feebleness of the constitution in general, and often of the lungs and other organs in particular. Supposing then an inherited tendency to disease of the lungs, with or without the additional tendency to inflammation of a low type which is so strongly insisted upon by Nieraeyer and others of his school, the question naturally follows, why are the a/pices attacTced more frequently than other parts of the hcngs? Inherited vireakuess of constitution no doubt has some part in j^roduciug this special vulnerability of the apices to the disease, but the immediate cause of the phthisical lesion in the apex appears to be a local one. The respiratory activity of the lung is less in the apex than elsewhere even in health, but in certain conditions of the chest the deficiency becomes very marked. These conditions are either congenital or acquired. They are (1) contraction of the upper part of the chest wall, either from early ossification of the cartilage of the first rib, and subsequent imperfect development of the expansion of the chest, as was long ago suggested by Freund, or from occupation, habits of stooping or what not; and (2) imperfect development of the inspiratory muscles or loss of muscular power from any cause producing the alar or phthinoid, and flat chests (p. 84). Thus imperfect expansion, from the shape of the chest, and from want of muscular power (both of which defects may be congenital), diminishes the inspiratory ex- pansion of the apices of the lungs. To this must be added firstly that they are more subject to atmo- spheric pressure than other parts, since they project out of the thoracic cavity above the clavicles, and secondly that they are subject to expiratory pressure during forced expiration. All of these anatomical