Lectures on diseases of the respiratory organs, heart and kidneys / by Alfred L. Loomis.

Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on diseases of the respiratory organs, heart and kidneys / by Alfred L. Loomis. 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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    Usually at first there is soreness of the throat, accompa- nied by a sense of constriction, or a tickling sensation with a tendency to cough ; the larynx is tender on pressure, there is difficulty in swallowing, which becomes more and more marked as the disease progresses ; to this is soon added difficulty of breathing. The character of the respiration varies with the seat of the inflammation. If it is confined exclusively to the upper por- tion of the larynx, as it often is at the onset of the disease, the difficulty will be with inspiration only, which will be prolonged and accompanied with stridor;—if the lining membrane of the whole larynx is involved, and the calibre of the larynx becomes contracted from cedematous infiltra- tion and spasmodic approximation of the vocal cords, there will be difficulty with both inspiration and expiration, and both will be protracted and wheezing; in severe cases the patient spends all his energies on the respiratory acts, and he will be unable to lie down. There is a harsh, stridulous cough, with (at first) little or no expectoration: if there is any, it is tenacious; later it may become thick, purulent and abundant. The voice is hoarse or is reduced to a whisper. These local symptoms are accompanied by a flushed face, a hot, dry skin, the temperature often rising as high as 105° F. The pulse is frequent and hard in character. In severe cases, as the disease advances, both acts of respiration become more and more labored, the cough more and more metallic in character,—the patient’s distress increases, symptoms of imperfect aeration of the blood are developed, the counte- nance becomes pale and anxious, or livid. During the exa- cerbations caused by spasm of the laryngeal muscles, suffo- cation seems imminent; in the intervals, the patient be- comes drowsy, the vesicular murmur over both lungs is feeble or is no longer audible, the capillary circulation in the extremities is imperfect, the lips and nails become blue, a cold perspiration breaks over the surface, the respiratory sounds become gurgling and gasping in character, and final- ly delirium and coma close the scene. As soon as the characteristic symptoms of acute catarrhal laryngitis are manifest, a laryngoscopic examination will