The dyspnoea of asthma & bronchitis : its causation, and the influence of nitrites upon it / by Thomas R. Fraser.

  • Fraser Thomas R. (Thomas Richard), Sir, 1841-1920.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: The dyspnoea of asthma & bronchitis : its causation, and the influence of nitrites upon it / by Thomas 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.

    18/46
    much in the time of their occurrence, at both sides of the chest. The patient at one time said the breathing “is quite easy,” and at another that it was “ a little difhcult.” The pulse was 78 _and_ the respirations were 24 per minute. He was, however, lying in a normal position in bed. These conditions remained unchanged until 5 25', when the observations were stopped. Observation IV.—An observation with nitrite of ethyl was again made on this patient, on the 24th of January 1887. On this occasion, the first symptoms of an asthmatic paroxysm began to show themselves soon after midnight. At 12 35'A.M. the patient was sitting up in bed, supporting him- self on both elbows, and breathing with great difficulty. He stated that this difficulty was more pronounced during expiration than inspiration. There was loud wheezing, audible in tlie corridor of the ward, at least thirty yards from the patient’s bed. A little sputum had been expectorated, consisting of dark masses of a gelatinous substance. At 12 40', on auscultation, it was found that at the right side there were numerous rhonchi and sibili with both inspiration and expiration; and that at the left side, sibili were almost continuous through inspiration and expiration. The time-relation of inspira- tion to expiration at both sides was f : 1;|. The pulse was 79, and the respirations were 30 per minute. At 12 50', the patient received 10 minims of a 25 per cent, alcoholic solution of nitrite of ethyl in a little water. At 12 51', he said, “The breathing is easier.” At both sides rhonchi were heard during both inspiration and expiration, but there were no sibili. The time-relation of inspiration to expiration was at the right side, f: f ; and at the left side, |: f. At 12 54', the wheezing had become slight. The pulse was 75 and the respirations were 24. At 12 57', the breath sounds were at both sides quite clear, almost vesicular in character, and entirely free from accompani- ments. The time-relation of inspiration to expiration was at the right side, 1; |; and at the left side, f: f. At 1 A.M. there was no wheezing, and the breath sounds were everywhere vesicular in character. The patient was able to lie down in a normal posture. The pulse was 72, and the respirations were 20 per minute. At 1 6', at the right side, an occasional slight and distant rhonchus was heard at the end of the expiration ; and on the left side a similar sound at the commencement of inspiration. Slight wheezing was also audible. 1 111 the conditions were tlie same as at 1 6'. At 1 14, patient said he felt “ quite free” in his breathing. The pulse was 72, and the respirations were 20 per minute.