A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ; translated from the latest French edition, with notes and a sketch of the author's life, by John Forbes.

  • Laennec, R. T. H. (René Théophile Hyacinthe), 1781-1826.
Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the diseases of the chest and on mediate auscultation / by R.T.H. Laennec ; translated from the latest French edition, with notes and a sketch of the author's life, by John Forbes. Source: Wellcome Collection.

Provider: This material has been provided by King’s College London. The original may be consulted at King’s College London.

    182/774 (page 154)
    their being punctured with a pin. Sometimes the air, though truly extravasated under the pleura, cannot be displaced by pressure in the manner just mentioned. This happens when the extravasation is situated at the point of re-union of the partitions which divide the different groups of air cells, as above mentioned. In this case the projection has usually a triangular shape and is not very considerable. I have never found this extravasated air penetrate, to any considerable extent, into the substance of these interlobular partitions, nor into the cellular substance which surrounds the larger blood vessels and bronchial trunks; but I have seen the pulmonary substance in the interior of the lung lace- rated by over-distension of the air cells. In these cases, over the site of the laceration we observe an irregular projection, on which the dilated cells are as distinct as elsewhere. Upon cutting into this, at a greater or less depth, we find the lace- ration of a proportionate size to the external projection. This is found to contain air, and sometimes also a small quantity of blood, either coagulated or loose; and the surrounding air cells, which form the immediate walls of the excavation pro- duced by the rupture, ai-e observed to be loose, flabby, and without their natural globular figure. The bronchial tubes, especially those of a small calibre, are sometimes very evidently dilated in those portions of the lung where the emphysema exists. This fact is easily proved by comparing the diseased and sound portions of the lungs. It was to be expected; and, indeed, it is singular that the cir- cumstance is not more common, since the cause which dilates the air cells must act equally on the bronchia : this dilatation is, nevertheless, very rare. To enable us to have a correct notion of this disease, we must inflate the affected lungs and immediately dry them. If they are then cut into slices with a fine instrument, we per- ceive at once that the air cells are almost always more dilated than they appear externally; insomuch that those which form a projection on the surface, of the size of a hemp-seed, are found capable of containing a cherry-stone. We observe, moreover, that some of the cells are simply dilated, while others are ruptured, the intervening partitions of several being destroyed more or less completely. When we blow into an emphysematous lung, the dilated