Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    235/976 (page 215)
    condition generally becomes more pronounced as tire disease advances. Then the respirations not infrequently amount to forty or fifty in the minute, and are sometimes more numerous than this. After a while they are apt to become moaning or groaning in character. It has been asserted that the odour of the breath is in these cases peculiar and characteristic. The respiratory acts assume the characters just described, independently of all pulmonary disease, and in cases where the lungs are not at all affected, or where the affection is so slight as not to have caused special symptoms. But in the greater number of pyaemic cases, the lungs and pleurae become secondarily affected; cough comes on, which may or may not be violent; secretion takes place from the bronchial mucous membrane, or fluids get poured out from the air-cells into the bronchial tubes ; and the congh con- sequently becomes loose, and attended with expectoration, which may according to circumstances be simply mucous, or purulent, or even distinctly pneumonic. The local phenomena correspond more or less to the morbid processes taking place in the chest. Tracts of dulness may sometimes be recognised on percussion, and sometimes uniform dulness at the base; but partly from the scattered arrangement of the patches of pulmonary disease, and partly from the absence ordinarily of any large amount of effusion of fluid into the pleura, dulness is often scarcely or not at all recognisible. Pleural friction-sounds again may occasionally be detected; but owing probably to the limited extent of the false membranes, and to the shallowness of the breath movements, they are not heard so often as might be supposed. The local signs most commonly present are such sounds as are heard in bronchitis, viz. crepitation, often amounting to gurgling and lhonchus. Pleuritic stitches may be complained of. ' (c) Organs of Circulation.—The pulse in Pyaemia is specially remark- able for its feebleness. At the onset of symptoms it may differ little nr frequency or in any other respect from its previous healthy con- dition. But generally it becomes from the very beginning rapid, or if not rapid at least variable, so that the slightest exertion of mind or body raises it twenty or thirty or even forty beats in the minute. The rapidity of the pulse however is generally considerable, and its rapidity tends to increase as the disease advances ; so that not in- frequently the beats of the nulse amount to 140 or 160. and mav even