Lectures on Clinical Medicine Volume 3; Delivered at the Hotel-Dieu, Paris (Paperback)

This historic book may have numerous typos and missing text. Purchasers can download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1870 Excerpt: ...to promote its flow. The flow does not begin till the patient is told to take deep inspirations; or better still, to strain as if at stool. The effusion then gushes through the canula, and after a certain time dribbles out, the gush being resumed only when respiratory or straining efforts are made. The glottis being closed, the air, which cannot escape by the superior opening of the windpipe, continues to distend the lung; the capacity of the pleural cavity being at the same time diminished by the contraction of the expiratory muscles and of the diaphragm, the effused fluid, solicited from all parts to effect its exit by the opening made into the chest, escapes in jets, the spurts corresponding with the respiratory movements and the expiratory efforts. The exertion of coughing produces similar results. Though at first it is necessary to ask the patient to cough, that is soon not required. The person who only coughed when ordered to do so, at last has frequent and involuntary coughing fits, because the lung, which has not breathed for a long time, experiences, when the air enters and opens up the air vesicles, a sortof irritation, a sort of excitement, from coming in contact with its natural stimulus, to which it had become unaccustomed. This involuntary cough may become very violent, very frequent, and very painful, and may resist all treatment. Dr. D., whose case I related to you, complained of experiencing such severe pains when the air entered the chest as made him afraid to breathe; his respiration was short, jerking, and sobbing; and an hour and a quarter elapsed before it calmed down. This fatiguing cough sometimes did not come on till very late in the da'. The pains which accompanied it seemed to me to depend on the tearing of the false membranes, by...