File:The principles and practice of medicine, designed for the use of practitioners and students of medicine (1892) (14781365952).jpg

Identifier: principlespract00osle (find matches)
Title: The principles and practice of medicine, designed for the use of practitioners and students of medicine
Year: 1892 (1890s)
Authors: Osler, William, Sir, 1849-1919
Subjects: Medicine
Publisher: Edinburgh London : Young J. Putland, c1892
Contributing Library: Dentistry - University of Toronto
Digitizing Sponsor: University of Toronto

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r flank, or even beneath the shoulder-blade. Deep inspiration andcough aggravate it. Dyspncea is a very prominent feature. The respira-tions may be from forty to sixty in the minute and in exceptional casesand in children may rise to eighty. To produce this shortness of breathmany fac^tors combine;—the fever, the loss of function in a considerablearea of lung tissue, and the excessive pain in the side, which makes it im-possible to draw a d(;ep breath. There may be nervous factors at work,as with the (crisis the number of res2)irations may fall nearly to normal. 518 DISEASES OF THE KESPIRATORY SYSTEM. while the consolidation of the lung still persists. The type of breathingin pneumonia is peculiar and almost distinctive. The inspirations are Jnn. if) ii 12 13 n ir, in n ifi /g Resp. 75 70 C5 60 55 50 15 10 35 30 25 20 15 10 Pnlse190 180 170 ICO 150 140 130 120 110 100 90 80 70 60 50 40 Temp,109 108 107 106 105 101 1C3 102 101 1009998 96Temp. Pulse Resp.Stools Urine 3ay ofiiicasc £!
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10 11 12 13 14 BLACK, temperature; red, pulse; blue, respiration Chart XV.—Fever, pulse, and respirations in lobar pneumonia. short and superficial. Expiration is often associated with a short grunt.The ratio between the respirations and pulse may be 1 to 2, or even 1 to PNEUMONIA. 519 1-5. Ill no other disease do we see sucli marked disturbance in the pulse-respiration ratio, and this is sometimes an aid in diagnosis. The cough is also very characteristic—frequent, short, restrained, andassociated with great pain in the side. It is at first dry, hard, and with-out expectoration. In old persons and drunkards and in those debilitatedby long illness there may be no cough. The sputum is mucoid at first,but within twenty-four hours shows special features. A brisk lia3moptysismay be an initial symptom. Pneumonic sputum is viscid, tenacious, andblood-tinged. The gummous viscidity, together with the red blood-cor-puscles in various stages of alteration, give pathognomonic characters to

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