On chronic bronchitis : especially as connected with gout, emphysema, and diseases of the heart, being clinical lectures delivered at the Middlesex Hospital / by E. Headlam Greenhow.

  • Greenhow, Edward Headlam.
Date:
1869
Catalogue details

Licence: Public Domain Mark

Credit: On chronic bronchitis : especially as connected with gout, emphysema, and diseases of the heart, being clinical lectures delivered at the Middlesex Hospital / by E. Headlam Greenhow. Source: Wellcome Collection.

Provider: This material has been provided by University of Bristol Library. The original may be consulted at University of Bristol Library.

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    oedematous and, presently,lier legs also swelled. She liad several times noticed that her expectoration was streaked with blood. On December 15, when I first examined her, she had a dry noisy cough, attended by very scanty ex- pectoration. Her face was puffy, and her hands, feet, and legs were very oedematous, pitting deeply on pressure. Her piilse was 102, feeble and compressi- ble ; the respirations were quick and very laborious; urine high-coloured, specific gravity 1030, loaded with lithates and copiously albuminous. Eespira- tion was for the most part dry and attended by loud rlionchus and sibilus, but there were some moist sounds in the base of the left lung. A loud diastolic* blowing murmur was heard below the left mamma. Its point of greatest intensity was close to the right border of the left nipple, and it was moi'e faintly heard over the prtecordia, and in the axilla, where it had a musical tone; it was not audible posteriorly. Both cardiac sounds were clear at the aortic and jduI- monary orifices, but the second sound was much ac- centuated in the latter situation. The patient gradually sank, and died on December 22. Towards the end of life, the proportion of albumen in the urine decreased, and the pulse acquned an intermittent character. At the post-mortem examination, the lungs were much congested and presented scattered patches of * It is so called in my note book; but was, doubtless, what is now commonly known as a prae-systolic murmur.