File:Principles and practice of physical diagnosis (1911) (14784774993).jpg

Identifier: principlespracti1911daco (find matches)
Title: Principles and practice of physical diagnosis
Year: 1911 (1910s)
Authors: Da Costa, John C., jr., 1871-
Subjects: Diagnosis Diagnosis
Publisher: Philadelphia and London : W.B. Saunders Company
Contributing Library: Francis A. Countway Library of Medicine
Digitizing Sponsor: Open Knowledge Commons and Harvard Medical School

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ryto plastic inflammation of the pleura, whence fibrous bands penetratethe lung by way of the septa between the lobules and along the peri-bronchial lymphatics; or a pleural thickening and contraction mayprogressively compress the adjacent lung and set up interstitialchanges in the atelectatic territory. Compression atelectasis, asby neoplasm or by aneurism, and also pulmonary syphilis are DISEASES OF THE BRONCHOPULMONARY SYSTEM 203 capable of initiating a more or less diffuse fibrosis of the lungs.The cirrhotic lesions arising primarily from irritation by dustsare considered in connection with Pneumokoniosis (p. 241), andthe fibrosis due to tuberculosis is described under Fibroid Phthisis(p. 223). The cirrhotic areas consist of dense, pigmented collections of graycicatricial tissue disseminated throughout the organ, commonly byperibronchial radiations between the lobules and the lobes, and inthe extreme case converting, by contraction of the fibrous overgrowth, Areas of consolidation
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Area of fibrosis Fig. 99.—Chronic interstitial pneumonia (Jefferson Hospital Laboratories). the lobe or even the lung into an airless, sclerotic mass of extraordi-narily small volume. At autopsy a lung thus damaged may be reduced.to a compact, indurated mass of fibroid material the size of a cante-loupe, lying against the spinal column. In consequence of thisunilateral shrinkage the thorax on the fibroid side is strikingly con-tracted and otherwise distorted (see Fig. 45), and the heart, which ishypertrophied, especially on the right side, is drawn toward the focus 204 PHYSICAL DIAGNOSIS of the cirrhosis, along with the other mediastinal contents. Thebronchi are generally dilated, and the air-vesicles are quite oblite-rated in the fibroid areas, while elsewhere both these structuresshow a variable degree of catarrhal inflammation. In the non-fibroid parts of the affected lung and throughout the other lungcompensatory emphysema develops, and the pleural surfaces arethickened and adhe

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