The Medical Clinics of North America Volume 5, Nos. 4-6

The Medical Clinics of North America Volume 5, Nos. 4-6

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This historic book may have numerous typos and missing text. Purchasers can usually download a free scanned copy of the original book (without typos) from the publisher. Not indexed. Not illustrated. 1922 edition. Excerpt: ...signs which would suggest pulmonary tuberculosis. Her throat we can undoubtedly rule out as a cause of her cough, as I said before. Can it be that this is simply a nervous type of cough and that it does not rest upon any definite pathologic basis? This would hardly be considered on account of her temperature and general appearance. The positive D'Espine's sign gives us the clue and I think we can make a diagnosis of enlargement of the tracheobronchial lymph-nodes as a cause for her cough. The "brassy" character of the cough is also in favor of this as an etiologic agent. It is not difficult to decide that her cough is due to this cause, but it is quite another question what has caused enlargement of these nodes. It is not possible to say, from the physical examination or from her history, whether her infection is tubercular or non-tubercular in character. The general character of the cough and the history of exposure are perhaps in favor of tuberculosis, and against it is the rather acute onset. There are three additional diagnostic procedures which should help us: (1) The white blood-count; (2) the von Pirquet test; (3) Roentgen ray examination of the chest. Her white blood-count is 11,400. The von Pirquet was done two days ago and was absolutely negative. Her x-ray plate, which I will show you, shows considerable congestion in both lung roots and a certain amount of enlargement of the tracheobronchial nodes, especially on the left (Fig. 270). It does not look especially like tuberculosis, as in a tubercular process we would expect to see more calcified glands. The white blood-count in this particular case does not help us very much, one way or the other, although it is a little high for tuberculosis. The more

Product details

  • Paperback | 270 pages
  • 189 x 246 x 14mm | 485g
  • United States
  • English
  • black & white illustrations
  • 1236794621
  • 9781236794628