Editorials and Medical Intelligence

1829 Boston Medical and Surgical Journal  
The thorax only was examined. The body retained ils plumpness, and the adipose matter under the skin was unusually thick. The sternum, with the cartilages of the ribs, being removed, the left side of the thorax seemed occupied in front principally by the heart. This arose not from the magnitude of the heart, but from the diminished size of the lungs on that side, and from a quantity of adipose matter covering the pericar-..iiuii-i, and connected with a similar matter spread over the
more » ... ver the mediastinum. The lungs on this side adhered to the surrounding parts, to the ribs, diaphragm, and pericardium. The adhesion was formed by coagulable lymph recently effused. This adhesion was quite strong in the posterior and inferior parts. It was wanting at the side over a small space, where a reddish serum was effused to the quantity of an ounce or more. The pleura piilmonalis in most parts, when the lymph was removed, was found to have retained its polish, and seemed to have partaken less in the inflammatory action than the pleura costalis. The portion of the cellular, or rather adipose covering of the pericardium, to which the pleura costalis adhered, had a very slight and superficial blush, having partaken of the inflammation in the slightest degree. Both lobes of the left lung were diseased throughout, but most at the posterior and inferior parts. At the apex there was a small, distinct por-tion, in size equal to a large English walnut, which was quite solid and of a red color; properly hepatized and containing no air. The parts surrounding this were similarly changed, but in a less degree, and some frothy and bloody serum flowed from them. Lower down in the superior lobe and in the anterior half, the lung was less diseased, crepitated very slightly, and poured out upon incision more frothy fluid. The posterior part of this lobe and all the inferior lobe were different in their appearance. These parts resembled the spleen as much as diseased lung ever resembles liver ; that is, they did not crepitate, they were destitute of frothy fluid when divided by the knife, and they were not indurated. Likewise their color was dark, like that of the spleen. The very lowest part bad a leathery feel when handled. If the pleura had been detached from it, and it had been presented to an anatomist, he would not easily have detected, by its texture, from what part of the body it had been taken. It may, perhaps, be compared, except as to color, to a piece of lung half boiled and then gently pressed. The part thus described could not be said to be inflamed. It seemed to have been compressed, and the air to be so excluded.. On the right side the lung adhered very generally by cellular bands, evidently not of recent formation. The lung itself was quite healthy. The pericardium contained less than an ounce of water, and was healthy ; as also was the heart.
doi:10.1056/nejm182904070020804 fatcat:6uonylxcbrahpckxqw4luf6avm