Art. III.—On Typhoid Pneumonia Associated with Muffled Tympanitic Resonance, with Cases
Thomas Hayden
1866
The Dublin Quarterly Journal of Medical Science
May 28.--Inflammation has extended downwards, engaging the entire oft he anterior surface of the lung, as low as the sixth rib; left side of chest generally dull in front, to a point below the nipple, but clear behind a line extending obliquely downwards and forwards from the posterior fold of the axilla; pulse 90 and occasionally intermitting; heart's action corresponding, but otherwise normal; sputa "rusty;" tongue dry; features haggard and shrunken; to be cupped to three ounces in mammary
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... ion, and have, within the next twenty-four hours, ten ounces of whiskey and six of wine at intervals; quinine and beef-tea, with arrowroot, to be continued. May 29.---Respirations 30; pulse 72, not intermitting. June 1.--Progressing favourably; tongue now clean; pulse 72, full, regular, and not intermitting; respirations 30; returning vesicular breathing in apex of lung, with feeble and sparse crepitus. In mammary region bronchial respiration with muco-crepitus; general dulness in front; resonance behind, as on the 28th of May. June 3.--Tongue clean; pulse 72; respirations 24; dulness in front less pronounced; in sub-clavicular region it is modified by a peculiar resonance of a somewhat tympanitic character, but from t~he clavicle to the sixth rib a grepitus is still audible, beneath the clavicle only at end of full respiration. Treatment continued, with exception of whiskey which was reduced to five ounces. June 5.---Pulse 66; respirations 18; a coarse systolic, murmur of a rubbing character, heard in second left intercostal space, near the sternum. June 6.--Pulse 60; respirations 18. June 8.--Pulse and respiration as on the 6th; tongue clean. A loud grating friction both heard and felt over base of left lung posteriorly, and bronchial respiration in left supra-spinal fossa. June 12.--Pulse 60, full, strong, and regular ; first sound of heart rather prolonged, and attended with a soft murmur over left base ; whole of left side comparatively dull in front, with muco-crepitus inferlorly; pleuritic friction audible over greater part of same side posteriorly ; appetite good ; sleeps well. Discharged this day. This was a case of typhoid pneumonia engaging the superior lobe of the left lung, and complicated, towards the close, with pleuritis without effusion, and a slight attack of pericarditis. The work in which the man had been employed was well calculated to deteriorate his health. The inflammation, as is usual in typhoid pneumonia, invaded first
doi:10.1007/bf02946454
fatcat:747pbcxkfrcpxekrkrs6jw24ya