Transactions of Branches

1862 BMJ (Clinical Research Edition)  
enough, by observing a strict regimen, until November last, when he had an attack of fever and cough, with the return of the old pain in the chest. The fever went off in a week; but not so the cough and pain. He now perceived, for the first time, aismall swelling in front of his chest, which in the course of twenty-four hours acquired double its present size. He had a severe cough and loss of appetite at the time, but no hemoptysis. Present Symptoms. He was now sitting on bis bed, with the head
more » ... bed, with the head erect, and slightly inclined to the right, breathing tranquilly, but as if it were with a weight on the chest. The veins of the neck were distended; the lips slightly livid. The body was somewhat emaciated; the cODjUnCtiVae were reddish; there was no great ansemia; the tongue was clean and moist; the bowels regular; the appetite good. Pulse feeble, and equal at both wrists. The anterior aspect of the chest was broken of its usual symmetry by an oval tumour, situated a little above the middle of the stertnumn, encroaching more upon the right side. It was about two inches in diameter, and bounded above by the cartilage of the first rib of the right side, and below by that of the fourth; those of the second and third ribs seeming, to be included in its substarnce, bent forward, and much absorbed, allowing a portion of an elastic fluctuating
doi:10.1136/bmj.2.82.86 fatcat:54hndbfjofh27f2tzmtghgdg3u