Lung disease

“ With the access of the hot stage the characteristic symptoms of lung disease are manifested, at first resembling those of congested lungs, but less severe than those given under that head. There is a distinct increase of the body temperature; the visible mucous membranes are suffused with a blush; the expired air feels hot upon the hand; the breathing, 30 to 40 per minute, is short and accompanied by much lifting of the flanks— (labored) ; the cough is deep as if coming from the depth of the chest, but not so hard nor so painful as in bronchitis ”

“ The lung disease, called lung sickness, in cattle, does not, with regard to the organ attacked, affect human beings, but the tendency of the present race of mankind is to anemic rather than acutely inflammatory diseases. ”

“ All pulmonic patients will, while taking counsel of some physician, do well to remember that their cases rest largely in their own hands; indeed, more depends on their own care of themselves than on the efficacy of any system of medicine. Lung disease is usually of a most flattering character, and its influence on the mind differs from that of any other, in that the patient is lulled into a serene and hopeful condition. ”

“ No matter what the essential disease, an almost constant finding in young children after death is small areas of inflammation in the lungs in and around the terminations of the air tubes. The situation renders it evident that the organisms which caused the lesions entered the lung by the air tubes. The mouth of the child is unclean and harbors numbers of the same sort of organisms as those causing the lung inflammation; but in the absence of such a mode of infection as is given by spray formation it is difficult to see how the extension from the mouth to the lungs could take place. ”

“ Consumption is due principally to lowered vitality attributable to an insufficient amount of air being inhaled. The impairment of vitality renders the system open to attacks from disease germs. Imperfect breathing allows a considerable part of the lungs to remain inactive, and such portions offer an inviting field for bacilli, which invading the weakened tissue soon produce havoc. Good healthy lung tissue will resist the germs, and the only way to have good healthy lung tissue is to use the lungs properly. ”

“ The lungs may sink as a result of disease. 2. Respiration, even in healthy lungs, may be so imperfect that they may sink. 3. Emphysema pulmonum neonatorum. 4. Putrefaction. 5. Artificial inflation.
1. That in consequence of disease the entire lungs, or portions of them, may sink, and yet respiration may have taken place. Disease of the lung may occur previously to birth or soon afterwards, but it is scarcely probable that the disease would attack every portion of the [Pg 172] lung. Parts, doubtless, small in proportion to the diseased part, may yet have been sufficiently inflated to float. ”

“ When once the disease has obtained a foothold in the body its course, like one of Napoleon's campaigns, is short, sharp, and decisive. Beginning typically with a vigorous chill, sometimes so suddenly as to wake the patient out of a sound sleep, followed by a stabbing pain in the side, cough, high fever, rapid respiration, the sputum rusty or orange-colored from leakage of blood from the congested lung, within forty-eight hours the attacked area of the lung has become congested ”

“ Deteriorated conditions of the blood, anaemia, chlorosis—such as occurs so commonly in young women—is prone to make the outlook in pneumonia more serious. Pneumonia of the upper lobes of the lungs is more apt to be followed by complications, and is therefore more serious than pneumonia of the lower lobes. Secondary pneumonia—that is, inflammation of the lungs which develops as a complication of some other disease—is much more unfavourable than primary pneumonia which develops in the midst of health. The amount of lung involved is of course a serious factor in the prognosis. ”

“ Other factors that may cause them are pre-existing lung disease and the weakened general condition of the aged. These we are able to control by tak- ing pains to make careful examinations of all persons before they submit to operation, and by eliminating the unfit. Within the last few years surgeons have become familiar with other affections aris- ing in the lung after operation, one a con- dition in which the entire lung on one side is collapsed, airless and so useless; the other, one in which an abscess develops in one lung. ”

“ This will soon reduce the inflammation and effect a cure.
PNEUMONIA, Sometimes called Lung Fever, is an acute inflammation of the lungs, usually caused by a cold, and commencing with a chill and feverish symptoms. At first there is a dry cough and what is known as the brick dust sputum, and in the advanced stages a peculiar dark tint in the cheeks, known as the mahogany flush. The breathing becomes very hurried, rising as high as forty respirations per minute. It is an exceedingly rapid and frequently fatal form of disease. ”

“ Since the symptoms progress gradually, COPD patients may not even realize in the early stages that they have the disease. Over the years, as the lung damage continues, breathing becomes increasingly difficult. ”

“ As the disease becomes generalized, implicating the lungs, there is a dry paroxysmal cough and hurried breathing, becoming more oppressed on the slightest exertion. If quiet and thin enough for auscultation and percussion the usual morbid lung sounds can be heard. ”

“ The respiration is accelerated. On auscultation it is often difficult to discover signs of chronic tuberculosis. The lung is the site of repeated congestive changes, resembling those of broncho-pneumonia or contagious pleuro-pneumonia. The pleura and walls of the chest become extremely sensitive, as in the last-named disease, and the abdomen may exhibit signs of peritonism, as at the beginning of acute peritonitis. The pulse rises to 80, 90, 100, or even 705120 beats per minute, and the urine contains albumen in notable quantities. ”

“ Chronic obstructive lung diseases afflict an estimated 17.2 million Americans, with more than three million being disabled to a greater or lesser degree by such disorders as chronic bronchitis, asthma, and emphysema and many other serious lung diseases of known and unknown causes. ”

“ The relation between such lung diseases as bronchitis and pneumonia and the unwholesome condition of the air of our dwellings has not been sufficiently recognized by the medical profession and the public. One of the most common causes of an attack of bronchitis is a Budden exposure of the bronchial mucous membrane to extreme conditions of air. A man who breathes for some hours the hot and dry vitiated air of an unventilated room is prone to be thus affected on passing out into cold, damp night air. ”

“ The lung, which is at first enlarged, becomes shrunken, dense in texture and solid, any unaffected portions being emphysematous; the bronchi are dilated, the pleura thickened, and the lung substance often deeply pigmented, especially in the case of miners, who are apt to suffer from this disease. The other lung is always greatly enlarged and distended from emphysema; the heart becomes hypertrophied, particularly the right ventricle ”

“ This immunity extends through every age of life. Hepatic and kindred diseases are unknown; of lung affections there is no land that can boast of like exemption. Be it the equability of the temperature or the aseptic condition of the atmosphere, the free sweep of winds or the absence of disease germs, or what else it may be ascribed to, one thing is certain, that there is no pneumonia, bronchitis, or pleurisy lying in wait for either the infant or the aged. ”

“ The number of children born exceeds the number of deaths. Mortality appeared to be low for the two years I was near these people. The prevailing diseases are of the lungs and bowels. The lung diseases are induced by constant exposure to extremes of wet and cold and the inhalation of foul air laden with terebinthine odors, arising from the resinous woods used for fuel. Changes of the wind blowing in at the door cause the interior to become filled with smoke, which is endured rather than admit the cold air from without. ”

“ I have not a doubt, that a universal neglect of cleanliness not only favors, in this way, the production of lung diseases—especially of those colds which are so frequent in our climate, and which often pave the way for other and still more dangerous diseases—but also that it tends to aggravate such diseases of the lungs as may already exist, or to whose existence there may be in us, either by inheritance or otherwise—a predisposition. ”

“ Breathing by the lungs is simply the means by which the taking up of oxygen and the giving off of carbon dioxide by the cells is made possible.
HYGIENE OF RESPIRATORY ORGANS The liability of the lungs to attacks from such dread diseases as consumption and pneumonia makes questions touching their hygiene of first importance. Consumption does not as a rule attack sound lung tissue, but usually has its beginning in some weak or enfeebled spot in the lungs which has lost its "power of resistance." ”

“ When the practitioner is first consulted he often finds only indications of the crisis period of a localised pneumonia at the base of the affected lung. The symptoms include fever, accelerated breathing, moaning, loss of appetite, cough without discharge, dulness over the base of the lung on percussion, disappearance of the respiratory murmur in the dull area, souffle opposite the inferior bronchi, and normal or juvenile respiration towards the front, i.e., in the anterior lobe, and sometimes in the cardiac lobe. ”

“ In pneumonia, for instance, the lower part is usually first affected, and in tuberculosis one often can get the physical indications in the lower part of the lungs posteriorly before they can be found any other place. The upper parts have to be used and consequently they get more exercise and more blood and hence become more resistant. It is well known that when the upper part of the lungs become affected the disease is very grave.
Men, as well as women, are guilty of shallow breathing. Many men are very inactive and their breathing becomes sluggish. ”

“ Inhaling cold air after sitting in a close atmosphere, will induce an attack of bronchial inflammation, or thickening of the air-tubes, in persons of all classes and conditions. Persons who are liable to frequent attacks of bronchitis, are apt to imagine that their lungs are affected, since it prevents a free use of the voice in singing or speaking audibly. I will repeat that this complaint generally terminates with a loss of tone in the lung substance, caused by the failure of the tubes to supply them with oxygen or air ”

“ Even primary diseases of the lungs often exist with peculiar violence, or continue for many years without inducing a consumption. I have never known but one instance of the whooping-cough ending in consumption, and all our books of medicine contain records of the asthma continuing for twenty and thirty years without terminating in that disease. The reason in both cases, must be ascribed to those two original diseases of the lungs not being accompanied by general debility. ”

“ In pneumonia or inflammation of the lung-substance the process is different. A portion of one or other lung, sometimes of both, becomes overfilled with blood, or congested, and though the air-tubes themselves are not the special seat of the congestion, yet the air-cells are pressed on by the surrounding swollen substance, and the entrance of air into them is impeded. If the mischief goes further the substance becomes solid and impervious to air, and lastly it becomes softened, its structure destroyed, and infiltrated with matter ”

“ In America from the day of Washington and all centuries before his time, man has dreaded diseases of the lungs more universally than any other one disease. If we compare pulmonary diseases with other maladies we find more persons die of consumption, pneumonia, bronchitis and nervous coughs than from smallpox, typhus and bilious fever and all other fevers combined. ”

“ In that case the lungs are always affected; and the symptoms of fever, cough, and wasting usually show themselves within the first three or four months, and the infants almost invariably die within the year. Now and then, however, an infant thus affected may continue apparently in good health for a few months, and then be suddenly attacked by symptoms of acute inflammation or of severe bronchitis which prove rapidly fatal; and it may be found after death that the acute attack destroyed life because the lungs were already the seat of extensive consumptive disease. ”

“ There is ample evidence that primary lesions appear not only in the skin and nasal mucosa, but also in the bronchia, intestines, and other parts. Much time and ink have been wasted in attempts to prove that pulmonary lesions are always secondary, and doubtless many are so, but the cases in which the lesions are confined to the bronchia or parenchyma, and the many parallel cases of direct infection of the lungs by other diseases (tuberculosis, lung plague, contagious pneumonia, influenza, etc.,) furnish conclusive enough evidence that the germ may be inhaled and colonize this part first. ”

“ But modern research has demonstrated that there is no relation whatever between the symptoms and the morbid state of the lung, which it is the object of the well-informed physician to remove. It would be easy to show that there are many cases where all the symptoms of a pneumonia have been present, but 264where a post-mortem examination has proved that there was no inflammation of the lung; and that a still larger number of instances might be cited where fatal pneumonia has occurred without any of its symptoms having existed during life. ”