Modern surgery, general and operative . uponthe back and the respiration is a severe blow upon the chest there isgreat shock and may even be instant condition of shock so produced iscalled concussion of the chest. After a severeblow upon the chest a Hmited area of inflammation may arise in the pleiira{traumatic pleuritis). Severe \dsceral injiuy is announced by positive symp>-toms. A contusion of the lung causes extravasation of blood and leads to pain,cough, expectoration of bloody mucus, dyspnea, and possibly distinct hemo-phthisis. Over the contused region the p
Modern surgery, general and operative . uponthe back and the respiration is a severe blow upon the chest there isgreat shock and may even be instant condition of shock so produced iscalled concussion of the chest. After a severeblow upon the chest a Hmited area of inflammation may arise in the pleiira{traumatic pleuritis). Severe \dsceral injiuy is announced by positive symp>-toms. A contusion of the lung causes extravasation of blood and leads to pain,cough, expectoration of bloody mucus, dyspnea, and possibly distinct hemo-phthisis. Over the contused region the percussion-note is dull and on ausculta-tion crepitus is audible. It may be mistaken for phthisis, but complete andearly recovery soon dispels this fear. Traumatic pneumonia always usuaUy involves a limited area of lung tissue, but genuine croupous pneu- ^ F. W. Parhams paper on Thoracic Resection for Tiimors Gro^ing from the Bony Wallsof the Chest. Read before the Southern Surgical and Gynecological Association, November,. Fig. 567.—The Fell-0 Dwyer illustration shows an early model; sincethen the bellows has been improved by theaddition of a strong wooden frame, whichholds it steadily, and is provided with a longarm that acts as a powerful foot-piece forcompressing the machine with the leastamount of muscular effort. Treatment of Contusions of the Chest 897 monia may arise after injury of the chest even when no rib was broken. Thephysical signs and symptoms are not evident until two or three days after theaccident (Sir Thomas Oliver, in Brit. Med. Jour., April 30, 1910). Trau-matic pneumonia may be caused by other things than external violence, viz.,inhalation of illuminating gas, of dust, or of a foreign body. In rupture of the lung the physical signs are dependent on the extentand situation of damage. A minute rupture would not produce definitephysical signs. If the lung is ruptured and the pulmonary pleura is not, therewill not be pneumothorax,
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