. Diseases of the lungs . ation. But usually there is a smallamount expectorated with the early morningcough which may contain yellow streaks or opaquespots. As the softening advances there is lessmucoid and frothy material, and more of the pur-ulent expectoration. When cavities are presentthe expectoration is in the form of rounded massesof a greenish gray or ashy gray color. The odoris stale, but may be sweetish or fetid. Shouldthe lung be breaking down rapidly the expectora-tion is profuse and contains a cheesy times the expectorated material resemblesboiled sage. This is also m
. Diseases of the lungs . ation. But usually there is a smallamount expectorated with the early morningcough which may contain yellow streaks or opaquespots. As the softening advances there is lessmucoid and frothy material, and more of the pur-ulent expectoration. When cavities are presentthe expectoration is in the form of rounded massesof a greenish gray or ashy gray color. The odoris stale, but may be sweetish or fetid. Shouldthe lung be breaking down rapidly the expectora-tion is profuse and contains a cheesy times the expectorated material resemblesboiled sage. This is also met with in bronchitisand is not characteristic of tuberculosis. Although these patients show an increasedfrequency of respiration, especially noticeabletowards evening and on exertion, they seldomcomplain of dyspnea except in the late stages ofthe disease. The reduction in the volume ofblood and the gradual appearance of the pul-monary disease have been looked upon as explain-ing the absence of the subjective sensation of. PHYSICAL SIGNS DURING THE EARLY STAGE OF TUBERCULOSIS. 262 PULMONARY TURERCULOSIS. dyspnea. In those cases where other chronic con-ditions appear dyspnea is often a marked symptom. These cases do not advance very far before thepatient complains of pain in the chest, usually inthe axillary or mammary region. It may be amere sensation of pain or it may be stitching oragonizing, and attended with tenderness on percus-sion. In the cases where cavities have formedthere may be a dragging pain due to stretch-ing of the parietal pleura and intercostal pains must not be mistaken for the rheu-matic pains that are found about the chest wall insome patients, nor the general tenderness that isobserved on percussion of cachectic subjects. The appearance of an afternoon elevation oftemperature is an important symptom. The fevermay be preceded by a slight shivering, but sel-dom does it amount to a marked rigor. The feveris highest between 2 and 10 p. m., and the
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