Diseases of the chest and the principles of physical diagnosis . from twoto three days, the process mayterminate in two or three days insteadof being prolonged for a week ormore. In children, the aged, and theasthenic, the amount of fibrin pro-duced may be small and the alveolibut slightly distended, so that theusual dry, granular appearance of thelung is not observed (Adami). —The first evidencepointing to the stage of resolutionis a breaking up of the fibrin andfatty degeneration of the lung becomes smaller, has a boggy feel and the pleura becomes re-laxed and thro
Diseases of the chest and the principles of physical diagnosis . from twoto three days, the process mayterminate in two or three days insteadof being prolonged for a week ormore. In children, the aged, and theasthenic, the amount of fibrin pro-duced may be small and the alveolibut slightly distended, so that theusual dry, granular appearance of thelung is not observed (Adami). —The first evidencepointing to the stage of resolutionis a breaking up of the fibrin andfatty degeneration of the lung becomes smaller, has a boggy feel and the pleura becomes re-laxed and thrown into folds. On section the surface is yellowish incolor, very moist and a creamy, almost purulent fluid can be squeezedout. The softened exudate is removed partly by being expectorated andpartly by absorption; the latter is probably the more important as theexudate disappears in cases in which both cough and expectoration areentirely absent. The dissolving of the exudate is due to autolysis. The coagulated albumen is broken up into soluble albuminoids and. Fig. 272.—Gray hepatization withanthracosis. DISEASES OF THE LUNGS 409 further decomposition products through the action of a ferment that isprobably given off by the leukocytes (Strtimpell). Cook, in OsiersClinic, has shown that the excretion of the dissolved exudate takes placethrough the kidneys as shown by the excessive nitrogen excretion in theurine. With the removal of the exudate the desquamated epithelium in thealveoli are replaced by regeneration from those remaining intact; gradu-ally there is a complete restoration to the normal. In the vast majorityof cases, especially in young, healthy individuals, complete resolutiontakes place uninterruptedly. In a small proportion of cases the dis-eased area instead of undergoing a normal involution becomes the siteof an abscess, a gangrenous process, or fibroid induration. Site of the Disease.—^It has been shown in every series of cases oflobar pneumonia that the low
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1920
