Modern diagnosis and treatment of diseases of childern; a treatise on the medical and surgical diseases of infancy anf childhood . tial symptomsare frequently misleading. They may consist of vomiting,diarrhea, pain in the abdomen, nosebleed, and prostration, sug-gesting the beginning of typhoid, or convulsions and vomitingmay predominate justifying the diagnosis of meningitis. Wherethe pneumonic lesion is located centrally (central pneumonia), pneumoniathe physical signs, nay, even the cough, may be absent or slight, Threestages. Suddenonset. Absrnce of ough in 266 DISEASES OF RESPIRATORY SYST
Modern diagnosis and treatment of diseases of childern; a treatise on the medical and surgical diseases of infancy anf childhood . tial symptomsare frequently misleading. They may consist of vomiting,diarrhea, pain in the abdomen, nosebleed, and prostration, sug-gesting the beginning of typhoid, or convulsions and vomitingmay predominate justifying the diagnosis of meningitis. Wherethe pneumonic lesion is located centrally (central pneumonia), pneumoniathe physical signs, nay, even the cough, may be absent or slight, Threestages. Suddenonset. Absrnce of ough in 266 DISEASES OF RESPIRATORY SYSTEM. so that remittent fever is often thought of or even intermittentfever, if the temperature pursues an irregular course. Further-more, there are also numerous abortive cases of pneumonia whichterminate in a few days—often before the diagnosis has beenestablished. Of course, the majority of cases of pneumonia present typicalphysical signs and can be readily disclosed on careful examina-tion. Auscultation reveals during the first and third stages finecrepitation, crepitation at the edge of the consolidation, and during the. Tubular Fig. 71.—Diplococcus Pneumoniae (Pncumococcus) : (a)single diplococci; (b) the same in chains (Wolfs double stain).Leitz ocular I, oil immersion Yvz- (Lenharts and Brooks.) second stage, distinct tubular breathing and bronchophony overbreathing, the affected portion of the lung. In the first day or two of thedisease the percussion sound is usually tympanitic, but as theDullness, pneumonia advances, first dullness and later flatness can readilybe elicited, the experienced hand perceiving also a distinct increaseof sense of resistance on percussion. Pectoral fremitus is ordi-narily not sufficiently distinct in young children except when theycry aloud, which act should always be encouraged to facilitate thedetection of the physical signs. Croupous pneumonia runs a self-limited course, between fiveand thirteen days, or longer, most frequently termina
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectchildren, bookyear191
