. Essays on consumption; together with some clinical observations, and remarks on pneumonia. little from thenormal. On examining now you will not hear anycrepitations, but a single click at the end of inspira-tion marks the position where the tubercular focus wasestablished. Here we were prepared, when we saw the rise intemperature, to find a new centre of infection, and knowingwhere to expect it if it was in the previously sound lungthe mischief was at once detected, and I think we maysay that the prompt treatment has checked any furtheradvance in this lung, at least for the present. The expl
. Essays on consumption; together with some clinical observations, and remarks on pneumonia. little from thenormal. On examining now you will not hear anycrepitations, but a single click at the end of inspira-tion marks the position where the tubercular focus wasestablished. Here we were prepared, when we saw the rise intemperature, to find a new centre of infection, and knowingwhere to expect it if it was in the previously sound lungthe mischief was at once detected, and I think we maysay that the prompt treatment has checked any furtheradvance in this lung, at least for the present. The explanation of the facts above noted is to be foundin the arrangement of the bronchus as it enters the lung,and the position of the first subdivision into the largerbranches of the bronchial tubes. Casts of the bronchialtubes have been made by several observers, all of whichagree very closely in shape and appearance, and may betaken to represent accurately the branchings of the air- Clinical Observations. 241 tubes. The accompanying figure shows how these brandl-ings differ on the two Main branches of the Bronchial Tubes—modified from a ca9t byBirch-Hirschfeld—shown in their position within the chest. It will be seen that on the right the bronchus passesalmost horizontally into the lung, and after a short coursedivides into a number of branches. The position of thissubdivision is shown by the figure to correspond with thesituation I have indicated for the first signs of infection ofthe right lung by sputa passing down the bronchus. Thesputum would be checked where the tubes suddenly becomesmaller and the straight direction of the bronchus the left side the bronchus passes less horizontally andreaches further into the lung before it breaks up into itsbranches, thus bringing the place of subdivision moreunder the anterior margin of the axilla. s. R 242 Consumption. CHAPTER XXI. CLINICAL OBSERVATIONS. The Temperature in Phthisis. The temperature chart in a case of
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