. Physical diagnosis . reful consideration of the history and the associated signs andsymptoms may help us to decide. Large solitary abscess of the liver, occurring as it almost in-variably does in the posterior portion of the right lobe, produces anarea of flatness on percussion, which rises to a much higher level in DISEASES AFFECTING THE PLEURAL CAVITY. 353 the axilla and back than in front or near the sternum (see Fig. 175),and may be in this way distinguished from empyema; but when theliver contains many small abscesses, as in suppurative cholangitis,this peculiar line of dulness is not p
. Physical diagnosis . reful consideration of the history and the associated signs andsymptoms may help us to decide. Large solitary abscess of the liver, occurring as it almost in-variably does in the posterior portion of the right lobe, produces anarea of flatness on percussion, which rises to a much higher level in DISEASES AFFECTING THE PLEURAL CAVITY. 353 the axilla and back than in front or near the sternum (see Fig. 175),and may be in this way distinguished from empyema; but when theliver contains many small abscesses, as in suppurative cholangitis,this peculiar line of dulness is not present. (d) Rare diseases, such as cancer or hydatid of the lung, maybe mistaken for pleuritic effusion. The history of the case and theresults of exploratory puncture usually clear up the difficulty. Examination of Exudates and Transudates. Only such methods as can be carried out without a thermostatwill be here described. Hence the examination of diphtheriaswabs, blood cultures, and pus are excluded. We have left the. Fig. 176.—Lymphocytosis in Pleural Fluid. Primary tuberculous pleurisy. (X 750 diameters.) (Musgrave.) fluids obtained by tapping the pleura, the peritoneum, and the spinalcord. The first is the most 354 PHYSICAL DIAGNOSIS. Pleural Fluids.—A fluid withdrawn from the pleura by punct-ure may be a mechanical transudate (hydrothorax), may be evi-dence of tuberculous pleurisy (primary or associated with phthisis),or, rarely, an exudate of septic or cancerous origin. To investigate these fluids we note: 1. Color. Bloody fluids suggest cancer, but occasionally occurin pneumonia and tuberculosis. 2. Dropsical fluid is generally below in specific
Size: 1625px × 1538px
Photo credit: © Reading Room 2020 / Alamy / Afripics
License: Licensed
Model Released: No
Keywords: ., bookcentury1900, bookdecade1900, bookpublis, booksubjectdiagnosis
