. Medical diagnosis for the student and practitioner. of respiration, particularlythe sterno-mastoids. Inspiratory retraction of the lowerinterspaces with excessive supraclavicular bulging is com-mon in advanced cases. The ribs are rigid, the costalcartilages prematurely ossified, the interspaces broadenedand the expiratory descent of the thorax is apex beat of the heart is ordinarly invisible, the neckappears short though often thin, and a compensatory curve of the spinal columnmay cause the chest to appear flattened and the patient round-shouldered. If such a patient lies upon
. Medical diagnosis for the student and practitioner. of respiration, particularlythe sterno-mastoids. Inspiratory retraction of the lowerinterspaces with excessive supraclavicular bulging is com-mon in advanced cases. The ribs are rigid, the costalcartilages prematurely ossified, the interspaces broadenedand the expiratory descent of the thorax is apex beat of the heart is ordinarly invisible, the neckappears short though often thin, and a compensatory curve of the spinal columnmay cause the chest to appear flattened and the patient round-shouldered. If such a patient lies upon the back on a table, the chest will at onceassume its typical emphysematous outline. Epigastric pulsation is common * The author has carried throughout his professional life the vivid clinical picture pre-sented by two walking cases showing extreme cyanosis, which were shown simultaneouslyto students by the great London clinician in whose clinic he was working; one a toddlingchild with congenital heart disease, the other an aged man with Fig. 134.—Emphy-sema. Attitude fre-quently assumed inmarked cases, conceal-ing barrel form ofchest. DISEASES OF THE LUNGS AND PLEURA 353
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Keywords: ., bookcentury1900, bookdecade1920, booksubjectdiagnos, bookyear1922
