. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. ay be present as a result of amyloid changes. Hemoptysis is gener-ally a late sjinptom, but is not very common. Diarrhea of a septicnature may occur in the course of the disease. Physical Signs.—The physical signs in all of my cases included alocalized area of dulness or flatness, over which there was broncho- 588 DISEASES OF THE RESPIRATORY SYSTEM phony and bronchial Ijreathinj;:, in .some cases witii gurgles. Abovethis area, over the base behind, there was on percussion a tympaniticnote,
. The diseases of infancy and childhood : designed for the use of students and practitioners of medicine. ay be present as a result of amyloid changes. Hemoptysis is gener-ally a late sjinptom, but is not very common. Diarrhea of a septicnature may occur in the course of the disease. Physical Signs.—The physical signs in all of my cases included alocalized area of dulness or flatness, over which there was broncho- 588 DISEASES OF THE RESPIRATORY SYSTEM phony and bronchial Ijreathinj;:, in .some cases witii gurgles. Abovethis area, over the base behind, there was on percussion a tympaniticnote, indicating the enlarged bronchus containing air. Tuberculosisis excluded by the absence of tubercle bacilli in the sputum, thoughbronchiectasis and tuberculosis may coexist. In most of my casesthere was a history of an antecedent attack of pneumonia. Exclusionof abscess of the lung is \-ery difficult in severe cases in which the quan-tity of sputum is excessive. The bronchiectatic cavity in these casesis very large. With the bronchiectasis, there may be diffuse bronchitisand emphysema of the Fig. -Showing bronchiectatic cavity in case of a girl, aged eight years, with signsas noted in text. Diagnosis.—A positive diagnosis of bronchiectasis cannot alwaysbe made, especially in those cases in which there are all the signs ofa localized empyema. Such cases show localized dulness or flatness,bronchophony, and absence of fremitus in a certain portion of thechest, generally at the lower portion behind. A needl?, on being intro-duced, withdraws pus, which in the cases I have seen was mingledwith air bubbles. On operation the pleura is found to be three instances I found this to be true. The evidence of a bron-chiectatic cavity lay in ths persistence of signs and sjinptoms afterthe healing of the chest wounds. In all 3 cases the expectorationpersisted in profuse quantities after operation (Fig. 137). Complications.—Complications include decomposition of the
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