. A practical treatise on medical diagnosis for students and physicians . ning, as in child-labor, are capable of producing it. Bronchiectasis. Dilatation of the bronchi occurs secondarily to affections which tend tcweaken the walls of the tubes and to lessen their elasticity. Hence it itifound in chronic bronchitis with emphysema, in chronic phthisis, ir!catarrhal pneumonia in children, in chronic obstruction from externa;pressure or foreign bodies. (See Obstructions.) It also occurs when thelungs contract in fibroid pneumonia or in pleural thickening. It occursin two principal forms : the si
. A practical treatise on medical diagnosis for students and physicians . ning, as in child-labor, are capable of producing it. Bronchiectasis. Dilatation of the bronchi occurs secondarily to affections which tend tcweaken the walls of the tubes and to lessen their elasticity. Hence it itifound in chronic bronchitis with emphysema, in chronic phthisis, ir!catarrhal pneumonia in children, in chronic obstruction from externa;pressure or foreign bodies. (See Obstructions.) It also occurs when thelungs contract in fibroid pneumonia or in pleural thickening. It occursin two principal forms : the simple, in which the affected tubes are uni-iformly dilated; and the saccular, in which larger or smaller pouches areformed. It is commoner in males than in females, and probably beginsmost frequently in adult or middle life. One lung only is affected inIabout one-half the cases, and when both lungs are affected (chronic bron-|chitis and emphysema), it is not often to the same degree. Subjective Symptoms. These consist of cough, expectoration, and a PLATE XXV. FIG. FIG. 2.—Posterior As / /*£ *^\.; •;-At Bronchiectasis. onie pleurisy with induration of the right lower lobe and bronchi*Vicarious emphysema of the left lung. Bronchitis. THE MORBID GROWTHS OF THE LUNGS. 907 variable amount of dyspnoea. Eventually there may be some loss offlesh and strength. The cough is usually paroxysmal. It may occur only in the morningafter the dilated tube fills and it may follow change in position. Aparoxysm is followed by copious expectoration, sometimes amounting to apint and a half in twenty-four hours. The sputa are grayish brown andmucopurulent, faintly or extremely fetid. They contain mucus, pus, castsof the tubules, and various salts. Charcot-Ley den and fatty crystals,vibrios, leptothrix, and bacteria (Fox) can be found on microscopicalexamination. Elastic fibres are found only if the tubes are ulcerated. Ina conical glass the sputum separates into three layers—a frothy
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