The Practitioner . Respiration 28 per minute, not has a frequent cough, which is somewhat paroxysmal and isnot suppressed to any extent. He brings up small quantitiesof slightly frothy mucopurulent sputum. Examination of chest shows it to be rather flat but fairlywell formed. Expansion is equal on the two sides. Vocalfremitus is well marked everywhere, except over the left baseposteriorly, where it is slightly lessened. Percussion shows slight impairment of note over the leftbase posteriorly, and also a rather high-pitched note over theleft apex posteriorly. Palpation reveals the p
The Practitioner . Respiration 28 per minute, not has a frequent cough, which is somewhat paroxysmal and isnot suppressed to any extent. He brings up small quantitiesof slightly frothy mucopurulent sputum. Examination of chest shows it to be rather flat but fairlywell formed. Expansion is equal on the two sides. Vocalfremitus is well marked everywhere, except over the left baseposteriorly, where it is slightly lessened. Percussion shows slight impairment of note over the leftbase posteriorly, and also a rather high-pitched note over theleft apex posteriorly. Palpation reveals the presence of an area of tendernessabout 3 inches in diameter over the 5th—7th interspacesbelow the left nipple. Percussion causes considerable painhere, and it is also the seat of pain when he makes anysudden movement. The breath sounds are vesicular—ratherharsh in character in front, a trifle weakened over the left baseposteriorly. Some slight very soft friction can be detectedover the painful area (see Fig. i).. Fig. I. The dotted area indicates the position of tenderness beneathwhich the pus collected. Sputum examined for tubercle bacilli with negative results. Other symptoms show nothing of note. For the ensuing three or four days there was little changein patients signs and symptoms. On January 9 he had anattack of pharj^ngitis which subsided under treatment, and histemperature, which had risen to ioi-8° on Januarys, gradually A CASE OF LOCALISED EMPYEMA. 199 came down to 99° on the nth, after which it commenced torise again. On the 12th a shght diffuse swelhng was observed over thetender area. There was no inflammatory redness and fluctuationwas absent. Examination of his blood showed a leucocytosisof 12,500. His temperature commenced to swing shghtly, butwas very irregular. Fluctuation was observable in the swellingon the 16th. His temperature rose on the i8th to 102-2, and on January19th, under ethyl chloride as a local anassthetic, an incision wasmade into the swel
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Keywords: ., bookcentury1800, bookde, bookpublisherlondon, booksubjectmedicine
