Modern medicine : its theory and practice, in original contributions by American and foreign authors . igns over the lower part of the left lung persisted. Therewas slight but varying dulness, most marked before and diminishing afterthe expulsion of the casts. Coarse crepitation was audible, beginningabout the middle and continuing to the end of inspiration, apparently dueto the separation of the casts; it resembled a coarse, exaggerated crepitationof pneumonia. The temperature varied from subnormal to 100°; thepulse was rapid, especially during the paroxysms; sleep was disturbed bythe cough a
Modern medicine : its theory and practice, in original contributions by American and foreign authors . igns over the lower part of the left lung persisted. Therewas slight but varying dulness, most marked before and diminishing afterthe expulsion of the casts. Coarse crepitation was audible, beginningabout the middle and continuing to the end of inspiration, apparently dueto the separation of the casts; it resembled a coarse, exaggerated crepitationof pneumonia. The temperature varied from subnormal to 100°; thepulse was rapid, especially during the paroxysms; sleep was disturbed bythe cough and soreness across the middle of the chest. There has been norecurrence since February, 1906, and her health has improved —In typical cases there is no difficulty in diagnosis; the casts bythemselves leave no room for doubt. From asthma there may be muchdifficulty in diagnosis, and in all doubtful cases the sputum should be care-fully searched for pellets and masses of rolled-up casts. A small foreignbody in a bronchus causes similar attacks, but the history and relapses of. Cast from a case of fibrinous bronchitis. FCETID OR PUTRID BRONCHITIS 679 fibrinous bronchitis will prevent error. Diphtheria is to be excluded by thebacteriology and the absence of membrane in the fauces and of laryngealsymptoms. In pneumonia, as in diphtheria, casts may also occur, but thehistory and physical signs usually leave no room for doubt. In bronchitisthe occurrence of an attack of dyspnoea and the absence of respiratory soundsover an area of lung, with but slight impairment of the percussion note,might be considered sufficient for a diagnosis, but to make it certain thesputum should be carefully searched for casts. Prognosis.—A fatal result is rare in an uncomplicated case. In Faggescase the loosened cast became lodged at the tracheal bifurcation and causeddeath by asphyxia. In the rare form in which acute attacks follow oneanother in rapid succession, death may occur d
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