Volume 1

Clinical treatises on the symptomatology and diagnosis of disorders of respiration and circulation / by Edmund von Neusser ; authorized translation by Andrew MacFarlane.

  • Neusser, Edmund von, 1852-1912.
Date:
1907-1909
Catalogue details

Licence: Public Domain Mark

Credit: Clinical treatises on the symptomatology and diagnosis of disorders of respiration and circulation / by Edmund von Neusser ; authorized translation by Andrew MacFarlane. Source: Wellcome Collection.

    82/216 (page 80)
    Dyspnoea and especially cyanosis have considerable diagnostic significance, as the latter is usually a late symptom in genuine, uncomplicated pneumonia. In very large exudates there is deep cyanosis of the whole body in consequence of the severe disturbances of circulation due to the limitation of the thoracic space, and there is besides edema of the ankles and later general dropsy. Marked dyspnoea and cyanosis also occur in comparatively small exudates, if they are mediastinal, and when there is also pronounced inter¬ lobular empyema. Intrathoracic carcinoma and sarcoma causing effu¬ sion into the pleural space may, as mentioned before, produce or increase cyanosis and dyspnoea by enlarge¬ ment of the glands and compression of the vena cava, of the pulmonary artery and veins, or by the direct extension of the growth to the walls of the vessels, with resulting thrombosis and embolism. Such thrombi in the branches of the pulmonary veins may be carried into the general circulation, especially on evacuation of the exudate. In other cases dyspnoea is coupled with anemia and especially in malignant neoplasms with bloody effusions in the pleural cavity. The persistence of dyspnoea or only its slight relief after evacuation of the effusion from the pleural cavity in the case of a carcinoma has already been mentioned. Cyanosis and dyspnoea in pleuritis may, aside from the quantity of the exudate, attain a high degree ow¬ ing to the accompanying paralysis of the diaphragm, especially in pleuritis diaphragmatica, where violent