On the relation of the chest-movements to prognosis in lung-disease : and on the application of stethometry to examinations for life assurance / by Arthur Ransome.

Date:: 1882

Credit: On the relation of the chest-movements to prognosis in lung-disease : and on the application of stethometry to examinations for life assurance / by Arthur Ransome. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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$ON PROGNOSIS FROM STETHOMETRY IN EMPHYSEMA. In some affections of the lungs the degree of diminution of the motions of the chest-wall is a direct measure of the extent to which the disease has advanced. In emphysema, and in complaints complicated by em- physema, such as some forms of asthma and chronic bronchitis, this is especially the case. It may readily be perceived also why this should be so. The position of the emphysematous chest in its advanced forms is that of full inspiration, or even an exaggeration of this position. The chest-walls are pushed out to their extremest limits, the more advanced the disease the greater is this disten- sion, and the more immovable do the ribs become ; in extreme cases they are so raised and pushed forwards and outwards that no lowering or indrawing in expiration is possible. Plence we are quite prepared to find that not only is the total amount of movement reduced in these cases, to a very small fraction of the healthy standard : but the motions in each plane are equally affected, equally dimin- ished, and their proportions to one another are unaltered. Owing to the urgency of dyspnoea the lower ribs are not unfrequently drawn inwards, in advanced cases, by the action of the diaphragm in the efforts at inspiration. And in consequence of the loss of elasticity of the lung-tissues$