| Popis: |
Summary In all these cases which we have described, and those illustrated above are only a few of them, the bronchial obstruction partial or complete has taken place in the main or second degree bronchi; if the same processes are at work in the smallest bronchi and bronchioles, and it would seem reasonable to conclude that they are, then the phenomenon of bronchial obstruction plays no small part in determining the morbid anatomy of pulmonary tuberculosis and, therefore, the physical signs of this disease. Many of us are old enough to remember with what disappointment and disgust we beheld our stethoscopes when some fifteen to twenty years ago the skiagram would reveal a large cavity when we had only detected a slight change in percussion note and a diminution of the air entry. What had become of the ‘crack-pot’ sound, amphoric breathinq, post-tussic suction and the like? Gradually this radiological experience taught us that the commonest signs of a cavity are An impairment in percussion note and a diminished air entry, and I think that bronchial obstruction offers the explanation of these physical signs. And, it is my opinion that in future, in all diseases of the lung, we shall be less concerned with infiltration, consolidation and so on, and more concerned with bronchial obstruction, partial or complete. |
