Violent Coughing Research Articles

Upper lobe bronchial abnormalities simulating significant pulmonary tuberculosis; with seven illustrative cases.

Among the problems presented in the increasing use of the mass roentgenologic chest survey is the demonstration of certain abnormal upper lobe processes involving the bronchi which may easily be mistaken for significant pulmonary tuberculosis. Symptomatic and disabling bronchiectasis is predominantly a disease of the lower lobes, but in recent years numerous cases, particularly of the subclinical, mild, or dry type, have been found involving the upper lobes exclusively. Mallory (1) has given a clear-cut analysis of the pathogenesis and pathology, especially as regards the symptomatic disease in the lower lung fields. The bronchiectases, however, do not differ with their location or their etiologic background (2). The microscopic character is the same, too, whether the dilatation is cylindrical, saccular, or ampullar. The essential finding is the destruction of the musculo-elastic layer of the bronchial wall, which is due to a non-specific process. Bronchial inflammation plus atelectasis or pneumonitis of non-specific type adequately explain the development of most cases of lower lobe bronchietasis. A great many cases of upper lobe bronchiectasis, on the other hand, represent burnt-out reinfection pulmonary tuberculosis; some follow obstructive lesions of the bronchi after healing of an active primary tuberculosis (3, 4), and a still smaller group is secondary to congenital anomalies of the bronchial tree (5). In one of the cases described below, a variation of the bronchovascular pattern in the right upper lobe was mistaken for active pulmonary tuberculosis in this region. Such interesting anomalies often unaccompanied by disease of the accessory or misplaced bronchial branches have recently been described in a discussion of the surgical approach to the bronchopulmonary segment (6, 7). Although there are no pathological differences between bronchiectasis located in the upper lobes and the disease in the lower lung fields, there are generally recognized clinical differences. Unlike an extensive process of the same sort in the lower lobes, upper lobe bronchiectasis may produce no disabling symptoms during the lifetime of the patient, or the only complaint may be recurrent blood-spitting. Many of these patients expectorate small amounts of mucopurulent sputum, but because of the favorable gravitational location of the disease, the sputum does not accumulate in bronchial pools. Expectoration is free when it is present, it comes in small quantities at a time, with little or no odor, and is not as a rule associated with violent coughing. So undisturbing is the respiratory complaint—sometimes the little sputum in upper lobe bronchiectasis is unconsciously swallowed rather than expectorated—that symptoms referable to the lungs are often elicited only on careful questioning. The nutrition and the general well-being of the patient usually do not suffer. Clubbing of the fingers is unusual.

PREVENTION OF SECONDARY POST-TONSILLECTOMY HEMORRHAGE WITH SULFATHIAZOLE GUM

The incidence of delayed, or secondary, hemorrhage following tonsillectomy is not great, but the complication occurs with sufficient frequency to warrant attention. This postoperative event, while alarming to the patient, is regarded as more annoying than serious by the surgeon. Occasionally the bleeding is of a severity necessitating a transfusion. Indeed, because of the rapid replacement of the blood lost and the apparent prompt cessation of tonsillar bleeding in the patient treated by transfusion, this procedure has been advised in all cases other than that of transient hemorrhage. Primary hemorrhage occurs within twenty-four hours after tonsillectomy and is due to incomplete hemostasis during operation, incomplete operation, relaxation of the walls of blood vessels or unavoidable slipping of a ligature during violent coughing or vomiting. Postoperative bleeding secondary to blood dyscrasias, acute inflammation at the time of operation, hypertension, arteriosclerosis or other causes brought out by the preoperative history and examination,

SPONTANEOUS MEDIASTINAL EMPHYSEMA

Mediastinal emphysema following stab wounds or other trauma of the chest has long been recognized. It has also been described as occurring secondary to violent coughing, bronchial asthma, artificial pneumothorax, pneumonia, difficult labor, straining at stool and other forms of extreme effort. McGuire and Bean 1 point out that Laennec 2 described grating sounds and bubbling rales during respiration as diagnostic of subpleural and interlobar emphysema. Skoda 3 subsequently confirmed these signs, and von Rokitansky 4 described the pathologic aspects of the condition. Muller 5 noted the presence of bubbling crepitations that occurred with the heart beat and the occasional disappearance of cardiac dulness. He observed that the presence of subcutaneous emphysema aided in making the diagnosis of mediastinal emphysema. Rees and Hughes 6 in a report on wounds of the chest encountered during World War I noted loud tapping sounds over the cardiac area in 9 cases of wounds of the left

Congenital obstruction of the alimentary tract

<h2>Summary</h2> Eight cases of congenital obstruction of the alimentary tract are reported.<ul><li>1.Congenital esophageal atresia with communication between the upper segment of the esophagus and the trachea.</li><li>2.Congenital esophageal atresia with probable communication between the lower segment and the trachea.</li><li>3.Partial atresia of the esophagus with narrowing of the lower one-third. The characteristic symptoms of atresia of the esophagus are immediate regurgitation with almost the first mouthful, and constant dribbling of mucus. There may or may not be violent coughing after feeding, with cyanosis.</li><li>4.Case of partial atresia of distal end of duodenum. Duodenal obstruction is to be differentiated from pyloric stenosis. The presence of bile in the vomitus, and x-ray examination with barium feeding will aid in the diagnosis.</li><li>5.A successful operative result of congenital obstruction of the ileum.</li><li>6, 7.Incomplete and complete obstruction, respectively, of the colon.</li><li>8.Obstruction due to volvulus with symptoms immediately after birth.</li></ul> It is interesting to note that of the eight cases reported seven were males. The symptoms of congenital intestinal obstruction are characterized clinically by persistent vomiting, distention, constipation or mucous stools stained with blood, anuria, and progressive loss of weight. Although congenital obstruction is very rare, it should be kept in mind whenever a newborn baby vomits. It is obviously important to recognize these cases early because operative intervention is the only treatment, however unsuccessful the results may be, or have been in the past.

TREATMENT OF WHOOPING COUGH

The disease known as whooping cough has been described under a multiplicity of names. Willis (1622-1675) named it "tussis convulsiva," while Sydenham (1624-1689) called it "pertussis," which means a violent cough of any kind. There are other Latin names, the most striking among them being "quinta," "paroxysmes quintes" and "quintana." It is possible that these came to be used because the cough was observed to return every five hours. Other countries have their own descriptive terms. Besides the familiar name "whooping cough" we have in English "hooping cough," "kick cough," "kink cough," or simply "the kink," and the frequently used expression "chin cough." In Austria the disease is spoken of colloquially as "<i>Stickhusten</i>" (stick cough) or "<i>Krampfhusten</i>" (cramp cough). In Bavaria pertussis is called "<i>Blauhusten</i>" (blue cough). Whooping cough cannot be definitely traced back further than the middle of the sixteenth century. It seems certain that Galen knew nothing of

TOXICITY OF THE CASTOR BEAN

Certain cases of sensitiveness to the poisonous action of the castor bean have been reported by Arnold,¹Bernton,²Robbins³and Snell.⁴A number of such cases developed in connection with experimental and research work involving the use of the castor bean and its products in the Department of Agricultural and Biological Chemistry of the Pennsylvania State College. Much work has been done in this department with the castor bean, particularly with the ricinus lipase. <h3>REPORT OF CASES</h3><h3>Case 1.</h3> —Mr. S., an instructor in the department, during the fall of 1922 contracted what appeared to be a severe cold, marked by violent and continuous sneezing and coughing, with irritation and edema of the mucous membranes of the nose, throat, eyes and ears, together with a dull headache and watering of the eyes. The condition seemed to grow worse instead of improving, and he gradually developed congestion

An anomalous case of central hemorrhage connected with increased pressure in the ear due to violent coughing

The LaryngoscopeVolume 10, Issue 1 p. 90-90 Article An anomalous case of central hemorrhage connected with increased pressure in the ear due to violent coughing Lederman M.D., Lederman M.D.Search for more papers by this author Lederman M.D., Lederman M.D.Search for more papers by this author First published: January 1901 https://doi.org/10.1288/00005537-190101000-00016AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinked InRedditWechat No abstract is available for this article. Volume10, Issue1January 1901Pages 90-90 RelatedInformation

An Anomalous Case of Central Hæmorrhage, connected with Increased Pressure in the Ear, due to Violent Coughing

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A Case of Violent and Obstinate Cough, Cured by a Preparation of Iron

A Case of Violent and Obstinate Cough, Cured by a Preparation of Iron