The term emphysema, we understand two different conditions, one of which (and far more important) is not quite right on that name, but this uncertainty does not lead to errors because, in terms of vesiculare emphysema and emphysema between lobulare, specify where the two diseases, and thus distinguish one from another. In emphysema vesiculare we have a painful condition of the peripheral organs of respiration similar to that we have described how, as well. If Laennec done nothing for medical science, his discovery of this morbid condition, and the causes of it, it would be enough to make his name immortal. Vesicular emphysema is a constant of light, and respired air is actually contained in them, and not, as in ordinary emphysema, become extravagant rich in intermediate texture. It is not unfrequently occurs very rapidly as the development substitutivno lung parenchyma in cases where most of the lung was impenetrable, and it seems that especially the production of high degree in the last moments of existence, as
worked with inspiration, which is then . Thus, we find multiple hepatisation edge inflamed loose particles and emphysema, and extremely light, the same state observed in the interstitial parenchyma between and in the surface layer of the lung. Similarly, he develops himself as a succession of acute and chronic diseases that prove fatal, paralyzing the nervous apparatus of the Presidency of the chemical process, and which is the most labor intensive of the respiratory muscles, deep breath, and insatiable thirst for air, or it occurs as a consequence of a sudden check in time, and for bleeding air from the pipes when the bronchi were interrupting. In such cases, we observed the following performances: emphysematous lungs of zahordylysya, and passes into the hands of a special feeling that can be compared with pillows filled with air, pale, in various shades of red palish dull white color, and very anemic, dry, fast breaks that cut, but crepitation >> << fuzzy and dull, it floats on the surface when placed in water, its cells are more or less dilated and their walls weakened in proportion to the speed with which change has been painful developed. Finally, the sometimes large gap expanded cells, and emphysema of the lungs, it presents the appearance of ragged network swollen with air. This form of emphysema rarely reaches such a degree, except the front edge and at the base and the place where it causes the air in the lung pleura, which, therefore, easy to peel. This form of emphysema, as related to the weakening of the walls of the expanded cells, is an analogy with senile atrophy of the lungs. Another form of developing emphysema vesicular itself slowly, gradually spreading over most of the lung until it finally includes a body, it appears, in particular, on the other reasons already mentioned, and is a primary pulmonary disease, which as Laennec remarks, of course, leads to most of the so-called nervous asthma. It presents many varieties in degree and scope. By degrees, we are talking about expanding the degree of lung cells, it should be, however, noted that in emphysema ago, we both are always a few degrees of extension, and it is only the beginning of the disease, which has expanded to be uniform. Pulmonary cells can be expanded to the size of millet, seeds or pin, or as hemp seeds, peas and even beans, and, in proportion to the size they reach, they deviate more from its original form. First, illness is real, just stretching the cells and when cell walls are somewhat thickened and stiff, it can be seen as an extension of active cells more similar
light. In higher degees, on the contrary, dilatated cells represent a large space, their walls become atrophied from pressure, they give each other. These hemp seeds, peas, beans or size of cells is always very irregularly convoluted, but generally rounded, and show a special arrangement for their internal surface is elevated ridges, which appear at different heights in cavities in enlarged cells through them in different directions, and the formation of boundaries and poorer sections of walls of different curves. We also accept thin filaments, as the expansion of cells, or hanging freely in its cavity: a coating of high ridges and remnants of walls adjacent lung cells. Pressure on adjacent, leading to their atrophy commensurate expansion of cells and cell walls become thick and hard, emphysema, as part produced, or not offset at all, or is destroyed very slowly. In addition, this form of emphysema occurs most often and most developed in the peripheral part, and along the edges of the light: not unfrequently associated with bronchial dilatation, and this, along with other characteristics, establish the proximity of these two diseases. It attacks or only a small portion of light, being limited to particular cutting edge of a top fate, or whether it extends to a portion or all of the light, or even both lungs. In those cases, emphysema, and unite all the anatomical features is the following picture of the disease:
barrel extension with a continuous reduction in intercostal spaces, a large dorsal curvature of the spine, hypertrophy of the respiratory muscles, and clear sound with percussion.
On opening the chest, lungs expand beyond the walls of the chest, seen an unusually large, and not fall under the pressure of the atmosphere. On the surface, and especially on their front edges, we find round performances of the size of a hemp seed or peas, or stand alone or grouped, and which are nothing more than advanced lung cells that have already been described. Lungs are very kind, soft, supple feeling that can be compared with a pillow filled with down. To cut down they are destroyed very slowly, and air out slowly, with very sparse sound, just the amount of crepitus, a bit like air slowly escaping from a pair of fur. Their pale fabric of all anemia, and only dry. When only one lung emphysematous, only the corresponding half of the chest expanded, but the important fact in this case the shift of the mediastinum and heart to the opposite side. Finally, if only some parts of the lungs are emphysematous, they can if they lasix for congestive heart failure are very numerous, and very advanced disease, prevent pressure expansion neighboring healthy cells, and thus keep them in a state of sustained contraction. The conditions that gave rise to the production of emphysema and its pathogenesis as a whole, although much effort has been devoted to love, is still not clear. Laennec considered as a result of his so-called dry catarrh with pearl-colored secretion, and this explains the mechanical way: it is a secret, and catarrhal swelling, prevents the bronchi so that although they can breathe air to enter the pulmonary vesicles, reducing energy the act of expiration is an obstacle to his salvation, and therefore part of his remains. In the following inspired new air again handed pulmonary vesicles, which thus effectively made the expansion, the expansion of inhaled air from the high temperature will undoubtedly contribute to the result. In addition, prolonged breath-holding during childbirth, chair, or wind instruments, can lead to emphysema. In opposition to the idea that emphysema is the result of cold cases, which are non-existent or Qatar, or if he just followed
as a symptom of existing emphysema, in connection with the last name causes are said to have been in individuals who were never exposed to these diseases. Thus, the spontaneous expansion of the pulmonary vesicles, it was assumed that the time is premature atrophy of the weakening of cell walls, while at other times, equally from unknown causes, it is due, as in other hollow organs, with hypertrophy cell wall. .
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