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Constant moist rales, much coarser than those the earlier stages, and varying much in size, abundance and neamess, and in quality, are present, in a majority cases. As the softening the lung advances the rales become more striking in character until, finally, with the advent definite cavity formation, gurgling rales appear. If advanced solidification occurs, the rales are apparently extremely superficial, and are loud and harsh in tone.

Vocal fremitus, sharp bronchial respiration, bronchophony and whispering pectoriloquy are found, the latter suggesting search for vomica. Cavernous respiration may detected if the cavities Pleuritic friction a frequent phenomenon best write my paper website in advanced tuberculosis, and may heard over the extending infection in the lung, and, ith rather surprising frequency, over the less involved lung.

Unusually clear transmission the heart sounds suggests the likelihood that solidified lung tissue may responsible for The increased obstruction the pulmonary circulation frequently causes the pulmonary second sound accentuated. In cases involvement the left apex, the retraction the area involved may uncover the base the heart upon the left that this accentuation may Physical signs, apart from those described in the lung, are some importance in advanced tuberculosis.

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Myoidema suggestive over-excitability the muscles the chest, or the nerves supplying them, and should lead a careful physical examination the lungs, although little specific diagnostic value.

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Clubbed fingers occur in a majority the cases advanced phthisis. Hypertrophic pulmonary ostearthropathy rare, but much significance thesis titles Course the Disease. Pulmonary tuberculosis may arrested, especially if early diagnosis and intelligent treatment have been attained before any marked physical signs have been found, and toward the accomplishment such a result every effort should made.

Complete arrest may well permanent if the patient live an intelligent life.

Unfortunately the majority cases progress slowly write my college essay me from one stage another, and eventually reach the stage chronic ulceration. The duration may anywhere from a few months many years, a great majority falling within the limits two eight essay editor for students years. I have known a woman raise a family six children adult age while signs chronic tuberculosis persisted in her lung, several these children becoming infected.

The occurrence college essay ideas help partial arrest with subsequent outbreak and rapid advance the disease too common.

Many cases advanced phthisis die from the various complications the disease, especially from pneumonia, hemorrhage, pneumothorax, amyloid disease, nephritis, laryngeal involvement, meningitis, etc.

Pope's tables show that, all the progressive cases are dead within six months, within proquest thesis database one year, within four years, while, or per cent, live from ten forty years. The disease more acute in the young and commonly less acute in the aged than in adults middle life. Complications. Hemoptysis the most frequent one, occurring at some time during the course in about three-fourths the cases. Extension i need help with writing an essay the tuberculous process the larynx and various viscera extremely common. Tuberculous meningitis not infrequent Acute lobar pneumonia a grave and not unusual complication phthisis. If the pathognomonic sputum and bacterial evidence wanting the diagnosis may difficult in a patient seen Abscess lung, gangrene and bronchiectasis may occur. Pleurisy in its various forms has been considered.

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