258 DISEASES OF THE PARENCHYMA OF THE LUNG. 



alone ; the surrounding pulmonary substance being pushed aside and 



It is exceedingly rare for medullary fungus of the lung to soften, 

 and break down, so as to form cavities. The disease is much more 

 liable to extend into the pleura, and, as the pleural folds rapidly adhere, 

 to spread through them into the walls of the chest, which it often 

 penetrates. 



SYMPTOMS AND COUKSE. In the great majority of instances, no 

 characteristic marks of cancer of the lung are to be observed, and it is 

 hardly ever possible to prove the existence of the disease with cer- 

 tainty, except in cases wherein a carcinomatous breast has been extir- 

 pated, or in which extensive cancerous disease of other parts of the 

 body can be discovered. Should dyspnoea, cough, blood-spitting, and 

 pain in the chest, symptoms indicative of chronic disease of the lung, 

 appear in such a case, instead of apprehending the formation of tuber- 

 cle, we should bear in mind the rarity of tuberculosis in cancerous per- 

 sons, and of the frequent relapses of the malady, in the form of pul- 

 monary carcinoma, after extirpation of cancerous masses. 



Diagnosis will be confirmed if percussion and auscultation show a 

 consolidation of the substance of the lung, especially as, unlike tubercle, 

 cancer is not habitually situated at the summit of the lungs. 



We are very seldom able to prove the existence of any character- 

 istic objects in the sputa. The diagnosis is more commonly rendered 

 certain by the perforation of the thorax by the disease and its extension 

 into the integument. 



TREATMENT. Of course, there can be no idea of treating a cancer 

 of the lung. The hyperaemia in its adjacent parts, the oedema, the 

 hemoptysis, must be treated according to directions already given. 



ADDITIONS TO THE REVISED EDITION OF 1880. 



SECTION III. DISEASES OP THE PAEENCHYMA OF THE LUNGS. 



1. P. 142. 



(Edema of the lung is often, and as I think erroneously, re- 

 garded as the actual cause of death ; whereas it is a sequel of the 

 death-agony due to failing heart-action and relaxation of the vascu- 

 lar walls. 



2. P. 149. 



Niemeyer's theory that bronchial haemorrhage may lead to in- 

 flammation with caseous degeneration, and thus cause phthisis, has 



