PNEUMONECTOMY 



1128 



PNEUMONIA 



Pneumonectomy (nu-mon-ek' -to-me) [nvevfiov, lung ; 

 EKTOfir/, excision]. Excision of a portion of a lung; 

 pneumectomy. 



Pneumonedema [nu-mon-e-de' '-mah) [irvev/iav , lung; 

 oifinpa, edema]. Edema of the lungs. 



Pneumonemia (nu - mon - e f - me - ah) [nvEVfiuv, lung ; 

 alfia, blood]. Congestion of the lungs. 



Pneumonemphraxis (nu-tnon-em-fraks' -is) [ttvev/jhov, 

 lung; Efi^pa^iq, obstruction]. Obstruction of the lungs 

 or the bronchi. 



Pneumonemphysema (nu - mon - em -fiz -e' - mah) 

 [tcvevuuv, lung ; £u®van/ia, inflation]. Emphysema of 

 the lungs. 



Pneumonia (nu-vio' -ne-ah) \txvevjiuv ,lung]. Any in- 

 flammation of the lungs. Pneumonitis. By usage the 

 word pneumonia, used without qualification, implies 

 croupous pneumonia, q. v. P., Abortive, a condition 

 of acute congestion, such as is seen in the first stage 

 of pneumonia, but which is not succeeded by the other 

 stages. P., Acute. Synonym of P., Croupous. P., 

 Adynamic, pneumonia attended with debility, depres- 

 sion of the circulation and of the nervous system. 

 P. alba. Synonym of P., While. P., Alcoholic, 

 the croupous pneumonia of drunkards. It is often 

 associated with delirium and is very fatal. P., Apex, 

 P., Apical, croupous pneumonia of the apex of a 

 lung, by some believed to be more grave than basal 

 pneumonia; many cases, however, run a favorable 

 course. Cerebral symptoms are said to be more com- 

 mon when the apex is affected. P., Apoplectic, 

 pneumonia associated with hemorrhage into the lung. 

 P., Aspiration, a broncho-pneumonia due to the 

 inspiration of food-particles or other irritant substances 

 into the lung. The condition is met with in cases in 

 which the sensitiveness of the larynx and trachea is 

 benumbed, as in apoplectic coma or uremia, and in low 

 fevers ; also in the insane from stuffing of the mouth 

 with food and in defective deglutition. P., Ataxic. 

 Synonym of P., Adynamic. P., Bilious, pneumonia 

 accompanied by icterus. P., Broncho-. See Bron- 

 cho-pneumonia. P., Caseous Lobular. Synonym 

 of P., Desquamative. P., Catarrhal. Synonym of 

 Broncho-pneunionia. P., Central, a croupous pneu- 

 monia beginning in the interior of the lobe of the 

 lung. The physical signs are obscure until the in- 

 flammation reaches the surface. P., Cerebral, that 

 form of pneumonia associated with marked cerebral 

 symptoms. It is most common in children and in 

 the beginning resembles meningitis. P., Cheesy. 

 Synonym of P., Caseous. P., Chronic. Synonym 

 of P., Interstitial. P., Cirrhotic. Synonym of 

 P., Interstitial. P., Contusion, pneumonia follow- 

 ing contusion of the chest. P., Creeping. See P., 

 Migratory. P., Crossed, croupous pneumonia of 

 the lower lobe on one side, associated with the 

 same disease in the upper lobe of the other 

 side. P., Croupous, lobar Pneumonia, that 

 commonly called simply pneumonia, an acute dis- 

 ease, running a definite course and tending to re- 

 covery. It is most often due to a specific micro- 

 organism, the pneumococcus of Fraenkel, and may be 

 epidemic in certain districts. But besides the pneu- 

 mococcus, of Fraenkel, which is really a lanceolate 

 bacillus occurring in pairs, other microorganisms can 

 give rise to croupous pneumonia, e.g., the bacillus 

 pneumoniae of Friedlander, the streptococcus and the 

 staphylococcus pyogenes, die bacillus of typhoid fever. 

 The disease occurs more frequently during the winter 

 months, and in males than in females. The lower 

 lobes are the parts usually affected, and especially 

 that of the right side. The apex, however, may be 

 the part involved, especially in children. Occasion- 



ally a double or bilateral pneumonia is encountered, 

 both lower lobes or both apices being involved. The 

 disease is ushered in by a chill, followed by high 

 fever, flushed cheeks, dry, coated tongue, rapid, shal- 

 low respiration, and pain in the affected side. More 

 or less cough is present, and there is usually the 

 characteristic bloody or rusty expectoration. The 

 respirations are rapid, and quite a characteristic feature 

 is the disturbance of the pulse- respiration ratio — 

 instead of 4 to I, it may be 3 to I, or 2 to 1, i. e., 

 we may have a pulse of 84 and respirations 42, or 

 even more. The physical signs are distinctive — im- 

 mobility of the affected portion of the chest, increased 

 tactile fremitus, dulness on percussion (rarely a 

 peculiar wooden tympany), a fine, crepitant rale in 

 the first stage, bronchial breathing and bronchophony 

 in the second, to which moist rales are added when 

 resolution begins. In nearly every case there is an 

 associated plastic pleurisy, which is responsible for the 

 pain. It may give rise to a friction-sound. The urine 

 is high-colored and deficient in chlorids, the bowel- 

 sluggish. A crisis usually occurs on the seventh day. 

 The anatomic change consists in the appearance of 

 a firm or solid exudation in the pulmonary alveoli. 

 The disease proceeds through the following stages : I. 

 Congestion, in which there is intense congestive hyper- 

 emia. 2. Red Hepatization , in which the lung is bulky, 

 heavy, firm, and airless, and its surface granular, its red 

 tint being due to extravasated corpuscles and distended 

 capillaries. 3. Gray Hepatization, due to the degen- 

 eration of the exudate and anemia from compression 

 of the capillaries. In the majority of cases resolution 

 takes place and the lung returns to its previous condi- 

 tion. P., Deglutition. Synonym of P. , Aspiration. 

 P., Desquamative, a form characterized chiefly by 

 an intense desquamation of the cells lining the 

 air-vesicles, a proliferation of the connective-tissue 

 cells of the septa between the vesicles, and the 

 exudation of a scanty albuminous fluid. The exudate 

 goes on to caseous degeneration. Three sub- varieties 

 are described : the lobular form, the conjiuenf, or lobar, 

 and the bronchial, or caseous bronchopneumonia. The 

 cause of the disease is, in the majority of cases, the 

 tubercle-bacillus. P., Dissecting, a suppurative in- 

 flammation extending along the interlobular and peri- 

 bronchial tissues. P., Double, croupous pneumonia 

 of both lungs. P., Drunkards'. Synonym of P.. 

 Alcoholic. P., Embolic, pneumonia due to embi 

 of the vessels of the lung. P., Epithelial. Synonym 

 of P., Desquamative. P. epizootica, pneumonia of 

 animals. P., Erysipelatous, a severe pneumo 

 usually migratory, occurring in connection with, oi 

 after exposure to erysipelas, and apparently influei 

 by that disease. P., Fibrinous. See P.,C; 

 P., Fibroid, P., Fibrous. Synonym of /'., Inter 

 stitial. P., Food, a form of inspiration-pneumonia. 

 q. v. P., Gangrenous, gangrene of the lung. P.- 

 Gouty, pneumonia developing in a gouty sub 

 P., Grippal. See P., Influenzal. P., Hemor- 

 rhagic. See Hemorrhagic. P., Hypostatic, a pneu 

 monia, generally lobular, occurring in the debilil 

 and those suffering from other diseases. It usu 

 affects the lower posterior portions of the lui 

 is dependent upon the dorsal decubitus, the w 

 circulation, and the inspiration of food and 1 

 particles. Section of the vagus nerve in animal- 

 gives rise to this form of pneumonia, In 

 paralysis of the air-passages favors the aspiration <>t 

 foreign matters. P., Influenzal, a peculiar condil 

 of the lung observed in association with innu< 

 There appears to be a failure of function dm- to pi 

 moparesis. There may also be inflammation ol 



