SCARLET FEVER. Synonyms.—Scarlatina; Scarlet Rash. Definition ...

Fibroid Phthisis.—Definition.—Fibroid phthisis is that condition
where the normal lung" tissue is replaced by fibrous connective tissue,
resulting in contraction and induration, and where a microscopic
examination reveals tubercle. Chronic interstitial pneumonia is now
classed as fibroid phthisis, there being no tubercle present, at least not
till near the end of the disease.
Pathology.—The replacement of lung substance by connective tissue
usually begins in the apex, more rarely in the middle lobe, and
gradually extends downward till the whole lung is involved. As the
disease progresses, the lung becomes contracted and indurated. As a
result of this, the chest of the affected side becomes flat, and the
shoulder drops. But one lung may be affected, the opposite fellow
becoming hypertrophied as a compensation. There is often dilatation of
the larger bronchi and thickening of the pleura.
Symptoms.—The symptoms depend, to some extent, on the manner in
which it begins. Thus Clark Hadley and Chaplin describe three forms of
the disease: first, a pure fibroid phthisis, where no tubercle exists;
second, a tuberculo-fibroid, where the tubercle develops first, to be
followed by the connective tissue; and, third, the fibro-tubercular form,
where the tubercle follows the fibroid change.
Cough is one of the earliest and most persistent symptoms, coming- on
in paroxysms, and attended by expectoration of a mucus, sero-mucus, or
purulent material. The paroxysms are more persistent in the morning.
There is but little if any fever. The patient gradually loses flesh and
strength. There is some pain in the affected side, and dyspnea follows
slight exertion.
On inspection, we notice that the affected side is nat or sunken, and
that the shoulder droops. Auscultation reveals a bronchial sound, while
percussion gives more or less dullness, the result of induration and the
effacement of the air-cells. Where tubercles are present the symptoms
are similar, with the addition of a slight fever and a more purulent
expectoration. Sweating is not so profuse in the fibroid form as in the
ulcerative phthisis, but hemorrhages are more frequent and also more
serious. Albumen is often present in the urine, and dropsy is frequently
seen, especially of the feet, and occurs in the later stages. The disease is
decidedly chronic, lasting from ten to thirty years.
Diagnosis.—The diagnosis is not always easy. Coming on insidiously,
The Eclectic Practice of Medicine - PART I - Infectious Diseases - Page 204