Levitra Buy Uk | OVERNIGHT Delivery!

FELLOW OF THE AMERICAN LARYNGOLOGICAL ASSOCIATION ; ETC. Lecture L General Diagnosis and Therapeutic Indications in Acute Diseases of the Lungs. Gentlemen : It is a fundamental rule of diagnosis that its object is twofold — first, to ascertain the presence and na- ture of any local disturbances which may exist, and, second, to investigate the remainder of the body in order to deter- mine the extent to Levitra Buy Uk which either the general condition of the patient or particular affections of other parts may modify the prominent lesion. In considering constitutional dis- eases — the essential fevers, for instance — this rule may be re- versed and the diagnostician required, first, to point out the general disease, and then to identify the local complications, should any exist. The relations of each organ or part of the body to all the rest are such that we can not afford to ignore this rule ; for even those morbid conditions which are, to all appearance, entirely limited, such as slight bruises, contusions, or wounds, may be followed by the most disas- trous consequences if the rest of the organism is not in its normal condition. The importance of this statement is nowhere more per- fectly exemplified than in the acute and chronic diseases of the respiratory apparatus. The diagnosis must be made not only with reference to the prominent local lesion — which may be called the classi- fying lesion — but also to the general habit or constitution of the patient, and the condition, particularly, of his respira- tory and circulatory apparatus. We know, e. g., that the character of inflammatory processes in the respiratory tract is influenced to an impor- tant degree by the co-existence of a phthisical tendency. Diseases which in other persons would run a favorable course and end iu recovery, Levitra Buy Uk or at least tend to do so, will, in the person of one who has inherited the consumptive habit, be altered Levitra Buy Uk in their course, and, if our therapeutic ef- forts are not successful, shade off into chronic and incurable processes. The gouty and rheumatic diatheses predispose to congestions, particularly of the mucous membranes, and render them more intractable than they would otherwise be. Diseases Levitra Buy Uk of the circulatory apparatus, particularly those of the heart, have an Levitra Buy Uk influence whose malignity is too well known for it to be necessary for me to do more than allude to it. As for the respiratory tract itself, we should ever bear in mind that the course of the acute disease with which we have immediately to deal will be affected by the previ- ous existence of other pathological conditions. An acute inflammation will, for instance, be worse in one who is al- ready emphysematous than if the lungs were Levitra Buy Uk previously normal. Pneumonia ingrafted upon phthisis is likely to result unfavorably either as regards the life of the Levitra Buy Uk patient or the rapidity of extension of the phthisical process. Levitra Buy Uk And many other examples might be cited to illustrate the neces- sity of determining Levitra Buy Uk not only the nature of the disease, but the kind of lung in which it is found. These points are of value, not only as guides to the intelligent treatment of the disease, but also because they enable us better to calculate the chances for or against our patient. The art of prog- nosis is Levitra Buy Uk Levitra Buy Uk founded upon the art of diagnosis. For the one to be reliable, the other must be exact and comprehensive. The acute diseases of the lungs are largely vascular disturbances, and their consideration may be advantageously prefaced by a cursory allusion to the anatomy and physiolo- gy of the pulmonary circulation. The important anatomical facts are, first, that the vascu- lar supply of the large Levitra Buy Uk and medium bronchial tubes is dis- tinct from that of the bronchioles and pulmonary lobules, though their anastomosis is such that injections, as shown by Dr. Waters, may pass from one set of Levitra Buy Uk vessels into the other. So that intense bronchial engorgement may exist with little or no pulmonary hypersemia, while, on the other hand, extensive pneumonitis may occur and be associated with little or no bronchitis. Second, the capillaries of the lung are .so distributed iu the walls of the alveoli and connective tissue of the lobules that the blood flows through them most easily when the lung is expanded, though fixation of the thorax in the posi- tion either of inhalation or of exhalation impedes the pul- monary Levitra Buy Uk circulation. Third, the vessels of the lung differ from those in the body at large in that, whereas in the latter the veins far ex- ceed the arteries in capacity, in the former they are of the same caliber. It results from this that, if the pressure in the veins is increased, the change is felt immediately in the artery, pro- vided the tone of the smaller vessels is not decreased. The capillaries and smaller arteries and veins are, however, capa- ble, when relaxed, of containing three or four times the quantity of blood which they ordinarily hold. Here, as in all the viscera, the vascular tonus is the great and all-important factor in the circulation. This, reo-ulated by the nerves of the pulmonary plexuses, in association with those of the heart, and under ordinary circumstances, varies slightly from time to time, according to the needs of the organism. Under abnormal conditions, the vascular tone may be lost, either throughout the pulmonary system or Levitra Buy Uk in certain parts of it, and congestion ensues. Pulmonary congestion, then, the first of the acute pul- monary diseases to attract our attention, is a vaso-motor dis- turbance, of greater or lesser extent and intensity, whose Levitra Buy Uk gravity depends upon the nature of the e.xciting cause and the condition of the patient, both local Levitra Buy Uk and general. With- out attempting even to enumerate all the causes of this con- dition, we may say that, with the exception of those cases which are directly due to cardiac disease, the most impor- WESTBEOOK: Levitra Buy Uk DIAGNOSIS AND TREATMENT OF DISEASES OF THE CHEST. [N. Y. Mel. J.k'k., tant to the diagnostician are the predisposing causes, be- cause these so often exist in the body of the patient and must be dealt with therapeutically. Pre-eminent among them stands alcoholism. The effect of alcohol when taken in excessive quantities is to paralyze the vaso-motor apparatus and induce various visceral conges- tions. This effect is most marked when the condition of chronic alcoholism results from continued abuse of the drug. The vascular tone is lessened, and, under the depressing effect of cold or of fatigue, or both combined, the most grave disturbances occur. The appearance of the patient g&nerally