Problems in Respiratory Medicine
The topics chosen for discussion represent the most common problems referred by family doctors to chest clinics. It was taken for granted that the reader will be familiar with the symptoms, signs, and natural history of respiratory diseases, so that the stress is on differential diagnosis and treatment. Tuberculosis once occupied nearly all the time of chest physicians. At present weeks go by without a single case presenting itself. There has been no comparable improvement in cancer of the lung, which remains one of the most intract able problems. Asthma was seldom referred to out-patient clinics when the disease was regarded as more unpleasant than dangerous. The hazards of severe attacks and the advan tages of liaison with a hospital department are now widely recognized. A similar change of attitude to the management of chronic bronchitis brought many new patients to the chest clinics in place of the vanishing tuberculous population. Some uncommon pulmonary diseases are included: allergic alveolitis, because of the importance of early diagnosis, and sarcoidosis in order to discourage unnecessary treatment. The book is intended to be a practical guide and is not a critical review. This might serve as an excuse for its didactic style and the exclusion of controversial subjects. Some statements are repeated at more than one place in order to help readers who wish to consult individual chapters bearing on some current problem. Source references are omitted and are replaced by a short list of books recommended for further reading
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1 Symptoms, clinical signs and breathing tests
Cough
Sputum
Haemoptysis
Dyspnoea
Pain
Percussion
Auscultation
Clubbing of the fingers-Cyanosis
Pursed-lip breathing
2 Pneumonia
Defences of the lung-Factors predisposing to infection
Classification
Clinicalfeatures
Investigations
Complications
Recurrent pneumonia
Differential diagnosis
Treatment
3 Chronic bronchitis
Prevalence
Pathology
Clinicalfeatures
Investigations
Differential diagnosis
Complications
Treatment
4 Asthma
Pathogenesis
Classification
Clinicalfeatures
Investigations
Differential diagnosis
Prognosis
Treatment
5 Tuberculosis
Mortality
Natural history
Presentation
Diagnostic tests
Investigation of contacts
Prevention
Treatment
6 Cancer of the lung
Mortality
Aetiology
Classification
Presentation
Clinicalsigns
Progress
Investigations
Differential diagnosis
Prevention
Treatment
7 Pleural effusions
Aetiology
Investigations
Differential diagnosis
Tumours of the pleura
Complications
Treatment
8 Recurrent respiratory illness in children
Viral infections
Cystic fibrosis
Immune deficiencies
Bronchiectasis
9 Fibrosing alveolitis
Diagnosis
Treatment
10 Spontaneous pneumothorax
Pathogenesis
Symptoms and signs
Treatment
11 Pulmonary sarcoidosis
Natural history
Treatment
Further reading