The Body at Work: A Treatise on the Principles of PhysiologyHill, Alex
Science
The Body at Work: A Treatise on the Principles of Physiology
Hill, Alex
Physiology
It is not possible to make anything like an accurate estimate of the
number of alveoli in the lungs; 725,000,000 is a figure arrived at by
measuring the average cubic capacity of an alveolus, and comparing it
with the total cubic capacity of the lungs. Each alveolus supports some
forty or fifty capillary vessels. The superficial area of vascular
membrane exposed is placed at 90 square metres, or about 100 times the
area of the skin. Figures such as these convey very little meaning, but
they help one to realize the magnitude of the provision made for the
aeration of the blood.
Pneumonia is a condition in which the lining of the air-chambers is
inflamed, usually, possibly always, owing to the entrance of bacteria.
Lymph exudes through the walls of the alveoli. Epithelial scales flake
off. Pus cells (dead leucocytes) accumulate in the air-chambers.
Respiration is curtailed, and dyspnœa results. After a time, if the
case progresses favourably, “resolution,” as it is technically termed,
begins to occur. The exuded substances are either expectorated or
absorbed, and the lung-tissue returns to a normal condition.
Here a few words may be devoted to respiratory sounds. _Spirare_
means to sigh. Breathing received the name by which it is known in
physiology from the sound which accompanies the exit of air from
the nostrils. Since the introduction of auscultation as a means of
ascertaining the condition of the lungs, other sounds, not heard until
the ear or a stethoscope is placed against the chest, have acquired
great importance. These sounds, termed “murmurs,” may be divided
into two classes. (_a_) When the ear is placed against the windpipe,
or in the middle of the back between the shoulder-blades, a murmur
is audible, due to the movement of air through the larynx. If the
larynx, the trachea, or the bronchi contain mucus, it is a harsh,
rough, bubbling, or crackling sound. It accompanies both inspiration
and expiration. (_b_) A softer, more delicate murmur is heard when
the ear is placed against the front or the side of the chest. This is
the vesicular or pulmonary murmur. It is heard during inspiration,
and is due to the passage of air out of the smallest bronchi into
the more spacious infundibula in which they end. These two kinds of
murmur must be rigidly distinguished—the laryngeal murmur, heard in
situations in which no lung-tissue intervenes between the ear and the
great tracheal or bronchial tubes; and the pulmonary murmur, heard
over all regions where the bronchi are buried in lung. Healthy lung is
as bad a conductor of sound as a sponge or a wad of cotton-wool. The
laryngeal murmur is inaudible in regions in which lung lies beneath the
chest-wall. It would be far beyond the scope of this book to attempt to
describe the very varied alterations in the chest-sounds which may be
produced by disease. The student would do well to familiarize himself
with the nature of the sounds which are heard in health, and the
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