This term is applied to a form in which there is induration, followed
by contraction of the affected lung tissue, due to an overgrowth of
fibroid tissue. The greater number of cases are primarily tubercular,
but have run a fibroid course. Other cases are primarily fibroid,
followed by tuberculous infections. It may begin as an ordinary
ulcerative phthisis, or it may begin as an inhalation bronchitis. In
other instances it may follow a chronic tuberculous bronchial pneumonia
or pleurisy.
The =onset= is extremely insidious. There is persistent cough, often
paroxysmal in character. Dyspnea is marked, especially on exertion,
but little or no fever is present. The expectoration is profuse and
mucopurulent. There is slight loss of weight. In the later stages edema
is marked. It is a disease of long duration, lasting from ten to twenty
years. The patient is often able to pursue some occupation and may have
fair health.
There is marked dullness over the affected side, which is commonly much
depressed. There is distinct bronchial breathing at the base, while
at the apex there may be cavernous sounds. The heart is frequently
displaced and the right ventricle hypertrophied. The bronchi are
dilated. The clinical history is identical with that of simple
cirrhosis of the lung from which it is often separated with difficulty.
Both lungs may become the seat of tuberculous disease. Prolonged
suppuration results in amyloid changes in the liver, spleen, kidneys
and intestines. X-ray plates are of value in diagnosis.