The Lettsomian lectures, delivered at the Medical Society of London, 1879, on bronchial asthma : its causes, pathology and treatment / by John C. Thorowgood.

  • Thorowgood, John C. (John Charles), 1833-1913.
Date:
1887
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Licence: Public Domain Mark

Credit: The Lettsomian lectures, delivered at the Medical Society of London, 1879, on bronchial asthma : its causes, pathology and treatment / by John C. Thorowgood. Source: Wellcome Collection.

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    belladonna, and the speedy way in which chloroform vapour dissipates the spasm, further support the belief in the neurotic character of the seizure; and the more the nervous spasm predominates, the more certain is the relief obtained by the use of the above-named agents — a point I hope to work out satisfactorily when I come to the matter of therapeutics in my third lecture. Observations that I have had opportunities of record- ing have shown that there is no rise of body temperature during a night of intensely severe asthma, brought on by nervous excitement. Such are a few of the facts that make me think we must admit into our nosology bronchial asthma as an essential primary neurosis. Now comes group of evidence No. 2, based on physiological experiment, as well as on clinical observation ; and here I approach the question, so warmly contested just now, as to what part of the respiratory mechanism is the seat of the nervous spasm. Let us look first at the result of experiment. We find in the very smallest bronchial tubes a distinct layer of smooth muscular fibres disposed between an external and internal layer of elastic fibres. These elastic fibres support the borders and angles where several alveoli meet, and they are further distributed in a retiform manner over the alveoli of the lung. This membranous wall of the air-cell, according to Strieker, is entirely devoid of all trace of muscular fibre, and the air-cells were found by Dr. Williams, in 1841, to possess little contractile force under the influence of galvanic or chemical excitation, though the lung by its elasticity is capable of contracting generally to about one-third of its ordinary bulk when the thorax is opened. The contractility of the muscular element in the small bronchial tubes under the influence of mechanical,