On the characters of the expectoration in cases of fetid bronchitis and gangrene of the lung / by Arthur Gamgee, M.D.

  • Gamgee, Arthur, 1841-1909.
Date:
1865
Catalogue details

Licence: Public Domain Mark

Credit: On the characters of the expectoration in cases of fetid bronchitis and gangrene of the lung / by Arthur Gamgee, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

    11/12 (page 11)
    marked manner the odour of one of the volatile fatty acids—gener- ally of butyric acid. If the process be carefully carried on in a retort, and the distillate be neutralized with an alkali, evaporated to dryness and then acidulated, a fluid is obtained possessing in a marked manner the odour of the fatty acid occurring in the sputum —the odour being the best available test which we can employ in the detection of small quantities of these acids; being as character- istic as it is delicate. On examining the sputum of a patient recovering from acute bronchitis, I discovered that the acid which was evolved, after acidifying and boiling, had very much the odour of caprylic acid. The muco-purulent sputum of a case of phthisis yielded an acid vapour which had at first the odour of formic acid. On boiling the fluid farther, a butyric-acid odour was evolved. The acids which I think occur in the sputum are butyric acid, propionic acid, formic acid, acetic acid, and possibly caprylic acid. The occurrence of these acids in the sputum is not a matter for surprise. The researches of Scherer, Gorup-Besanez, and Schottin, have proved the existence of most of these in the muscular juice, milk, etc., which most probably derive them preformed from the blood. Formed by the oxidation of various fatty matters, they are probably constantly present in small quanti- ties in the blood, where they are partly consumed, and partly separated by the various excretory organs, and, like other volatile substances, especially by the lungs. When the air passages contain fluid it is only natural that they should be dissolved by the fluid, and thus find their way into the sputa. It will be a subject for future inquiry whether the quantity of the volatile acids in the sputum is not greatest in those cases where the function of the lungs is so much impaired as to interfere materially with the oxidation of the blood. The above observations answer, it appears to me, in a satisfactory manner, the questions which I purposed solving in this communica- tion ;—they show that the occurrence of butyric acid in the sputa cannot at present be proved to have any semeiological value j and that its presence is in no way characteristic of fetid bronchitis. In reference to fetid bronchitis, it appears to me that the facts v/hich have been collected with regard to it are scarcely of such a nature as to warrant our admitting a disease bearing this name into our nosologies. Like all other excretions, that of the air passages is occasionally liable to exhale a disagreeable odour. This sometimes occurs in acute and chronic bronchitis. No distinct and uniform series of phenomena have, however, been shown to characterize those cases of bronchitis in which the expectoration is fetid. We should, I think, avoid a needless and unphilosophical complication of our nosologies were we to speak of a bronchitis accompanied by fetid expectoration, instead of a disease sui generis fetid bronchitis. FEINTED BY OLIVER AND BOYD, EDINBURGH.