On dilatation of the bronchi, or bronchiectasis / by T. Grainger Stewart.

Date:
1867
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Licence: Public Domain Mark

Credit: On dilatation of the bronchi, or bronchiectasis / by T. Grainger Stewart. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    To many of tliem we shall have occasion to refer, as we proceed. Treading a path which has been so often trod before, it cannot be expected that I should bring forward many novel facts or opinions; but all the statements that I have to make have been verified by myself, and one or two are, I think, new. But, apart from con- siderations of novelty, the publication of a paper on the subject may supply a want at present existing in English medical literature. It may be well in starting to clear the ground, by enumerating the various changes in and connected with the bronchi which have been confounded with the lesion under consideration ; for, while this lesion, the true bronchiectasis, which is an important disease, arises, as I shall endeavour to show, quite independently of all other pul- monary affections, there are several minor varieties which result from other changes in the lungs; and much of the confusion whicli at present exists is attributable to the fact, that authors have not been sufficiently careful to mark them off from the disease which we have under consideration. There are,— Istj A general dilatation of the bronchi from hoofing-coucjh^ or from capillary bronchitis. — Of this INI. Fauvel relates, in his valuable paper on Suffocative Capillary Bronchitis,' that in a considerable number of his cases he found a general or partial dilatation of the bronchial ramifications. Tolerably uniform in calibre, it was most marked in the finer tubes, where the cartilages are either rare or wanting. It appeared to result from long-con- tinued violent inspiratory efforts, in the coui'se of which the air, being hindered from passing further in its natural direction, expanded the delicate bronchial walls. His observations are amply confirmed by Barthez and Rilliet. This form of dilatation is doubtless often recovered from : the tubes resuming their natural calibre when the dilating cause has been removed. 2c?, Dilatations from stricture of bronchi.—This variety of bron- chiectasis was first pointed out by M. Reynaud, in his paper on Gombaulf; (U. C. A.), Etude sur I'Anatomie pathologlque, etc., Th^se de Doctorat, Paris, 1858. Casalis (E. A.), Considerations sur la Formation des Dilatations bronchiques, These de Doctorat, Paris, 1862. Besnier, Anatomic patliologique, Causes, et Diagnoses de la Dilatation bron- chique, Union M^dicale, 1859, torn. iii. p. 469. Lancereaux, Dilatation moniliforme d'un grande Nombre d'Extr^mit^s bron- chiques, Bullet. Soc. Anatom., 1861, p. 92. Katz, Dilatation des Bronches, Th&se de Strasbourg, 1864. Empis, Dilatation des Bronches, Gazette des Hopitaux, 1863. Van Genus, Over Bronchcctasis, Nederlandsche Lancet, July and Aug. 1854, Bamberger, Bemerkungen liber die Bronchectasis Saccifonnis, Oesterr. Zeits- chrift, f. prakt. Heilkunde, 1859. Cejka, Prager Vierteljahrschrift, 1863. Holzhausen, Ueber Bronchectasie, Jena, 1865. Skoda, Wiener AUg. Med. Zeitung, 1864. Bamberger, Wurzburger Med. Zeitschrift, 1864. ' Mdmoires do la Socidtil M^dicale d'Obscrvation de Paris, 1844.