On the determining causes of vesicular emphysema of the lung / by William Jenner.

  • Jenner, William, Sir, 1815-1898.
Date:
1857
Catalogue details

Licence: Public Domain Mark

Credit: On the determining causes of vesicular emphysema of the lung / by William Jenner. 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.

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    emphysema;^ the air contained in the parts of the lung most powerfully compressed during expiration with a closed glottis, being forced in undue quantity into such parts of the lung as are less compressed and less perfectly supported. It is manifest that what has been above advanced, as to the effect on the air-cells of powerful expiratory efforts made when the glottis is partially closed, is equally true of the same cflForts when made with one or more bronchial tubes partially closed. Dilatation of some of the air-cells beyond the tubes must ensue, if those cells be not uniformly com- pressed during expiration. While, therefore, collapse of the lung is the consequence of complete occlusion of a bronchial tube, dilatation of the air-cells may be the result of imperfect occlusion. The objection to the theory of Laennec, urged by Louis, viz., that the ordinary seat of catarrh is the base of the lung posteriorly, that of emphysema the apex and anterior margin, is unanswerable. The objection of Dr. Gaii'dner to the same theory, viz., that impermeability of a bronchial tube is followed by collapse of the pulmonary tissue from which it leads, is equally fatal to it. But then the conclu- sion of Louis from his facts, viz., that there is no relation between catarrh and vesicular emphysema by no means necessarily follows. The relation between the two is, thaf catarrh excites frequently repeated \dolent expiratory efforts, with a more or less perfectly closed glottis, and therefore is one of the exciting causes of repeated over-distension of these air-cells, which during these efforts are the least sup- ported and compressed. Catarrh, then, of the base of the lung posteriorly, may be the exciting cause of vesicular emphysema of the apex and anterior margin, and Louis's conclusion as to the necessary want of relation between catarrh and vesicular emphysema, because they affect dif- ferent parts of the lung, is manifestly illogical. ' fiouis found the lower lobe of the left lung twice as often the seat of emphysema as the corresponding lobe of the right lung; while the apex of thu right lung was more frccjuently affected with cniphvsouia than the apex of the left lung.