A treatise on pathological anatomy / by Carl Rokitansky ; translated from the German, with additions of diagnosis from Schoenlein, Skoda, and others by John C. Peters.

  • Rokitansky, Carl von, 1804-1878.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on pathological anatomy / by Carl Rokitansky ; translated from the German, with additions of diagnosis from Schoenlein, Skoda, and others by John C. Peters. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    this parenchyma, in connection with the formation of a theory of its origin, and its importance as a cause of bronchial dilatation. Laennec and most of the succeeding pathologists believe that bronchial dilatation is always produced in a mechanical way, by the accumulation of catarrhal secretions in certain portions of the tubes, aided by powerful inspirations during paroxysms of cough- ing, the walls from some unknown causes being at one time ren- dered thicker, at another thinner than natural. The condensation of the surrounding parenchyma, according to them, is a conse- quence of the compression exerted by the dilating bronchus. Hence Laennec describes the dilatation of the tube as the primi- tive affection, and the condensation of the parenchyma as a secondary change. Within a short time, Corrigan has put forth a theory directly opposed to this ; and believing the disease to be exactly analogous in its anatomical elements to cirrhosis of the liver, he has given it the name of cirrhosis of the lungs. According to him, the atrophy and obliteration of the pulmonary tissue is the primitive effect in the development of the disease; the dilatation of the tubes a consecutive affection, arising not only in consequence of an endeavor to fill up the space left vacant in the contracting lung, by the forcible expansion of the bronchi during the act of inspiration, but also by a dragging apart of the walls of the tubes from the shrinking of the pulmonary tissue itself. The alteration of the parenchyma of the lung in extreme cases consists in an atrophy, obsolescence, and contraction of the air cells, or even conversion of them into a cellulo-fibrous or callous fibro- cartilaginous tissue, which may either be white, or else punctated, streaked, or colored throughout with black pigment, and to which the fibrous sheaths of the bronchi become so intimately attached as to form a connected whole. When we consider the vast extent to which the' pulmonary tissue around the affected bronchus is atrophied, the nature and degree of this change, and recollect the fact that it does not always appear equally developed around the dilated tube, nor most marked the nearer we approach to it, then it becomes a matter of doubt if all this can be produced by the mere pressure of a thin, dilating bronchial tube, more especially as we see that simple condensation of tissue only, is induced by long continued and severe pressure from pleuritic effusions, &tc. A closer examination enables us to obtain other facts which