The Bradshaw lecture on the results of bronchial obstruction : delivered before the Royal College of Physicians of London on November 1st, 1910 / by G. Newton Pitt.

  • Pitt, G. Newton (George Newton), 1853-1929
Date:
1910
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Licence: In copyright

Credit: The Bradshaw lecture on the results of bronchial obstruction : delivered before the Royal College of Physicians of London on November 1st, 1910 / by G. Newton Pitt. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    by a growth which had also invaded the lung; the plenra in this part was f in. thick and fibroid. There was bronchiectasis; the tubes were filled with foul greenish pus, with patchy necrosis of the right lung. Case cxiii.—Primary Cancer of Bight Bronchus : Gangrene at Base: Pleuritic Effusion. 1899. Woman, aged 52. She had a right pleurisy due to malignant disease, which was tapped three times and finally drained. Post Mortem.—There was an enlarged kidney, with an extensive, dense growth in the right lung and pleura. The right lung was compressed to one-eighth of the normal size; the pleura was much thickened. The lung was solid, compressed, and airless, with a small gangrenous cavity at the base. The main bronchi were thickened; the tubes were not dilated. There were secondary deposits in the right kidney. The growth was a primary columnar-cell carcinoma of the right bronchus. Case cxiv.—Primary Cancer of Left Bronchus. 1899. Man. Admitted with right facial paralysis, with three nodules of growth on the head and several in the abdominal wall. Dullness at the right base below the angle of the left scapula. Diminished entry of air ; tactile vocal fremitus normal. Post Mortem.—The right lung was extensively infiltrated with growth, and there were disseminated nodules over the left lung. Diffuse bronchopneumonia. Primary colum- nar-cell carcinoma of the left bronchus, with diffuse growth and bronchopneumonia in the left lung. There were secondary deposits in the skin, scalp, right sterno-mastoid gland, and liver. Case cxv.—Cancer of Left Bronchus: Gangrenous Cavity: No Bronchiectasis. 1906. Man, aged 69. Pain in the left chest with dysp- noea and foul sputum for six months. Note over the left chest was impaired, and there was dullness at the base; bronchial breathing and bronchophony; fatal haemoptysis. Post Mortem.—The left bronchus at 2.5 c.cm. below the place of origin was infiltrated with a primary growth which extended to the bronchial glands. The bronchus opened direct into an irregular, foul, sloughing, gangrenous cavity for one and a half inches. The rest of the lower lobe was fibroid but no dilatation of bronchi was present; the upper lobe was becoming fibroid; the right lung was emphysematous; there was septic bronchopneumonia at the base. Case cxvi,—Cancer of Left Bronchus : Bronchiectasis : Pleuritic Effusion. 1900. Man, aged 36. Two years ago he had pleurisy, and again six months ago. There was blood stained expectoration; the left chest was dull, with deficient breathing. On February 1st 36 oz. of fluid were aspirated ; on February 26th 2 oz.; on March 12th 9 oz. of blood- stained fluid were withdrawn. There was increasing dyspnoea. Post Mortem.—A carcinomatous growth had started in and occluded the left bronchus and invaded the lung; the tubes beyond were dilated and filled with pus. The peri- cardium was invaded by growth. The pleura was £ in. thick; the lung was solid with growth, and there was bronchopneumonia. Case cxvii —Squamous Epithelioma infiltrating Wall of Trachea and Bronchi. 1906. Woman, aged 17. Severe paroxysmal dyspnoea for one week; temperature 99.6; some muco-purulent expectoration; afterwards there was slightly deficient breathing at the left base. There was always a good vesicular murmur. Death resulted from dyspnoea. Post Mortem.—There was diffuse infiltration, with appa- rently a primary growth of the wall of the trachea for a length of 6 c cm. and for 3 c cm. in each bronchus. The lumen of each tube partially reduced in size; there was no complete stenosis, no bronchopneumonia nor septic bronchiectasis in the lungs, but oedema was present; there was a trace of muco-pus in the tubes. The growth thickened the wall towards the lumen. Microscopically it was a squamous epithelioma, and no growth could be found elsewhere.
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