On the pathological anatomy of bronchitis, and the diseases of the lung connected with bronchial obstruction / by W.T. Gairdner, M.D.

  • Gairdner, W. T. (William Tennant), Sir, 1824-1907.
Date:
1850
Catalogue details

Licence: Public Domain Mark

Credit: On the pathological anatomy of bronchitis, and the diseases of the lung connected with bronchial obstruction / by W.T. Gairdner, 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.

    75/86 (page 73)
    the other hand, much greater tendency to the development of em- physema from violent and repeated forced inspiration, when partial collapse or atrophy is present elsewhere. 8. The irregularities ol movement of the thorax tend ultimately to affect its form, producing in the child the pigeon-breast, by lateral flattening of the yet flexible and soft ribs, with depression of the lower costal cartilages, and pro- tusion of the sternum; in the adult or older child, slighter lateral flat- tening, with expansion or bulging of the cartilages, and arched pro- trusion of the sternum ; and in both the child and the adult, increase of the antero-posterior diameter relatively to the lateral, and of the upper zone relatively to the lower. 9. The deformity of the chest usually accompanying emphysema of the lungs is neither a cause nor an effect of that lesion, but both emphysema and the emphy- sematous chest depend on the altered respiratory movements m bronchitis, and the exaggerated respiration necessary to overcome the tendency to bronchitic collapse of the lung. It may appear to some readers that the above explanation of the seat of election of pulmonary collapse and emphysema is superfluous, and that the gravitation of the mucous obstructions in bronchitis to the posterior portions of the organ, is a sufficient reason for the oc- currence of collapse in that situation, and of emphysema in the op- posite region. To this opinion, however, some facts stand in direct opposition. The most important is that in the horse, in which emphy- sema and the other diseases of the lung are common, and in which the position of the lung as respects the effect of gravitation is pre- cisely the reverse of what occurs in man, the seats of election of em- physema and of pulmonary condensation are nevertheless nearly as in the human subject. In various experiments on the rabbit, also, I have noticed the same tendency of emphysema to the borders of the lung, and of collapse to its root, although the animals were allowed to maintain the natural position, in which the force of gra- vitation ought to have had an opposite tendency. For these reasons, I have been induced to ascribe very much less effect than most ob- servers to the simple statical condition of the fluids in pulmonary diseases, and to look for some dynamical cause which would explain the position of the lesions found in bronchitis, pneumonia, and em- physema, in a more satisfactory manner than hitherto. To what extent the preceding paragraph is a successful attempt at such an explanation, must be left to the judgment of the reader, and to the future observation of facts bearing on the subject. Pathological alterations of the Bronchi in Pulmonary Atrophy and in Emphysema.—The memoir of M. Reynaud1 on obliteration of the bronchi, has been referred to by most subsequent writers as hav- ing enumerated and described with great completeness all the more Memoires de l'Academie de Medccinc. Tome Lv.