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
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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.

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    from bronchitic collapse, or some of the more complex varieties which proceed from other lesions, such as tubercle or chronic he- patization. With regard to obliteration or contraction ot a bronchus, it is indeed self-evident that this must be the case; and the reader of the foregoing parts of this memoir will see without difficulty by what steps the obstruction of the air-tubes leads to their contrac- tion, along with the collapse and gradual atrophy of the vesicles to which they lead. In the case of dilated tubes, it is an observation of all the later pathologists, in which I fully concur, that the pul- monary tissue around these dilatations is usually impermeable, and in a condition of fibrous atrophy, most commonly without marked induration. It was this circumstance which gave rise to the theoiy of bronchial dilatation by Dr Corrigan, which led him to call this disease cirrhosis of the lung, 1 conceiving that the formation of a peculiar contractile fibrous tissue in the interstices of the bronchi, and the obliteration of the air-cells, led to the expansion of the tubes, by the gradual operation of the inspiratory forces, and constituted the true pathological condition of the disease. Although I have little doubt that Dr Corrigan's theory is fallacious, in so far as regards the existence of any new or 'peculiar fibrous element in this affection, yet there is no doubt that his observations were in other points correct, and that in particular he has the merit of being the first to draw attention in a decided manner to the morbid altera- tion and obliteration of the air-cells, a fact singularly enough nearly overlooked by Laennec. What, then, is the origin of bronchial dilatation ? The explana- tions of Laennec and others, which ascribe it to violent coughing, to distension by accumulated mucus, &c, are clearly unsatisfactory, on precisely the same grounds as have been already indicated in the case of emphysema, and which there is therefore no occasion again to repeat here. As in the case of emphysema of the vesicles, it seems more consonant with reason to ascribe these dilatations (as is done by Dr Corrigan) to the expansive forces of inspiration acting upon the bronchi of atrophied lung. But it is difficult to understand, on this principle, the occasional partial character of the lesion—the expansion of one portion of a bronchial tube into a sacculated globular enlargement, while adjoining tubes and adjoin- ing portions of the one affected, retain their natural size. In such cases it becomes necessary to suppose the existence of some more local affection, rendering the bronchial tube dilatable at the point in question. To those who have studied this subject only in the light of Laennec's description, the following remarks will probably appear too bold and sweeping a generalization. They are, nevertheless, the result of much consideration, both of the descriptions of authors, 1 Dublin Journal. May 1838.