An introduction to pathology and morbid anatomy / by T. Henry Green.

  • Green, T. Henry (Thomas Henry), 1841-1923.
Date:
1895
Catalogue details

Licence: Public Domain Mark

Credit: An introduction to pathology and morbid anatomy / by T. Henry Green. Source: Wellcome Collection.

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    air-passages, especially when the glottis is insensitive. During opera- tions on the mouth or nose, or as a consequence of wounds or diseases of these parts, blood and putrid discharges may also be sucked into the bronchi. Any of these may give rise to suppurative or gangrenous broncho-pneumonia. Simple bronchitis, and those specific forms due to measles, whooping cough, variola, diphtheria, and tubercle are by far the commonest varieties of broncho-pneumonia. Tubercular broncho-pneumonia frequently affords an instance of the occurrence of this form of pneumonia without any appreciable bronchitis, though signs of bronchitis at the apices are often some of the earliest indica- tions of tubercle. Tubercular broncho-pneumonia also affords frequent exceptions to the rule that, being consecutive to bronchitis, both lungs will be affected. All conditions depressing the general health and strength pre- dispose to broncho-pneumonia. They do this by weakening the re- sistance of the tissues, and thus permitting the primary infection, as well as the subsequent spread of the inflammation. Possibly, they may also act by diminishing the power of the respiratory muscles, and thus favouring the occurrence of pulmonary collapse, as the finer tubes become blocked by the swelling of the mucous membrane and the presence of tlie catarrhal secretion. Collapse often seems to precede the inflammation; but evidence of its importance as a predisponent to broncho-pneumonia is unsatisfactory : it may, by interfering with the circulation in the collapsed alveoli, still further weaken the resistance of the tissues, and thus render infection easier. But whenever bronchitis has reached the finest tubes, extension of the inflammation to the alveoli seems natural without assistance from collapse, such extension being probably assisted by the act of inspiration, which would tend to draw the contents of the bronchioles into the alveoli. PATHOLOGY.—Broncho-pneumonia has been studied experi- mentally. Animals have been made to inhale irritant gases or suspended particles of various kinds. Further, by division of the vagus, saliva and food have been permitted to enter the air-passages. The resulting changes vary (1) with the size of the inhaled particles, and (2) with the intensity of the irritation they are capable of exciting. Thus, very fine particles cause widely scattered miliary foci of inflam- mation ; larger ones block the smaller bronchi, and cause collapse and secondary inflammation of lobules—a result which has led to the name of lobular pneumonia. The aspiration of a quantity of septic dis-