PHTHISIS PULMONALIS. 75 



ties. Single vesicles, like fish bladders, of various sizes, sometimes 

 project from the surface or margins of the lung, in some instances 

 attaining an extraordinary bulk.* 



Treatment. — This disease may exhibit itself under two circum- 

 stances : first, it may have existed from infancy, or the causes 

 which produce it may have been present from the earliest period of 

 life ; second, it may result, as before stated, from obstructions de- 

 pendent on bronchitis and the other causes enumerated. Now, in 

 the first case, our treatment avails but little ; all we can do is to pal- 

 liate the symptoms : the mode of treatment in the second case is 

 evident enough. In this disease we must, as in all others, direct our 

 attention to the cause ; in fact, we should as soon as possible remove 

 the obstruction of the tubes, and then endeavour to restore the lung 

 to its original condition. 



The patient should clothe warmly, particularly about the ^Q^i^ and 

 should live in a sheltered genial situation. He should also take care 

 to avoid all causes of indigestion and flatulency, because, if the ac- 

 tion of the diaphragm is impeded, an attack of dyspnoea may be 

 brought on directly. 



The fits of dyspnoea may often be relieved by opium and ether. 



PHTHISIS PULMONALIS. 



Phthisis pulmonalis is owing to the development in the lungs of a 

 peculiar substance, called tubercle. 



Of tubercle. — Andral describes tubercle, at its origin, as a pale 

 yellow, opaque, round body, of various degrees of consistence, in 

 which no trace of organization or texture can be detected by the 

 naked eye, although the microscope shows various forms of cells, 

 imperfectly developed ; so that tubercle evidently consists of un- 

 healthy lymph, whose powers of organization are imperfect. 



Seat of tuberculous matter. — The prevailing opinion among pa- 

 thologists is, that the seat of tuberculous matter is the cellular tissue 

 of organs. It may, however, be formed on secreting surfaces ; as, 

 in the mucous follicles of the intestines, on the surface of the pleura 

 and peritoneum, and likewise in false membranes, or other morbid 

 products, and in the blood itself. 



Dr. Carswell regards the mucous surfaces as the principal seat of 

 tuberculous matter ; and asserts, " that, in whatever organ the for- 

 mation of tuberculous matter takes place, the mucous system, if con- 

 stituting a part of that organ, is in general either the exclusive seat 

 of this morbid product, or is far more extensively affected with it 

 than any of the other systems or tissues of the same organ." Andral 

 considers the cellular tissue its chief seat, but that it may occasion- 



* Dr. Hope's Morbid Anatomy, Part 2. 



