292 



RESPIRATION. 



1. Catarrhal inflammation. 



a. Acute. 



b. Chronic. 



2. Exudative processes (croupous inflam- 



mation.) 



3. Pustular inflammation. 



4. The typhous process on the mucous 



membrane of the air passages. 



c. Inflammation of the submucous areolar 



tissue. 



d. Ulcerous processes. 



e. (Edema of the mucous membrane of the air 



passages. 



/. Gangrene of the air passages. 

 g. Adventitious products. 

 B. Diseases of the cartilaginous skeleton of the 

 air passages 



a. Inflammation of the perichondrium of the 



laryngeal cartilages. 



b. Inflammation and softening of the epi- 



glottis. 



c. Ossification. 



d. Adventitious products. 



7. Anomalies in the contents of the air passages. 

 Abnormal Conditions of the Lungs. 



1. Deficiency and excess of formation. 



2. Anomalies of size. Hypertrophy and 



Atrophy. 



3. Anomalies in form and position. 



4. Diseases of texture. 



a. Rarefaction of the pulmonary tissue 



(Emphygema.) 



b. Condensation of the pulmonary 



tissue. 



c. Ilypaeremia (stasis). Apoplexy of 



the lungs. 



d. Anaemia of the lungs. 



e. (Edema of the lungs. 



j\ Inflammation of the lungs (Pneu- 

 monia). 



1. Croupous pneumonia, typhous 



pneumonia. 



2. Catarrhal pneumonia. 



3. Inflammation of the interstitial 



tissue of the lungs (Interstitial 



pneumonia). 

 g. Deposits in the lungs (Melastatic 



processes). 



h. Gangrene of the lungs. 

 i. Softening. 

 k. Adventitious products. 



The preceding distribution of the morbid 

 conditions of the air passages may be advan- 

 tageously methodised under two heads : first, 

 those of the bronchi (as defined in the account 

 of their normal anatomy) ; secondly, those of 

 the lungs. 



The bronchi are liable to several forms of 

 inflammation : 



a. Acute bronchitis. 



b. Chronic bronchitis. 



c. Plastic bronchitis. 



Collapse of the lungs should be considered, 

 pathologically, as rightly ranking under the 

 denomination of the diseases of the bronchi. 



The various forms of asthma, and hooping 

 cough, belong to this species.* 



The bronchi are subject to two forms of 

 dilatation. In the first, a tube is uniformly 

 dilated at every part of its circumference. In 

 the second, the dilatation is saccular. The 



* For an account of the morbid statis of the 

 larynx, and upper part of the trachea, see Art. 

 Larynx. 



small bronchi and those near the surfaces and 

 borders of the lungs are most liable to suffer 

 this change. The walls of the tubes at the 

 dilatations are hypertrophied and thickened. 

 Sometimes, with the saccular variety, the 

 same parts are relaxed and attenuated. 



The bronchitic collapse of the lungs occurs 

 under two distinct aspects, the diffused form, 

 and the limited or lobular form. Of these 

 the latter variety is the more striking or cha- 

 racteristic, and has been, especially in the 

 lungs of children, the subject of more discus- 

 sion than the former. But the diffused form 

 is by far the more common, and is of frequent 

 occurrence in its slighter degrees. In both 

 conditions the pulmonary tissue presents a 

 dark violet colour as seen beneath the pleura ; 

 internally it is red. 



In considering the causes which tend to 

 produce this condition they seem to resolve 

 themselves into the following: 1st. the exist- 

 ence of mucus in the bronchi, which is more 

 liable to produce obstruction according as it 

 is more thick and viscid ; and 2ndly, weakness 

 or inefficiency of the respiratory power; Srdiy 

 inability to cough and expectorate. Of 

 these conditions, the first must be considered 

 as the exciting cause, the others as predis- 

 posing, co-operating with the first, but in- 

 capable, without it, of producing collapse.* 



With bronchitic collapse of the lung is 

 almost always associated emphysema of the 

 unaffected portions of the same lung(Gairdner). 



Inflammation of the mucous membrane of the 

 bronchi produces changes which are denoted 

 by redness and tumidity of the tissue, a 

 secretion of muco-serum, purulent mucus, or 

 pus, according to the stage and intensity of 

 the inflammation. 



This latter is the condition of superficial 

 suppuration. The swelling of the mucous 

 membrane and sub-mucous tissue, which as- 

 sumes the form of watery infiltration into the 



* For a full discussion of this interesting subject, 

 see " Pathological Anatomy of Bronchitis, and the 

 Diseases of the Lung connected with Bronchial Ob- 

 struction." By W. T. Gairdner, Edin. 1850. Md- 

 moire sur une Distinction nouvelle de deux Formes 

 de la Bronchite ; precede' de quelques considerations 

 generales sur I'lnflammation de la membrane mu- 

 quese des voies-aeriennes. Par J. H. S. Beau. 

 Archives Generales de la Medicine, Sept. et Oct. 



1818. Memoire sur quelques Parties de PHistoire 

 de la Bronchite et de la Broncho-pneumonie chez 

 les Enfants. (Archives Ge'nerales, Oct. 1851, et 

 suivantes.) Memoire sur la Broncho-pneumonie 

 Vesiculaire chez les Enfants. (ReVue Me'dico- 

 Chirurgicale de Paris, 1852. Par les Drs. Barthez 

 et Rilliet.) Traite Pratique des Maladies des 

 Nouveaux-Nes, &c. Paris, 1852. Par M. Bonchut. 

 A Memoir by Legendre and Bailly, in the Archives 

 Ge'ne'rales de Medicin, on the " e'tat foetal " of the 

 lungs, torn. Ixiv. On the Diseases of the Organs of 

 Circulation and Respiration, Art. Atelectasis. By 

 Hasse. Sydenham Society. Die Bronchio-pneu- 

 monie der Neu-gebornen und Sauglinge. Berlin, 

 1837. By Seifert. Medico- chirurgical Trans., for 

 1830. By Dr. Alderson. Der Mechanismus der Re- 

 spiration und Circulation. By Mendelssohn. Beitrage 

 zur Experimentellen Pathologic und Physiologic. 

 By M. Traube. Die Bronchitis der Kinder.' Leipzig, 



1819. Dr. Fuchs. Diseases of Infancy and Child- 

 hood. West. 



