968 The American Naturalist. [November, 
hence atalectosis, then 
that no micro-organisms are present in the tubes, the cellular 
plugging up of the alveoli does not begin in those adjoining the 
tubes, but in those on the extreme limits of the infundibulus. 
The wonderful provisions of nature are nowhere more marvel- 
ously displayed than in the protective function of the cilia of the 
bronchial mucosa ; so long as the mucosa remains comparatively 
normal, these delicate hairs move all foreign substances, including 
a surplus of secretion, towards the larynx, whence they are ex- 
pectorated. This has reference to all forms of micro-organismal 
life as well. But when the mucosa becomes severely engorged, as 
in the case in point, the movements of the cilia become heavy and 
retarded, and when the engorgement of the vessels is so severe as 
to lead to serous effusion, these movements become completely par- 
ralyzed, the natural result being the retention of any foreign ele- 
ments present at the point where they are caught. This serum and 
the existing temperature offer the most favorable conditions for 
the development of any germs which may be present. It can be 
truly said that in such a case we have a sort of natural " Esmarli 
Suhe." If such germs are caught at the termination or near 
there, or along the course of the most delicate bronchioles, they 
at once commence to develop into colonies, and soon fill up the 
tube, causing an irritation of the embracing alveolal walls, and set 
the epithelium of the same into active proliferation, the natural 
result being broncho-pneumonia. This pneumonia will depend 
for its character on the specific nature of the germs, which may 
be simply mechanically irritative in their action, purulent, or gan- 
grenous. According to my experience, the first is the most com- 
mon variety. In such a case, then, the individual has a pretty 
poor chance for life. To an already begun stagnation pneumonia 
is added one of a bronchial type, or vice versa. Again, in such 
an invasive broncho-pneumonia, the germs soon find their way 
into the circulation, either by the lymphatics or through pene- 
trating the capillaries, most probably the former, and in such cases 
we naturally would find a mixture of micro-organisms in the blood. 
As said, this occurs in typhus abdominalis. How many 
times has a physician congratulated himself and his patient 
