A case of chronic tuberculosis of the nose, tonsils, larynx, trachea, and main bronchi (sclerous lupus (?) without external manifestations), producing stenosis of the trachea and bronchi / by Thomas Whipham and Sheridan Delépine, read March 8, 1889.

  • Whipham, Thomas.
Date:
[1889]
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Licence: Public Domain Mark

Credit: A case of chronic tuberculosis of the nose, tonsils, larynx, trachea, and main bronchi (sclerous lupus (?) without external manifestations), producing stenosis of the trachea and bronchi / by Thomas Whipham and Sheridan Delépine, read March 8, 1889. 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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    is more like what is found in cases of leprosy, and m many parts the structure of the mucous membrane agrees remark- ably with some of the descriptions given of rhino scleroma. Sixth objection.—We have been unable to discover any Bacillus tuberculosis in a large number of sections taken from various parts of the organ. [I examined at least fifty pre- parations, in the staining of which I used various prepara- tions of ordinary fuchsin and of rubin coming from the best sources. At my request Dr. Slater was kind enough to examine also a large number of: sections, and was equally un- successful.—S. D.] In presence of all these difficulties it is necessary to discuss the possibility of any other explanation of the case. Stenosis of the larynx or trachea (we suppose that most processes affecting the mucous membrane of the larynx may also affect that of the trachea by extension) may be due to : 1. Chronic non-specific inflammation, traumatism (Gintrac, Andral, Trousseau, Demarquay, Gibb, Wilks, &c). 2. Syphilis (Worthington, Moissenet, Charnal, Boeckel, Payne, Lancereaux, Norton, Thornton, Cornil, Beger, Oudin, Berger, Morell Mackenzie, Jacobson, Dubar, Frankel). 3. Tuberculosis(Rokitansky?, Sopel?, Lemcke?, Bateman?). 4. A mixture of syphilis and tuberculosis (Rokitansky, Schnitzler, Arnold). 5. Lupus (Tiirck, Tobold, Ziemssen, Grossmann, Lefferts, Morell Mackenzie, Cornil and Ranvier, Babes, Kaposi). 6. Leprosy (Morell Mackenzie, Cornil and Ranvier, Babes, Wolff, Gibb, Schroetter, Elsberg). 7. Bhinoscleroma (Chiari, Hebra, Billroth, Kaposi, Pelliz- zari, Cornil and Alvarez.) 8. Chronic glanders (Tardieu, Dubar). (A few authorities only are given in support of these state- ments, but a great many more could easily be found.) The presence of distinct granulomata in the diseased tissues allows us at once to put aside simple inflammatory thickening. It is equally evident that we have no indication in the case of the existence of leprosy or glanders. There remains, therefore, only syphilis, tuberculosis, and rhinoscleroma to discuss. We have already pointed out most of the features which give to the lesions a syphilitic appearance. Against this view we have the following facts : 1. There is no history of acquired syphilis, which, accord- ing to Rmdfleisch, is the disease which generally gives rise to