Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis.

  • Pierre Charles Alexandre Louis
Date:
1844
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Licence: Public Domain Mark

Credit: Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    several orifices. Two only of the bronchi open below the softened tuberculous matter, wherewith the cavern is partially filled. The mucous membrane of the bronchi had in some cases retained its natural whiteness in the vicinity of tuberculous cavities ; but in the majority was of a bright red colour. This red discoloration apparently arose from the frequently repeated passage of the purulent contents of the communicating cavities; for it was not observed at aU, or at least rarely observed, in the neighbourhood of masses of gray matter or non-softened tuber- cles ;—it was less frequent in ramifications opening into recently formed cavities than in those communicating with excavations of long standing;—and, when general, it was more strongly marked close to the latter than in any other situation. When red, the bronchial mucous membrane was in some cases slightly thickened, in others the seat of small ulcerations, or, as was much more common, the bronchi were dilated and the tissues composing them thickened. This thickening was more especially marked at the apices of the lungs, where the tubes were frequently three and four times thicker than natural. These various structural changes must, as it is readily conceivable, materially increase the danger of the original malady. Except in a single case (that of a patient observed, at the Hospital of La Pitie, since the publication of the first edition of this work) I have never met with tuberculous pseudo-membrane on the mucous membrane of the bronchi. The patient was a young man, aged eighteen, of middle height, and well-developed muscular system; respecting his commemorative history I was unable to obtain any very precise information, as he was seized with symptoms of meningitis on the day after his admission. The lungs contained tubercles in tolerable abundance, but no cavities ; and in the upper lobe, on the left side, one of the bronchi presented in its interior, close to its origin, a tuber- culous pseudo-membrane, extending entirely round the tube, and measuring an inch in length. It reappeared about an inch lower down, and thence extended onwards with exactly the same appearance as before, to the surface of the lung. It was less than half a Une [less than 1 millimeter] thick, and easily separable from the subjacent mucous membrane, which had retained its natural whiteness, thickness, and consistence.