A system of practical medicine. By American authors. Vol. 3 : $b Diseases of the respiratory, circulatory, and hæmatopoietic systems
Science
A system of practical medicine. By American authors. Vol. 3 : $b Diseases of the respiratory, circulatory, and hæmatopoietic systems
Medicine -- Practice
In pseudo-membranous or croupous bronchitis the bronchial tubes are
found lined, and in some cases filled, with a plastic exudate. Usually,
only a limited number of the bronchi are affected. The tube-casts that
may be expelled are generally in the form of balls, which may be
unrolled, and which will then be found to be fragments or complete
cylindrical casts of the tubes. They are, when expelled, usually
yellowish and often sanious. When washed they are white. There are
frequently points of enlargement along the casts which are caused
either by the presence of air-bubbles within them, or by a more rapid
exudation from that point on the bronchus. The largest casts are
usually solid and laminated in structure; the smaller ones more
frequently are hollow, containing a greater or less number of
air-bubbles; the smallest consist of a single solid thread. Under the
microscope the casts seem to be composed of a structureless or
fibrinous substance holding numerous mucus and pus-cells, more or less
numerous globules of fat, and occasional epithelial cells; seldom red
blood-corpuscles, although these may be numerous on the surface. The
casts are usually moderately compact, firm, and elastic. Toward the end
of the disease, however, they may be less firm. In some cases toward
the close of life epithelial cells are abundant in them, but in other
cases on post-mortem examination the epithelial lining of the bronchi
is found nearly or quite entire. The mucous membrane may be much
reddened, or, on the other hand paler than normal. The submucous
tissues are also sometimes involved in the swelling, and occasionally
infiltrated with serum.[7]
[Footnote 7: For a representation of one of the most complete specimens
of pseudo-membranous casts from the bronchi the reader is referred to
the paper of Glasgow in the _Transactions of the American Medical
Association_, already referred to.]
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