. The principles and practice of modern surgery. of breathing in astooping posture. But when very large, it may produce a most danger-ous difficulty of swallowing and breathing, and congestion in the headby its pressure on the trachea, oesophagus, and -jugular veins ;t or it mayinduce thickening and disease of the trachea, with most obstinate cough,which may end in consumption. Diagnosis.—It is to be distinguished from encysted and other tumorsby its shape, by its want of fluctuation, and by its mostly affecting bothsides. Prognosis.—If it be soft and recent, and occur in a young patient, itwi
. The principles and practice of modern surgery. of breathing in astooping posture. But when very large, it may produce a most danger-ous difficulty of swallowing and breathing, and congestion in the headby its pressure on the trachea, oesophagus, and -jugular veins ;t or it mayinduce thickening and disease of the trachea, with most obstinate cough,which may end in consumption. Diagnosis.—It is to be distinguished from encysted and other tumorsby its shape, by its want of fluctuation, and by its mostly affecting bothsides. Prognosis.—If it be soft and recent, and occur in a young patient, itwill most likely be cured; but probably not, if it be old, hard, and thepatient advanced in life. Anatomical Characters.—The cells of the gland are found enlarged;—of various sizes from that of a pea downwards;—and filled with aviscid fluid, which becomes gelatinous if immersed in alcohol. Henceit has been presumed that the disease consists essentially of an increasedsecretion of the matter contained in the cells of the gland. Sometimes. t;;^»—r—j;^ * From the Kings College collection. The oesophagus is seen to be pushed to the rightside by the tumor. t Mr. Howship gives a case of bronchocele with the jugular vein passing through its sub-stance. The patient suffered greatly from congestion in the head. BRONCHOCELE. 393 they are filled with blood. In old cases, the tumor becomes hard, resem-bling a sarcomatous formation; and may contain ossific deposits.* Causes.—Bronchocele is what is called an endemic disease; that is, oneextremely prevalent in certain localities; amongst which may be men-tioned Derbyshire, Nottingham, and the chalky parts of England gene-rally ; and various Alpine and mountainous districts, especially the Tyroland valley of the Rhone. The use of melted snow or of water impreg-nated with calcareous or earthy particles, to which the inhabitants of allthose places are more or less habituated, although not perhaps the inva-riable cause, is the most
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