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Bromsgrove is situated in a highly-cultivated and richly- Opposite the third vertebra of the back the trachea divides wooded valley. On the Lickey Hill, which forms one of its into two great branches, named the bronchi, one branch for acclivities, are the sources of the riv. Rea, which flows each lung; the right bronchus going to the right lung, and through Birmingham; of the Salwarp, which passes through the left bronchus to the left lung. Droitwich; of the Arrow, and of several small streams, some of which fall into the basin of the Severn and ultimately into the Irish channel, while others descend in the opposite direction to the basin of the Trent and the German Ocean. The strata belong to the new red sandstone formation. The Lickey is composed of quartz, and must at some period have been an immense mountain; for it is considered by geologists as the source from whence have been derived the vast beds of gravel which extend through Oxfordshire, in the valley of the Evenlode, and even along the Thames.

Each of the bronchi at the place where it enters the lung, subdivides into several branches which penetrate the substance of the lung, where they again divide, subdivide, and spread out after the manner of the branching of a tree. Successively diminishing in size as they subdivide, the bronchi at length form an infinite number of minute tubes, which at their ultimate terminations dilate into the little bags termed the air-cells of the lungs. The larynx, the trachea, the bronchi and their ramifications, together with the cavities of the nose, the mouth, and the pharynx, are all classed together under the common name of the airpassages. All these parts are lined by a membrane, which from the nature of its secretion is termed mucous mem

At Hanbury, just without the confines of the par., Saurian remains are found imbedded in the lias, and at Stoke Prior commences red and green marl, traversed by veins of gyp-brane. In every part of the body the mucous membrane

sum.

In the par. of Stoke Prior, and closely adjoining that of Bromsgrove, are situated the extensive salt and alkali works carried on by the British Alkali Company. As this establishment furnishes an instance of the rapid introduction of a manufacture into a district which had been previously confined to agriculture, a short notice of its progress may be interesting. The manufacture of salt has been carried on for centuries in the adjoining bor. of Droitwich, where it is prepared from rich springs of native brine. The only situations where rock-salt had been met with in this isl. were in Cheshire, previously to its being discovered at Stoke Prior, where it was obtained in 1829, in the course of sinking a pit in search of brine. The beds of salt were of great thickness, and were excavated to a considerable extent; but at present the supplies for making refined salt are derived from a natural brine spring, which has communicated with the excavations. Immediately after making this discovery, the proprietors erected extensive works for the manufacture of salt, and for the preparation of British alkali, by the decomposition of this substance, which very speedily changed the green fields and retired lanes into an active manufactory and a lively village. The beneficial effects of this introduction of an extensive manufacture commence with an immediate demand for the surplus labourers, an increased consumption of the necessaries of life, and a contribution towards meeting the parochial expenditure; the neighbouring agriculturist finds his burdens relieved, at the same time that a market for his productions is brought into his immediate neighbourhood. A dispassionate view of instances such as the present would tend greatly to subdue the feeling of jealousy which exists between the agricultural and manufacturing interests in this kingdom. The benefits derived from the successful establishment of a manufacture is not confined to the labouring pop, and to occupiers of land in its vicinity alone, but extends more widely: thus, in the present instance, these works being situated on the banks of the Birmingham and Worcester Canal occasioned, on their being fully established, an increase in the value of that property to the extent of 70 per cent.; and the influence they are likely to produce in the rising port of Gloucester, by furnishing to it a large supply of salt for exportation, is calculated to be very considerable. (Communication from Bromsgrove.)

BROMWICH, WEST. [WEST BROMWICH.] BRONCHITIS, inflammation of the bronchi, that is, the tubes which convey air to the lungs. The respiratory organs consist of the windpipe, or the air-tube; of clusters of minute bags called air-cells, which constitute the proper substance of the lungs, and of a delicate but firm membrane which encloses the lungs, as in a sheath, termed the pleura. Each of these component parts of the respiratory apparatus is subject to its own peculiar diseases. Hence the diseases of the respiratory organs are arranged into three classes: first, into those which affect the air-tube; secondly, into those which affect the proper substance of the lung; and, thirdly, into those which affect its investing membrane, the pleura.

The air-tube or windpipe is divided into several portions. Each of these portions possesses a peculiar structure, and performs a specific function. Of these divisions the first is termed the larynx, which constitutes the principal organ of the voice, and is situated at the upper part of the neck. Immediately continuous with the larynx is a large tube called the trachea, situated at the fore part of the neck.

possesses the same essential structure, and is subject to analogous diseases. Accordingly, although the structure of the mucous membrane of the air-passages is somewhat modified in the nose, in the fauces, in the larynx, in the trachea, in the bronchi, and in the air-cells, according to the different functions which it has to perform in these different organs, yet as it possesses in its whole extent the same essential organic characters, so the diseases to which it is subject are perfectly similar. All these diseases may be included under congestion, inflammation, hæmorrhage (effusion of blood from its surface), emphysema (the dila tion of the tubes), and polypi (concretions growing from its surface, which obstruct and sometimes nearly obliterate the tubes).

Of these diseases inflammation is by far the most com. mon and the most important. Inflammation of the mucous membrane of the air-passages is divided into species ac cording to the nature of the secretion in which the inflam matory action terminates. Thus the inflammation may terminate in a secretion which does not concrete after its formation; this is termed catarrhal inflammation. It may terminate in a secretion which instantly concretes as it is formed; this is called plastic inflammation or croup or it may terminate in the destruction of the mucous membrane and the formation of ulcers; this is termed ulcerous inflammation.

Catarrhal inflammation, or that in which the inflammatory action produces a secretion which does not concrete, is again subdivided principally according to the colour and consistence of the matter secreted. If the secretion be of a yellow colour, and not tenacious, the disease is called mucous catarrh; if the secretion be transparent and viscous, the disease is termed pituitous catarrh. When the inflammation is confined, as it often is, to that portion of the membrane which lines the nose, it constitutes the disease commonly known under the name of cold or catarrh, the technical name of which is coryza. When the inflammation extends to the mucous membrane which lines the fauces, tonsils, and pharynx, the disease is called cymanche tonsillaris and pharyngea. When the inflammation is seated in that portion of the mucous membrane which lines the larynx, the disease is called laryngitis; and when it affects the mucous membrane of the bronchial tubes and their ramifications, it constitutes the disease termed bronchitis.

While a common function is performed by the air-passage from its commencement at the mouth and nostrils to its termination in the air-cells, namely, the transmission of air to and from the lungs, additional and very different func tions are performed by the several portions of this extended tube. Accordingly inflammation of the membrane that lines it produces widely different effects, according to the portion of the membrane in which the disease is seated; giving rise to the distinct forms of disease just enumerated. The description of these several diseases is given under their respective names; the disease named bronchitis is that at present to be treated of.

Medical writers distinguish between what they term the state of congestion and that of inflammation. In con gestion the blood-vessels are merely loaded with a preternatural quantity of blood; in inflammation the blood-vessels, besides being loaded with a preternatural quantity of blood, are in a state of diseased action, which, without any precise knowledge having been acquired of the nature of that action, is termed inflammatory. Simple congestion of

the mucous membrane of the bronchi is a frequent affection, altered; it gradually assumes a greenish tint; it then
which may be induced by any cause that impedes the return passes to yellow, and finally becomes of a bright brimstone
of the blood to the left side of the heart. If suddenly and hue. As the disease proceeds the condition of the mem-
intensely produced, which sometimes though rarely hap- brane is changed; for as the bland fluid is formed the
pens, it may prove fatal with all the symptoms of asphyxia morbid thickness and firmness of the membrane diminishes,
[ASPHYXIA]. Several cases are on record in which persons and it gradually returns to its healthy condition.
were seized suddenly, without any apparent cause, with ex- The redness, swelling, and firmness of the membrane,
treme difficulty of breathing, which progressively increased together with its altered secretions, are then local signs
until it terminated in death; and on the examination of the visible to the eye which denote the inflammatory condition
body, no morbid appearance could be detected, excepting a of the membrane in coryza and in cynanche tonsillaris, and
general congestion of blood in the capillary vessels of the pharyngea. The membrane being in part manifest to our
mucous membrane, of the bronchi and its ramifications. senses in the situations in which these diseases have their
In a slighter form, congestion of the mucous membrane of seat, we can observe the morbid process that goes on, and
the bronchi is a constant attendant on various diseases, mark its different stages. It is probable that a perfectly
more especially fever of every type, whether common con- analogous process goes on when portions of this membrane
tinued fever, or typhus, or scarlet fever, or measles, or which are placed beyond our view are inflamed. When the
small-pox. In the state of congestion the mucous mem-inflammation is seated in the larynx the membrane cannot
brane is preternaturally red, the tinge of colour varying be seen. That the particular portion of the membrane
according to the intensity of the affection from a pale to a which lines the larynx is in a state of inflammation is a
brownish or purplish red.
matter of inference derived from the disturbance of the
function of the organ, namely, the function which relates
to the formation of the voice. But when inflammation
descends further into the trachea, the bronchial tubes and
their ramifications, not only are we altogether unable to see
the condition of the membrane, but as the functions of those
tubes are so simplified as to be mere conduits of air,
the only indication we can obtain that they are in a state of
disease must arise from the disturbance of that single func-
tion, namely, difficulty of breathing. Certainly there will
be combined two other symptoms, namely, cough and ex-
pectoration; but these are common to various other diseases
of the lungs, and consequently cannot be diagnostic, that is,
distinctive: while difficulty of breathing is common to every
disease of the lungs and heart which has arrived at a certain
degree of intensity. When inflammation is scated in these
distant portions of the mucous membrane of the air passages,
it is impossible to arrive at any certain knowledge of the
specific disease from the symptoms or the signs of disordered
function only.

When the mucous membrane of the bronchi is in a state of active inflammation, it is of a bright red or crimson colour. This inflammatory redness may be partial or general; but it more commonly affects particular parts of the membrane than its entire surface. Sometimes the redness is confined to the larger bronchial tubes, or it may be limited to the smaller. Sometimes it exists in the bronchus of one side only; at other times it equally affects both bronchi.

Two consequences result from the congestion and inflammation of the membrane: first, the swelling and thickening of the membrane, in proportion to which must of course be an obstruction to the passage of the air; and, secondly, an increase in the quantity of its mucous secretion. This increase and change in the secretion are chiefly the result of inflammation, in some cases of which affection the secretion becomes so excessive as completely to fill up the bronchial tubes, and thereby to occasion suffocation.

The trachea and the bronchial tubes being mere conduits of air, the disturbance of function produced by the inflammation of this portion of the air passage must of course relate chiefly to impeded transmission of the air. Accordingly difficulty of breathing is the most prominent symptom of inflammation seated in this portion of the air-tube. This difficulty of breathing is proportionate to the obstruction to the passage of the air, which is proportionate to the degree of the swelling of the membrane, and to the extent of membrane involved in the inflammatory affection. If the inflammation be limited to a portion only of a single tube, the difficulty of breathing will not be great; if it affect the whole tubes of one side, the difficulty of breathing will be considerable; if it affect all the tubes of both lungs, the difficulty of breathing may be so great as to prove fatal. Together with impeded respiration, there is a feeling of tightness and oppression across the chest, accompanied with a sense of heat, sometimes amounting to a burning sensation, often referred by the patient to the sternum. Cough is always present. The cough at first is dry, because the membrane is dry; but the secretion soon becomes more abundant than natural. The matter first secreted is acrid; and this acridness diminishes as the quantity of the secretion increases; and when the matter secreted assumes a yellow colour, it is always quite bland; and then the cough is loose and the expectoration free.

When the inflammation is seated in the mucous membrane that lines the cavities of the nose and pharynx, the morbid changes which the membrane undergoes during this process are in some degree manifest to the eye. It is obvious that the part affected becomes redder than natural; that its blood-vessels appear larger, more numerous, and more turgid with blood; at the same time the membrane swells and becomes thicker and firmer than natural. At first it is perfectly dry; for the first effect of the state of inflammation is the suppression of secretion: but soon a transparent, thin and acrid fluid is poured out by the inflamed vessels, which irritates and even excoriates all the parts with which it comes in contact. After flowing for a certain time, varying from a few hours to two or three days, according to the intensity of the disease, this morbid secretion changes its character, loses its acrid nature and becomes more bland, but still remains transparent. In an indefinite time, in general in two or three days, still further changes take place; its bland character remains, but its colour is

One of the most brilliant achievements of modern science, the honour of which is due to Läennec, is the discovery of a series of local signs by which inflammation of the bronchial tubes, placed as they are deep in the cavity of the chest, is rendered almost as evident as any external disease of the body; this remarkable man having brought completely within the cognizance of the ear what the eye could never have seen, nor the sense of touch have reached.

It has been shown that inflammation of the mucous mem-brane of the air-passages has two consequences, first, a swelling of the membrane, and secondly, a change of its secretions; the local signs by which the inflammation of the bronchi and of their ramifications is ascertained and discriminated from all other diseases, have reference to the e two conditions.

The

When the inflammation of the mucous membrane of the
bronchial tubes is considerable, the swelling of the mem-
brane may be so great as completely to close that portion
of the tube in which the inflammation is seated."
consequence must be that the respiratory murmur [Aus-
CULTATION] cannot be heard in that portion of the lung
which the tube supplies, since no air can pass the obstructed
point; accordingly, on applying the ear, or the stetho-
scope [STETHOSCOPE] to the chest it is found, especially in
severe affections of this kind, that the respiratory murmur
is absent in various portions of the lungs. This absence of
the respiratory murmur is however common to several
other affections of the lungs. Hence percussion must be
called to the aid of auscultation. By striking the chest
[PERCUSSION] it is found that the sound elicited is natural
in bronchitis, while in almost every other affection of
the lungs it is dull where there is no respiratory murmur.
The reason of this difference is, that in bronchitis the cells
are filled with air, so that a natural sound is elicited by per-
cussion; but the obstruction occasioned by the swelling of
the inflamed membrane confines and prevents the renewal
of the air, and consequently the respiratory murmur is lost;
while in other affections attended by absence of the respira-
tory murmur the air-cells are impermeable, either from their
consolidation or compression, and then the sound, on per-
cussion, is invariably dull and fleshy. If on the other hand
the inflamed membrane he not so much swollen as com-
pletely to close the tube, then another and a totally dis-
tinct sound is produced-a whistling sound, a sound always

observed to accompany an indistinct respiratory murmur, on account of the diminished calibre of the bronchial tube. Moreover, when the swelling of the membrane diminishes, the nature of the sound is again entirely changed. It now becomes a loud, deep, and sonorous wheezing, the intensity of which is sufficient to cause a vibration upon the parietes of the chest, distinguishable by the hand; at the same time the respiratory murmur becomes more distinct, denoting that the bronchial tubes are more open; finally, the deep sonorous wheeze assumes a still deeper bass, merges into the respiratory murmur, mixes with it, and gives it a roughness which is termed rough respiration.

On the other hand, where the secretion re-appears and is in excess, a wheezing sound is produced, which is loud and noisy in proportion to the quantity of fluid poured into the tubes. This sound, when it is formed in the trachea, can be heard through the medium of the air alone; but the application of the stethoscope, or the ear, to the surface of the chest is necessary when it is formed in the bronchial tubes. By these local signs it is possible to decide at once whether the disease in question be bronchitis or not; it is possible to determine the exact extent of the affection; for the wheezing may be heard only in a single line, as if in the direction of a single bronchial tube, or it may be heard all over one lung, and occasionally over both; and by judging of the distance of the sound from the ear, it is possible to tell whether the bronchial tube affected be in the centre of the organ or at its surface. In this manner we are taught the nature and intensity of the disease by the kind of sound induced in the morbid condition of the organ.

Besides these local signs or symptoms derived from the altered condition of the immediate seat of the disease, there are others derived from the disturbance of the system in general, termed general signs. These symptoms of a disordered state of the system in general are all those which belong to the disease termed FEVER. Whenever any organ of the body is affected with any disease of a certain degree of intensity, in addition to the disordered function of that particular organ, the natural functions of the great and general systems, such as the nervous, the circulating, the digestive, and so on, become disturbed. The disturbance of these general systems is always of a certain kind, and takes place in a certain order, giving rise, as has been just stated, to the train of symptoms which constitute fever. The fever thus induced is not a primary disease, it is occasioned by the sympathy of the system with the disease of some particular organ: this secondary form of fever is called sympathetic or symptomatic, in contradistinction to fever when it is the original and essential disease, which is termed idiopathic [FEVER]. The general or feverish symptoms are lassitude, indisposition to motion, chilliness, often amounting to shivering, pains in the limbs, and more especially in the back and loins; dullness and heaviness of the mind, or inability to carry on the intellectual operations with the usual vigour. The pulse is rapid and weak, and the urine scanty and limpid. These symptoms are soon followed by irregular flushes of heat, sometimes occurring at one part of the body, sometimes at another, alternating with the cold and intermingling with it, so that the patient feels frequently, in consequence of the rapidity of these changes, the two different sensations in the same place and almost at the same instant. The skin at length becomes universally hot, and commonly dry; head-ache comes on; there is more or less thirst; the pulse continues rapid, but becomes full; and the urine, which is still small in quantity, is now high-coloured. Then perspiration succeeding to the dry condition of the skin, the functions are again restored in a greater or less degree to their natural condition, and there is a corresponding remission of the symptoms. After this remission there is commonly an accession of the febrile attack, usually in the evening.

The causes which predispose to this disease are whatever causes diminish the general vigour of the system, such as great fatigue, excess of every kind, long exposure to a humid atmosphere, and so on. The great exciting cause is cold, especially when combined with moisture.

With regard to the treatment-when the disease is in its mild form nothing is required but confinement to the house in a uniform temperature in a warm room; demulcent and diaphoretic medicines to determine to the surface; mild aperients, and the abstinence from all stimulating food and drink. When the feverish symptoms have subsided, when

all uneasiness of the chest is gone, and the cough is slight, some light tonic, as any of the ordinary bitters, will assist in restoring the strength of the patient, and in preventing a relapse.

When the disease is in its severer form, and more especially when it is very acute, that is, when there is much difficulty of breathing, much oppression at the chest, very irritating cough, and a high degree of fever, blood-letting is indispensable. The quantity of blood taken must of course be in proportion to the intensity of the disease and the strength of the patient, but it must be in sufficient quantity to produce a decided impression upon the heart's action, and consequently upon the power and rapidity of the circulation. Antimonials exhibited in decided doses immediately after the blood-letting, commonly prevent the necessity of any further depletion. The best preparation of antimony is the tartar emetic, given in solution, to the extent of from one to two grains every second or third hour. The vomiting induced by the first doses commonly subsides or becomes slight after the third or fourth dose. Occasionally, however, this remedy produces so much irritation in the stomach and the system in general that it cannot be given in the quantity necessary to render it efficient; then ipecacuanha forms an excellent substitute, the powder of which may be given in doses of from one to two grains every three or four hours. When the fever subsides, but the difficulty of breathing and oppression at the chest continue, blisters are highly advantageous. The cough, in itself teasing and exhausting, and often aggravating every other symptom, must be allayed by oily emulsions, barley water, linseed tea, &c.; and if these fail, and the cough continue so violent as to prevent rest, opium must be given to the extent necessary to subdue it. The opium should always be combined with diaphoretics, so as to determine to the skin, at the same time that irritation is allayed. The bowels should be kept moderately open during the whole course of the disease; and there is no remedial measure of greater importance than the maintenance of the temperature of the apartment steadily and invariably, day and night, at the same point, a point which will insure a moderate degree of warmth, from 65° to 70°; A great degree of heat is a most pernicious stimulus; cold is the great exciting cause of the disease, and any considerable alternation from heat to cold, or from cold to heat, is of itself sufficient to counteract the beneficial operation of the most efficient remedies the most skilfully combined. The due modification of this general plan of treatment according to individuality of constitution, more especially in the feeble, and in those predisposed to organic disease of the lungs, according to age, more especially in those of advanced age, in the child and in the infant, is of the last importance in practice: but it is impossible in this place to enter into minute detail; all that can be done is to state and illustrate the general principles that should guide the treatment. (See Läennec on Diseases of the Chest. Lectures on the Diseases of the Lungs, &c., by Dr. T. Davies. Art. Bronchitis, Dr. Copeland's Dict. of Practical Med.)

BRONCHITIS, or inflammation of the bronchi or airtubes of the lungs, is a very serious disease among quadrupeds. It is occasionally confined to the lining mucous membranes of these passages, but it more frequently spreads to the lining membrane of the windpipe and larynx, and to a greater or less degree involves the substance of the lungs.

Horses. It is not a common disease in the horse, but is easily recognized by an interrupted wheezing sound in the breathing that can be heard at some distance; a tendency to coldness in the extremities, distinct from the somewhat increased heat of catarrh and the deathy iciness of inflamed lungs; a pulse quicker than either in catarrh or the early stage of pneumonia, not so hard as in pleurisy, but more so than in catarrh or inflamed lungs; the nostrils dilated, and the respiration strangely quickened, being often more rapid than the pulse; a haggard countenance; an almost perfect inability to move, from fear of suffocation; a cough exceedingly painful; a purulent discharge from the nostrils of a greyish green colour, which soon becomes fetid or mingled with blood; the breath hot; and no expression of pain in any particular part indicated by looking at the side or flank. Pieces of hardened mucus, or organized membrane, are also frequently coughed up.

Bronchitis is sometimes a primary disease, but it is oftener the consequence of neglected catarrh or long-continued but slight inflammation of the lungs. It is occa