Treating Bronchocele With Phosphorus

In nine cases of bronchocele (fibrous) I have made trial of phosphorus in varied doses, but without good result. Dr. Leech (Manchester) has sometimes seen the growth subside under the use of this drug, after iodine had failed (British Medical Journal, i., 1874), and it may occasionally prove a resource. Dr. Moxon has pointed out that glandular tumors vary in size, not only under various remedies, but sometimes without apparent cause.

Treating Bronchocele With Iodine (Iodum)

In cases of fibrous and fibro-cystic bronchocele, where calcareous degeneration has not occurred, local applications of iodine should be combined with its internal use. If the part be tender or inflamed, soothing fomentations, or even moderate leeching, may be needed before using iodine; then either the liniment may be painted on once or twice daily for several days, according to the degree of irritation produced, or an iodized collar may be worn (made with iodine sprinkled on wool), or iodoform, or iodide of mercury ointment may be rubbed in as described (v. Mercury). I have sometimes been disappointed with the mere external use of iodine in bronchocele, but have had excellent results from its injection into fibrous and fibro-cystic cases (25) in which I have used it. In one large fibro-cyst, as to which there was difficulty of diagnosis, no fluid being suspected, 30 min. of the tincture were injected, and considerable diminution of the growth followed; a month afterward 3 oz. of fluid were drawn off, and the cyst injected with 2 dr. of a solution containing 1 part of tincture to 3 of water. The man was highly scrofulous, and the growth of long duration; but, after the inflammatory condition set up by the iodine had subsided, the bronchocele disappeared and gave no further trouble. The only case in which dangerous results occurred was one in which some iodine solution escaped into the cellular tissue, and sloughing of the part followed. Nineteen out of the 25 cases got well, 2 of them having been injected seven times. Lately, Dr. Lucke, of Berne, has reported equally good results in the fibrous form of enlargement. Of 16 cases treated by him, 11 were cured and 4 improved; and Dr. Morell Mackenzie, who at first considered this method inferior to others, records his later experience of it as very favorable. He obtained unexpected cures in fibrous and adenoid cases from the weekly or biweekly injection of 30 drops of tincture (Medical Times, i., 1872, and British Medical Journal, ii., 1873). Dr. Luton speaks well of similar injections of iodic acid - 1 part to 5 of water; he uses about 1/2 dr. at one time (Lancet, ii., 1873, p. 457). (v. Internal Use.)

Treating Bronchocele With Iodine (Iodum)

In simple soft goitre, in which malady, indeed, the reputation of iodine was first acquired, I consider it almost a specific. In recent cases, 1 to 5 min. doses of the tincture produce the best results, for, if unduly large quantities be given, the swelling becomes hard, tender, and painful. In more chronic cases already indurated, large doses- 1/4 to 1 gr. of iodine - may be given in conjunction with its external use (v. p. 71); some astringent syrup, e.g., of cinchona or orange-peel, should be added to prevent derangement of stomach. Mr. Bryant has known goitres rapidly disappear under the influence of an iodized atmosphere, obtained by simply placing iodine in a perforated box in the patient's room; he recommends also the local use of an ointment of iodide of ammonium ("Practical Surgery," 3d Ed.).

In Exophthalmic Goitre I have also seen a limited amount of success from the internal use of iodine tincture, the palpitation being frequently relieved by small doses.