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in almost every respect. The office of the broncho-respiratory is to convey air into the true respiratory system, while the true respiratory system is where the great function order phenergan phenergan syrup of vitaliz- ing the blood is perfected. The bronchial system is charac- terized by cartilage in its fibrous sheath. In the upper part, where it is necessary to prevent collapse of the tubes, the car- tilage is in nearly perfect rings, but as the tubes pass into the lung-structure, where they are occupied by the residual air, the cartilage gradually loses the character of rings, and ap- pears merely as deposits occurring at irregular intervals, down so far as the bronchial arteries extend, to where the bronchial veins commence to carry back the purchase phenergan blood that -has passed through the capillaries of the bronchial mucous membrane. The mucous membrane also, of the broncho-respii*atory sys- tem, is different from that of the true respiratory system, in this, that it is ciliated epithelial mucous membrane, while the other is of tesselated basement epithelium. The circulation also is entirely different. The convective system is supplied by the bronchial arteries ; the pulmonary substance by the pulmonary artery, and by the nutrient arteries of the lungs, which are the connecting link between the two systems. The nutritive arteries arise from the bronchial arteries, but have no accompanying veins. Thus, blood, after perfonning the proper office of nutrition in the pulmonary tissue, is at once reaerated, and passes into the venous radicles of the pulmonary vein prepared for systemic circulation. The bronchial arteries have been called the nutritive ar- teries by anatomists, but they have not dwelt upon the fact that the venae comites do not phenergan vc attend these arteries into the pulmonary structure, and that, consequently, this gives them a peculiar character. The bronchial veins return all the blood 494 EESPIEATOEY MURMUES. of the bronchial arteries ; the nutritive arteries have no veins. Their blood is reaerated where they do their work, and it finds its way into the venous radicles -of the pulmonary vein as ar- phenergan and codeine terial blood. This anomaly in the circulation is of great interest in explaining physiological causes and pathological effects. In pneumonia, it is the nutrient artery, accompanied with its plexes of ganglia of the organic nerve, lymphatics, etc., that preserves the life of the part, and governs the whole process of resolution. We can all remember the anxiety of practitioners, in the phenergan dm past, to prevent abscess and gangrene of the lung after inflammation. But time, and a more careful study of the natural history of the disease, have proved to us that gangrene and abscess are rare accidents, even when no treatment at all is had. This peculiar arrangement of the nutrient artery gives us an early knowledge, in many cases, of phenergan buy commencing phthisis. 25 mg phenergan Occupation of the air-sacs by tubercle interferes with the circulation, and blood is thrown back upon the bronchial artery, and phenergan codeine syrup the result is bronchorrhagia, a con- servative act ; for, like the application of leeches, it sets the absorbents' actively at work to phenergan mg remove the cause — the new tubercle. And, in this way, cases of early phthisis are self- cured, or, at all events, ameliorated, and the physician is guided in his treatment. This singular fact in the circulation was discovered by the late Dr. Cammann, in making his experiments phenergan with codeine to prove the non-anastomosis of the arteries of the lung. Using a colored fluid suitable for fine injections, he found that, when he in- phenergan 25 jected the pulmonary artery, the fluid returned easily by the pulmonary vein ; but, injecting the pulmonary vein, the fluid not only passed into the pulmonary artery, but, if the injection was carefully continued, it would also find its way into the bronchial arteries. Then, again injecting the bronchial ar- teries, he found that the fluid after a little time passed into the pulmonary vein ; this proved that there was communica- tion between the bronchial arteries and the pulmonary vein, but not with the pulmonary artery. This was shortly after 1840, and before, I believe, any experiments had been made in Europe, in regard to this circulation. Since then, several observers have come to nearly the same conclusion. Drs. I EESPIEATOEY MUEMUES. 495 Williams and Aclriani believe "tlie vessels of the bron- chial mucous membrane terminate in the pulmonary veins, and those of the deeper plexus in the bronchial veins." Dr. Waters saj'S, after explaining his experiments, which were very full and minute : " That a distinct and free communica- tion exists between the bronchial vessels and the pulmonary veins, admits of ocular proof. I have seen, with the aid of the dissecting microscope, the small vessels passing from the outer surface of the bronchial tubes, and forming a small trunk, which terminated in a pulmonary vein." Dr. Waters also says : " It may be said that such a view militates against the phenergan codeine generally-received opinion of the purity of the phenergan dm syrup blood re- turned to the left side of the heart, for, if the bronchial blood is 2)oured into cheap phenergan the pulmonary veins, it is returned to the left am*icle without undergoing the process of aeration. I would answer phenergan use that the view I have taken is supported by anatomical facts, a basis on which all physiological theories should phenergan cream be founded." I remember that Dr. Cammann, also, could not reconcile the incongruity of the apparent fact that venous blood passed directly into the aerated blood of the pulmonary vein, and then to the left heart. Both of these gentlemen overlooked the truth that phenergan iv the blood from the nutrient artery passes through capillaries in the true respiratory system on its way to the radicles of the pulmonary vein, and, of course, is reaerated. Dr. Robert Lee, if phenergan online my memory serves me (for I have not the paper at hand), says that the extension of the

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