Massive atelectasis due to fibrinous bronchitis.

Of all bronchial diseases, fibrinous, plastic, pseudo-membranous or Hoffmann's bronchitis seems to be one of the rarest. It has been estimated that up to 1869 about 130 cases had been reported (Walker, 1920); between 1869 and 1902 Bettmann (1902) collected 50, and between 1902 and 1920 a further 31 were reported (Walker, 1920). From 1920 to 1950 I have collected 25 new ones and these would bring the total up to about 136 in the world literature. The most important diagnostic feature is the coughing up of mucofibrinous casts during the course of a bronchitic type of illness. In some cases, however, casts are either not coughed up or not noticed; as the acute variety may be fatal, they may be found in the bronchi at necropsy, as in the case described below. Small fibrinous casts or plugs may be found in several acute or chronic lung diseases (Christian, 1919). This type of cast formation is symptomatic of the primary lesion and does not constitute true idiopathic fibrinous bronchitis. In the latter condition the casts are frequently long and may branch down to the seventh degree (Walker, 1920). They are greyish-white, sometimes hollow, and may contain Charcot-Leyden crystals and Cursch-