Bronchiectasis and atelectasis; temporary and permanent changes.

The introduction of iodized oil as a contrast medium in radiology by Forestier and Sicard made it possible for the first time to demonstrate dilated bronchi in the living body. Thus the diagnosis of bronchiectasis could be made with certainty during life and was no longer dependent on post-mortem verification. Cases of bronchiectasis became apparent which did not show the classical symptoms of long-continued ill-health, cough, and copious sputum, with clubbing of the fingers and signs of disease at the bases of the lungs. Wall and Hoyle (1933) were able to recognize cases of " dry bronchiectasis." The intimate association between atelectasis of the lung and bronchiectasis was recognized and commented on by many authors-Singer and Graham (1926), Anspach (1939), Warner and Graham (1933), and Warner (1934). Finally, cases of bronchiectasis were diagnosed within a short time of their onset, and subsequent restoration of the bronchi to normal calibre was shown (Findlay, 1935; Jennings, 1937; Lander and Davidson, 1938a; Fleischner, 1941; Ogilvie, 1941; and Blades and Dugan, 1944). This paper presents four cases of atelectasis with bronchiectasis in which subsequent re-expansion of the lung was attended in three cases by return of the bronchi to normal, and in the fourth by an alteration in the bronchographic appearances with a persistence of bronchiectasis. The experimental work which has a bearing on this problem is reviewed, and an attempt made to explain some of the anomalies and misunderstandings which have arisen.