Lymph-stasis, or, retardation of lymph as an element in the causation of disease, especially in regard to scrofula and tuberculosis / by Wayland C. Chaffey.

  • Chaffey, Wayland Charles.
Date:
1889
Catalogue details

Licence: Public Domain Mark

Credit: Lymph-stasis, or, retardation of lymph as an element in the causation of disease, especially in regard to scrofula and tuberculosis / by Wayland C. Chaffey. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    a distance from the bowel this is more likely to be the case than when several glands are affected or situated near the gut, as is the group related to the lowermost portion of the ileum. These facts are explained by the assumption that the lymph in the former case has greater facility for escape than in the latter. Tubercles will often be found studding the lymph channels only m the vicinity of ulcers or between them and the associated diseased glands. The muscular structures do not allow of stasis of lymph, though their proper muscular fibres may be affected as regards nutrition by reason of imperfect removal of waste products; whilst the bones, not being subjected to compression, afford facilities for lymph-stasis. It is true that the existence of lymphatics has not been satisfactorily demonstrated in the case of bones, but this is probably owing to the obstacles which naturally present themselves to successful injection. The apices of the lungs are affected more than the bases, pro- bably on account of the former being less subjected to the expira- tory compressing influence of the chest and abdominal muscles. The forcible expiratory and often long-continued puffs which precede the drawing in of the breath in whooping-cough must tend to drive the lymph out of the lungs through the bronchial glands. Now, if pneumonia have supervened the lymphatics will be overladen with lymph and much “ choking ” of the glands will arise from the cough. It is under these conditions that we meet with the much enlarged, softened, bronchial glands, which are supposed subsequently to undergo caseous change. If no broncho-pneumonia exist in whooping-cough cases the glands will be found quite small and the lungs highly emphysematous usually. The pneumonia of whooping-cough, together with that of measles, scarlatina, and diphtheria, is very prone to resist all attempts at cure and to undergo acute softening or chronic degenerative change, all of which owe their non-resolution to the extensive implication of the bronchial glands often met with in these diseases. 1 have sometimes observed at post-mortems on such cases that the pneumonia was commencing about the roots of the lungs, evidently in the vicinity of bronchial glands, whilst the peripheral portions of the lungs were simply emphy- sematous. I surmise that these damaged bronchial glands afford Lymph- stasis in- duced by whooping- cough.