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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    rm, The Rolandic area of the brain must be subject to of so-called great functional activity during the early years or “Basilar child-life, whilst this region of the cortex is deve- menin- lopinsr. Excessive functional activity means exces- gltls. sive waste and proportional tax on the lymphatics of the part. These are presumably contained in the perivascular sheaths of the middle cerebral arteries, whilst a few accompany the branches of the anterior cerebrals. Now it is quite conceiv- able that the adjustment between physiological cell-action and absorption of waste-product by the lymphatics may be tempo- rarily disturbed in this area, as for instance by a blow on the head. Under these conditions one can readily imagine how a retardation from overloading of lymphatics may arise, and that the bacillus of tubercle would find a congenial habitat. It seems to me that some such explanation, at any rate, accords best with the fact that tubercle is found in greatest abundance usually along the courses of the vessels named in so-called “ basilar meningitis.” With further regard to the pathology of the latter, I must confess that I have not yet been able to assure myself as to its being an inflammation at all. The morbid changes accord best, in my opinion, with the idea of lymph-effusion induced by weakening of the walls of the smaller arteries, and the blocking caused by the tuberculous granules. So far as I am able to judge, tubercle has no tendency, per se, to induce inflammation anywhere. Masses of greyish tubercle, which must have been forming many days, if not weeks, existed in the lungs of many of the cases quoted in the abstracts without anyr signs of pneu- monia ; and much grey tubercle was present in the peritoneum, in many cases, without any evidence of inflammation there. In “ tubercular meningitis,” which should perhaps be called “ tuber- cular lymph-stasis of the pia mater,” pus is very rarely seen, though the lymph may acquire a yellowish tinge and assume the character of puro-lvmph. “Purulent meningitis” has quite a different pathology, and partakes probably of the nature of a true inflammation. It sometimes complicates inflammation of the serous membranes elsewhere in the body. The nature This *s presumably not an inflammatory affection, of so-called but the result of distension with fluid of the «#aeh- “ optic ■mrwb sheath of the optic nerve. In this way the neuritis. return of lymph from the choroid will be obstructed