On spontaneous gangrene from arteritis and the causes of coagulation of the blood in diseases of the blood-vessels / by Joseph Lister.

Date:
[1858?]
Catalogue details

Licence: Public Domain Mark

Credit: On spontaneous gangrene from arteritis and the causes of coagulation of the blood in diseases of the blood-vessels / by Joseph Lister. Source: Wellcome Collection.

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

    12/18 (page 12)
    liave a sure, though imperfect glim])se, of the operation of mysteri- ous but potent forces, peculiar to the tissues of living beings, and capable of reversing the natural order of chemical affinities ; forces which I suspect will never be fully comprehended by man in the present state of his existence, and the study of which should always be approached with humility and reverence. Having thus obtained evidence of the active operation of the living tissues upon the blood, it occurred to me that the walls of the vessels might probably act to greater advantage upon their contents when of small than of large calibre, and that, in that case, the blood might be found fluid in the small vessels of the human body after death, although coagulated in the heart and large vessels. Accordingly, I have examined three human bodies with regard to this point, and in every case have found my idea confirmed. One of these was a woman, aged 70, who had been a j)atient under Dr Gillespie's care at the Infirmary, with senile gangrene. The right cavities of the heart were full of blood, and contained large clots buffed on their upper surface, and the large vessels also con- tained abundant soft coagula, but a small vein from one of the thighs yielded fluid blood, which coagulated slowly in a saucer. The body was examined about thirty-six hours after death. The other two had been patients under Dr Gairdner's care, also in the Royal Infirmary. One of these was a man about 30, who had died of meningitis. The heart had been removed before I saw the body, but the large vessels, such as the external iliac vein, con- tained coagula, whereas all the small veins which I observed con- tained perfectly fluid blood, which, however, had lost the power of coagulation. The third case was that of a young man, aged 21, who died of a complication of medical and surgical complaints, nearly forty-eight hours before the body was examined. The corneje were perfectly clear, and there was no appearance of any incipient decomposition. This case was investigated very carefully ; and as the subject is novel, it may be well to give the results in detail:— I was not present when the heart was removed, but Dr De Fabeck had evidently passed through an anastomosing channel, being present in the form of very numerous large and small bubbles. Having secured the ends of a long piece of this vein, I dissected it out and shed its blood into a saucer. Not a particle of clot existed in the vein, and complete coagulation took place within a quarter of an hour. The vein which had been exposed, in order to inject the air, contained here and tiiere portions of clot in tlie exposed part, the vitality of the vessel having doubtless been impaired by the mechanical violence to wiiich it was subjected in the dissection, or by the drying influence of the atmosphere. In order to illustrate the effect of mechanical violence applied to a vessel in promoting the coagulation of the blood within it, I pinched a vein of the same foot severely with dissecting forceps in about an inch of its length, at the same time tiiat 1 injected the air into the other vein. On examining the foot, seven hours later, the vein wiiich had l)een pinciied contained coagulum in tlie part which had been so treated, but fluid blood in tlie rest of its extent, both above and below the injured portion.—J. L., IQtli March 1868.