Cases and observations illustrating inflammatory effusions into the substance of the lungs, particularly as modified by contagious fevers / by William Aitken, M.D.

  • Aitken, William, 1825-1892.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: Cases and observations illustrating inflammatory effusions into the substance of the lungs, particularly as modified by contagious fevers / by William Aitken, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    of the capillaries, accounting for the presence of blood-dobules in the expectoration, as well as in the products of exudation the more characteristic, appreciable, and unmistakable changes 'take place in the diseased part itself, and in its secretion. The ten- dency of the deposit is to pass into organisms of a particular form —organisms depending for their characteristic appearances,— 1. On the nature of the morbid condition of the blood.' 2. On the amount of vascularity which the affected part retains. In other words, the characters of-the new formations will be found to vary with the quantity and qualily of the blood; and I am also inclined to ascribe much more influence to these two circum- stances in modifying the appearances of the exudation, than I am willing to allow to the power of affinity exercised between the his- tological elements of the structure in which the exudation takes place, and the constituents, normal or anormal, of the blood. When the first change in the deposit takes place, the func- tions of the capillary vessels are not suspended; circulation although impeded, still goes on in the part; and while effusion of blood plasma, and extravasations of blood itself, are insinuated into every minute space, imparting a degree of solidity to the texture, a great portion of the serum is at the same time rapidly absorbed. The quantity of red blood-globules extravasated with the liquor sanguinis varies with the amount of rupture which has taken place in the capillary vessels, and on this circumstance does the redness of the exuded matter depend, as well as on the increased amount of capillary injection. By this change the lung at first sight would seem to acquire increased hardness, and in point of fact it becomes more dense, and rapidly sinks in water. Reflec- tion, however, will show that the term ' hardening' here is merely comparative. A lung so affected is undoubtedly harder and heavier than it was in its previously spongy, light, and healthy state, on account of the displacement of air by the solidified exudation. But if the finger be thrust into a healthy, and then into a hepatized lung, it will be found, that whilst the former offers considerable resistance, the latter is friable, and readily breaks down, proving that in point of fact a softening of the tissue has taken place.'* According to authors, the specific gravity is increased as compared with the healthy lung in the proportion of 1'15 or 1*19 to 1, and the condensation throughout is generally complete, without a vestige of crepitation. The cut surface appears uniformly studded with flat granular elevations which are easily efl^aced. The patho- logy of this granulated appearance is differently accounted for by authors on pneumonia. Laennec considered the granulations to be the air-cells converted into solid grains by the thickening of * Bennett, Treatise on Inflammation, page 35. Hence Andral speaks of hepa- tized lung as softened.