On some of the principal effects resulting from the detachment of fibrinous deposits from the interior of the heart, and their mixture with the circulating blood / by William Senhouse Kirkes.

  • Kirkes, William Senhouse, 1823-1864.
Date:
1852
Catalogue details

Licence: Public Domain Mark

Credit: On some of the principal effects resulting from the detachment of fibrinous deposits from the interior of the heart, and their mixture with the circulating blood / by William Senhouse Kirkes. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    when the deposits on the right valves consist of large warty masses, as they occasionally do, portions of considerable size may be detached, and transmitted along the pulmonary artery, and so plug up one of the large branches of this vessel, just as similar masses detached from the left valves may be arrested in one of the main systemic arteries; but I have not yet met with a decided instance of such an occurrence. Probably the more usual manner in which the separation of fibrinous masses from the right valves leads to the formation of coagula in the pulmonary artery, is by the transmission of small particles to the minuter divisions of the artery, or to the capillary plexus, arrested at which they induce stagnation of the blood in those branches of the artery distributed to the seats of obstruction. Such a result is almost necessarily consequent on the peculiar mode of distribution of the branches of the pulmonary artery, which pass to their destination without anastomosis. In a paper on the formation of coagula in the pulmonary artery, published in the Transactions of this Society, Mr. Paget has clearly shown the influence which certain obstruc- tions in the pulmonary capillaries, such as oedema, chronic pneumonia, and pulmonary apoplexy, sometimes exercise in inducing coagulation of blood in the arteries supplying the obstructed parts. And I have likewise noticed a similar influence apparently resulting from other circumstances, such as extensive old tubercular disease, and extreme com- pression of the lung by false membrane on the pleura, which have obliterated large portions of the pulmonary tissue. Mr. Paget also narrates instances in which particles of can- cerous matter brought from remote organs to the right side of the heart, and thence transmitted to the lungs, became arrested in the pulmonary capillaries, and so induced stag- nation and subsequent changes of the blood, in branches of the pulmonaiy artery. Cases like these, of which I have seen several examples, seem to leave no doubt that a like coagulation of blood in the pulmonary arteries may result from obstruction caused by the arrest of particles of fibrine detached from the right valves of the heart, and transmitted to the pulmonary capillaries. An instance of this is fur-