Volume 2

The principles and practice of medicine / by Rustomjee Naserwanjee Khory.

  • Khory, Rustomjee Naserwanjee.
Date:
1885
Catalogue details

Licence: Public Domain Mark

Credit: The principles and practice of medicine / by Rustomjee Naserwanjee Khory. Source: Wellcome Collection.

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    cases of general wasting from any cause. In diabetes atrophy is sometimes extreme. It may also result from pressure upon the gland by morbid growths in its vicinity, or from diseases of the organ itself. Atrophy is generally associated with fatty degeneration. 4. Fibroid or cirrhotic changes in the pancreas. These may involve either the whole of the organ or some portion of it, the head of the pancreas being most often affected. The changes are the same as those which occur in the early stage of cirrhosis of the liver; they lead to induration of the organ, which becomes firm, tough, and granular, and also irregular in shape. The causes which give rise to this condition are prolonged venous congestion, chronic alcoholism, retention of the pancreatic fluid with dilatation of the ducts, cancer, and syphilitic growths. 5. Chronic suppuration.—This condition is sometimes due to the existence of calculi or formation of cysts. In scrofulous subjects and in tubercular disease caseous degenerations may follow chronic inflammation. In chronic suppuration the abscesses may burst into the abdominal cavity or other parts, or the pus may dry up and undergo calcareous changes. 6. Degenerations.—Those affecting the pancreas are of two prin- cipal kinds : fatty infiltration and fatty metamorphosis. The fatty infiltration is associated with obesity. It affects the interstices of the connective tissue, and ultimately causes wasting of the organ by pressure. The fatty metamorphosis affects the gland cells, and is of common occurrence in chronic alcoholism, in diabetes, and in other wasting diseases. The organ becomes small, soft, and flaccid, and may even be destroyed. 7. Morbid growths.—Cancer of the scirrhous variety is the most common, the other forms being very rare indeed. It is seldom primary, and is generally due to extension of the disease from the pyloric end of the stomach or the duodenum. Cancer of the pan- creas is more common in men than in women, and is rare under forty years of age. It generally affects the head of the organ, which then presents hard, irregular, nodulated elevations, which are whitish on section. The unaffected portions are atrophied, and the ducts are dilated, and often contain calculi. The disease has a tendency to extend to the neighbouring structures, and thus the stomach, duodenum, peritoneum, &c, are involved in the process of destruction and ulceration. In some cases it extends to the vertebrae, and leads to their destruction. Other morbid growths, as sarcoma, tubercle, and syphilitic gummata are extremely rare in the pancreas. 8. Obstruction and dilatation of the ducts and cystic formations.