Lectures on the principles of surgical diagnosis : especially in relation to shock and visceral lesions : delivered before the Royal College of Surgeons of England / by F. Le Gros Clark.

Date:
1870
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the principles of surgical diagnosis : especially in relation to shock and visceral lesions : delivered before the Royal College of Surgeons of England / by F. Le Gros Clark. 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.

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    stration. Yet, as this subject is treated and taught, I think much of the complexity which surrounds it is due to inatten- tion in generalising ; and might be removed by the avoidance of expressions w^hich are liable to misconstruction. Perhaps I should speak more correctly if I say that such expressions as I refer to should have their conventional meaning strictly defined and limited. Thus, acute and chronic inflammation simply de- note degrees of intensity or duration ; and specific inflammation in all its varieties, means only this condition occurring as a consequence of, or allied w^ith, some constitutional peculiarity. In all these instances, the actual state vi'hich we denominate inflammation is identical, though varying, as I have said, in degree; and modified, in this respect and in the consequences it entails, by accidental circumstances. Again^ as regards these consequences, it is too often the habit to view them as distinct from each other, and to describe them under the several heads of adhesive, suppurative, ulcerative, phagedaenic, and gangre- nous inflammation ; whereas the same remark applies here as to the pre-existing condition :—these results are only different phases of the same state, modified by accidental circum- stances. In slow ulceration, or progressive death of texture, the dead or effete matter is thrown off with the material supplied for repair. In phagedsena, the rapid destruction, without repara- tive effort, leaves the foul and sloughy surface. In gangrene, death falls suddenly on the part en masse; and the dry or moist form is associated with the existing condition of the textures, whether natural or acquired. Again, an ulcer is but an open abscess, and an abscess a closed ulcer. In one, the effete matter and accumulated but wasted material for reparation are retained; in the other, they are continually draining away. The abscess must be converted into a hollow ulcer before it will heal. A sinus holds an inter- mediate position between the two ; it has no special character- istic, except that which is due to its form and the consequent