Lectures to practitioners. On the diseases classified by the Registrar-General as tabes mesenterica / by W.T. Gairdner. On the pathology of phthisis pulmonalis / by Joseph Coats.

  • Gairdner, W. T. (William Tennant), Sir, 1824-1907.
Date:
1888
Catalogue details

Licence: Public Domain Mark

Credit: Lectures to practitioners. On the diseases classified by the Registrar-General as tabes mesenterica / by W.T. Gairdner. On the pathology of phthisis pulmonalis / by Joseph Coats. Source: Wellcome Collection.

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    22G what similar acute peritonitis. In the case of necrosis in the caseous form of phthisis the dead tissue may possibly give more ready passage to juices containing irritating pro- ducts in solution, and perhaps even to micro-organisms. If the patient survive, as will mostly be the oase, the acute pleurisy will probably subside by degrees, and give place to a chronic inflammation. The results of this, as in ordinary simple pleurisies, is adhesion of the pleura, and in this way we may have obliteration of the pleural sac by general adhesions such as we often meet with in phthisis. Pneumothorax also implies necrosis of the pleura, but it implies more than this. There must be in addition a partial separation of the dead piece, and the establish- ment of a communication between the pleural sac and the air passages. This infers the existence of a cavity beneath the necrosed piece of pleura. If beneath the necrosed pleura there is only a caseous piece of lung, then, although by softening of the caseous matter a cavity may ultimately form, yet before that has happened, adhesion may have occurred, and the danger of perforation may have been averted. But if, on the other hand, a cavity forms rapidly, then along with the softening caseous matter the necrosed pleura is also liable to soften, and may separate at its edge, just as does an ordinary slough. As the cavity communicates with the air passages, an open communica- tion is thus formed, by which air passes into the pleura. It is by the separation of such sloughs of the pleura that, in my experience, pneumo-thorax is brought about. I have here two preparations from the museum, which illustrate this mode of occurrence. I shall read to you the description of these cases as derailed in the Museum Cata- logue :—