Volume 1

A system of medicine / edited by J. Russell Reynolds.

Date:
1866-1879
Catalogue details

Licence: Public Domain Mark

Credit: A system of medicine / edited by J. Russell Reynolds. Source: Wellcome Collection.

    189/976 (page 169)
    the capillaries of the lungs as in common asphyxia, but in the arteries short of them. On section there was free bleeding from the roots of the lungs, but there was little or none in the peripheral parts; they were generally ex-sanguine. He says : “On cutting through the roots of the lungs a quantity of blood usually escaped from the divided vessels, and particularly from the pulmonary artery; in one case the quantity of this was two pints, in one case one pint, in one twenty-four ounces, in one three ounces, in one six ounces, and in nine between two and five ounces. In fourteen cases the lungs were completely collapsed, appearing in some cases like the lung of a foetus. In three cases they were considerably, in eight slightly, col- lapsed ; and in the remaining fourteen cases the collapse was in some cases altogether and in some partially prevented by old adhesions.” The absence of blood in the tissue or substance of the lung was generally pretty complete, though in some instances there was more redness in the periphery than in others. The small amount of blood in the lungs seems proved by their deficient weight. Thus, he found that the average weight of the right lung in twenty-two Europeans was fourteen ounces, and of the left twelve ounces six drachms. Hr. Clendinning gives the average weight of both lungs at forty-six ounces, and Dr. Eeid at forty- three ounces, showing a deficiency in the Cholera cases of fifteen to nineteen ounces. The lung tissue was flabby, with little crepitation when not collapsed, so that it may be considered to have been in an extremely anaemic state, owing to an arrest of blood before it had reached the capillaries and smaller arterial twigs. The colour of the lung on section was pale or dark, or an admixture of both. Some writers report a congested state of the posterior parts of the lungs ; probably from hypostatic congestion. The right side of the heart was generally full and distended, the blood coagulated but not firmly. Parkes found the blood incoagulable in rather more than one-fourth of his cases. The left side of the heart was nearly empty, or containing only a little black blood with a few loose coagula. In following0 out the situations of congestions we find that the larger hepatic veins and the branches of the portal vein, generally those leading from the stomach, duodenum, and small intestines and their small ramifications, are full both on the mucous and peritoneal surfaces of these organs. The blood is generally of dark colour, but turns brighter on exposure to the air, or to the action of the matter in the small intestines. The chemistry of the blood has already been attended to. There is some difference of opinion as to the state of the coagulability of the blood. Parkes Virchow, Briquet, and Mignot have noticed either that it coagulates imperfectly; or that there is a loose state of the coagulum in the oTeat vessels. T think that Th Q VO rrnvi quo llx nmrA A ,