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.

    211/976 (page 191)
    be now and tlien discovered after death from this disease, but have only a fortuitous connexion with it, we will limit ourselves to tie consideration of those morbid changes only which form, so to speak, an integral part of Pyamiia. . , . (a) Morbid Anatomy considered generally—The lesions which charac- terise Pyaemia consist in local congestions, extravasations of blood, inflammatory deposits, abscesses, and necroses. Simple congestion is a phenomenon which is apt to disappear after death, or to be modified and masked by mere post-mortem changes; it is frequently observed during life to accompany superficial pyasmic inflammations, it is fre- quently recognised after death in the vicinity of so-called “ secondary deposits,” and doubtless as a rule it precedes all the more important changes which attend this disease. Congestion is therefore a real and important link in the chain of pysemic events, but its presence or absence post-mortem cannot in all cases be taken as trustworthy evidence of its presence or absence during life. Extravasations of blood are of almost constant occurrence ; sometimes they appear as petechial spots or vibices; sometimes as clots infiltrating the tissues of organs— abruptly marginated and resembling patches of pulmonary apoplexy; sometimes they form decolourized fibrinous masses, much like the fibrinous “ blocks ” observed under other conditions in the spleen, in the liver, and in the kidney. Inflammatory deposits are rarely if ever absent; and may be associated or mixed up with other morbid conditions, such as extravasations of blood, or may occur independently of them. In the former case they often surround the extravasations, and in connexion with serous surfaces form distinct false membranes. In the latter case they constitute, in the lung, patches of lobular hepatization; and produce in other organs nearly equally well-marked changes. The term “ secondary abscess ” has been largely employed to designate the localised morbid processes taking place in the course of Pyaemia. And in most cases of Pyaemia abscesses doubtless exist. Sometimes, especially in joints and certain other places, suppuration takes place so instantaneously that the formation of pus would almost seem to be the very first evidence in them of a departure from the condition of health. But more commonly the formation of an abscess is distinctly a later process, supervening on the extravasation of blood or on the effusion of lymph, and commencing either at the margins of the diseased patch, or at some central point in it, or involving the patch simulta- neously in its whole extent. In some cases the cavities which pass for abscesses would seem rather to be the results of circumscribed ganorene than of true suppuration; for they yield a gangrenous odour, and contain a soft shreddy material, more or less adherent to the parietes and infiltrated with a d irtv-lnnkincr •Pnpfirl vm-nifn VTV» fln-I/'l A P 1