Outline of an inquiry on the pathology of consumptive diseases. Part 2 / by John Abercrombie.

Date:
[1822?]
Catalogue details

Licence: Public Domain Mark

Credit: Outline of an inquiry on the pathology of consumptive diseases. Part 2 / by John Abercrombie. 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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    unfit for the purposes of respiration; but it may remain long, perhaps in some cases through life, in a dormant state, that is, without passing into any farther state of disease. If it be of small extent, it may produce little or no uneasiness; but if the extent of it be considerable, it must impede the circulation through the lungs, as it is nearly impervious to the blood from the pulmonary artery. Hence it is likely to produce dyspncea, and, in the end, give rise to hydrothorax. But a mass of this kind is very prone to farther disease—to a low inflamma- tory action of a peculiarly unfavourable kind—and to a pecu- liarly unhealthy ulceration as the result of it:—and there are some points deserving minute investigation in regard to the ef- fects of inflammation on the various structures of which the mass is generally composed. It seems doubtful whether the proper white tubercle be susceptible of inflammatory action. It appears to undergo a change peculiar to itself, by which its contents are gradually softened, until they at last degenerate in- to an ill-conditioned pus. Though the tubercle itself however, be insusceptible of inflammation, it is probable that this process is accelerated by inflammation affecting the surrounding parts; but, in general, the tubercle seems to pass very slowly into the state of ulceration, and the ulceration to extend very slowly Over the neighbouring parts. Hence the symptoms in such cases are not acute, and their progress is very slow; and, even after the disease has been of considerable standing, we may find, on dissection, but a few small vomiem amid the mass of tuber- cular disease. The hepatised induration, on the other hand, appears to be highly susceptible of inflammatory action, and, under the influence of it, seems to run rapidly into extensive ulceration of a peculiarly unhealthy kind, presenting appear- ances remarkably different from the tubercular ulceration, and forming a modification of the disease remarkably different from the pure tubercular consumption. The symptoms are more se- vere at their commencement, and their progress much more ra- pid, the case perhaps being fatal in three or four weeks; and we find, on dissection, a dark-coloured induration of the lung, with a large cavity lined by ragged ulceration, as if a large por- tion had been forcibly torn out. This most important modifi- cation of the disease will be more particularly referred to in the sequel. This induration of the substance of the lungs appears to form the basis of the pathology of consumption. Researches calcu- lated to illustrate the subject must be directed to the nature and origin of the induration—the nature ot the various structures which enter into the composition of it—the peculiar changes