A case of pulmonary embolism, with notes bearing generally on the subject of emboli / by Wm. Robert Smith.

  • Smith, William Robert.
Date:
1877
Catalogue details

Licence: Public Domain Mark

Credit: A case of pulmonary embolism, with notes bearing generally on the subject of emboli / by Wm. Robert Smith. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    ing production in the arterial cavity ; in many cases gangrene of the limbs was found co-existent with plugging of the main arterial branch. Now, in such cases was the obstruction pri- mary, and the inflammation of the vessel a secondary matter caused by the irritating properties of the embolon ? or was the relation reversed ? or, in the third place, were the obstruction and inflammation the joint effects of a cause separate and distinct ? According to Virchow, the inner coats of arteries are not per- meable to inflammatory exudations from the vasa vasorum of such vessels, this exudation being capable of coagulation ; but this is found either between the outer and middle coats, or between the middle and inner ones; and this latter must give way before pus can be deposited in the arterial cavity. Some- times coagula are found in an inflamed vessel when they are caused by a deposition of fibrine upon a roughened arterial wall, or upon some projection through such wall, the result of imperfect nutrition. In some cases the coagulum adheres only to one wall of the vessel, with the effect of narrowing the tube. This is not true embolism, although such a condi- tion may give rise to embolic obstruction. Embolism may be defined as the existence of a clot in an artery without simul- taneous lesion of its walls, this clot having been carried with the circulating stream from some distant spot as far as it would go, the arrest always taking place in vessels of a suddenly constricted calibre, too small to allow the solid body to pass. Such are briefly the views set forth in Virchow's work on Arteritis. Since his time many able observers have written upon the subject, but their works are for the most part all based upon Virchow's theses, and are confirmatory of his observations. Time will not allow of reference to these, but I would remind you of Dr. Kirkes' conclusions from a careful study of the whole subject—viz., (1) that fibrous concretions did separate from the heart during life; (2) that these were arrested in