The pathology and diagnosis of diseases of the chest; illustrated especially by a rational exposition of their physical signs. With new researches on the sounds of the heart / [Charles J.B. Williams].

  • Williams, Charles J. B. (Charles James Blasius), 1805-1889
Date:
1835
Catalogue details

Licence: Public Domain Mark

Credit: The pathology and diagnosis of diseases of the chest; illustrated especially by a rational exposition of their physical signs. With new researches on the sounds of the heart / [Charles J.B. Williams]. Source: Wellcome Collection.

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    . cles; but, in the course of time, they gradually become, in consistence and colour, like soft cheese, and at length attain the liquidity of pus; this change generally beginning towards the centre. The miliary bodies become likewise converted into little opake yellowish granular tubercles when isolated ; but when in a cluster, frequently run together into one tuber- culous mass of considerable size. The tuberculous masses formed in the diffused induration may, of course, be of form and size as varied as those of the matrix in which they are developed. But the opaque tubercle seems likewise sometimes to increase of itself, to extend beyond the limits of the previous induration, and to encroach on the surrounding tissue. In some few instances this progress is limited by the formation of a fibrous cyst. ‘The yellow tuberculous matter is also pro- duced in some cases, without the previous induration, espe- cially in glands, in the ovaries, and in the vesicular structure of the lungs; and a tuberculous infiltration of this kind is not unfrequently found in the lungs and bronchial glands of children.* After the softening of the tuberculous matter, it is evacuated by a fistulous communication, generally into the bronchi, and rarely into the pleural sac. IV. After the softened tuberculous matter is evacuated, an ulcerous cavity is left, which presents to the anatomical observer a great variety of form. The walls of the cavity are sometimes simply the pulmonary tissue, in an abraded and sloughy state, or sometimes more or less red with inflamma- tion. ‘The result of this inflammation (excited probably by the irritation of the tuberculous matter) is, during life, on * Dr. Carswell regards the mucous surfaces as the principal seat of tuberculous matter; the serous surfaces, he says, also present it, and it may occur in blood or in lymph recently effused ; but in no instance, he says, is it deposited in the mole- cular structure of organs. (Cycl. of Pract. Med. Art. Tubercle.) Andral consi- ders the cellular tissue its chief seat, but that it may occasionally occur on mucous and serous surfaces. Lombard supposes it to be restricted to cellular tissue. I shall advert to this subject again.