A practical guide for making post-mortem examinations : $b and for the study of morbid anatomy, with directions for embalming the dead, and for the preservation of specimens of morbid anatomyThomas, A. R. (Amos Russell)
Science
A practical guide for making post-mortem examinations : $b and for the study of morbid anatomy, with directions for embalming the dead, and for the preservation of specimens of morbid anatomy
Thomas, A. R. (Amos Russell)
Anatomy, Pathological; Autopsy -- Handbooks, manuals, etc.
=Pneumonia=, or inflammation of the lungs, may affect both the air
cells, when the latter become filled with fibrinous exudations, and the
connective areolar tissue, which then become increased in quantity.
The following characters present themselves, corresponding to the three
recognized stages of the disease:—First, _congestion_; second, _red
hepatization_; third, _gray hepatization or softening_.
=Congestion.= From the peculiar structure of the lungs, in connection
with the free circulation through the same, these organs are peculiarly
liable to the several forms of congestion. In many cases of death,
without any original disease of the lungs, there will be a tendency for
these organs to become loaded with blood, giving rise to post-mortem
appearances, often with difficulty distinguished from those of a
pathological origin. In this post-mortem, or, as it has been called
_hypostatic_ congestion, the posterior and inferior portions of the
lungs are chiefly affected, as the blood after death, obeying the law of
gravitation, sinks to the lowest point. The congested portion presents a
dark red color, and though firmer than other portions, crepitates under
the finger and floats in water, the latter circumstance serving to
distinguish this form of congestion from that of an inflammatory origin.
If the congestion be confined to one lung, or to the anterior parts of
either, we may safely attribute it to a pathological cause.
In all cases of congestion, upon opening the chest, although there may
be no adhesions, the lung does not collapse, or does so feebly. When
cut, it is found to be loaded with blood, and upon pressure, much bloody
serum escapes, while the divided bronchial tubes will be found filled
with frothy mucus.
=Red Hepatization.= This condition of the lungs soon follows that of
congestion. The change is a gradual one, and is first marked by an
effusion of serum and coagulable lymph into the connective tissue and
air cells, thus rendering the lungs more solid, while as the change
becomes complete, the blood itself, which had during the congestive
stage been confined to the vessels, is now found extravasated into the
interstices of the tissues. The portion of the lung thus affected is not
only of a dark red or violet color, but solid, firm, does not crepitate,
sinks when thrown into water, and when cut and washed, the section shows
patches of a rough, granular aspect, totally different from that of
healthy lung tissue. The pleura in this condition may be wholly
unchanged, even though the solidification may have been of long
standing.
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