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.
The greater part of the upper lobe, may be found converted into one
irregular cavity; more frequently, the upper lobe presents two or three,
either isolated or communicating. The largest, when several are present,
is most commonly in the upper portion of the lobe. When entirely or
partially filled with matter, such cavities are usually termed _vomicæ_
or abscesses, while when empty, they are generally called _tubercular
cavities_ or excavations.
In the lower part of the upper lobes, the cavities are few and small.
The middle lobe of the right lung, rarely presents cavities, while the
lower lobes of both lungs are entirely free. The whole of these parts,
however, may be more or less indurated by the presence of hard,
irregular shaped masses, the result, probably, of inflammatory action.
_Tubercular cavities_ present a considerable variety, both in size and
shape. They may not be larger than a pea, or bean, or may reach the size
of an egg, or even of an orange. Always of an irregular shape, they
often consist of one large cavity, communicating with two or three
smaller ones. The interior will be found traversed by bands, or cords,
passing in various directions, but generally taking a longitudinal
course, and probably the remnants of blood-vessels and bronchial tubes.
The tissues immediately around a cavity, and forming its walls, will be
found firm, inelastic, almost cartilaginous in character, and of a dark
red, or brown color. The density of the structures is caused partly by
tubercular deposits in the lung, and partly by inflammatory induration.
While tubercular disease of the lungs is almost universally fatal, there
is reason to believe that, in a very small proportion of cases recovery
has taken place, and the post-mortem appearances of the lungs have
accorded with this view. These appearances may be described as follows:
We sometimes observe in examining the lungs of individuals who may have
died from diseases of other organs, that the pleura covering the upper
lobe of the lung, presents, at a certain point, a puckered, shrivelled
appearance, with a leather-like feel, and with a rounded, firm mass
beneath. Upon dividing the latter with the knife, the interior is found
composed either of a soft substance like putty, or more frequently of a
chalky nature. This is looked upon as a cicatrized or contracted vomica,
the putty or chalk-like contents being the residuary matter of the
softened tubercle, the thinner portion having been expectorated or
removed by absorption. In some instances, these bodies are of almost a
stony hardness, grating against the knife.
In other cases, cavities lined with a smooth, semi-cartilaginous false
membrane are found, containing air only, and with dilated bronchial
tubes opening into the same, no appearance of ulceration being visible,
everything indicating that a tubercular mass had once occupied the
cavity, its softening and expectoration having been followed by a
healing of the inner surface.
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