A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
History
A system of practical medicine. By American authors. Vol. 1 : $b Pathology and general diseases
Medicine -- Practice
The frequent occurrence of fibrinous exudations on the mucous
membranes of the larynx and trachea, accompanied by the suffocative
symptoms known as croup, has led to the use of the term croupous
inflammation as synonymous with fibrinous inflammation, and its
application to various parts of the body where croupous--_i.e._
suffocative--symptoms are not in question. Croupous inflammation, when
used, is to be considered as an anatomical term, indicating merely the
production of fibrin, and, for the avoidance of confusion, it is
preferable to substitute fibrinous for croupous when such
inflammations are described.
The disease, croup, it is well known, may exist without a
croupous--that is, fibrinous--inflammation, as is familiarly
recognized in the constant use of the terms spasmodic, membranous, and
diphtheritic croup.
Fibrinous inflammation of the mucous membrane of the larger
air-passages is much more frequently met with than that of mucous
membranes elsewhere, as of the intestines, uterus, and bladder. The
pseudo-membranous inflammations of the latter tracts are more commonly
the result of the catarrhal and diphtheritic varieties than of the
fibrinous form. Fibrinous exudations on mucous surfaces, according to
Weigert, can only take place when the epithelium is destroyed. Hence
those causes which give rise to the destruction or detachment of the
epithelium are alone capable of producing a fibrinous inflammation of
mucous membranes, and a fibrinous laryngitis, trachitis, and
bronchitis may result from {50} the local application of such
irritants as steam or ammonia, as well as occur in the diseases croup
and diphtheria.
Fibrinous exudations may also be present within tissues, especially in
those whose meshes are wide, provided the essential elements of
coagulation are present. The coagulative necrosis of various organs,
to be more fully mentioned hereafter, is closely allied to fibrinous
clotting, the fibrino-plastic element being derived from the death of
the parenchymatous cells of the part.
In the existence of a fibrinous pneumonia the conditions are somewhat
analogous to those present in the fibrinous inflammation of serous
surfaces and of the areolar connective tissue. There is present an
abundantly cellular exudation, held in the place of its origin, the
cells undergoing rapid death and surrounded by a wall whose
superficial cells resemble in structure, if not in origin, the
endothelial cells lining the smaller lymph-spaces of connective
tissue, as well as the larger cavities within the same, known as
serous cavities.
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