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
Although experiments show that a simple plethora with great distension
of the capillaries of the abdominal organs occasions no considerable
increase of transudation, a different result follows a hydræmic
plethora[25] induced by the injection of immense quantities of salt
water into the blood-current--often six times as much liquid as the
animal had blood. Here, too, the arterial blood-pressure shows no
permanent increase, nor does that within the large veins become
perceptibly increased till enormous quantities of fluid are injected.
The blood flows through the vessels with increased rapidity in
consequence of the diminished friction of the diluted blood, and an
increased transudation begins at once. The various glands, salivary
and gastro-intestinal, kidneys and liver, secrete more copiously, and
the flow of a dilute lymph from the thoracic duct becomes greatly
increased, while that from the cervical lymphatics becomes moderately
accelerated. The lymph from the extremities, however, is no greater in
quantity than that flowing from an animal in a perfectly normal
condition. The localization of the increased transudation from the
blood-vessels is further characterized by the abundant accumulation of
watery fluid in all the abdominal organs and abdominal cavity, in the
salivary glands and surrounding connective tissue, while elsewhere in
the body the organs and tissues are almost invariably in the same
condition with {69} regard to moisture as are those of a healthy
animal under normal circumstances.
[Footnote 25: Cohnheim and Lichtheim, _Virchow's Archiv_, 1877, lxix.
106.]
The importance of these experiments with reference to the causes of
the transudation of fluid from the blood is obvious. The pressure upon
the walls of the blood-vessels cannot become sufficiently increased to
be accompanied with augmented transudation until limits are reached
which are beyond the possibilities of occurrence in the human body.
When such limits are attained in animals, the increased pressure,
however great it may be, does not suffice to produce a general
transudation, but one limited to the vessels of those parts of the
body whose normal function is connected with too abundant transudation
of fluid. A simple hydræmic condition of brief duration has been
proven, by experiment, insufficient to give rise to increased
transudation, neither increased secretion nor increased flow of lymph
taking place. The inference from these experiments is that an
increased transudation is more dependent upon conditions of the filter
than upon those of blood-pressure. The absence of any observable
changes in the filter leads to the assumption of an increased
permeability, of physiological occurrence in certain parts of the
body, as the chief feature in the occurrence of increased
transudations.
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