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
Whatever may be the origin of the cheesy condition, the material
presenting this appearance is liable to further changes, known as
softening and calcification. The former event results from the soaking
of the dead part with liquid, in consequence of which a detritus
results. The softening usually begins at the oldest part of the cheesy
mass, and advances toward the periphery. The sanatory evacuation of
the emulsive detritus is permitted when a surface continuous with that
of the external surface of the body is reached, as instanced by the
escape of softened cheesy material from the lungs through a bronchus.
The possibility of the complete removal of the dead mass is thus at
hand, and an eventual obliteration of the resulting cavity may take
place by an adhesive inflammation of its walls.
The complete absorption of the cheesy material of an ischæmic necrosis
may occur by the extension into the latter of a granulation-tissue
from the periphery. Whenever cheesy appearances are found on surfaces,
as the degenerated tubercles of mucous membranes or the circumscribed
necroses in diphtheritic inflammation or in typhoid fever, healing may
be accomplished by their detachment as sloughs, a clean ulcer being
left. Cheesy material is frequently encapsulated--_i.e._ imbedded in a
layer of dense connective tissue, a condition which indicates a local
cessation of the process through which the cheesy appearances arose.
The same may be said of the infiltration of the cheesy mass with
earthy salts--calcification--an event which will again be referred to
in connection with the consideration of the general subject.
_Hyaline Degeneration, Fibrinous Degeneration, Croupous
Metamorphosis._
Certain of the conditions now regarded as indicative of a coagulative
necrosis or a hyaline degeneration were previously described by Wagner
as the result of a croupous or fibrinous metamorphosis. According to
this observer, the cell-contents were transformed, under certain
circumstances, into a substance resembling externally clotted fibrin.
The formation of croupous and diphtheritic membranes, especially of
the larynx, pharynx, and trachea, was thus explained, also the hyaline
casts of the kidney.
{81} The results of this metamorphosis presented a hyaline appearance
under the microscope, and the term hyaline degeneration is now applied
more especially to indicate the production of microscopic changes,
while the hyaline appearances visible to the eye are rather included
under mucous, colloid, or amyloid metamorphoses.
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