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
Maly, this genetic relation between the coloring matter of the blood
and bile, shown in the production of hydrobilirubin, is the only
chemical evidence of the connection of the two pigments.
[Footnote 41: _Hermann's Handbuch der Physiologie_, 1880, vii. 155.]
[Footnote 42: _Op. cit._, 161.]
Hæmatoidin is to be regarded not only as directly derived from
solutions of hæmoglobin, but as originating through the medium of
indifferent cells. Langhans claims that this pigment is formed within
movable cells which accumulate in great numbers in the vicinity of the
blood-clot, and, in virtue of their amoeboid properties, take into
themselves the extravasated corpuscles, entire or in fragments. The
indifferent cell may become enlarged into a giant-cell, and then
contain numbers of whole or disintegrated red corpuscles. In time
these colored corpuscles and fragments become smaller, more
glistening, and darker-colored, and eventually are transformed into
granular or crystalline hæmatoidin. These granules may be set free by
the fatty degeneration of the cell, or may be transferred within the
cell to distant parts.
{92} The diffusion and absorption of a solution of hæmoglobin, and the
formation of crystals of hæmatoidin from the same or through the
medium of cells, are supplemented by an apparent inspissation and
condensation of the hæmoglobin. The resulting dark-brown pigment may
remain at the seat of the hemorrhage indefinitely, and may be
accompanied with reddish-brown flakes, which, as shown by Kunkel,[43]
are composed of hydrated ferric oxide.
[Footnote 43: _Virchow's Archiv_, 1880, lxxxi. 381.]
Another feature in the absorption of extravasated blood is to be found
on examination of the nearest chain of lymphatic glands. These may be
seen swollen, of a dark-red color, and homogeneous surface. In density
and color, as well as shape, they suggest the small supplementary
spleens so frequently met with. These glands owe their change in
appearance to the presence of large numbers of unaltered red
blood-corpuscles which have entered the lymphatics traversing the
region of hemorrhage. Within the lymph-glands they undergo a
metamorphosis similar to that taking place at the part from which they
were transferred. In the course of weeks or months there remains in
the place of extravasation simply pigment, either as crystals or
granules. Such pigment may remain for years imbedded within the
tissues, or it may become absorbed, no trace of the original
disturbance remaining. Its removal may take place presumably through a
local solution of the pigment or the transfer of the granules or
crystals by means of wandering cells to the nearest lymphatic glands
or to the more remote parts of the body. An eventual elimination may
occur through the secretions, especially the urine or bile, or there
may result a deposition and permanent retention of the granules.
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