Memoirs of John Abernethy: With a View of His Lectures, His Writings, and Character; with Additional Extracts from Original Documents, Now First PublishedMacilwain, George
Science
Memoirs of John Abernethy: With a View of His Lectures, His Writings, and Character; with Additional Extracts from Original Documents, Now First Published
Macilwain, George
Abernethy, John, 1764-1831; Physicians -- Great Britain -- Biography
Those who recollect the remarkable results which Abernethy sometimes
obtained in regard to this intractable and often formidable class of
diseases, will, I think, be disposed to agree in thinking that few
maladies are more open to improved investigation, or promise a more
encouraging prospect of enlarging the boundaries of philosophical
medicine.
SECTION.
HIS PAPER ON A CURIOUS CIRCUMSTANCE SOMETIMES
FOLLOWING INJURY TO THE LUNGS.
Fractured ribs are common accidents, and illustrate very beautifully
those conservative principles in animal bodies which give such interest
to the study of their economy.
When first we consider that the ribs form the greater part of that
box in which the lungs and heart are enclosed, and by which they are
protected, we are disposed to regard a fracture of one or more ribs as
a very serious affair.
Nevertheless, these accidents generally do extremely well. In the first
place, the gristles, or cartilages as they are called, by which the
ribs are attached to the sternum in front, give, in conjunction with
the spine behind, considerable elasticity to the whole structure of the
chest. Most injuries have therefore to overcome this elasticity, before
anything gives way; and when the rib has done so, and is fractured, the
resiliency of the cartilage or gristle to which it is attached _tends_
to restore it to its place, or to set it, as we phrase it.
Another very curious thing in accidents is the instantaneity with which
muscles which are _ordinarily_ under the dominion of the will, become
reluctant to obey it, or altogether repudiate its authority. In all
fractures, of course, the most material thing is absolute repose; and
there is very little chance of a man moving his rib when it is broken.
He instinctively begins to expand his chest, for the admission of the
necessary air, by other muscles, usually to the exclusion of those
which are attached to the broken bone.
The Lung, which may be considered as a series of tubes, some conveying
blood, and others air, is often wounded; but the blood immediately
stops the leak, from its tendency to coagulate when out of the
vessels; and no harm ensues. Occasionally, however, a circumstance
occurs, which, until it is understood, appears curious and alarming.
Either from the extent, the scratching of the surface, or some other
peculiarity in the wound of the lung, the air escapes from it, and the
patient is as it were blown up, as to the chest, neck, and face, by
the air impelled from the lung beneath the skin into the connecting
tissue, exactly in the same manner as the butcher does when he is
preparing veal. This blowing-up is called, from the Greek word for it,
_Emphysema_; and it was on this feature in these accidents that Mr.
Abernethy wrote a short paper.
Public-domain text, read in full here on John Shaqi.
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