North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826Various
History
North American Medical and Surgical Journal, Vol. 2, No. 3, July, 1826
Various
Medicine -- Periodicals
"But there was an effect, here overlooked, which was to be
expected to take place in the abdomen of the dog, from the
injury done to the surrounding parts by the operation itself,
and which would be quite independent of any effect arising out
of the experiment. In the human subject, the effect would be
the highest form of inflammation, by which coagulable lymph or
pus would be poured upon the surface of the peritoneum. There
would, therefore, be inflammation excited in the abdomen of the
dog; but as the lower animals are less easily acted on than
man, the inflammation would in this case be in a lower degree.
But every degree of inflammation has its particular product.
The highest occasions a discharge of pus, whilst the lowest,
when seated in a serous membrane, is a larger portion of its
proper serous fluid. This, therefore, might be the product of
the inflammation, which was produced incidentally by the
experiment in the abdomen of the dog; and it would be just as
reasonable to regard the coagulable lymph in the human subject,
which would result from such an experiment, as an effect of the
mechanical obstruction, as to consider the fluid effusion in
the dog to be so."
In respect to those instances of diseases of the liver, connected with
ascites, in which, in addition to its other morbid states, a partial
occlusion of the vena portae, by the effusion of coagulable lymph into
it, is said to have existed, our author remarks, that they are very few
in number, occurring, perhaps, in one out of several hundred cases of
ascites with hepatic disease; and that we are justified, from analogy,
to assume, that any obstruction given to the circulation by diseased
vessels, would be quickly relieved by the enlargement of the
anastomosing branches, and that no effusion of water into the abdomen
would result from it. After referring to some cases, related by the late
Mr. WILSON, in which the vena cava was completely obliterated, and no
effusion took place; and some cases of morbid condition of the heart of
an analogous kind, by which the course of the circulation became greatly
obstructed, and yet, without being followed by effusion; our author
concludes, that from these facts and others, to be presently noticed, it
appears evident,
"That the dropsical effusion, in whatever part it may be
seated, does not arise from any want of tone in the exhalant or
absorbent system, or from a mechanical obstruction in the liver
or other viscus; but, that it proceeds from a morbid action in
the cellular or serous tissues, and that this action, as we
shall now proceed to show, is allied in its nature to
inflammation."
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