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
"Now from these, and similar examples, which have fallen under
my observations, I think it may be assumed, that ascites, when
proceeding from some visceral disease, (and the principle
applies to hydropic effusions from the pressure of disease in
other cavities,) does so by the gradual extension of the
chronic inflammation of the internal cellular or serous tissues
of the diseased organ, to its outer external coverings; and
that, commencing here as from a point, the serous or hydropic
inflammation is progressively propagated through the whole of
the serous membrane of the cavity. By the disease within the
cellular tissue of the diseased viscous increasing, a
corresponding increase, in these cases, will ensue of the
disease on the surface of the membrane investing it; until at
length a susceptibility to take on a higher action is induced,
which only requires any slight occasional cause to establish.
Under this condition of an increased excitement in the
peritoneal or other serous membrane, coagulable lymph is
discharged into its cellular tissue, and a thickening of it
takes place; until at length the operation of paracentesis,
which in the early stage of the disease was attended with only
inconsiderable inconvenience, becomes an adequate cause of a
still higher inflammation, which terminates perhaps in
suppuration; and, in the _post mortem_ examination the serous
fluid is found so mixed with coagulable lymph, and purulent
matter, as to give a whey or milk-like appearance to the mass.
The quantity of serous fluid, in these cases, is generally
small, when compared with what was accumulated in the
intervals of former tappings; for the vascular excitement
which occasions the discharge of coagulable lymph, is
destructive of that which pours out the serous fluid."
Dr. A. remarks, that, besides the particular facts deduced from
observations on dropsy as a local disease, and which prove its relation
to diseases of local excitement, there is a further support to be given
to these views by various proofs that are afforded from observations
upon the urine, of serous inflammation producing local dropsy, being
frequently connected with one of a general kind. "So that the
inflammatory state of the system becomes sometimes a cause of the
effusion into a cavity, and at other times an effect of this state."
After giving full credit to Drs. WELLS and BLACKALL for their researches
into the state of the urine in dropsy, our author remarks, that there
are certain conclusions deducible, which appear not to have been
contemplated by those gentlemen, but which are strictly accordant with
the pathological views he has endeavoured to establish in the present
work.
Public-domain text, read in full here on John Shaqi.
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