On the origin of inflammation of the veins: and of the causes, consequences, and treatment of purulent depositsLee, Henry, M.D.
History
On the origin of inflammation of the veins: and of the causes, consequences, and treatment of purulent deposits
Lee, Henry, M.D.
Blood; Veins -- Diseases
VI. The cancellous structure of bone may be compared to the cellular
tissue in soft parts. When inflamed, its intervals become filled up
by effusion from the vessels, and an abscess may be as accurately
circumscribed in the hard as in the soft structures of the body. In
a healthy constitution, the adhesive inflammation will, in this way,
always precede the suppurative; but where the inflammation is not
circumscribed by adhesion, the secretions may permeate from cell to
cell in unadhering parts. In soft structures, a remedy is at hand for
allowing the escape of the matter, by a free division of the parts; but
in bone, where the same thing takes place, the hard unyielding sides
offer an effectual obstruction to the escape of any effused fluid. The
cells of the bone then may become infiltrated, and, unless the veins
of the part have been closed, there is nothing to prevent the diseased
secretions from finding their way into the circulation.
M. Cruveilhier assures us, that a single drop of mercury introduced
into the cancellous structure of living bone, may subsequently be
detected in the capillaries of the lung, where it becomes the centre
of one or more patches of livid congestion. This experiment appears to
afford a perfect illustration of the way in which diseased secretion
may be conveyed into the circulation, when the natural processes of
repair in bone are abortive. These processes are the same in bone as in
the other structures of the body; viz., union by the first intention,
and adhesive inflammation. In soft parts, as the fibrin, which forms
the bond of union in the first of these, is absorbed, the divided veins
collapse, and thus continue closed; but in bony structures, where the
injured vessels are held open, as the fibrin which at first closed
their extremities becomes removed, their channels may be left as much
open to the diseased secretions of the part, as to the globule of
mercury in M. Cruveilhier's experiment.
The low degree of organization in bone, and the comparative slowness
with which actions are there carried on, render it, in a peculiar
degree, liable to interruptions in the process of repair; especially
when, as not unfrequently happens, there is reason to believe that the
vitality of some portion of the bone has been threatened. The offensive
smell of the bone, as well as the appearance of its cancellous
structure infiltrated with puriform matter, will frequently show in
such cases, that the processes above-named have not followed their
natural course.
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