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
It is remarkable in this disease, that the most vascular parts are
those which soonest lose their vitality. Thus, in the case last
referred to, portions of the surface of the skin perished, while the
deeper layers recovered; again, it is not unusual to observe the whole
thickness of the skin destroyed, without any corresponding affection
of the cellular membrane beneath. The quantity of blood sent to a part
would thus appear to favour mortification in this disease. The reason
of this peculiarity will be considered in the next section.
In two of the instances recorded in the Appendix (Cases XXII and XXVI),
the lining membrane of the rectum was found of a very dark colour, and
in one it had assumed a greenish appearance. This discoloration was at
first looked upon as some accidental complication, or as depending upon
previous disease. But M. Gaspard has noticed a similar condition, after
the artificial introduction of putrid fluid into the blood.[34] In one
of the experiments referred to, the mucous membrane of the intestines
was everywhere healthy, except in the _rectum_ and _duodenum_. In the
former situation, the rugæ were prominent, and of a violet colour;
in the latter, the membrane was of the colour of pale lees of wine.
From the coincidence thus observed, we are led to believe that the
same condition which produces congestion in the skin, may produce an
analogous affection of the mucous membrane. Nor must we omit to note,
in connexion with this subject, the fact of the mucous membrane of the
vagina being occasionally found of a dark purple colour in those who
die of puerperal affections.
[34] Journal de Physiologie, t. iv, p. 45.
In the cellular membrane, serum, lymph, and pus, may be deposited,
mixed with each other in various proportions. The surrounding
vascularity, in these cases, is unusually small, and the lymph effused
not properly organized; there is, consequently, no natural boundary to
the disorganizing process, and the fluid secreted becomes infiltrated
in the surrounding parts.
When the muscular structure is affected, suppuration takes place with
great rapidity; portions of muscles may be found quite soft, and
sometimes pultaceous, in circumscribed patches, around which the fibre
is perfectly healthy. Pus is occasionally deposited on the exterior
of muscles; and it will be then smeared over the surface, and rather
infiltrated in the cellular tissue, than contained in a cyst. In the
interior of muscles, there is the same absence of the natural limit to
the inflammation; but, owing to the more compact structure of the part,
the deposits of matter generally remain circumscribed.
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