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
As the aggregate diameter of the vessels in the body decreases, the
blood in them flows with greater rapidity and force; and when near
the heart, it is placed in circumstances unfavourable to coagulation,
in consequence of the rapid motion there communicated to it; and we
accordingly find that, although adherent coagula may be formed in the
veins leading from the seat of injury, and may be traced thence through
other larger vessels, they will usually terminate abruptly, when these
open into the vena cava. But when the blood arrives in the cavities
of the heart, the tendency to coagulate may again manifest itself.
Diseased coagula, presenting a "mottled appearance, partly brown,
and partly of a dirty yellow colour", or "dark coloured, and partly
composed of a yellowish grey opaque substance", or "with portions
inelastic, and of an opaque yellow colour", will be found entangled
among the projecting fibres of the auricles and ventricles. In the
arteries, the blood is in the most unfavourable circumstances for
coagulation during life, in consequence of the comparative smallness of
their diameters, and the succession of impulses communicated to their
contents; but even here, diseased and adherent coagula may be found in
cases of secondary inflammations.
M. Cruveilhier[37] relates an instance in which, after child-birth, the
pulmonary artery was found filled with coagula following its divisions.
The principal clot had lost its colour, and was _adherent_ to the sides
of the vessel, and contained in its centre puriform fluid.
[37] Op. cit. p. 669.
In another case, following the operation for necrosis, the following
post-mortem appearances were observed. The left lung presented, in
several places, patches of red hepatization, perfectly defined, and
resembling so many spots of lobular inflammation. When cut into, these
patches presented several puncta of puriform fluid. The _veins_ of the
lung contained fibrinous-looking coagula blocking up their cavities;
and in the centre of these coagula was a whitish purulent looking fluid.
The diseased condition of the blood may thus be traced visibly from the
original wound, through the larger vessels, to the heart, and again
from the heart to the capillary system. The disposition to coagulate,
once impressed upon the blood, is not destroyed by that fluid being
conveyed to a different part of the body: the action may be retarded by
motion in, as well as out of the body, but will nevertheless occur when
it is placed under more favourable circumstances.
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