On the origin of inflammation of the veins: and of the causes, consequences, and treatment of purulent deposits — John Shaqi
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
In Experiment VIII, the obstruction formed was sufficient to resist
even firm pressure, and in a great measure, if not altogether, to
prevent the pus injected from finding its way along the vein. The
coagulum was felt in the vessel during the operation, and was there
found after death. One effect of the coagulation of the blood thus
immediately produced, is necessarily to retain the vitiated blood
in the part, and to prevent its being carried in the course of the
circulation. This intention may be interfered with, either by accident
or design. The coagulum, as in Experiment VI, may be broken up during
the process of its formation, or after it has formed, and the parts
of which it was composed carried forward with the circulating blood.
In such a case, the vein in which the coagulum first formed, is found
in its natural condition (except at the part where it may have been
mechanically injured), and dark patches of congestion may be found in
distant systems of capillaries. If the coagulum be allowed to remain,
the vein in which it is formed soon becomes thickened; but, as the
experiments cited prove, _this thickening is the effect and not the
cause of the stagnation of the vitiated blood in the vessel_.
II. When blood coagulates in a serous cavity, a thin pellicle forms
upon its surface, and, becoming thickened by deposition from the
fibrin of the blood, forms a cyst, which completely circumscribes the
effusion. This point has not probably received the attention which it
deserves; and as it is believed to be of primary importance in the
investigation of the present subject, a short space will be devoted
to the purpose of fully establishing it, and tracing its connexion
with other and subsequent changes. Every layer of lymph observed upon
dissection, has perhaps too generally been considered as the result
of inflammation; and hence there has arisen a confusion in the terms
employed. That lymph may be derived from the blood directly, and
deposited in the form of a membrane, without being secreted by any
vessel, has been fully shown by a paper in the _Medico-Chirurgical
Transactions_.[8] Such layers of lymph assume so much the appearance
of others, derived by secretion from inflamed capillaries, that they
have been described as identical. But the mode of their formation in
the two instances is altogether different. In the one case, the process
is a local one, confined to the blood itself, and subsequently to the
membrane with which it happens to be in contact. In the other case,
it is an effort of the constitution, accompanied by constitutional
symptoms. The former of these processes was clearly described by
Hunter. In describing the process of union by the first intention,
"Coagulation", he says, "I imagine to proceed upon exactly the same
principle as the union by the first intention. It is particle uniting
with particle by the attraction of cohesion, which, in the blood, forms
a solid; and it is this coagulum uniting to the surrounding parts
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