Surgery, with Special Reference to PodiatryStern, Maximilian
Science
Surgery, with Special Reference to Podiatry
Stern, Maximilian
Foot -- Surgery; Surgery
+Diseases.+ Here are classified (_a_) new growths, both benign and
malignant; (_b_) changes due to age and environment, and (_c_)
diseases not belonging in either of the above classes. These latter
are generally known as _idiopathic_ or _spontaneous_ in their
etiology. These terms, however, often indicate only a limit of
knowledge as to their true etiology.
+The Tissues.+ The tissues of the body, though apparently so different
and varying so decidedly in their functions, are in many respects
similar.
Every tissue is composed of two parts: the _cellular elements_ and the
_intercellular substance_. These are called _cells_ and _stroma_. Upon
the first of these depends the vitality and function of the part,
while its density, shape and general physical properties are
determined by the second. Likewise along the same lines of reason, all
of our organs have two separate areas of tissue: the _parenchymatous_
and the _interstitial_. The first contains the functioning and the
second the supporting elements.
The physical conditions of the interstitial tissue or the
intercellular substance vary greatly in density. _Blood_ is a tissue,
the intercellular constituent of which is fluid, and as we consider
more dense tissues, we encounter all degrees of density of the
framework or intercellular substance, until with the additional
presence of calcareous elements, we conceive the hardness of bone and
dentine. Tissues as a whole, however, are not solid; there are spaces
in the supporting structure to admit of the passage of arteries,
veins, nerves, and lymphatics.
Abnormal conditions arise in the various parts of the tissues. Certain
diseases affect the parenchymatous tissue in an organ more than the
interstitial tissue and again others affect the blood vessels
particularly.
There may be _hypertrophy_, in which the entire organ or part becomes
larger as a whole, the active cells and stroma sharing alike in the
process, or there may be an _hyperplasia_, in which the active cells
of the part proliferate abnormally. When the interstitial tissue alone
develops excessively it is known as an _infiltration_. Under such
circumstances the parenchymatous cells often undergo what is termed
_pressure atrophy_; they are diminished by squeezing.
_Atrophy_ of the part or organ, from whatever source, signifies its
diminution in size; its function is, of course, either impaired or
suspended as the process goes on.
The efforts on the part of the organism as a whole to combat or repair
injury, bacterial invasion and disease are directed along definite
lines. The study of these functions does not rightly come within the
scope of these pages, belonging to physiology, but must be considered
here, if only in brief for the purpose of a good understanding of the
processes at work in surgical conditions.
As surgeons, the functions which concern us most are the
1. Nervous
2. Circulatory
3. Lymphatic
+THE NERVOUS SYSTEM+
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