The principles and practice of modern surgery — John Shaqi
The principles and practice of modern surgeryPark, Roswell
Science
The principles and practice of modern surgery
Park, Roswell
Surgery
A. =Physiological Atrophy.=--1. This is always the result of disuse
or impaired function from any cause. Its evidences are generally seen
in the fatty structures and muscles--_i. e._, in the soft parts. It
is true, however, even of the bones, or, of greater interest, even in
the brain cells. We see evidences of it also in minute organs; as,
for example, in the digestive glands in certain cases where diet is
restricted. Again, we see it in the diminution of the size of the heart
after hip amputation, less being required of that organ, and also in
the entire structure of the rectum after colostomy.
2. Examples of the _developmental type_ are best seen in the natural
disappearance of the hypogastric arteries, the ductus arteriosus,
the vitelline duct, the Wolffian bodies, and in the various
generative ducts (Gärtner’s, etc.) shortly after the birth of the
human individual. We sometimes see it also in the prostate after
orchidectomy. Equally illustrative is the disappearance of the tail
and gills of the tadpole, the eyes of animals living in caverns, and,
in a general way, of organs which become useless owing to a different
environment.
3. _Senile_ atrophy is seen equally well in the hair follicles, the
teeth, the bones, and the sexual organs of elderly people--in fact, in
all their tissues, even in the brain.
B. =Pathological Atrophy.=--4. Acute atrophy of surrounding tissues
is the necessary accompaniment of destruction by suppurative or other
disturbances; that is, parts disappear by absorption which have not
been interfered with by pyogenic organisms. So complete may atrophy
occur under these circumstances as to cause disablement of an organ
or part. This kind of senile disappearance is merely an expression of
phagocytic activity, although not now a question of bacteria.
5. The same is true of that variety spoken of above as _biological_ or
_developmental_, since phagocytes are the active agents in producing
the disappearance of the tadpole’s tail.
6. A more slow form of pathological atrophy is seen in the _gradual
disappearance_ of tissues in the neighborhood of advancing tumors,
enlarging cysts, etc. This is perhaps but another expression of atrophy
from continuous pressure. But a still better illustration is the
atrophy which comes from immobilization of a part without pressure.
This is usually the case when splints or orthopedic apparatus have to
be kept in place for some time.
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