The consequences of embolism vary with the character of the embolus
and its situation. A simple plug of fibrine in a vessel only produces
changes in the circulation, but a plug from a gangrenous thrombus has
a tendency to excite suppurative inflammation wherever it lodges.
The size of the artery thus obstructed, and the character of its
collateral circulation also lead to a variety of results. If a large
artery is stopped, the part becomes empty; if a small one the part
may become extravasated with blood from the collateral circulation.
Thus, if the large arteries supplying the extremities are obstructed,
paralysis of the muscles, and finally dry gangrene, ensue.
Emboli of the pulmonary arteries produce sudden death; of the
coronary arteries, sudden death; of the cerebral arteries, softening
of the brain; of the retina, sudden blindness; of the mesenteric
arteries, congestion and gangrene of the intestines.
Abscesses are also produced. This takes place when the embolus is
of an irritative and gangrenous nature. Large abscesses are only
found in the lungs and liver, therefore the mechanical results of an
embolus produce the following condition of affairs: A set of vessels
are first emptied of their blood, and the nutrition of their walls
thus impaired; after a time these vessels are filled up from the
veins, their abnormal walls can no longer resist the blood pressure,
and hemorrhage takes place.
After an hemorrhagic infraction is formed, the subsequent changes
are of a degenerative character. The blood loses its coloring matter
and breaks down into a mass of granules, forming a dry, yellow,
wedge-shaped mass, or it may break down and form into a puriform
fluid, or it may be surrounded by a zone of inflammation or of
gangrene.
The above condition of the system will explain why and under the
circumstances enumerated, the injection of a blood vessel may
be brought to a sudden stop without any apparent cause, and the
injecting fluid flow back towards the injecting point.
The various causes for such a result have been clearly demonstrated,
but with the knowledge of these causes as previous stated, the remedy
can be applied without much trouble. It can be estimated by the
amount of fluid injected, about to what extent the vessel has been
filled, and by following its course the point where the obstruction
is, can be easily ascertained.
By reopening the vessel at a point above, the injection may still be
carried on successfully, or the corresponding vessel on the other
side of the body may be used for that purpose.
It is then that even a limited amount of knowledge of anatomy of
the human body will be found of immense advantage to the operator,
inasmuch as it will trace the cause of action, to be followed in this
case, and will enable him to do so with success.
Public-domain text, read in full here on John Shaqi.
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