A Manual Of Pathological Anatomy | by Carl Rokitansky, William Edward Swaine

The numerous unsuccessful attempts which have been made to present the following work in an English translation, sufficiently attest the very general estimation in which it is held, as well as the difficulty of the undertaking. The task having at last been executed by the united labors of four gentlemen, each well qualified for the portion intrusted to him, the American publishers take much pleasure in presenting to the profession of the United States, this great store-house of pathological knowledge, in a convenient and accessible form. The world-wide reputation of the author and of his work render eulogy superfluous, while the appearance of the translation under the auspices of the Sydenham Society is a guarantee of its fidelity.

Title	A Manual Of Pathological Anatomy
Author	Carl Rokitansky, William Edward Swaine
Publisher	Blanchard & Lea
Year	1855
Copyright	1855, Blanchard & Lea
Amazon	A Manual of Pathological Anatomy

By Carl Rokitansky, M.D, Curator Of The Imperial Pathological Museum, And Professor At The University Of Vienna, Etc.

Translated From The Last German Edition By William Edward Swaine, M.D., Charles Hewitt Moore, Edward Sieveking, M.D., George E. Day, M.D., F.R.S.

Four Volumes:

Volume I. General Pathological Anatomy

Volume II. The Abdominal Viscera

Volume III. The Bones, Cartilages, Muscles, And Skin, Cellular And Fibrous Tissue, Serous And Mucous Membrane, And The Nervous System

Volume IV. The Organs Of Respiration And Circulation

American Publisher's Notice: The numerous unsuccessful attempts which have been made to present the following work in an English translation, sufficiently attest the very general estimation in which it is held, as well as the dif...

Editor's Preface To Vol. I: In issuing this portion of Rokitansky's Pathological Anatomy, it is necessary to offer, on behalf of the Council of the Sydenham Society, some apology for the delay which has attended the completion...

Author's Preface: The appearance of this first volume brings the publication of my Pathological Anatomy to a close. As was the case with the earlier volumes, the completion of this one has been delayed by lack of lei...

Explanation Of The Plates. Plates I And II: Figs. 1 and 4 represent proliferous cyst-formations from the cortical substance of the kidney, as a sequel to Bright's disease. The two figures, 1 and 4, illustrate well Roki-tansky's history of proli...

Introduction: Pathological Anatomy may be said to be a modern science. It is indeed only of late years that it has assumed the dignity of an independent science at all. Although, according to Pliny, dead bodies ...

Classification: Just as there is a general and a special anatomy, physiology, pathology, so there must in like manner be a general and a special pathological anatomy. The former treats of general anomalies of organiz...

Classification. Part 2: 2. The Disease Extends To Remote Formations The Disease Extends To Remote Formations, both similar and dissimilar. This mode of diffusion does not imply concurrent general disease, but proceeds, ac...

Classification. Part 3: 4. Issue In Death Diseases are mortal for the most part, (a.) Through exhaustion of power and of organic matter, tabescence, loss of fluids. (b.) Through the suspended function of organs esse...

Classification. Part 4: The number of malformations, however, to which this doctrine fully applies, is as yet very small. Amongst those which do not admit of such an explanation are duplicate formations, and the great majori...

Classification. Part 5: Complicated anomalies are classed in three subdivisions. 1. Heterotaxies (Irepos And Ratiq) Anomalies important in an anatomical sense, but neither visible externally nor obstructive of any func...

Classification. Part 6: The second class has two subdivisions. I. Double malformations from coalition. II. Double malformations from implantation. The first subdivision breaks up into four orders. 1. Coalition...

Classification. Part 7: On the other hand, we have here to- notice, in a general way, the laws which nature observes in the production of malformations, so far as a general working out of this subject has revealed them to us...

Classification. Part 8: With the aforesaid laws, derived more immediately from malformations, a mistaken attempt has been made to couple two other special laws: 1. The first being that of Serres, according to whom the de...

Chapter I. Anomalies In Respect Of The Number Of Parts: These consist in diminution or augmentation of the normal number of organic parts. It is not rare for both to be found united in one individual, one part presenting a deficiency, another, in virtue of...

Anomalies In Respect Of The Number Of Parts. Part 2: The acquired absence of particular parts is the result of mechanical influence or of disorganization. To the former kind belongs maiming by accident or design; for example, amputation, extirpation, an...

Anomalies In Respect Of The Number Of Parts. Part 3: 3. One species of twin formations can at the present time only be satisfactorily explained by the assumption of an ovum in ovo, - one ovum being primitively enclosed within another. We refer to twin f...

Chapter II. Anomalies Of Size: Anomalies of volume manifest themselves as irregularities in magnitude, and as their opposite, diminutiveness, both being either congenital or acquired. They are often relative only, that is, applicab...

Hypertrophy: Hypertrophy and the dilatation of hollow organs require to be considered somewhat more at large. Hypertrophy consists, as the term implies, in augmented nutrition, resulting in increase of mass, an...

(A.) True Hypertrophy: True hypertrophy appears, a priori, incontestable, and numberless instances have been recorded of its occurrence in every part of the body. It is remarkable, however, that when tested by an analysis, ...

(B.) False Hypertrophy: This has been already adverted to as a heterologous product. As such it occurs frequently in the form of infiltration. False hypertrophy is for the most part cognizable at a glance from the alienation...

Causes Of Hypertrophy: The causes of hypertrophy are: 1. Morbid Increase Of The Quantity Of Blood Morbid Increase Of The Quantity Of Blood in the capillaries of, and retarded circulation in, the affected organ; repeat...

Abnormal Diminutiveness: Congenital abnormal diminutiveness affects the entire body, as dwarf stature (microsomia), the individuals being termed dwarfs, or pigmies. These are either born diminutive, or, owing to inherent pred...

Atrophy: Atrophy, wasting [tabes], consists in the withdrawal from a formation, after it has reached a certain grade of maturity and bulk, of its constituent elements, without any compensating regeneration of ...

Chapter III. Anomalies Of Form: Anomaly of form, or deformity, affects either the entire body or portions of it only, - general or partial deformity. It is either primitive or acquired; simple or complicated, that is, conjoined with...

Chapter IV. Anomalies Of Position: Preternatural position - situs mutatus, inversus, alienus, dislocatio, ectopia - is either congenital or acquired. In either case, it may affect a single organ or implicate several. To congenital a...

Chapter V. Anomalies Of Connection. Cleft-Formations: These anomalies (vitia nexus) consist in diminution or total absence, or else in enhancement of the natural connection and contiguity of organs. They are both primitive and acquired, and, in either ca...

2. Malformations Through Fusion (Symphysis): To these belong: (A.) Cyclopia In this malformation we find in the forehead a single eye, or the two eyes blended into one. It is met with under every gradation of the fusion of both eyes. The n...

3. Atresia: (A.) Atresia Palpebrarum The eyelids are said to coalesce naturally towards the end of the third or the commencement of the fourth month, and to separate afterwards. Accordingly this malformation w...

Chapter VI. Anomalies Of Color: Anomalies in the color of organs are either essentially conjoined with or independent of change of texture. Our concern here is principally with the latter kind. We shall content ourselves with a simp...

Anomalies Of Color. Continued: 3. A Third Species Of Death-Marks A Third Species Of Death-Marks arises from the imbibition, by the coats of bloodvessels, and the transuding from thence into the neighboring tissues, of blood-seru...

Chapter VII. Anomalies Of Consistence: Consistence [the normal degree of mutual cohesion and of resisting power pertaining to the elements constituting a texture] is either augmented or diminished. In either case the gradations and also th...

Chapter VIII. Separations Of Continuity: They are engendered either by external and especially by mechanical influences, or else by various internal causes which may, in like manner, operate mechanically. To the former belong: 1. Simpl...

Chapter IX. Anomalies Of Texture: These are the most important of all. They affect the solids and the fluids, especially the blood, in so far as certain form-elements enter as essential ingredients into its composition, and so far as ...

I. Organized New Growths. A. Of Organized New Growths In General: These resemble normal textures, at least in their elementary composition, - and very frequently in the (secondary) arrangement of their form-elements. Where they appear amorphous, the character of the...

Organized New Growths. A. Of Organized New Growths In General. Continued: 2. Where, on the other hand, the heterologous formation is developed and increases from an interstitial point, or even from an originally circumscribed infiltration, so that at its circumference it ra...

Organized New Growths. Microscopic Analysis: Microscopic Analysis, therefore, from which important disclosures in relation to the diagnosis of benignant and of malignant growths, and tenable grounds for the establishment of a system were expecte...

Of Blastema And Its Metamorphoses, With An Especial Reference To Fibrine: The blastema for pathological new growths ultimately proceeds from the general fluid of nutrition, the plasma of the blood. Accordingly, its source is that out of which all normal textures are develop...

Primitive Anomalies Of Blastema: Primitive Anomalies Of Blastema may be occasioned in a twofold manner: (a.) They may be rooted in a general dyscrasy of the sanguineous mass. The effusion of blastema coincides with manifest anomal...

Coagulated Fibrin: The simple coagulum met with in the heart or great vessels after death, and in blood drawn from bloodvessels during life, furnishes the chief groundwork for this inquiry. These coagulations, which ...

Metamorphosis Of Blastema: 1. Textural Development. Organization Solidified Blastemata, at their very development, either constitute various pure and unmingled new growths, or enter in the shape of intercellular substance, b...

Metamorphosis Of Blastema. Part 2: Fluid Blastemata Fluid Blastemata, in their development to textures, obey the laws of the cell theory (Schwann's). The perfect nucleated cell, however, originates in two different ways: (a.) The...

Metamorphosis Of Blastema. Part 3: Other Changes Suffered By Blastemata Other Changes Suffered By Blastemata, either in their primitive state, or after having attained to different stages of development, are: 1. Resolution into a...

Hyperemia: It is to be understood that we have to deal only with local hyperemia - congestion, so called. It consists in an excessive amount of blood in the capillaries of an organ; that is, in an injected co...

Hemorrhage: Hemorrhage consists in the extravasation of blood bodily, and in its entirety, from the bloodvessels, consequent upon a breach of their continuity. Herein it differs from red effusions resulting from ...

Haemorrhophilis - Habitual Hemorrhage: Haemorrhophilis - Habitual Hemorrhage - depends, so far as we at present know, upon a preternaturally delicate and vulnerable structure of the coats of the vessels, coupled with a thin, watery, condit...

Hemorrhage. The Remedial Process: The Remedial Process is difficult and complicated proportionately to the amount of blood extravasated, to the resulting destruction of texture, and to the solidity of the coagulated fibrin as a centra...

Anaemia: The chapter on hyperaemia naturally leads to a passing consideration of the opposite state, namely ancemia. Just as we have before treated only of local hyperaemia, we shall here, in like manner, limi...

Inflammation, Phlogosis: This pathological process is of paramount interest, not only on account of its great frequency, and of the great variety of external causes by which it is called forth, but also as being that in which...

Inflammation, Phlogosis. Part 2: 4. The step to which stasis ultimately leads is genuine effusion, that is, the exudation of blood-plasma, a fluid holding in solution fibrin, albumen, and salts. It is thrown out into parenchymata, fi...

Inflammation, Phlogosis. Part 3: Our own opinions accord with those of Henle, whose theory we shall therefore adopt as the groundwork of any future remarks on this subject. Even here the causal momentum influences the peripheral n...

Varieties Of Inflammation: Inflammation is characterized by much variety and anomaly. On the one side, it recedes so far from the foregoing description of the process, that it has been attempted to distinguish certain forms as ...

Relation Of The Inflammatory Process To Crasis: A twofold relation exists between inflammation and an anomalous crasis, the latter being either a mere result of the inflammatory process and secondary, or else pre-existent and primary, and the infla...

Exudation: The greatest and most marked differences of inflammation are manifested in its products. In inflammations due to a pre-existent crasis, such difference is intelligible enough, the product of the stasi...

(A.) Simple Or Plastic Fibrinous Exudation: A grayish, yellowish-gray, or if containing blood-corpuscles, even red, reddish-gray exudate which, in great part, speedily solidifies, into bulky, membranaceous, plug-like, or frame-like coagula, whi...

(C.) Croupous Exudation: Croupous Exudation has several varieties, dependent upon a qualitative impairment of the fibrin. It is, with the utmost impropriety, confounded with the former and its kindred crases. It is marked by ...

(B.) Croupous Exudation: The above-mentioned characters, especially the opacity and the greenish coloration, are here more strongly developed. It consists, together with an amorphous blastema, of nucleus and cell-formations, ...

(R.) Croupous Exudation: Aphthous Exudation, a yellow, greenish-yellow, dingy-grayish, opaque product, wont, upon surfaces, to solidify into tough membranes, and then melt down, reducing the implicated textures to the same co...

2. Albuminous Exudation: Albuminous Exudation occurs united to a proportion of fibrin as a fibrino-albuminous; or as a mere albuminous; or again, mingled with a certain proportion of serum, as a sero-albuminous exudate. Al...

3. The Serous, Dropsical Exudate: Serous effusions are, generally speaking, either merely serous (blood-serum); or again from their containing a larger proportion of albumen, albumino-serous; or, lastly, owing to an admixture of fibri...

Pus, Ichor: No product of disease has, perhaps, been the subject of such zealous research as pus and ichor, and yet nowhere has a greater number of shortcomings been overlooked or glossed over than here. These we...

Pus, Ichor. Continued: Pure Pus Pure Pus we believe to be an albuminous exudate, out of which, like other elementary bodies, the pus-cell becomes developed by virtue of a specific conversion. This process, the so-called ...

The Formation Of Flesh-Granules: The Formation Of Flesh-Granules is not decisive evidence of a bland, benignant pus. It may accompany, and even luxuriate under, the production of ichor. In the one case, however, the granulations are ...

Hemorrhagic Effusion: Looking at the often slight intensity of the inflammatory symptons, the analogy between a granulating wound (abscess) and a secreting organ, - between pus and a secretion prepared by those elementary ...

(B.) The Hemorrhagic Exudate: It is indispensable in the first place to discriminate between exudates reddened by blood-pigment only, and those which contain substantive blood, that is, blood-corpuscles. The former are met with...

Issues Of Inflammation: The so-called issues of inflammation comprehend a variety of processes. They concern either the inflammation itself or its products and the involved structures; that is to say, they embrace, in the la...

2. Reliquefaction And Resorption Of The Inflammatory Products: This issue of inflammation is contingent upon previous exudation, and consists in resorption of the products. It takes place with greater or less facility, according to the measure of the exudation, a...

3. Abiding Of The Inflammatory Product: The products of inflammation are retained bodily, or after imperfect resorption, partially, in their original, or it may be in an altered shape and constitution. Conformably with what has been stated,...

4. Ulceration, Ichorous Destruction: It consists in a wasting of the textures from the corrosive quality of the exudate. Herein ulcerous consumption of the textures differs from the loss of substance which inflamed textures undergo, with...

Gangrene, Necrosis: Under gangrene, necrosis, is understood the death of an organ or part, as manifested by the more or less rapid breaking down and chemical decomposition of its texture. Gangrene may affect both soft an...

Gangrene: Gangrene is developed - 1. Out of absolute blood-stasis, which may occur under various circumstances: (a.) Every hyperemia in organs, or sections of organs, paralyzed or enfeebled, or obnoxious ...

Characteristic Of Inflammatory Textures And Diagnosis Of Inflammation In The Dead Subject: In the period preceding the real exudation, an organ is, within the range of the inflammation, reddened, injected; that is, more than ordinarily vascular, swollen, and at the same time relaxed, softer...

Deposits. - Metastasis (So-Called): Together with those inflammations leading rapidly and insensibly to exudation, the term deposit (metastasis, capillary phlebitis, lobular process) applies aptly to certain processes which, considering...

B. Organized New Growths Specially Considered: Having now treated of organized new growths in general, of their blastemata, and of the several processes through which these are engendered, we come to the special consideration of new growths. Wh...

1. Areolar Tissue Formations: The new growth of areolar tissue is a very widely extended one. Newly generated areolar tissue occurs both pure, and also as a constituent of other new formations, for which it often furnishes a sort ...

2. Fibroid Texture: In an extended sense, the collective term fibroid texture may be made to comprise all fibrous tissues, the development of which has been already delineated, and the occurrence of which as a more or le...

Cornification: Cornification is observed especially in the vegetations about the heart's valves, and in the layers accumulated within arteries. The growth becomes dry, denser, of horn-like toughness, and of dull tra...

3. Elastic Tissue And Texture Of The Annulo-Fibrous Membrane Of Arteries: The elastic and nucleus-fibres enter, more or less, and sometimes in very considerable quantity, into the composition of the most varied new growths, although in no instance are the latter entirely co...

4. Cartilaginous Growths: Wounds of cartilage are not reunited by means of cartilaginous substance, nor is this substance regenerated when destroyed. Nevertheless new growths of cartilage-texture are both frequent and volumino...

5. Bone-Formation: Bone-formation comprises various new growths, which, in their developed stage, are readily divided into two classes, according to the analogy which their texture bears to that of normal bone. Still th...

1. Uniform Or Almost Uniform With The Normal Bone: Uniform Or Almost Uniform With The Normal Bone, are: (a.) Bone developed in permanent cartilages, and especially in those of the larynx, sometimes and in part also the ossifications of costal carti...

2. Osteoid: Several of the growths adverted to as deviating in certain points from standard bone-texture, might be transferred to this section. To it, however, belong more especially ossifications of costal carti...

3. Concretions: Under certain, as yet unknown, conditions, the lime-salts in a soft basis are, by dint of a revulsive metamorphosis, set free so as to incrust and penetrate the said basis, - in a word, effect its oss...

6. Growth Of Bloodvessels: Setting aside all dilatations of the smaller vessels and capillaries, constituting the so-called aneurysma anastomoticum and telangiectasis, we shall here treat of all that concerns the new growth of ...

(A.) Cavernous Textures, Cavernous Blood-Tumors: These growths are of a cancellated structure, somewhat resembling that of the corpora cavernosa. They consist of areolar tissue fibres, constituting a multilocu-lar stroma, the interspaces of which ar...

(B.) Fungus Haematodes, Blood Fungus: What is commonly held to he fungus haematodes, is a luxuriant vascular growth, mischievous, both from its liability to occasional hemorrhage, and from its tendency to exhaust the constitution by the h...

7. Fat Formation, Fatty Degeneration: The anomalous occurrence of fat is no less frequent than multiform. The subject is daily acquiring fresh interest, in proportion as the importance of fat in the animal economy, from the incipient stag...

2. Abnormal (Fat-Texture): To this category belong, in the first place, cases in which the contents of the fat-cells vary from the natural character; in the second place, cases in which the cells themselves deviate from the nor...

3. Free Fats: The occurrence of free fat, - a condition, we think, properly meriting the term of fatty disease - takes place under different circumstances: 1. It is immediately secreted as such. The seat of its ...

8. Epidermidal And Hair Formations: The excessive production over expansive surfaces, both external and internal, of epidermis, with a normal form and aggregation of its elements, is often well exemplified, so far as the mucous membran...

9. Pigment Formation: Irrespectively of all other anomalous coloration, but with a retrospect to that conversion of blood-pigment alluded to under the head of hemorrhage, we shall here treat of granular pigment. It appears...

The Pigment: The Pigment may, independently of any development out of extra-vasated blood, be brought about through - 1. The obliteration of small bloodvessels or capillaries, with the conversion to pigment of ...

10. Colloid: Colloid, colloid substance, is a sufficiently common heterologous formation. It is requisite, however, to state, that under this term substances have been brought together which, in a physical and che...

11. Cyst And Alveolus: In asserting cyst to be a substantive new growth, with a distinctive elementary groundwork, we exclude all accidental cyst formations, that is, capsules and sheaths forming around foreign bodies, extr...

The Cyst-Wall: The Cyst-Wall consists of densely-reticulated areolar tissue, the internal layer constituting an epithelium of cells or nuclei. In large cysts this is, for the most part, absent, and the internal laye...

The Excrescence: The Excrescence, as described at No. 3, arises through the development of areolar tissue out of a transparent amply nucleated blastema. In its cavity are lodged, sometimes in vast quantities, simple a...

1. In The Cortical Substance Of The Kidneys: In The Cortical Substance Of The Kidneys, especially during the decline of Bright's disease, a luxuriating cyst-formation is not uncommon. In the dimpled depressions upon the surface of atrophied, ...

2. The Renal Preparation At First Sight: The Renal Preparation At First Sight so much resembles the texture of the thyroid gland, and more particularly the goitred thyroid gland, as to render it impossible to discriminate between the two. Si...

Cancer-Cyst: Cancer-Cyst varies in respect to size from the microscopic, to the circumference of the colossal cysts, in the compound cystoid. The alveoli of areolar cancer in particular - that is, the small cysts ...

2. Divested Nuclei: Divested Nuclei, which, like the cell-included nucleus (cell-nucleus), expand into larger, transparent, structureless vesicles. These - (a.) Remain sterile cysts. (b.) They give birth to numerou...

The Structureless Vesicles: The Structureless Vesicles alluded to offer many further points of interest: (a.) There is, frequently, a marked difference in the contents both of the simple vesicles, and of the individual layers...

1. Upon Mucous Membranes: Upon Mucous Membranes, and especially upon that of the urinary bladder, there occurs a cancerous growth which we have elsewhere termed villous cancer, as a structure pertaining to medullary carcinoma,...

2. Upon Serous Membranes: Upon Serous Membranes, and the peritoneum in particular, we have, in connection with luxuriating medullary cystocarcinoma of the ovaries, met with medullary vegetations which, judging from their appea...

3. The Encysted Parenchyma: The Encysted Parenchyma is often contained free within the cyst space; sometimes, however, there is present a meshwork, issuing from the inner wall of the cyst, the spaces of which are filled up with ...

6. Finally, In The Domain Of Physiology: Finally, In The Domain Of Physiology, we encounter, upon the vascular plexuses in the lateral ventricles of the brain, a formation which, as comparative microscopical investigations teach us, fully co...

Other Vesicles: Other Vesicles, again, consist of three or of four, the inner, secondary, and tertiary ones being by turns central and extra-centrical. This species of complex and involved sheathing is met with in ve...

The Vesicles And Granulated Spheres: The Vesicles And Granulated Spheres, the incrustations, the areolar tissue developments and the fat-globules, render the contents of the vascular plexus-cyst more or less opaque. y. Finally, we hav...

The Contents Of Simple And Compound Cysts: The Contents Of Simple And Compound Cysts properly consist of a viscid fluid, in some cases translucent and colorless, in others, of a reddish tint. In compound cysts, these two conditions often alter...

The Presence Of All The Semi-Transparent And Opaque Formations: The Presence Of All The Semi-Transparent And Opaque Formations renders the cyst-contents whitish, or turbidly yellow. This portion of the cyst's contents is frequently separated in the form of a depos...

The Structureless Cyst: The Structureless Cyst is developed in a consolidated, structureless blastema, commonly studded with spherical and oblong nuclei, or else in a nidus of caudate and other cells. In the former case, the...

The Parietes Of The Vesicle: The Parietes Of The Vesicle, whatever may be the nature of the contents, are uniform with the sheath of the nucleus. They resist the influence of acetic acid, or else the latter occasions thickening o...

12. Sarcoma And Carcinoma: Kindred new growths, important from their frequency no less than from the question arising, in every concrete case, as to their innocency or malignancy. They constitute an extensive group, comprising ...

Sarcomata: These, as already stated, represent benign new growths. They are always purely local affections, and therefore exist almost always as a solitary growth. They are most commonly due to mechanical influe...

1. Gelatinous Sarcoma: A very frequent heterologous formation, of which there are several varieties. It consists, besides some albumen, almost wholly of a gluten-, chondrin-, or pyin-like substance. The varieties are pri...

2. The Albumino-Fibrous Tumor; Fibrous Sarcoma: This tumor is of a fibrous texture, and is distinguished from other and especially the pure, gluten-yielding fibroids, by its albuminous contingent. The genesis of the fibres and their relation to ...

3. The Albumen-Like Fibrous Tumor. (Johannes Muller): The albumen-like sarcoma is a gibbous, tenacious, albumen-like tumor, sparely and but partially vascularized where its texture is slightly reddened and less firm. It consists, generally, of a white or...

Cysto-Sarcoma: The combination of the heterologous parenchyma with cyst-formation, the groundwork of which is here, as elsewhere, the parent cyst and the alveolus, together imparting to the new texture the glandular...

B. Cancer - Carcinoma: Heterologous growths not distinguishable from sarcomata by definite generic marks, and, like these, to be dealt with only as species, but contrasting with sarcomata in the single feature, common to th...

The Size Of Carcinomata Greatly Varies: As tumors, some, and in particular the gelatinous and medullary forms, attain to a very considerable magnitude. A special notice is due to the occurrence of cancer in the shape of little millet- or he...

Carcinomata Terminations: Its Terminations, besides discussion of the inflammatory stasis, and resolution, are: 1. Abiding of the 'products in their primitive crude condition, or else disruption, wasting, textural conversio...

1. Colloid, Gelatinous Cancer. Alveolar Cancer (0. Areolaire): In the array of cancers we again encounter a gelatinous, colloid new growth, namely, gelatinous cancer, better known under the epithet alveolar, derived from its very frequent alveolar fabric. This te...

2. Fibro-Carcinoma. Simple Carcinoma: The schirrhus of older pathologists, the only new growth designated by them as cancer; other equally and still more malignant formations being by them divided into sarcoma and fungus. It is upon the w...

3. Medullary Carcinoma: In every way the most malignant heterologous growth, described by Burns as spongioid inflammation; by Hey, and afterwards by Wardrop, as fungus haematodes; by Abernethy as medullary sarcoma; by Monro ...

Medullary Cancer: Medullary Cancer consists mainly of albumen, with fat, according to Wiggers a phosphorus-holding fat (brain-fat), according to Gugert cho-lesterine, and, as Eichholtz contends, with pyin. ...

Medullary Carcinoma: Medullary Carcinoma ordinarily assumes the form of roundish tumors; not rarely, however, both primarily and consecutively, that of infiltration into the parenchyma of every variety of organ. To the na...

(A.) Cancer Melanodes: The entrance of pigment into the composition of any cancer converts it into cancer melanodes. Nowhere, however, does this substance occur in so marked a degree as in a cancer closely resembling the me...

Typhous Substance: The product of typhous blood-stasis deposited, in intestinal typhus in the follicular apparatus of the bowel, in broncho-typhus in the bronchial glands, and probably in plague-typhus in different supe...

Epithelial Growths, Epithelial Cancer: These growths are without doubt often merely local, and curable by extirpation. In many cases, however, notwithstanding precisely the same morphological and chemical relations, they accord so entirely...

Carcinoma Fasciculatum: (Johannes Muller). Formerly termed, also by Johannes Muller, carcinoma hyalinum, because of its jelly-like transparency. An alien growth, according to our observation, of very rare occurrence, whic...

Villous Cancer: An alien growth, whose cancerous nature is incontestably proved, both by its attendant cachexia, and by its frequent alliance with the cancers before discussed. Owing to the close affinity of its elem...

Tubercle. - Tuberculosis: The collective term tubercle is made to embrace sundry formations, which have nothing in common beyond their outward form. Still, after having well sifted this side of the question, we shall ours...

Fibrino-Croupous Tubercle: Fibrino-Croupous Tubercle appears in the shape of roundish nodules, as also, and that very frequently, of irregular, gibbous, branched masses of considerable diameter, or, upon free surfaces as gibbo-...

Metamorphoses Of Tubercle: As metamorphoses of tubercle, we have already been made familiar with its decadence or obsolescence, its softening, and its cretefaction. The first is proper to the simply fibrinous, the last two to t...

Tuberculosis. The Consumption Of Textures: The Consumption Of Textures would here remain inconsiderable, but for the breaking down of fresh tubercle in the proximity of the original ulcer. Inflammation here plays an important part. (a.) Thi...

Cretefied Tubercle: Cretefied Tubercle resides, for the most part, within textures isolated by products of inflammation, entering into a fibroid transformation and then cornifying and shrivelling into a callous capsule. ...

Tuberculosis. Vascularity: Vascularity, in truth, belongs as little to the nature of tubercle as organization itself. Still it is undeniable that bloodvessels are sometimes met with in tubercles. Two cases are here possible. In...

Tuberculosis. The Exudate: The Exudate offers in regard to its so-called tuberculization, certain points of interest, as observed most particularly upon serous tunics. (a.) In the first place, only a portion of the entire ex...

Inflammatory Tuberculosis: Inflammatory Tuberculosis, like the foregoing species, is rarely primary. It generally accedes to antecedent, insensibly generated tubercle, invading either the organ already diseased, or a structure ...

Inflammatory Tuberculosis. Part 2: Let us now, as a sequel to the foregoing, discourse respecting that anomaly of the crasis upon which tubercle is based. With a view, however, to establish a suitable groundwork for the exposition of t...

Inflammatory Tuberculosis. Part 3: 3. Typhus And Tuberculosis Typhus associates itself with tuberculosis only under the influence of very intense epidemics; in other words, it very seldom attacks tuberculous individuals. On the othe...

Inflammatory Tuberculosis. Part 4: 8. The Relation To Tubercle Of Venosity The Relation To Tubercle Of Venosity (that is, an habitual preponderance of venous blood in the system) and of cyanosis, as resulting from mechanical hindran...

Inflammatory Tuberculosis. Part 5: It will now become necessary to inquire how certain exceptional cases are to be explained. Individual cases of the kind are represented in tubercle associated with cancer, or with venosity mechanicall...

Inflammatory Tuberculosis. Part 6: The ensuing remarks appear to us well deserving of attention, as affording evidence of the imperfection of any summary scale of frequency. (1.) At every point where capillaries occur, there may be ...

Inflammatory Tuberculosis. Part 7: Albuminous Tubercle. Acute Tuberculosis Under this denomination is understood a disease presenting many points, both of resemblance and of dissimilitude with the tuberculoses already discussed. It ...

Albuminous Crude Blastemata: Under this head we shall discuss certain products in their nature probably albuminous, and essentially distinguished from other albuminous blastemata by their persistence in the condition of crudity. ...

II. Unorganized New Growths. A. - Of Unorganized New Growths In General: These lack both the internal order and the definite forms which characterize organized new growths, and their development comes under the dominion of chemical laws. Between the rudiments of what is, a...

B. - Of Unorganized New Growths In Particular: We have here, in the first place, to bring forward and to examine in detail the substances which constitute new growths. 1. Protein Substances The primitive form in which these emerge from their...

- Of Unorganized New Growths In Particular. Continued: 5. Lime-Salts (a.) Basic phosphate of lime, as a gelatino-granular mass, soluble in acids. It occurs both in fluids and in solidified formations, in a soluble combination of protein-substances, wit...

Chapter X. Anomalies Of Contents. Pneumatoses And Dropsy: In this chapter we have to treat of: A. Pneumatoses and Dropsy, which we have already adverted to as non-organized new formations. B. Foreign substances introduced into the body. C. Parasites...

B. Foreign Substances Introduced Into The Body: Inanimate foreign bodies are not unfrequently met with in the organism. They are introduced accidentally or designedly, either through the natural orifices, as the mouth, the anus, the orifices of ...

C. Parasites And Vegetable Growths, Occurring In And Upon The Living Body: Under this generic term we comprehend such formations, infesting the organism both within and without, as represent independent entities,, either from the vegetable or animal kingdom. Their investigat...

I. Parasite Plants (Epiphytes, Entophytes): These all belong to the lowest forms of plants, the fungi, and unless collected together in redundant growth, they are too minute to be cognizable with the naked eye. Respecting their origin by pro...

1. Fungi Upon And Within The Common Integument: The most important are: - (a.) The myeoderma in tinea favosa (Schonlein, Gruby). Shut up in splitting capsules, it constitutes the skin-imbedded favus. These fungi, like the torula cerevisiae, pres...

2. Fungi Upon Mucous Membranes: These are very often found upon the mucous membrnne of the mouth, the pharynx, the oesophagus, the intestinal canal, that is to say in fibrino-croupous, and especially in corroding, aphthous exudates....

II. Parasite Animals (Siebold): Parasite animals are divisible, although not strictly so, into ecto-para-sites (epizoa), and into ento-parasites (entozoa). The former infest the surface of the body, the latter its different cavities...

3. Arachnida, Acarina: (a.) The itch-mite, acarus scabiei, sarcoptes hominis, punctiform, from a quarter to half a-millimetre long, ovoid, garnished with transverse, bandlike, dorsal striae, and with central, acuminate wart...

4. Intestinal Worms. - Helminthes. - Entozoa: Restricting ourselves here to the consideration of such as are peculiar to man, we would preface our special description of them with the following general remarks: (a.) Intestinal worms, in their ...

Nematoidea, Round Worms, Thread Worms: Filaria medinensis, the thread or Guinea-worm, of about the thickness of packthread, whitish, from half a foot to several feet long, at the broader end obtunded, terminating behind in a pointed curve....

Strongylus Gigas [Pallisadenwurm]: Giant strongle; a very large, cylindrical worm,\of from five inches to three feet long, and from two to six lines in thickness; when recent, of a fine red color. Sexes distinct; the male smaller, more...

The Filaria Bronchialis: [Hamidaria lymp)hatica, Treutler - H. sub-compressa B., once seen by Treutler in a degenerated bronchial gland in the human subject.] Filaria oculi humani [in the liquor Morgagni and in the cataractou...

Trematoda, Suction-Worms: Especially characterized by their peregrinations and metamorphoses. Distoma hepaticum, and D. lanceolatum, Liver-fluke; flat, melon-seed or lancet-shaped, soft worms, of a yellowish-white color, wi...

Cestoidea - Tapeworms: These are characterized by their enduring growth, and by the great length to which they attain. They consist of a succession of linked joints, of which the fully developed, sexually mature, hindmost o...

Cystica. - Vesicular Worms: In the formation of their head, these resemble tape-worms to such a degree, that even in 1836 Johannes Muller proposed to unite them in a single order, with two subdivisions. Light has, however, been ...

Echinococcus Hominis: The relation of both to each other, and the import of the last-named animal in particular, will become manifest from the following description: (A.) Echinococcus Within a sac of fibroid texture ...

(B.) Acephalo-Cyst, Aceplialocystis (Laennec): Under this term we at this day understand nothing beyond those vesicles which we have just described as being inhabited by the echinococcus, but which are in some instances sterile. The above name has...

Spurious Parasites: As such are to be reckoned all those foreign bodies reputedly or really, accidentally or designedly, conveyed upon or into the human body; but which are proved either not to infest it in reality, or t...

Blood Diseases - Dysceases: Humoral pathology is simply a requirement of common practical sense; and it has always held a place in medical science, although the limits of its domain have, no doubt, been variously circumscribed o...

1. Fibrin-Crasis: The fibrin-crasis occurs in several most important forms and varieties, which the term hyperinosis - as designating a frequent but by no means necessary and invariable excess in the quantity of fibrin...

Fibrin-Erases: Fibrin-Erases become, for the most part, primitively developed under the conditions of a free respiratory function. Of this fact, striking examples offer in the tuberculoses, and the setting in of cro...

Croupous Crasis A: It is characterized by the following relations of the fibrin in its coagulation and exudation. The coagula - engendered in the death-agony - are, in the heart, either clod-like, cord-like, more or ...

Croupous Crasis Fb: Its characters are nearly those of the former, as regards the outer aspect of the coagula and of the exudates, only more strongly developed. Thus, the opacity of the coagula and of the exudate-fibrin ...

Croupous Crasis R. Aphthous Crasis: In the croupous crases hitherto described hyperinosis commonly prevails; in the crasis we are now entering upon, the amount of fibrin in the blood is for the most part scanty. By so much the more sign...

(C.) The Tubercle-Crasis: Although there are, no doubt, tuberculoses purely local, a tuberculosis extending through several organs, or even through one entire organ, is invariably the offspring of a tuberculous dyscrasis. T...

The Qualitative Impairment Of The Blood-Fibrin: The Qualitative Impairment Of The Blood-Fibrin here again, as in the fibrin-crasis of a higher grade, serves to explain summarily the fact, that in individuals with blood impoverished in fibrin, - or ...

Pyaemia. Pus-Blood: This crasis again represents a local pus-production, and also a spontaneous primitive pyaemia of the entire blood-mass. In pyaemia it is necessary to distinguish two different grades or stages, in ...

2. Venosity, Albuminosis. - Hypinosis (Simon): This constitution of the blood is characterized by deficiency in fibrin but preponderance of albumen, and generally speaking, also of blood-globules. The blood is upon the whole thickish, tenacious, d...

Pus-Formation: Pus-Formation, we have to observe, is alien to the genuine typhous process whether general or local. Wherever it does occur, it is founded in a degeneration or change in the typhus-crasis, of which we...

(C.) The Exanthematous Crasis: Its domain, viewed from the anatomical side is a very extensive one. However, we might wish to limit this crasis to scarlatina and measles, a number of acute blood diseases naturally cluster around th...

A Crasis Appertaining: A Crasis Appertaining to this class often becomes localized, as one of the exudatory processes adverted to, uponthe intestinal mucous membrane, as in many instances of acute diarrhoea and of dysentery...

(D.) Hypinosis In Diseases Of The Nerves: The similarity of the crasis in this class of diseases with the typhous and exanthematous crases is very striking. It even partakes, in common with these, of a proneness to localize itself upon the in...

(E.) The Drunkard's Dyscrasis: That dyscrasial condition induced by the abuse of alcoholic drinks, and especially of gin, occurs under two forms, differing in the course which they run - in other words, there is a chronic and also ...

(F) The Crasis Of Acute Tuberculosis: This crasis has the greatest resemblance with the exanthematous, and the disease assimilates so closely in its manifestations during life to typhus [intestinal typhus], as only to be distinguishable f...

(G.) Cancer-Dyscrasis: A crasis the existence of which is shown from the exclusive relation stated, in the general section on Tubercle, to exist between cancer and tuberculosis. To demonstrate a cancer-dyscrasis from ana...

The Fibrin-Crases: The Fibrin-Crases, however, accompanying, or at least coincident with cancer, are of great interest, not alone, as running counter to our theory of the nature of cancer, but more particularly because,...

3. Hydremia; Anemia: (A.) The Serous Crasis; Hydremia Fibrin, albumen, blood-globules, are here all diminished in quantity; the amount of ivater increased. The blood is attenuate, watery, pale in various degrees to the...

4. Decomposition. Putrid, Septic Crasis. Sepsis Of The Blood: We have repeatedly had to refer to a decomposition, a putrid decomposition [sepsis'] of the blood, as a consecutive crasis resulting from the degeneration of another crasis. The conditions we are h...

Independent Anomalies Of The Blood-Corpuscles: An anomalous relation of the blood-corpuscles, founded in dyscrasial conditions of the plasma, occurs under several forms, some of which have been already adverted to, especially those of turgescence,...

Vol II. Editor's Preface: The principal hospital of the Austrian capital, the largest in the world, offers very extensive opportunities and unusual facilities for the cultivation of Pathological Anatomy. Exclusive of the Lying...

Part I. Abnormities Of The Digestive Apparatus. Chapter I. Abnormities Of The Alimentary Tube. Sect. I. Abnormities of The Mouth And Fauces: 1. Deviations In Form And Size As excess of development, we have here to mention the more or less complete repetition of one or more parts, which sometimes advances to such an extent that the bones...

Section II. - Abnormities Of The Pharynx And Oesophagus: 1. Defect And Excess It is only necessary to allude to the congenital absence of this passage as occurring in acephalous monsters, to its partial defect with a blind termination, its fusion with th...

5. Textural Diseases Of The Pharynx And Oesophagus: 1. Inflammation Catarrhal inflammation: - This is rarely seen very intense in the acute, but certainly not uncommonly in the chronic form. The appearances produced in that case are oedema of the mu...

Section III. - Abnormities Of The Peritoneum: 1. Defect And Excess Of Formation Arrest of development in the peritoneal sac occurs in the shape of fissure in the mesial line, or external to it; in the case of the diaphragm being absent, of a f...

2. Inflammation Of The Peritoneum (Peritonitis): Inflammation of the peritoneum presents the symptoms common to inflammation of serous membranes. It may occur as an idiopathic affection, or in consequence of traumatic lesions of the abdomen, of ...

Adhesions Of The Intestinal Coils: Adhesions Of The Intestinal Coils, producing very manifold transpositions among themselves, and with the mesentery, with the colon, in reference to the hypogastric parietes of the abdomen and the pelv...

Hemorrhagic Exudation: Hemorrhagic Exudation is frequently seen on the peritoneum; it forms largo, saturated coagula, disposed in thick layers. Thin strata present a deep black or bluish-black discoloration, the effect of t...

3. Heterologous Formations. A. Anomalous Occurrence Of Cellular And Of Serous Tissue: This appears on the peritoneum in the shape of the above-mentioned organizing processes of a plastic character, and especially as serous cysts, in which case the pseudo-membrane includes, during its o...

D. Tubercle: Tuberculosis of the peritoneum occurs in the various forms of which we gave a general sketch when treating of the tubercular disease of serous membranes, both as an acute and as a chronic affection. ...

E. Carcinoma Of The Peritoneum: The peritoneum is either secondarily affected by carcinoma, a cancerous growth originally generated externally to it, ap-proaching and involving it in its metamorphosis, perforating it and penetrating...

5. Morbid Contents Of The Peritoneal Cavity: In reference to this subject we may direct the reader to the preceding remarks, to the general investigation of the abnormities of serous membranes, and to subsequent paragraphs. At this place we mere...

Section IV. - Abnormities Of The Stomach: 1. Original Arrest Of Development Of The Stomach Original Arrest Of Development Of The Stomach involving at the same time a large portion of the intestinal canal is found in very imperfect monstros...

6. Diseases Of The Stomach Tissues: As we have already treated of the diseases of the peritoneum, we shall now discuss those of the gastric mucous and submucous tissues, and the consecutive affections of the muscular coat of the stomach...

C. Inflammation Of The Submucous Cellular Tissue: Idiopathic inflammation of the submucous cellular tissue of the stomach, resembling pseudo-erysipelas, and passing on to suppuration, is a very rare phenomenon; it not unfrequently occurs as a seconda...

The Mucous Membrane Of The Stomach: The Mucous Membrane Of The Stomach almost invariably suffers the changes of the third degree, though in varying extent and thickness. It is either affected in single folds, or streaks which pass from ...

A Torpid Suppurative Process: A Torpid Suppurative Process is commonly the result of a more profound injury, and is seen in the shape of abscesses and sinuses of the muscular coat, and of the condensed cellular sheath of the oesop...

2. Ulcerative Processes: The ulcerative loss of substance which results from one or the other of the processes we have hitherto considered, requires no separate examination, as it presents nothing characteristic. There are ot...

Ulcerative Processes. Continued: Perforation and its temporary or permanent cure, demands a more minute exposition. If it takes place at a portion of the stomach, which, like the greater part of the anterior gastric parietes, but ...

(B.) Hemorrhagic Erosion Of The Gastric Mucous Membrane: Very frequent opportunities are presented to us of observing loss of substance accompanied by bleeding, in the mucous membrane of the stomach. There are round or roundish spots of the size of a pin's ...

3. Softening Of The Stomach: We must distinguish two primary forms of softening, which present essential differences in numerous points; both, however, are to be carefully distinguished from cadaveric softening, the self-digestio...

4. Heterologous Formation: Heterologous Formation, a. Anomalous occurrence of fatty tissue, of lipomatosis tumors between the gastric membranes, and chiefly in the submucous cellular tissue. - These growth's project into the ca...

E. Carcinoma Of The Stomach: Carcinomatous diseases affect the stomach very frequently, and carcinoma of the stomach is moreover the most common carcinomatous disease of the digestive tube. It must be carefully distinguished, as ...

The Pylorus: The Pylorus, indifferently at all parts of its circumference, is known to be the chief seat of primary fibrous and areolar cancer of the stomach. From this point the degeneration extends chiefly along...

7. Anomalous Contents Of The Stomach: Among the anomalous contents of the stomach, we class, first, the secretions of the mucous membrane, which, both as regards quantity and quality, in various ways depart from their healthy condition; s...

Section V. Abnormities Of The Intestinal Canal: 1. Defective And Excessive Formation A complete absence of the intestinal canal when an abdominal cavity existed, has probably never been observed. It is frequently defective; at times it is a shor...

2. Abnormities Of The Intestinal Canal Size: The congenital malformations belonging to this section, are the anomalies which we have described above, when speaking of the length of the intestine, and the true diverticulum. The acquired malfor...

3. Deviations Of The Intestinal Canal Position: The intestinal canal may be irregular in position, either being placed altogether external to the abdominal cavity, or by its relations and its disposition within the cavity being irregular. In the...

1. Internal Hernia: 1 - We define internal hernia, in contradistinction to external hernia, as a change of position in the intestine leading to incarceration, which occurs in the abdominal cavity without the formation of...

2. Invagination Of The Intestine: Invagination or intussusception,1 incorrectly termed volvulus, consists in the inversion of a portion of intestine into the cavity of the adjoining upper or lower portion. We frequently find intuss...

3. Prolapsus Ani: Intussusception has an analogue in prolapsus ani. Prolapsus ani is a volvulus without a sheath, and it is characterized by an inversion of the internal portion of the intestinal tubing. It represen...

4. Altered Position Of The Intestine Consequent Upon Adhesions: These changes of position1 vary according to the point of adhesion, and assume very different forms. They are of importance, as they sometimes offer impediments to the propulsion of the contents of th...

5. Diseases Of The Tissues: The muscular coat is scarcely ever proved (by cadaveric examination), to be primarily affected; the disease almost invariably arises in the mucous and the submucous cellular tissue, and involves the f...

1. Hyperaemia, Anosmia: a. Hyperaemia is the result of active congestion, arising from idiopathic, sympathetic, or metastatic irritation, or it presents itself in the passive form as the precursor of asthenic inflammation, i...

2. Inflammations Of The Intestinal Mucous Membrane: We are acquainted with a catarrhal (erythematous) and a croupy form of inflammation, and, on account of the prevalence of a dyscrasic type, we may consider the typhous and the dysenteric processes occ...

B. Exudative Processes Of The Intestinal Mucous Membrane: Under this head we include all those products of serous, albuminous, pasty, fibrinous, puriform, and purulent exudation occurring on the mucous membrane, which are more or less profuse, and are preced...

C. The Typhous Process: The first duty of the pathological anatomist in this case, is to institute a comprehensive investigation of the local typhous processes, and we offer the results derived from the observation of normal...

The Typhous Process. Part 2: This metamorphosis sometimes attacks the entire patch, sometimes it only affects single portions or separate folliculi; in the latter case the remainder of the patch passes through a retrograde metamo...

The Typhous Process. Part 3: The fringe of mucous membrane which lies upon the base of the ulcer, gradually connects itself, from without inwards, with the cellular tissue that invests the base, and uniting with it becomes paler ...

Summary Of The Most Remarkable Anomalies Of The Local Typhous Process: An acquaintance with the many anomalies of this process is of such importance, that we would not trust a person ignorant of them to judge of a post-mortem examination in a case of acute fever. Their d...

Appendix. Anomalies in reference to the Degree and Character of the Typhous Process in the Mesenteric Glands: 1. Tumultuous Metamorphosis Tumultuous Metamorphosis of the typhous product in the mesenteric glands. This sometimes consists in very violent congestion of the gland, which not unfrequently give...

Epicrisis: Firstly Typhus is characterized anatomically and in reference to the alterations in the solids, by the deposition of a peculiar product, which undergoes a peculiar metamorphosis. Secondly Its...

D. The Dysenteric Process: 2 - We are acquainted with the dysenteric process as a substantive disease of the mucous membrane of the colon, and inasmuch as it is here presented in its most exquisite form, its habitat has been co...

The Dysenteric Process. Continued: The peritoneal coat presents, in the higher, and particularly in the highest degree of the affection, a dirty-gray discoloration, and a total absence of lustre; at intervals it presents a dilatation a...

Appendix. - The Non-Typhous Intumescence Of The Follicles And Villi Of The Intestines: Although the intumescence of the intestinal follicles occurring in various morbid conditions is not the consequence of palpable inflammatory action, it may yet be fairly considered at this place, as i...

6. Morbid Growths In The Intestinal Canal: Under this head we consider lipoma, the formation of an anomalous, serous, and fibro-serous tissue, fibrous and fibro-cartilaginous tissue, calcareous concretions, erectile tissue, tubercle, and scirr...

F. Tubercle: The presence of tubercle in the tissue of the intestinal mucous membrane, and by extension, in the deeper-seated coats, constitutes a most important disease - tuberculosis of the intestine in the wide...

G. Scirrhus, Carcinoma Of The Intestine: The carcinomatous affections of the intestine, occur in the three forms of fibrous, areolar, and medullary cancer, with and without the formation of pigment: two of these or all three, may be combined...

The Annular Stricture: The Annular Stricture, which in the first instance is unattached, may, as the cancer advances, become fixed in a similar manner at the point of its original development, or at different parts at a dis...

7. Theory Of The Ileus Produced By Cancerous Degeneration Of The Intestine: Independent of the degree of stricture, the degenerated portion of the intestine, owing to the adventitious growth deposited in the submucous tissue, and still more from the consequent disorganization...

Appendix. Diseases Of The Duodenum. Diseases of Separate Sections of the Intestinal Canal: Separate sections of the intestine demand special attention, inasmuch as not only many diseases occur more frequently at one part than at another, and are subject to numerous modifications in referenc...

B. Diseases Of The Caecum And The Vermicular Process: The caecum and the vermicular process are occasionally absent, or are only imperfectly developed; in some cases the former has been found fissured (Fleischmann). Anomalies in the position of the ca...

C. Diseases Of The Rectum: The main defect of development to which the rectum is liable, is that represented by atresia ani, or congenital occlusion of the anus. In this case the rectum either has a blind termination, is absent...

6. Anomalies Of The Intestinal Contents: 1. Excessive accumulation of gas is very frequently caused by an increase in the secretion on the internal surface of the intestine, accompanied by an impediment to its escape. This occurs over a larg...

Anomalies Of The Intestinal Contents. Continued: To the latter belong biliary calculi, which have reached the intestine by the natural passages, or by ulcerative communication; and the fatty and chalky concretions which have formed in abscesses adjo...

Appendix. - On Spontaneous Ileus: We distinguish between the so-called organic ileus, into the nature of which we have inquired in preceding paragraphs, and dynamic or spontaneous ileus. The latter deserves a careful investigation of ...

Chapter II. Abnormities Of The Accessory Organs Of The Alimentary Canal. Sect. I. Abnormities Of The Liver: The diseases of the liver have continued to remain to the present day a subject of extreme difficulty, in spite of the progress made in the anatomy of this viscus. As one of the chief organs concerned...

A. Liver Hypertrophy: Under this head we consider not only the abnormal condition dependent upon exalted nutrition and increased deposition of the peculiar normal constituents of the organ, but those anomalies also in whic...

B. The Nutmeg Liver: That condition of the liver in which a separation of the yellow and reddish-brown substances takes place, especially if the former predominates, and which presents a close resemblance to the section o...

Y. Fatty Liver, The Adipose Metamorphosis, Morbid Accumulation Of Fat In The Liver: A well-marked case is distinguished by the following anatomical characters: the liver is enlarged, the increase of size taking place chiefly in a lateral direction; its edges are flattened and swollen...

D. Lardaceous (Speckig, Baconny) Liver: Next in order to the fatty liver are the infiltrations of the hepatic parenchyma by a coarser, gray, sometimes transparent, albuminous, lardaceous, or lardaceo-gelatinous, substance. This affection is...

B. Atrophy Of The Liver: Atrophy of the liver, independent of the marasmus senilis of the organ, appears in various forms. We first draw attention to two distinct forms which have not been remarked hitherto, and which, simila...

3. Abnormities Of Form Of The Liver: 1 - These abnormities are either congenital, and are then in part foetal conditions of the liver, in part acquired. To the former belong the round, the unlobulated, or but slightly lobulated (embryoni...

4. Abnormities Of Position of the Liver: Abnormities of position are either congenital or acquired. To the former belong the abnormal position of the liver, external and internal to the abdominal cavity; as in cases of fissure of the abdomin...

6. Diseases Of The Liver Tissues, A. Uypercemia, Apoplexy, Anosmia Of The Liver: Hyperaemia of the liver appears in three forms: as active hyperaemia, resulting from idiopathic or consensual irritation; as passive hyperaemia, dependent upon torpor in the portal vascular system; an...

B. Inflammation Of The Liver (Hepatitis): Although inflammation of the liver may not be a very rare affection, it is certain that the intense degrees, which terminate in suppuration and abscess, do not occur very frequently with us. We may re...

C. Inflammation Of The Vena Portae: This is, under all circumstances, a very important affection. It occurs both in a primary and in a secondary form, and may in either lead to obliteration or suppuration, and may attack the trunk and t...

D. Deposits, Metastases In The Liver: Metastases occur in the liver under the same conditions under which they take place in the lungs. They are, however, much less frequent in the former than in the latter and in the spleen; and the so-c...

E. Gangrene Of The Liver: Gangrene of the liver is very rare, in fact Ferrers and Berard deny its occurrence, but we have seen it in one well-marked case, associated with pulmonary gangrene. It is developed in parts affected w...

F. Granular Liver: Granular liver is one of the most important, though in many respects, and especially in reference to its pathogeny, one of the most enigmatical affections of the liver; it is termed by Laenncc cirrhos...

Granular Liver. Part 2: With regard to their texture, we sometimes find that they consist of normal, or at least tolerably normal, hepatic parenchyma. Commonly, however, this is not the case; the parenchyma of the granulatio...

Granular Liver. Part 3: In this variety, therefore, the original anomaly consists in the hepatic parenchyma being gradually reduced to the capillary gall-ducts which have assumed the shape of the granulations; and in so far ...

G. Adventitious Growths. A. Anomalous Production Of Fat: This occurs in two distinct forms. We have already become acquainted with one in the shape of adipose deposition, or infiltration of the hepatic tissue with free fatty matter; the second is very unusu...

Y. Cysts in Liver: The liver is more liable to the formation of encysted tumors than any other parenchymatous organ; and we repeat that the rarity of tubercular deposit in the liver enhances the importance of the hydati...

D. Tuberculosis Of The Liver: Contrary to the received opinion, we assert that the liver is rarely the seat of tubercular disease. It scarcely ever occurs in this organ as a primary affection, but is not unfrequently found as a se...

E. Carcinoma Of The Liver: Carcinoma of the liver is a disease of much greater importance than tubercular deposition, as it occurs very frequently and is often a primary affection. Although we do not coincide with Cruveilhie...

Section II. - Abnormities Of The Biliary Passages: We now come to the consideration of the diseases of the gall-bladder and its efferent duct, those of the ductus communis choledochus, of the ductus hepaticus, and of the branches and ultimate distribu...

5. Textural Diseases In The Biliary Passages: A. Inflammation We often observe catarrhal inflammation occurring in the biliary passages, with various terminations and results. Like catarrhs of other mucous membranes, it not unfrequently is a p...

6. Adventitious Products In The Biliary Passages: A. Fibroid Tissue Under this head we class the textural alteration occurring in atrophy of the gall-bladder after inflammation. b. Anomalous osseous deposit - ossification, as elsewhere in mucou...

7. Anomalous Contents Of The Biliary Passages: The most remarkable are those entirely abnormal contents of the biliary passages, which are either the product of textural changes and morbid processes in their coats, or which after being generated e...

Section III. - Abnormal Conditions Of The Spleen: 1. Defect And Excess Of Formation The spleen is generally absent in acephalous monsters, together with other organs of the abdomen and thorax. Occasionally it is found wanting, together with the st...

1. Hyperaemia Of The Spleen, Anaemia: Hyperaemia of the spleen arises either from a mechanical impediment in the circulation of the blood, or from the peculiar relation alluded to as existing between the spleen and certain anomalous condi...

2. Tumors Of The Spleen: We have already discussed the tumors of the spleen arising slowly or rapidly from hyperaemia, and from the congestion of dyscrasic blood, as far as regards the mere increase of volume. We have now to ...

3. Inflammation Of The Spleen: The very important conclusions to be derived from pathological anatomy in reference to inflammation of this organ, and with regard to its influence upon sanguification, will be self-evident. We can...

4. Gangrene Of The Spleen: Gangrene is as rare an occurrence in the spleen as in the liver; we have had an opportunity of observing it once in a chronic tumor of the spleen, affecting the organ to a considerable extent. ...

5. Adventitious Growths of the Spleen: A. Anomalous, Fibrous, And Fibrocartilaginous Tissue This tissue occurs a. Very often upon the surface of the organ underneath its peritoneal sheath, in the shape of smooth and level, or tuberculat...

Section IV. - Abnormities Of The Pancreas, And The Other Salivary Glands: We shall first examine the abnormities affecting the parenchyma of the above-named glands, and then proceed to examine those of their efferent ducts, and of their contents. We may observe, generally, ...

2. Abnormities Of The Different Pancreatic Ducts And Of Their Contents: Next to salivary fistula subsequent upon injuries and ulcerative destruction of the tissues, which occurs chiefly at the ductus stenonianus, but which we have also seen in the shape of pancreatic fist...

Part II. Abnormities Of The Urinary Organs. Section I. - Abnormities Of The Kidneys: Under this head we comprise the morbid anatomy of the kidneys and the efferent apparatus, viz. the calices, the bladder, and the urethra; the two are of course very intimately related to one another. ...

7. Diseases Of The Tissues Of The Kidneys. 1. Hyperemia, Apoplexy, Anosmia: Hyperaemia of the kidneys not unfrequently occurs in the active form accompanying an exaltation of the renal functions; or as passive congestion in consequence of general marasmus, and especially in c...

2. Inflammation Of The Kidneys: Inflammation of the kidneys is either primary, secondary, or metastatic; in the first case it results from injury, concussion of the intestines, cold, or specific irritation (turpentine, cantharides, ...

3. Bright's Disease Of The Kidney: This affection of the kidneys, which has been named after its discoverer, Bright, and has of late been extensively investigated, is of extreme importance. It has been termed granular degeneration, by ...

Bright's Disease Of The Kidney. Part 2: Fifth Form The kidneys are enlarged or of the normal size, or they may be reduced in size; their surface is granular and racemose, or whilst certain portions present the nodulated and prominent app...

Bright's Disease Of The Kidney. Part 3: The whitish or ashy, milky or creamy product, which may resemble albumen in its various degrees of coagulation, and consists of solitary and accumulated molecules, or of more or less globular fibrinou...

4. Deposits In The Kidneys: The same circumstances that give rise to deposits or metastases in the lungs, the liver, and the spleen, may induce them in the kidneys. They follow inflammations of the endocardium, and of the lining...

5. Morbid Growths In The Kidneys: A. Fatty Deposit In The Kidneys We shall examine this subject under the head of Hypertrophy of the Fascia Adiposa. B. Formation Of Cysts Although we explicitly exclude the consideration of al...

D. Tubercle In The Kidneys: Tubercle exists in the kidneys under two distinct conditions; in both, however, the cortical substance is the chief seat of the deposit. a. In one case, it is the result of a very high degree of tu...

E. Carcinoma In The Kidneys: Carcinomatous growths occur frequently in the kidneys, and in the primary form. This is particularly the case with medullary cancer, which we find attaining a very large size, whereas areolar and hyal...

6. Anomalous Contents Of The Kidneys: Besides the anomalies already alluded to, we have to advert to the following morbid contents of the urinary cana-liculi. a. The formation of calculous urinary concretions, which appear in the shape...

Section II. - Diseases Of The Urinary Passages: 1. Defect And Excess Of Formation It is self-evident that where one kidney is deficient, the corresponding portion of the urinary passages must be entirely, or at least partially, absent; but when ...

4. Anomalies Of Texture Of The Urinary Passages: 1. Inflammation of the urinary passages have to be first mentioned, and especially a. Catarrhal inflammation, both on account of its frequent occurrence, as on account of its consequences and its tran...

2. Morbid Growths Of The Urinary Passages: a. Fibroid tissue and calcareous concretions result from chronic inflammation of the urinary passages in the manner above described. b. Cysts appear to be more frequent in the urinary passages than...

Section III. - Abnormities Of The Urinary Bladder: 1. Defect And Excess Of Formation Arrest of development occurs in various forms and degrees. Complete defect is a very rare occurrence; we may meet with it accompanying a very imperfect developm...

2. Deviations Of Size And Form Of The Urinary Bladder. Hypertrophy And Atrophy Of The Bladder: With the exception of the above-mentioned congenital small-ness of the bladder, and the congenital dilatations of the organ from contraction or atresia of the urethra, the anomalies to be classed unde...

5. Anomalies Of Texture Of The Urinary Bladder: Here too the diseases of the mucous membrane are of main interest, as those of the muscular coat are rare in themselves, and when they occur are generally consecutive or secondary. We shall consider t...

2. Inflammation. A. Catarrhal Inflammation Of The Urinary Bladder: This occurs in the acute form, but more frequently as a chronic affection; it is commonly presented to the morbid anatomist in the latter shape. Both generally offer the symptoms common to catarrha...

B. Exudative Processes Of The Urinary Bladder: Primary croup of the vesical mucous membrane is extremely rare; but secondary exudative processes are by no means as unusual as is commonly thought. The latter occur during the course of exanthematic ...

C. Pustular Inflammation Of The Urinary Bladder: We advert to the rare formation of variolous pustules upon the authority of other observers. We have ourselves not seen pustules in the bladder, even in cases in which the urethral mucous membrane was...

D. Pericystitis Of The Urinary Bladder: We have already alluded to the more or less diffused inflammation of the cellular tissue surrounding the bladder, which supervenes upon intense inflammation of the muscular coat and suppuration of the...

5. Adventitious Growths Of The Bladder: a. We have never observed the formation of cysts between the coats of the bladder, or in its mucous membrane, though from their occurrence in the ureters, pelvis, and calices (vide p. 167), we are not...

Section IV. - Abnormities Of The Urethra: 1. Defective Development The urethra is absent in those rare cases in which the entire uropoietic system is wanting, as also in those in which the bladder is deficient; it is also wanting in those ...

5. Diseases Of The Tissues Of The Urethra: 1. Inflammation A. Catarrhal Inflammation It commonly commences with a more or less acute or inflammatory stage, and subsequently passes into a protracted or chronic (blennorrhoic) stage. It res...

6. Anomalous Contents Of The Urinary Passages: The anomalous contents of the urinary passages are very various, and may be classified as follows: 1. The products of the organic affections of the secretory as well as the efferent apparatus; they...

Anomalous Contents Of The Urinary Passages. Continued: C. Specific Gravity This is either above or below the normal standard. It is excessive in diabetes mellitus, and very low in diabetes insipidus. In the chronic form of Bright's disease it is dimini...

N. Numerous Medicinal Substances Of Urinary Calculi: The formation of calculous concretions in the urinary organs is a matter of extreme importance; it takes place within the kidneys, in the pelvis and calices of the kidneys, in the ureters, the bladder...

Appendix. - Diseases Of The Suprarenal Capsules: The suprarenal capsules are occasionally deficient, especially when there is a deficiency in other organs also. They are not always absent in acephalous monstrosities; and as their absence generally i...

Part III. Abnormities Of The Sexual Organs. Chapter I. On Abnormities Of The Sexual Organs Generally: The sexual organs are occasionally entirely absent; a defect that is commonly associated with imperfect development of other parts, and especially with acephalia; a more or less important section of t...

Chapter II. Abnormities Of The Male Sexual Organs. Section I. The Testes And Vasa Deferentia: 1. Defect And Excess Of Formation The testes are absent when the entire sexual apparatus is absent; sometimes they are wanting when the other parts are defectively developed, or are represented by ...

Inflammation Of The Tissues Of The Male Sexual Organs: a. Inflammation of the testicle is a common occurrence; but nevertheless, rarely a subject of cadaveric investigation. It may be either primary, secondary, or metastatic. It may also be acute, or, ...

Morbid Growths Of The Tissues Of The Male Sexual Organs: a. We have already found that fibroid tissue occurs as a consequence of chronic inflammation, and its termination in induration. b. The formation of cysts is very unusual, a fact that acquires spe...

Appendix. - Abnormities Of The Tunica Vaginalis Testis: In consequence of an arrest of development, the cavity of the tunica vaginalis may remain in communication with the peritoneal cavity, and thus give rise to congenital inguinal hernia. All the dise...

Section II. - Abnormities Of The Vesiculas Seminales: 1. Arrest And Excess Of Development The vesiculae seminales are absent when the testicles are deficient, and are more or less abortive when the testicles are imperfectly developed. It is stated ...

Section III. - Abnormities Of The Prostate: The prostate is generally found to be small when the organs of generation are in an imperfect condition. Its most important anomalies consist in: 1. Abnormities Of Size And of these the most com...

Section IV. - Abnormities Of The Penis: 1. Defect And Excess Of Formation The penis may be smaller than usual, whilst the remainder of the sexual organs are normal, or themselves imperfectly developed, or it may present some further anom...

Section V. - Abnormities Of The Cutaneous Covering Of The Penis And The Scrotum: 1. Defect And Excess Of Formation As a defect of formation, we notice the occurrence of extreme shortness or contraction (phimosis) of the prepuce; fissure and entire absence of the foreskin in hyp...

Chapter III. Abnormities Of The Female Sexual Organs. The External Genitals. Sect. I. Abnormities Of The Pudenda: Arrest of development occurs in the shape of total absence of the pudenda; absence or defective development, i. e. unusual smallness of individual parts, the labia majora and minora, or the clitoris; ...

Section II. - Abnormities Of The Vagina: 1. Defect And Excess Of Formation The vagina may be totally absent, or partially deficient; in the latter case there is a cul-de-sac opening externally, or the vagina terminates blindly at a greate...

5. Diseases Of The Vaginal Tissues: 1. Inflammation a. Catarrh affects the vagina very frequently in the protracted acute, or, if blennorrhoic, in the chronic form, and presents the most various characters. It may be a simple benigna...

The Internal Sexual Organs. Sect. I. - Abnormities Of The Uterus: 1. Defect And Excess Of Formation Complete absence of the uterus must be considered as extremely rare; in most cases in which the uterus was found deficient in the dead or living subject, rudiments...

Abnormities Of The Uterus. Part 2: If the two rudiments of the uterus bipartitus are developed uniformly, according to the type of the one-horned uterus, two uterine halves are formed, which unite at one point of their convexity, and t...

Abnormities Of The Uterus. Part 3: The Division Of The Uterine Cavity The Division Of The Uterine Cavity by a vertical septum into two loculi extends in rare cases into the external orifice, but more generally is united to the cavit...

2. Anomalies Of Size Of The Uterus: These consist in irregular enlargement or diminution. The former either occurs as precocious development, depending upon a congenital vice or accompanying early puberty, or it is the result of morb...

3. Anomalies Of Form Of The Uterus: Besides those malformations of the uterus which we have alluded to as resulting from arrest of development, we have here to mention congenital obliquity of the uterus. Although many doubt its existenc...

4. Deviations Of Position Of The Uterus: As a congenital anomaly of this variety, we have to mention the oblique position of the womb, brought on by shortness of one of the broad ligaments, which it also retains in the impregnated state. Amo...

5. Deviations Of Consistency Of The Uterus: We shall subsequently advert to numerous deviations in the consistency of the uterine parenchyma, and especially to a diminution of consistency, resulting from various morbid processes; but an increas...

6. Solutions Of Continuity Of The Uterus: Under this head we include the solitary cases observed by old writers, of rupture of the pregnant womb about the middle of pregnancy, caused by a deficiency in the substance of the uterus bicornis; th...

7. Diseases Of Tissue Of The Uterus. 1. Hyperaemia - Apoplexy Of The Uterus - Ancemia: Hyperemia of the uterus, and especially of its mucous membrane, with effusion of blood in various states of coagulation and discoloration, is often observed in the dead subject as menstrual congestion...

2. Inflammation Of the Uterus: Although we shall, as much as possible, distinguish between the mucous membrane and the uterus itself in examining this subject, we must confess that, as may be expected from the close anatomical conn...

3. Ulcerative Processes Of the Uterus: In treating of catarrh of the vagina, we have alluded to excoriation, superficial and follicular ulceration of the vaginal portion of the uterus. The specific character of the catarrh and the follicul...

4. Morbid Growths Of the Uterus: A. Cysts Cysts are very rarely formed in the uterus; we have not met with a single example in Vienna, and I myself have only inspected one case of uterine acephalocysts. It is necessary to distingu...

Metamorphoses And Diseases Of The Uterine Fibroid Tumors. Spontaneous Cure: We have already spoken of ossification, congestion, inflammation, suppuration, and solution of fibroid tumors generally; and those remarks apply with the more force to uterine fibroid tumors, as we as...

6. Tubercle Of the Uterus: Tubercle occurs primarily as tubercle of the uterine mucous membrane; the uterine parenchyma is like the submucous muscular layers, only attacked secondarily by tubercle. It generally occurs in the...

7. Carcinoma Of the Uterus: Next in frequency to fibroid growths is the occurrence of cancer. It always attacks the cervix in the first instance, and especially that portion which projects into the vagina; the primary occurrence...

8. Cauliflower Excrescence Of The Os Uteri Of the Uterus: We append to the above remarks on uterine cancer a brief account of the so-called - Cauliflower Excrescence Of The Os Uteri Cauliflower Excrescence Of The Os Uteri, which we are inclined to conside...

Section II. - Diseases Of The Uterus After Parturition: Under this head we include diseases to which the uterus is liable in consequence of the puerperal state, which are essentially (in reference to causation) connected with the latter, and especially wit...

1. Puerperal Endometritis Of The Uterus: This affection, as has already been observed, is invariably an exudative process; but it offers the greatest variety, both in reference to the plasticity of its product and to the condition of the dis...

2. Inflammation Of The Veins And Lymphatics Of The Uterus: Both, but especially phlebitis, are important puerperal diseases. Uterine phlebitis is generally a primary affection, originating in the open mouths of the veins at the insertion of the placenta, a...

3. Inflammation Of The Peritoneum: Inflammation Of The Peritoneum (peritonitis puerperalis), viewed in connection with puerperal inflammations of other serous membranes. - Peritonitis is known as a very common puerperal disease; in ...

4. Puerperal Inflammation Of The Ovaries And Fallopian Tubes: We shall examine these affections when we speak of the diseases of the respective organs. The first is always complicated with one of the processes that have been just discussed, and probably always w...

5. Phlegmasia Alba Dolens (Sparganosis): Various theories have been formed in reference to this disease of the puerperal state, from its symptoms in the living subject; and very different views have been even propagated with regard to its an...

Phlegmasia Alba Dolens (Sparganosis). Continued: We have here to advert briefly to two symptoms that occur during the course of puerperal peritonitis, and which not unfrequently coexist - they are, vomiting of the biliary matters contained in the du...

6. Termination And Consequence Of The Puerperal Processes: We confine ourselves at present to an account of those terminations and consequences of the fundamental puerperal processes, which are not to be inferred from the previous remarks. Puerperal perito...

Section III. - Abnormities Of The Fallopian Tubes: 1. Defect The tube may be absent on either side if there is a corresponding defect of one-half of the uterus, but this certainly is not always the case, inasmuch as it is not only often present whe...

4. Diseases Of The Tissues Of The Fallopian Tubes: 1. Hyperaemia, Hemorrhage Hyperemia of the Fallopian tube is almost always a symptom of general congestion of the sexual organs, and especially of the uterus. In rare cases, however, the hyperaemia...

Section IV. - Abnormities Of The Ovaries: 1. Defect Of Formation It is very unusual for one of the ovaries to be wanting, if the sexual apparatus is otherwise normal. The ovaries often appear, together with the other portions of the sex...

2. Inflammation Of The Ovaries: Inflammation occurring in the ovary, independently of the puerperal state, is limited to the follicles. The coats of a follicle are occasionally found injected, reddened and softened, and friable; ...

3. Morbid Growths Of The Ovaries. Cysts: A. Cysts In no part of the body are cysts so frequent, or so various as in the ovary, in the peritoneum, in the neighborhood of the internal sexual organs, or in the subperitoneal cellular tissue; ...

Morbid Growths Of The Ovaries. Cysts. Continued: If both ovaries are involved in the disease, inasmuch as they are generally affected successively, and one is less enlarged than the other, the smaller one remains in the pelvis, and its retention is ...

D. Carcinoma Of The Ovaries: Cancer, on the other hand, if we collect all that comes under this denomination, is not unusual. a. The most frequent form is areolar cancer in the above-described shape of areolar hydrops ovarii: ...

Section V. - Abnormities Of The Mammary Glands: 1. Arrest And Excess Of Formation Froriep has lately recorded an extremely rare case of absence of one of the mammary glands in a female; the muscles and bones of the corresponding or right side of...

Section VI. - Abnormities Of The Ovum: We shall first discuss the anomalies presented in the attachments of the ovum, i. e. its attachment and development at a point external to the uterine cavity, extra-uterine pregnancy and the degenerat...

1. Abnormities Of The Membranes And Of The Liquor Amnii: The membranes of the ovum may undoubtedly become the seat of hemorrhage and inflammation at a very early period of pregnancy; these affections are probably the cause of the formation of moles, but the...

2. Abnormities Of The Placenta: . The placenta offers considerable variations as to size, without being morbidly affected. We have here only to mention that extreme development of the intervascular substance of the decidua wh...

3. Abnormities Of The Umbilical Cord: The instances of absence of the funiculus umbilicalis, recorded by ancient writers, must evidently, as Meckel has pointed out, be considered as cases of extreme shortness of the cord. The subject is o...

4. Abnormities Of The Foetus: We pass over those deviations of congenital development which we have already discussed, and devote this section to the consideration of the remaining anomalies, although we have already cursorily tou...

Variola, Measles: Variola, Measles, and various cicatrices have been noticed on the foetal integuments. To this head also pertains pemphigus and various vesicular eruptions, the vesicles of which contain a livid, sero-...

The Urinary Organs Of The Foetus: The Urinary Organs Of The Foetus do not frequently become diseased, but their affections occasionally attain a very considerable development. The kidneys are subject to hyperaemia and apoplexy; the pa...

Editor's Preface To Vol. III: A knowledge of the value of Professor Rokitansky's personal instructions increases my estimation of the honor of being called to translate and edit a portion of his writings. I take this opportunity o...

Part IV. Anomalies And Diseases Of Cellular Tissue: 1. Varieties In Regard To Quantity The cellular tissue contained in the human body is subject to variations in quantity which come within the sphere of Pathology. In some bodies this tissue is o...

Anomalies And Diseases Of Cellular Tissue. Part 2. Inflammation: Inflammation of cellular tissue (inflammatio teloe cellulosse) is a disease of much importance, not only on account of the circumstances attending its occurrence in that tissue itself, but also ...

Anomalies And Diseases Of Cellular Tissue. Part 3: 3. Depositions, Metastases Depositions, Metastases, are very frequent both in the subcutaneous and in the deeper layers of cellular tissue. The deposits are of purulent and ichorous nature, and are...

3. Anomalies Of Secretion And Accumulations Of Foreign Bodies In Cellular Tissue: In the first place, the fat is subject to considerable deviations from its natural quantity and quality. Not unfrequently it is found collected in excessive amount, and at the expense of the nutrit...

Part V. Anomalies And Diseases Of Serous And Synovial Membranes In General: 1. Deficiency And Excess Of Development In The System Of Serous Membranes There are various kinds of primordial defect in serous membranes. They may be entirely wanting. Sometimes the organs they s...

2. Inflammation Of Serous Membranes: This is one of the most frequent of all diseases: it befalls chiefly the larger sections of the system of serous and synovial membranes of large joints, like the knee and hip. It is sometimes a primar...

Inflammation Of Serous Membranes. Part 2: B. Opacity And Thickening In those parts where the membrane is reddened and injected, and still more evidently in the interspaces between them, it becomes dull, loses its lustre, transparency, and ...

Inflammation Of Serous Membranes. Part 3: B. Chronic Inflammation Chronic inflammation presents itself in three different forms or kinds: a. It commences as a latent, and continues as a lingering inflammation: though ordinarily moderate in...

Inflammation Of Serous Membranes. Part 4: Y. Chronic Inflammation Chronic Inflammation may extend from the serous membrane to the pseudo-membranous structure which lines it, and lead to a deposition of its products both within the substanc...

Inflammation Of Serous Membranes. Part 5: The thickness and consistency of the hemorrhagic exudation are proportioned to the quantity and plastic properties of the fibrin it contains: it forms a peripheral coagulum, which cleaves to the walls...

Inflammation Of Serous Membranes. Part 6: 3. Softening Of Serous Membranes There is no such disease as primary softening of these membranes: when it does occur, it is consecutive, and in the peritoneum and pleurae, ensues upon prior soften...

D. Abnormal Bony Substance, - Ossification, As It Is Called, Of Serous Membranes: This, like the adventitious substance last described, is found as a subserous formation, on the outer side, and in the substance of the serous coat, after it has undergone a fibroid condensation of it...

E. Tubercle. Tuberculosis Of Serous Membrane: Tubercle affects chiefly the larger divisions of the serous system; the peritoneum, pleura, and pericardium. It is ordinarily the product of a general constitutional disease, which has been already lo...

F. Cancer Of Serous Membrane: Serous membranes are often perforated by malignant growths which originated externally to them: the pleura is invaded by masses of cancer deposited in the mediastina, and by large exuberant growths in...

G. Anomalies Of Secretion Of Serous Membrane, And Morbid Contents Generally: Free gas is not unfrequently found collected in different quantities within serous sacs. It is met with chiefly in large serous cavities, such as the pleura and peritoneum, and its presence is due to ...

Part VI. Anomalies And Diseases Of Mucous Membranes In General: 1. Defective And Excessive Development Congenital deficiency of a mucous membrane involves deficiency of the apparatus which it composes, or which, as the expression is, it invests or lines: always...

1. Hyperoemia, Apoplexy, Hemorrhage, Ancemia Of Mucous Membranes: Mucous membranes are sometimes actively congested, either in consequence of some direct irritation, or from a special relation of the constitution of the blood to a particular portion of the membrane:...

2. Inflammations. A. Catarrhal Inflammation: This is the common inflammation of mucous membrane; it is sometimes an ordinary catarrh, resulting from the known atmospheric influences; sometimes it is the local expression of a constitutional disea...

Chronic Catarrhal Inflammation Of Mucous Membranes: The anatomical characters of this form of inflammation are, - (1.) A dark, dull redness inclining to brown, injection, and a varicose state of the vessels. (2.) Increase of bulk; the mucous memb...

B. Exudative Processes Of Mucous Membranes: Processes of exudation are frequently met with in particular portions of the system of mucous membranes; but their nature is very various, as their products, and the condition of the mucous membrane i...

C. The Exanthematous Processes Upon Mucous Membranes: The Exanthematous Processes Upon Mucous Membranes are allied to the exudative. They are sometimes the manifestation of a very great degree of constitutional disease, and form a complementary addition ...

3. Ulcerative Processes Of Mucous Membranes: Ulcerative processes are very frequent upon mucous membranes; and withal very various in their forms, in regard both to the anomaly of texture which gives rise to them, the mode in which the ulcerativ...

4. Oedema Of Mucous Membranes: All the processes already described, especially the exudative and exanthematous, are attended with oedema; and so also is the ulcerative, in various degrees and to various distances from the actual se...

5. Deposition - Metastasis - On Mucous Membrane: This, on the whole, is an uncommon appearance. It sometimes presents the character of a small collection like a furuncle, and sometimes forms a flat scale over the superficial layer of the mucous memb...

6. Mortification Of Mucous Membrane: Mortification presents itself in various forms: the mucous membrane may become a grayish-white, or whitish-yellow, dry and rotten, or moist and lacerable, eschar: such is the change that results from ...

7. Softening Of Mucous Membranes: If we exclude from consideration the relaxations of tissue that mucous membranes suffer from inflammation and oedema, and the solutions which take place during and after exudative processes, we shall ...

8. Change Of Texture Which Mucous Membrane Undergoes: Change Of Texture Which Mucous Membrane Undergoes when pre-ternaturally exposed to atmospheric air, and when long subjected to distension. - a. The mucous membrane of prolapsed and everted organs is l...

9. Adventitious Formations Of Mucous Membranes: Strictly speaking, very few adventitious growths are developed in and from the parenchyma of mucous membranes themselves: for, with the exception of teleangiectasis, tubercle, and cancer, and of these...

H. Tubercle Of Mucous Membranes: Tuberculosis is one of the most frequent, and, at the same time, most destructive diseases of mucous membranes: its frequency, however, is not the same in all of them. The devastations which it produc...

I. Cancers Of Mucous Membranes: Mucous membranes are very subject to cancerous affections; some are more frequently diseased than others, and especially the mucous lining of the whole alimentary tube. It would, however, be erroneous...

Part VII. Anomalies And Diseases Of The Skin: 1. Defect And Excess In Development Congenital deficiency of the integuments is extremely rare, whether extending over the whole, or only over parts of the body. An instance of the former kind was ...

5. Anomalies In Color Of The Skin: The deviations from the natural color of the integuments are very numerous. They are, in general, either an absence of color or pallor; or a deepening of it; or with one or other of these may be combi...

6. Anomalies Of Texture Of The Skin: 1. Congestion, - Hemorrhage, - Anoemia A passive congestion, limited to certain parts of the skin, may be constantly observed on the dead body. It is seen, too, on the whole integuments, as a dark ...

A. Erythematous Inflammation Of Skin: Erythematous inflammation, as has been said, is an inflammation of the outermost layer of skin, which contains the papillae; and it includes not only the slight inflammation produced by external agent...

B. Phlegmonous Inflammations Of Skin. (True Dermatitis): Phlegmonous inflammation extends beyond the papillae into the deeper strata of the corium, and sometimes involves not only the entire thickness of that part, but also more or less of the subcutaneous ...

C. Furuncular Inflammation Of The Skin: The forms in which this kind of inflammation occurs are furuncle and anthrax; it occupies the deeper, areolar layer of the corium, and the cellular tissue filling the interspaces of its network. A cir...

D. Exanthematous Inflammations Of The Skin: To this class belong all acute and chronic exanthematous processes which present the following general characters. They are preceded or accompanied by symptoms of inflammation: either at one spot, or ...

3. Ulcerative Processes Of The Skin: The ulcerative processes are, for the most part, results of inflammations already described; and they are especially liable to occur when those inflammations, having been raised to unusual intensity b...

4. Mortification Of Skin: Mortification is not an unfrequent occurrence in the skin; it arises from congestion and inflammation, and takes place more readily the more insuperable the mechanical interruption to the circulation,...

5. Adventitious Growths Of The Skin: Here again I cannot avoid remarking that, whether from the apparent insignificance of these growths in themselves, or from the regard paid to that affection of the internal organs which gives occasion...

K. Cancer, And Cancerous Ulcer Of The Skin: Cancer, And Cancerous Ulcer, are of frequent occurrence in the skin. Cancerous degeneration and ulceration of subcutaneous tissues very frequently involve the skin over them, and cancers of the subcut...

L. Parasites Of The Skin: Several kinds of pediculus, the itch insect (acarus scabiei), and without doubt other acari also, occur both in and upon the skin: the subcutaneous cellular tissue is infested with the filaria medi-ne...

Appendix. Anomalies And Diseases Of The Sudoriparous And Sebaceous Glands: A. In several of the exanthematous processes the sudoriparous glands and their ducts are unquestionably subject to frequent and various diseases, both primary and secondary, but the anatomical investi...

Anomalies And Diseases Of The Horny Tissues. A. The Cuticle: The Cuticle is subject to several anomalies, but they are not accurately known; and their relations to diseases of the cutis require especially to be explained. 1. It is very often formed in excess...

B. Anomalies And Diseases Of The Nails: 1. These have in some few cases been found wanting in all, or in some of, the fingers and toes. They are very frequently absent in ill-developed supernumerary fingers and toes. When such parts coalesc...

C. Anomalies And Diseases Of The Hair: 1. It may be congenitally deficient in whole or in part (Alopecia connata): the deformity which is thus produced lasts only so long as the growth of the hair is delayed; sometimes, however, it continu...

Part VIII. Anomalies And Diseases Of The Fibrous System: I shall confine my observations, in the following chapter, to the membranous, and the fasciculated fibrous structures, except in the instance of periosteum, which I shall consider as fully as can be d...

1. Inflammation Of The Fibrous System: Inflammation in fibrous structures is a frequent result of stretching and various kinds of injury, as well as of mere exposure. Not less frequently it extends to them from other organs, such as bones ...

2. Adventitious Growths Of The Fibrous System: Adventitious Growths are, on the whole, but rarely found in this system, though there are some fibrous structures which form an exception to the rule in the instance of particular new growths. Such is...

Part IX. Anomalies And Diseases Of The Osseous System. Chapter I. Anomalies And Diseases Of Bone In General: 1. Deficiency And Excess Of Development The entire bony fabric of the body has been found wanting in some few cases of monstrosity, and even in some individuals whose development in other respects ...

2. Anomalies In Size. Hypertrophy And Atrophy Of Bone In Particular: The anomalies of this class present many varieties, both when the volume of the bone is greater than natural and when it is less. An increase in the size of the bones occurs in various forms. 1....

A. Hypertrophy Of Bone - Hyperostosis: Bone increases in substance in two ways, which are not essentially different from one another. 1. In the one case, while the density of the bone remains unchanged, new osseous substance is deposite...

A. Exostosis: By the term exostosis should be understood a purely bony mass, set upon a bone forming with it an organic whole, and, where it is possible, originating, or proceeding, from the bone. When its developm...

B. The Spongy Exostosis: The Spongy Exostosis proceeds from a circumscribed rarefaction, or expansion, of the bony tissue (osteoporosis); it forms a tumor of cellular texture abounding with marrow, which is surrounded by a co...

B. Osteophyte: Although no well-marked line of distinction can be drawn between the exostosis and the osteophyte, yet the latter presents such striking peculiarities, that, in the majority of cases, it may at once b...

B. Atrophy Of Bones: Atrophy of bones occurs under many forms and various circumstances. (1.) After a long-continued and exhausting disease of bone, such as caries, after exhaustive healing processes, such as fractures...

3. Anomalies Of Form Of Bones: The deviations from the natural shape of the bones are many and various; in some instances they are congenital, very frequently they take place after birth. When congenital, they sometimes occur indep...

4. Anomalies In The Relative Position Of Bones, And In Their Connection With One Another: The connection between bones is sometimes unnaturally close and intimate, and sometimes unnaturally loose: when the latter condition is very decided, it is usually combined with some deviation from th...

5. Anomalies Of Consistence Of Bone: These anomalies, expansion of the tissue, and so-called softening of bone, on the one hand, and induration on the other, are, essentially, changes of its texture, and of its chemical composition: the ...

Repair Of Bone Fracture By The First Intention: When the extravasation produced by the fracture of the bone and simultaneous injury of the soft parts, and the vascularity of the soft parts, of the lacerated periosteum, the surrounding cellular tiss...

Of Arrests Of The Growth Of Callus In General, And Of New Joints In Particular: The modes and degrees in which the formation of callus may be arrested, are very various. The quantity formed may be insufficient for its purpose, or there may be none at all: it may undergo the chang...

Union Of Fractures By Suppuration: Compound fractures unite in a different manner from that by first intention: yet the repair by suppurative inflammation, in its essential particulars, has been far too little investigated. It is analo...

Repair Of The Bendings And Fissures Of Soft Bones: When the bones of children or of persons affected with rickets have been slightly and gradually bent, and the bony tissue and periosteum have been stretched without suffering a breach of their continu...

Repair Of Injuries Of Bone Complicated With Loss Of Substance: The mode in which wounds of bone combined with loss of substance are repaired is, on the whole, the same as that by which fractures unite. Under favorable circumstances it is effected by the first int...

Repair Of Injuries In Which Bone Is Denuded Of Its Soft Coverings: There is no question that injuries of this kind are repaired by first intention. The soft tissues and the bone together furnish an exudation which becomes organized at one part into a layer of callus ...

7. Diseases Of Texture Of Bone. Congestion Of Bone. Hemorrhage: Although diseases of bone generally, and those of its texture especially, have been the object of much valuable investigation, both clinically and anatomically, yet our knowledge of them is still very...

2. Inflammation Of Bone: Inflammation of bone (ostitis) is sometimes evidently the result of external causes, of various injuries, for example, most of which have been already enumerated, of concussion of the bone, or of ...

Inflammation Of Bone. Continued: A High Degree Of Inflammation In Bone A High Degree Of Inflammation In Bone leads to the effusion either of a fibrinous product, which more or less rapidly softens; or of a purulent exudation, whic...

3. Ulceration Of Bone, - Caries: This disease corresponds to ulceration in the soft parts. It is sometimes the immediate result of an inflammatory process of low type (dyscrasia), the product of which exerts a solving power upon the ...

The Sanies Produced By The Bone: The Sanies Produced By The Bone is an acrid fatty fluid, itself discolored in various ways, and which, as is well known, blackens silver probes and linen. It almost always contains small particles of ...

4. Necrosis (Mortification Of Bone): Necrosis in bone corresponds to mortification in the soft parts, more particularly to dry gangrene, or mummification. It has in general a less serious character than the latter, inasmuch as by the app...

Necrosis (Mortification Of Bone). Continued: Superficial Necrosis In superficial necrosis, the inflammation that takes place in the bone around leads to an exudation, which afterwards ossifies upon its surface under the periosteum; and as the...

5. Expansion, Softening, Of The Tissue Of Bone, And The Consequent Indurations: Expansion, or rarefaction, though often combined with softening of bone, must yet be distinguished from it. The former is produced by dilatation of the Haversian canals and cells, and constitutes the ...

B. Osteoporosis Sometimes Arises From An Inflammation Of The Bone And Medulla: Osteoporosis Sometimes Arises From An Inflammation Of The Bone And Medulla, which furnishes a product in the cavities of the bone, differing in its nature from the ordinary ossific exudation (p. 129)....

A. Rickets (Rhachitis Juvenilis In Contradistinction: Rickets (Rhachitis Juvenilis In Contradistinction to rhachitis adul-torum and rhachitis senilis, which are equivalent to mollities ossium) is a disease of early childhood. It is, in most cases, develo...

B. Mollities Ossium: Mollities Ossium (Osteomalacia, Malakosteon, Rhachitismus adulto-rum, and senilis), is quite a different disease from true rickets, and affects grown persons in the period between early manhood and ol...

Consecutive Induration: Consecutive Induration appears to me to be the mode in which one of the described processes of expansion and softening of bone subsides or heals. The previous occurrence of such a process is at once s...

6. Adventitious Growths Of Bone: These formations are, on the whole, a rare appearance in the bony system; by far the most frequent of them is cancer. Those which originate in some general diseased condition, are usually the expressi...

G. Tubercle of Bones: The frequency of tuberculosis in the bony system is unquestioned. The tubercle either assumes the granular form, or, as very frequently occurs, it is a product of inflammation of the bone, and present...

H. Sarcoma And Cysto-Sarcoma in Bone: Sarcoma And Cysto-Sarcoma occur in bone pretty frequently; they are sometimes situated on its surface, and sometimes developed in its interior. When deeply seated, they usurp the place of the natural ...

I. Cancers in Bone: Numerous growths of cancerous nature are met with in bone; they are distinguished from one another by their internal structure and external configuration, as well as by the mode in which they destroy ...

Cancers in Bone. Continued: Examination Of The Body It was emaciated in every part, and pallid. The bones of the trunk, especially the ribs, sternum, and vertebrae, were softer than natural: the vertebrae could be easily inde...

8. Foreign Bodies In Bones: In some cases in which mercury has been medicinally employed, either internally or externally, particles of the metal have been found in bone. Fragments of all kinds of instruments by which bones have...

Scrofulous Inflammation Of Bone: Scrofulous Inflammation Of Bone, as it is called, that is, inflammation resulting in tubercular product, and scrofulous caries, have been described already (p. 151), with tubercle of bone, and the tub...

Tubercle Of Bone: Tubercle, when it softens in spongy bones, as in the bodies of the vertebrae, destroys the bone in rounded spots, which are clustered together so as to give it a honeycombed appearance. The destruc...

Appendix - Anomalies And Diseases Of The Medulla: Although it is highly probable that the medulla is the part in which all pathological plastic processes in bone originate, yet very little is known of its diseases. And upon this deficiency of informa...

Chapter II. Anomalies And Diseases Of Particular Parts Of The Skeleton, And Of The Several Bones Composing Them. Section I. - The Skull And Its Several Parts: 1. Deficiency And Excess Of Development In cases of Acephalus, the skull is altogether wanting, or is reduced to a merely rudimentary condition. It is liable, also, to various degrees of defect, in...

2. Anomalies In The Size Of The Skull: The skull, like the brain, may deviate in either direction from its proper size. In some cases it does not reach, in others it exceeds, its natural dimensions. Smallness of size may be general over th...

Anomalies In The Size Of The Skull. Continued: The layer of new bone varies in thickness, from that of a very thin film to half a line, a line, or more. It is usually thickest along the sutures, the longitudinal furrow, and the grooves for the art...

Chronic Inflammation Of The Skull: Chronic Inflammation gives rise to a considerable thickening and induration of the walls of the skull, and irregularity and roughness of their surface, with, sometimes, an almost monstrous thickening ...

Atrophy Of The Skull: Atrophy is, in some instances, confined to certain portions of the skull; it then presents itself either in the form of diminution of particular parts of the cavity of the skull, or of other cells and...

3. Deviations Of Form Of The Skull: The skull is subject to very various deviations from its healthy form. It will be sufficient to furnish a general account of them, without entering into a detailed description of any but the most impo...

Malformations Of The Skull: Malformations of a peculiar kind, are produced by great projection of the cerebral skull above and in front of the facial; or, as is more frequently the case, by its receding behind the face; the faci...

4. Anomalies In The Mutual Connection Of The Cranial Bones: The connection between the bones of the skull may be loosened, and their sutures separated (diastasis). This separation very rarely occurs, and is less important as a result of violent injury to the s...

5. Solutions Of Continuity Of The Skull: The skull is very liable to solutions of continuity, in consequence of its exposure to mechanical injuries. In the infant it may be indented and fissured, or simply indented by the pelvis of the mothe...

6. Anomalies In The Texture Of The Cranial Bones. Hemorrhage: 1. Hemorrhage Under this head, a disease is included which is of frequent occurrence in the skull of the new-born child, namely, the sanguineous tumor - thrombus neonatorum, cephalhematoma, - a dis...

The Cephalhematoma: The Cephalhematoma is constantly circumscribed near the margin of the affected bone, and does not pass beyond the sutures. It is a circumstance of considerable importance, though it has hitherto be...

2. Inflammation, Caries, And Necrosis Of The Bones Of The Skull: The cranial bones are frequently the seat of these processes, which may be set up not only by violence, but by many other external influences, and very frequently by some internal cause. Sometimes, al...

Section II. - Of The Trunk And Its Several Parts: 1. Deficiency And Excess Of Development Deficiency of the whole vertebral column is met with only in monsters which are very incompletely developed; more commonly, only a portion of it is wanting. ...

2. Anomalies In The Form Of The Vertebral Column, And Of Its Several Parts: Deficiencies of development involve, as has been stated, various anomalies in the shape of the several vertebrae, and also, as will further appear, deformities of the whole column. Moreover the approx...

Case I. Compound Scoliosis, Occasioned By The Presence Of Supers Numerary Lateral Halves Of Vertebras: Compound Scoliosis, Occasioned By The Presence Of Supers Numerary Lateral Halves Of Vertebras, which compensate each other. The spine of a woman, set. 46, a very old preparation in the Museum at Vienn...

Case II. Scoliosis Produced By Deficiency Of One Half Of A Vertebra: The spine of a tailor 70 years of age. It consists of the cervical skeleton (excepting the atlas), of twelve half dorsal vertebrae on the left side, and eleven on the right, of four abdominal and f...

Case III. Angular Curvature (Kyphosis): Case III. Angular Curvature (Kyphosis), produced by the twelfth dorsal Vertebra consisting of two divided lateral halves. - The spine of a woman, aet. 55. The two portions form triangular rudiments in...

A. Active Muscular Contraction: Active Muscular Contraction, arising from some idiopathic and substantive, or from a secondary, affection of the nervous system, especially of the nervous centres, and usually combined with other defo...

B. Curvature Of The Vertebral Column: Curvature Of The Vertebral Column backward presents itself either as an arching of its dorsal portion, a morbid excess of the natural curve in that region (excurvation of Bampfield), or in the form of...

C. Curvature Forward - Lordosis: Curvature Forward - Lordosis - is met with in greatest extent and frequency in the lumbar region: it scarcely ever occurs as a primary curve in that situation, but is almost always consecutive upon so...

Kyphosis, Or The Angular Projection: Kyphosis, Or The Angular Projection, which is formed by two sides of an angle, is counterbalanced by a curvature forward (lordosis). The compensation is sometimes effected chiefly by the upper, someti...

1. The Deformities Of The Thorax: The most extreme deformity presented by the thorax is that which occurs in lateral curvature, and in the combination of lateral with angular projection. It seems displaced in the opposite direction to...

2. The Deformities Of The Pelvis: The deformities of the pelvis in curvature of the spine are, in many respects, still more remarkable, and an acquaintance with them is, at the same time, more important. They are frequently the primar...

3. Solutions Of Continuity In The Vertebral Column, - Dislocation, - Anchylosis: Various kinds of solution of continuity are met with in the vertebral column as results of external violence; and their characters are those of incised, punctured, or gunshot wounds, according to the ...

4. Hyperostosis - Atrophy Of The Osseous Structure Of The Spinal Column: Hypertrophy of the osseous structure of the spinal column never occurs to an extent at all to be compared with what is observed in the skull: sometimes only, in opening a vertebral canal, we may meet ...

5. Diseases Of Texture Of The Vertebrae: Congestion of the bodies of the vertebrae is sometimes observed in the lower dorsal and lumbar part of the column, and it usually occurs when the vertebral plexus of veins is dilated and swollen; it i...

The Thorax: 1. Deficiency And Excess Of Development The full growth of the thorax is arrested in various degrees in monsters which are very incompletely formed; especially in those which are also acephalous or...

The Pelvis: 1. Deficiency And Excess Of Development There are various ways in which arrest of development is manifested in the pelvis. Sometimes the sacrum and coccyx are defective, or altogether absent, or th...

2. Deviations Of The Pelvis From Its Natural Size And Form: Amongst the former are included specimens in which the pelvis is unnaturally large or wide in all its diameters, as well as those in which it is unnaturally small or narrow in the same respect. As pel...

5. The Oblique Pelvis: This class includes by far the greatest number of misshapen pelves. Its characters are as follow: the ileo-pectineal eminence approximates unnaturally to the promontory on one side; that half of the p...

6. The Triangular Pelvis: When the amount of this kind of deformity is slight, the inlet of the pelvis forms a triangle, with its angles rounded off, and the sacrum for its base. In a higher degree of it, the sides of the tria...

3. Deviations Of The Pelvis From The Healthy Condition: Deviations From The Healthy Condition of the Articulations of the Pelvis, and Solutions of the Continuity of its Bones. - There are various circumstances under which the synchondroses are liable to be...

4. Hyperostosis, Atrophy, And Diseases Of The Texture Of The Bones Of The Pelvis: With the exception of those osteophytes which form on the pelvis in consequence of inflammatory processes, or caries in the hip-joint, we find hyperostosis but rarely in the pelvic bones; whilst atrop...

Of The Extremities: 1. Defective And Excessive Development The former class includes those cases in which one, or more, or all of the extremities, or some part of one of them, is wanting, or in which their development...

Of The Extremities. Continued: The Rubbing Of The Surfaces Against One Another The Rubbing Of The Surfaces Against One Another gradually wears down their fibroid covering of callus; it gradually, also, renders them smooth, and p...

Part X. Anomalies And Diseases Of Cartilages: Cartilages are naturally divided into the true and the fibrous, and accordingly the morbid affections of each kind require to be separately noticed. 1. Deficiency And Excess Of Development An ab...

4. Diseases Of Texture of Cartilage. Inflammation: The principal disease to which cartilage is liable is- 1. Inflammation, a subject of much discussion, on which its anatomical characters and experiment have been alike brought to bear. From our ...

Appendix. Anomalies And Diseases Of Joints: Of all deviations from the healthy condition of Joints, the diseases of texture are the most serious, both on account of their frequency, of their relations to other diseases, and of the varieties whi...

5. Diseases Of Texture In Joints: These diseases commence either in the fibro-serous capsules, or in the bones, and scarcely ever in the cartilaginous coverings of the ends of the bones or in the interarticular cartilages. In the cour...

The Cartilages Of The Joint And The Bones: The Cartilages Of The Joint And The Bones remain, in many cases, uninjured throughout the process: and excepting a perceptible turbidity, nothing unnatural is found in the synovia. In other cases, on ...

B. Inflammation Of The Spongy Articular Extremities Of Bone: Inflammation, and the inflammatory osteoporoses or rarefactions, of bone having been already considered, there are only a few special remarks to be made in this place. The articular ends of bones ...

2. Adventitious Growths of The Cartilages: A. Lipoma This occurs in joints under the form which Johann Müller has distinguished by the name of lipoma arborescens, - a branching growth of fatty tissue in the free part, or in the duplicatures...

Part XI. Anomalies And Diseases Of The Muscular System: 1. Deficiency And Excess Of Development In very incompletely-formed monsters no muscles whatever, or merely a few traces of them, are to be found. Not unfrequently, when that portion is imperfectly...

Anomalies And Diseases Of The Muscular System. Continued: Hypertrophy In The System Of Voluntary Muscles Hypertrophy In The System Of Voluntary Muscles, to an extent that would be called morbid, and would essentially disturb the functions of the part, is ...

6. Diseases Of Texture Of The Muscular System: 1. Hemorrhage. Apoplexy The various solutions of continuity, lacerations, and blows, which happen to muscles, give rise to effusions of blood within them: they are also liable to spontaneous hemorr...

Diseases Of Texture Of The Muscular System. Continued: In a few cases this mode of termination has been found throughout the whole of a large muscle, and even in all the muscles of one or more of the limbs, particularly of the lower extremities: they were...

5. Morbid Growths Of The Muscular System: The muscular system is rarely the seat of morbid growths, except when it is involved in those which have originated in other tissues. A. Teleangiectasis It occurs under the form of more or less ...

Morbid Growths Of The Muscular System. Continued: C. Cysts With the exception of cysts which enclose entozoa, these growths are very rare in the muscular system. Even the large sized acephalocyst sacs are very seldom found. And this recalls the fa...

Part XII. Anomalies And Diseases Of The Nervous System. Chapter I. The Brain. Sect. I. - Anomalies And Diseases Of The Membranes Of The Brain: The abnormal conditions of the nervous system may be subdivided into those of the brain, those of the spinal cord, and those of the nerves. To the description of the two former I shall prefix an accou...

Anomalies And Diseases Of Dura Mater: 1. Deficient And Excessive Development 1. This membrane is sometimes entirely wanting in consequence of the absence of the brain; and portions of it are deficient, when the development of the brain...

4. Diseases Of Texture Of Dura Mater: A distinction will be drawn in the following remarks, wherever it is possible, between the actual dura mater, and its innermost shining stratum. For, though the latter cannot be demonstrated as a sepa...

2. Adventitious Growths Of Dura Mater: A. Cysts Cysts properly belonging to the dura mater are extremely rare; though some examples have been met with in its substance of fat-cysts containing hair. I have in some cases seen tumors attac...

E. Carcinoma Of Dura Mater: Even excluding from consideration the various growths of cancerous nature, and those more or less allied to cancer, which present themselves on the internal shining surface of this membrane, we yet fi...

The Arachnoid: The arachnoid is a shut sac, the visceral or cerebral layer of which is, for the most part, blended with the pia mater in the same manner as serous membranes are with the tissue which lies beneath the...

2. Hemorrhage Of The Arachnoid: Spontaneous extravasations of blood into the sac of the arachnoid are by no means uncommon. They mostly happen on the convex surface of the hemispheres; at least, in the more extensive effusions, it i...

3. Inflammation Of The Arachnoid (Arachnitis, Arachnoditis): The condition of the pia mater subjacent to an inflamed arachnoid membrane, produces sundry peculiarities in inflammation of the cerebral layer of the arachnoid. In the first place, inflammations o...

4. Adventitious Growths Of The Arachnoid: Cysts, and lipomatous tumors, are rarely formed in the arachnoid; but both they and the fibroid growths, ascribed to the dura mater (p. 250), when they occur, may sometimes belong rather to the pariet...

3. Anomalies In The Contents Of The Arachnoid: Some of these anomalies have been already detailed: the accumulation of serous fluid in the arachnoidal sac in any beyond the natural quantity, constitutes another instance of them. When the accumulat...

The Pia Mater. (The Choroid Coat): The intimate relation subsisting between the pia mater and the brain, and the frequent coexistence of disease in the latter with that of the former, render the affections of the pia mater those of the...

2. Oedema Of The Pia Mater: The infiltration of the tissue of the pia mater with serum, which I have just brought forward as one result of congestion, constitutes oedema of the membrane. It is most commonly chronic: it may be co...

3. Inflammation Of The Pia Mater: Inflammation of the pia mater (true meningitis) is the most important of the inflammatory affections of the membranes of the brain. In its essence it is inflammation of a loose areolar tissue. It is ...

Tuberculosis Of The Pia Mater: It is very frequent, and is, of course, one of the most important of all the tuberculoses. It is met with as a chronic disease, but more frequently it assumes the forms of acute tuberculosis, and of m...

Of The Prolongations Of The Arachnoid And Pia Mater Within The Brain: 1. Diseases Of The Choroid Plexuses The choroid plexuses are subject to congestion, opacity, and thickening, and to a varicose state of their vessels: and these changes are mostly observed when the...

Cancer Of The Ventricles: This disease, occurring alone in the choroid plexuses, is one of the very rarest ever met with. I have seen a medullary degeneration of the choroid plexus of the fourth ventricle. 2. Cancer Of The ...

1. Hydrocephalus. Dropsy Of The Ventricles: I would here offer the following general remarks: that, in accordance with what has been already said, by the term hydrocephalus is meant Hydrocephalus stricte sic dictus internus, - dropsy of the v...

Hydrocephalus. Dropsy Of The Ventricles. Part 2: The most remarkable, and one of the most important of the post-mortem appearances, in both the principal forms of acute hydrocephalus, is this almost constant softening, or, as it is called, maceratio...

Hydrocephalus. Dropsy Of The Ventricles. Part 3: The subjects of it are, for the most part, children; but adults, and even persons advanced in life, suffer from the secondary form, especially when it is a process connected with tubercle. The seco...

Hydrocephalus. Dropsy Of The Ventricles. Part 4: The following are unessential, and, to a certain extent, merely accidental combinations: hypostatic congestions of the lungs, lobular pneumonias, slight pleuritic exudations, enlargement of the liver,...

A. Chronic Hydrocephalus, Commencing After Birth: This is either a termination or continuation of acute hydrocephalus, especially of the second form of it; or else it is chronic from the first. The symptoms during life in the latter case were not suc...

B. Congenital Hydrocephalus: This form of hydrocephalus is one of an eminently chronic character; it exists at birth, and usually has then already made considerable progress; but, if not, it soon increases, and, by the extraordin...

C. Hydrocephalus Occasioned By A Vacuum Within The Skull: When an empty space is formed within the skull by a reduction of the volume of the brain, it is filled up (as already pointed out, pp. 253 and 260), by an increase of the volume of the inner membranes...

2. Adventitious Growths Of The Ventricles: A. Cellular And Fibroid Formations Cellular And Fibroid Formations have already been mentioned to occur as inflammatory products on the free surface of the ependyma, and to occasion the increase in...

Section II. - Abnormal Conditions Of The Brain: 1. Deficient And Excessive Development Of The Brain Acephalus, or deficiency of the head, affords an instance in which the brain is entirely wanting. In such a case more or less of the spinal marro...

2. Deviations Of Form Of The Brain: The form of the brain generally corresponds to that of the skull, but anomalies occur, principally in the cerebrum. In the first place, the brain is subject to variations, in respect to its length, it...

3. Anomalies Of Position Of The Brain: Disregarding, for the time, the displacements within the skull to which the brain is subjected by various growths, we find the most striking anomaly in respect to the position of the brain to be herni...

4. Deviations In Size Of The Brain: Many individuals present peculiarities in respect to the size of their brain; but the organ is subject to other and more essential deviations from its natural bulk. I shall treat first of unnatural ex...

B. Enlargement Of The Skull: Enlargement Of The Skull, as a consequence of hypertrophy, takes place only in the child; but it occurs, whether the bones be held together by interstitial membranes still, or by sutures. The enlargem...

2. Unnaturally Small Size Of The Brain: Such a condition of the brain may, in the first place, be a consequence of some fault in its original development. The whole brain is then small, but the cerebrum is evidently the most diminished, and...

A. Congestion Of The Brain: Hyperemia ex vacuo. These congestions give rise to the transient or protracted attacks, which simulate apoplexy, and are so frequent in old age. B. Actual apoplexy, hemorrhage, finds one of its chi...

5. Solutions Of Continuity Of The Brain: Amongst these are classed in the first place, various incised, punctured, and shot wounds, contusions, and lacerations of the brain: the latter are produced partly by the instrument with which the inj...

6. Diseases Of Texture Of The Brain. Hyperoemia, - Ancemia: 1. Hyperoemia, - Ancemia Congestion of the brain is a very common appearance; and it is generally associated with a corresponding degree of congestion of the pia mater. Its anatomical characters...

2. Cerebral Hemorrhage. Apoplexia Sanguinea; Apoplexia Gravis: Hemorrhage (Apoplexia Sanguinea; Apoplexia Gravis) is a very common disease in the brain, and is often suddenly fatal. I class it with hyperaemia, although it is not necessarily accompanied or caused ...

Recent Apoplexy: Recent Apoplexy is followed by numerous changes in the cavity itself, in the cerebral substance around it, and even in the whole brain; and the description of the recent cell may now be followed by so...

Recent Apoplexy. Part 2: The Apoplectic Cavity The Apoplectic Cavity is, in general capable of a still further reparative change, or decay (involution): viz., gradual contraction and finally closure - wasting of the apople...

Recent Apoplexy. Part 3: The Cerebrum The Cerebrum affords the best opportunity for observing the healing process just described. Very large cavities close in this part, and even in the cerebellum also, at least so far as ...

Recent Apoplexy. Part 4: Apoplexy appears in the body under all these circumstances, both in the form of the cavity, and, not unfrequently, in the capillary form. Hemorrhage very commonly occurs in the brain in persons lab...

3. Edema Of The Brain: I have already mentioned several of the conditions under which the substance of the brain becomes infiltrated with serum. This occurrence is very frequent, and varies much in degree. A slight amoun...

Appendix. Serous Apoplexy: In considering the subject of oedema of the brain, a question already several times suggested, has again arisen, as to a mode of death, which is known by the name of Serous Apoplexy. I have postpone...

4. Inflammation Of The Brain: Inflammation of the brain (encephalitis, the phrenitis of old writers) is not, on the whole, a rare disease, although it is so in comparison with other diseases of the brain: it is seldom found as a ...

Inflammation Of The Brain. Part 2: B. Other inflamed spots, again, are found deep in the brain, and especially in the white substance, in which the softening, above described, is wanting, and hardness and resistance are the prominent c...

Inflammation Of The Brain. Part 3: Even very extensive inflammations terminate in this manner. There is no question that the cavity, just spoken of, may gradually diminish, and at length close, like the apoplectic cyst, - for which it ...

Inflammation Of The Brain. Part 4: The destruction of brain, and the loss of its substance resulting from the inflammatory process, give rise to a remarkable consequence. The nerve-fibres which are involved in the inflamed spot become ...

5. Metastasis Of The Brain: In some cases, in which the blood is poisoned by containing a large quantity of purulent matter, as, for instance, in the purulent diathesis, or pyaemia, of lying-in women, the brain becomes the seat ...

6. Softening Of The Brain: The most prominent feature of softening of the brain, or encephalomalacia, is the alteration of consistence: but the disease results from other fundamental changes, and is treated of amongst the disea...

Softening Of The Brain. Part 2: These are the appearances in a well-marked case; but there are different degrees of the affection as may be seen in the immediate neighborhood of a part which is thoroughly disorganized. They are dist...

Softening Of The Brain. Part 3: b. The same remark applies to the secondary softening. This form either immediately surrounds a spot of apoplexy or an adventitious product (in which case, as in the primary, it is entirely free from ...

7. Induration Of The Brain - Sclerosis: The consistence of the brain is liable to increase under very different circumstances, and in every degree, from that which is imperceptible to that of a leather-like or fibro-cartiliginiform hardness...

8. Adventitious Growths Of The Brain: Although there are some forms of adventitious products which are rarely seen in the brain, yet there are others which are comparatively frequent: so that this class, on the whole, supplies an average ...

E. Tuberculosis Of The Brain: Tubercle is the most common of the adventitious products in the brain, and it is frequent in comparison with other diseases. Tuberculosis presents several peculiarities in the brain. The number of ...

F. Cancer Of The Brain: There is no organ in which growths of a cancerous nature occur in such number, and in such variety of internal elementary structure, as in the brain. I must refer the reader on this subject to the gen...

Appendix. Diseases Of The Cerebral Appendages. (Hypophyses.) The Pituitary Gland: The pituitary gland is far more frequently the subject of disease than the other hypophysis. Morbid processus, especially those which are deeply seated, have their site in its anterior vascular lobe. ...

Chapter II. The Spinal Cord. Sect. I. - Anomalies And Diseases Of The Membranes Of The Spinal Cord: Of The Dura Mater Of The Spinal Cord 1. The fibrous investment, and the other membranes of the spinal cord, are but partially developed, or are not developed at all, in cases of acephalus, in -whic...

Of The Spinal Arachnoid Membrane: The spinal arachnoid, especially in its visceral layer, occupies a different position from that of the cerebral arachnoid, both physiologically and pathologically; for it forms a sac, which does not, ...

Of The Pia Mater Of The Spinal Cord: 1. Diseases Of Texture 1. Congestion, Apoplexy The anatomical characters of this congestion are too evident to require description. The subjects of it are mostly those in the tenderest childhood...

Section II. - Of The Spinal Cord: 1. Deficiency And Excess Of Development A total absence of the spinal cord, such as occurs when both the head and the trunk are wanting, is rarely met with: but a partial deficiency of it is more f...

Of The Spinal Cord. Continued: Hypertrophy of the spinal marrow is exceedingly rare when compared with that of the brain. Although some of the many cases which have been adduced as hypertrophy are certainly of a different nature, a...

4. Diseases Of Texture Of The Spinal Cord: Congestion, Apoplexy Congestion of the spinal cord is a symptom in the course, and a sequel, of sundry acute and chronic diseases. Such, most probably, is its real import, in those who have died of...

Diseases Of Texture Of The Spinal Cord. Continued: Case II St. Leopold, aet. 22, after a fall on his head, three years ago, had been suffering from pain, which was at first slight and transient, and confined to the occiput, but subsequently became ...

4. Softening And Induration Of The Spinal Cord: The same forms of softening which happen in the brain, are found to occur in the spinal marrow also. But, on the whole, they are more rare in the latter. White softening very seldom reaches that degre...

5. Morbid Growths Of The Spinal Cord: Growths of this nature, even those which, like tubercle and cancer, are frequent in the brain, are very unfrequent in the spinal cord. a. Tubercle I have observed only in combination with other adv...

Chapter III. Anomalies And Diseases Of The Nerves: I VENTURE to treat of all these under one head, introducing the affections of the ganglia at the end of each chapter, somewhat in the form of an Appendix. To subdivide diseases of the nerves into such...

3. Anomalies In Size Of Nerves: These anomalies relate to the thickness of the nervous cords. A palpable increase of all the nerves beyond their natural bulk is extremely rare; a few instances of it only having been observed in idio...

4. Solutions Of Continuity Of Nerves: Nerves, just like other parts, are liable to incised and punctured wounds, to contusion, stretching, laceration, etc. A clean cut affords the best prognosis; especially when the ends of the nerve are ...

5. Diseases Of The Texture Of Nerves: 1. Congestion - Apoplexy It may be that nerves are not unfrequently congested; but there is scarcely ever opportunity in the dead subject to see any such condition of either their trunks or branche...

3. Morbid Growths In Nerves: A. Cysts Even in the trunks of very large nerves such formations are extremely rare. It is at once clear from the conditions under which the cyst is developed that it performs the office of a bursa...

Part I. Abnormal Conditions Of The Respiratory Organs: We shall consider the abnormal conditions of the respiratory organs under three heads: - 1st. As they occur in the air-passages; namely, the larynx, trachea, and bronchi. 2d. As they occur in the p...

1. Dilatation Of The Larynx And Of The Trachea: A uniform dilatation of this canal is not unfrequently seen in marasmus or senile atrophy. Its existence in advanced age is interesting, since it always occurs with senile marasmus of the lungs (emphy...

2. Dilatation Of The Bronchi (Bronchestasis): There are forms of bronchial dilatation besides that which depends on the wasting of the tissues in old age, or senile marasmus. In fact, this portion of the air-passages is remarkable for the frequen...

Laennec: Laennec, and almost all subsequent pathologists, believe that bronchial dilatation is always a mechanical consequence of catarrh; that it is dependent on the accumulation of the bronchial secretion at...

B. Contraction Of The Air-Passages: This may occur in any part of the respiratory apparatus; but the nature and degree of the affection may be extremely various; in fact, in the latter point of view, the change may proceed to closure an...

C. Hypertrophy And Atrophy Of The Respiratory Organs: We have already spoken of hypertrophy of the mucous membrane of the air-passages, of the muscular fasciculi of the trachea, of the fibrous sheaths of the bronchial tubes in cases of dilatation arising...

3. Deviations In Form Of The Respiratory Organs: Here we must mention the acquired malformation to which the larynx, trachea, and bronchi are subject, occurring in the form of flattening, indenting, or curving from a morbid and enlarged thyroid glan...

6. Diseases Of Texture Of The Respiratory Organs: Diseases of texture occur in all the tissues entering into the composition of the air-passages, but especially in the mucous membrane, which is the primary seat of disease in by far the greatest numbe...

B. Inflammations Of The Mucous Membrane: 1. Catarrhal Inflammation This is one of the most common diseases of the air-passages. It may be either acute or chronic, and in one or other of these forms often attacks only single portions of th...

B. Chronic Catarrhal Inflammation Of The Respiratory Organs: This is very frequent in certain portions of the air-tubes; it is often remarkable for its great intensity, and is of the highest importance from its sequelae. These observations especially apply to c...

2. Exudative Processes (Croupous Inflammation) Of Mucous Membranes: Under this head we must place processes allied to each other, since they originate in one general disease, but differ extremely in their local morbid centres. This difference exhibits itself anatomica...

3. Pustular Inflammation: The only form of pustular inflammation occurring in the air-passages is the variolous, which, however, is very perfectly developed.. It is usually present whenever the variolous process exhibits consi...

4. The Typhous Process On The Mucous Membrane Of The Air-Passages: The typhous process occurring in the air-passages presents numerous peculiarities in reference to its connection with the general disease, with the morbid state of the mucous membrane of the small int...

C. Inflammation Of The Submucous Areolar Tissue: In addition to the part that the submucous areolar tissue takes in inflammation of the mucous membrane of the air-passages, it is also subject to inflammations, occurring as primary affections. These ...

D. Ulcerous Processes Of The Air-Passages: In the course of the preceding observations we have already noticed some of these processes; others still require to be described. Their position is, with very few exceptions, in the larynx and trache...

E. Oedema Of The Mucous Membrane Of The Air-Passages: This affection has especially attracted the attention of pathologists when it has been situated in the larynx, where it has received the name of oedema glottidis. It is in this position that its attac...

F. Gangrene Of The Air-Passages: This affection occurs both here and in the parenchyma of the lungs in two distinct forms, either as a circumscribed eschar on the mucous membrane, eating its way into the submucous tissue, in which it...

B. Diseases Of The Cartilaginous Skeleton Of The Air-Passages: A. Inflammation Of The Perichondrium Of The Laryngeal Cartilages. (Perichondritis Laryngeal) In the examination of the dead body we have occasional opportunities of noticing a peculiar form of supp...

D. Adventitious Products Of The Air-Passages: Adventitious formations occurring in the air-passages are of the highest importance when they project into the interior of the air-passages in the form of broad or pedicled vegetations, and thus give ...

6. Tuberculosis Of The Air-Passages: Tubercle is very commonly met with in the air passages, but it is found in some parts of them much more frequently than in others. The most common position is in the the larynx; it is very rare in the...

Bronchial Tuberculosis: This is seated in the bronchial mucous membrane, which becomes so infiltrated with yellow, lardaceous caseous, tuberculous matter, as finally it appears converted into it. The bronchial tube itself be...

7. Anomalies Of The Contents Of The Air-Passages: We must here notice: 1. The products of various morbid processes on the mucous membrane of any portion of the air-passages, such as blood, or as mucus (which may collect in large quantity, and may ...

II. - Abnormal Conditions Of The Pleura: 1. Deficiency And Excess Of Formation The pleural sacs are altogether absent when there is an entire deficiency of the respiratory apparatus, as in cases of acephalia, the thoracic cavity being the...

B. Inflammation Of The Pleura (Pleuritis, Pleurisia): This is the most frequent of the diseases of the pleura; it generally appears as an idiopathic and primary affection, most commonly of a rheumatic nature; in consequence of a wound or shock affecting ...

Contraction Of The Pleura: Contraction, even when arising from general pleurisy, may affect only one portion of the chest; the upper portion may be thus modified, while the lower remains either absolutely dilated, or, at all ev...

Pleurisy: Pleurisy sometimes occurs simultaneously on both sides; in these cases both sides may be attacked at the same time, or the pleurisy on one side may succeed that of the other. Pleurisies with long-s...

1. Gangrene Of The Pleura: Gangrene Of The Pleura occurs in consequence of its being denuded by accumulations of pus or ichor in the costal or pulmonary wall. The pleura then assumes the appearance of a yellowish-white, or more...

2. Tuberculosis Of The Pleura: Pleural tubercle occurs in all the forms in which we have stated that tuberculosis attacks serous membranes; that is to say - (a), as a rapid metamorphosis (either complete or partial) of a pleurit...

3. Cancer Of The Pleura: Cancer of the pleura is much rarer than tubercle. It never occurs as the first in the series of cancerous deposits occurring in an individual, but is always the result of a cancerous dys-crasia that h...

4. Morbid Contents Of The Pleural Sacs: In addition to the anomalous contents of the pleural sacs, which have been already mentioned, and to which we shall have occasion subsequently to allude, we shall only at present treat of the presence...

III. Abnormal Conditions Of The Lungs: 1. Deficiency And Excess Of Formation In very imperfect monsters, as for instance, in cases of acephalia, the lungs as well as the central organs of circulation, are altogether absent. In lower deg...

A. Rarefaction Of The Pulmonary Tissue. Emphysema: Under the term pulmonary emphysema we comprehend, according to Laennec, two different conditions, of which one (and by far the more important one) is not fairly entitled to this name; but this inaccur...

Laennec's View: Laennec's View regarding the former mode of development of the affection, is essentially an important one. We do not, however, believe that the long retention of the breath is, in itself, the principa...

The Dyspnoea, Conditional On Emphysema: The Dyspnoea, Conditional On Emphysema, depends on several causes. a. The excessive accumulation of air in the pulmonary vesicles hinders the proper filling of the capillaries ramifying on their wa...

B. Condensation Of The Pulmonary Tissue: A certain degree of condensation is natural to the lungs of children; it sometimes occurs in adults as an individual peculiarity, and is then often associated with smallness of the lungs and pleural s...

C. Hyperoemia; Stasis - Apoplexy Of The Lungs: No organ with the exception of the brain, is so frequently the seat of hyperoemia as the lung. It occurs in various degrees, and developes itself either gradually or with intense rapidity, and is the ...

Haemoptoic Infarctus: Haemoptoic Infarctus bears the greatest similarity to red hepatization of the pulmonary tissue; none but very inexperienced persons can, however, mistake one for the other, for each of the above prope...

D. Ancemia Of The Lungs: There are various conditions which may give rise to a deficiency of blood in the lungs. It may depend: a. On exhausting hemorrhages. b. On wasting of the blood, consequent on various acute and chro...

E. Oedema Of The Lungs: Pulmonary oedema is a very frequent and extremely important disease. Its essential and primary symptom is the infiltration of the parenchyma with a serous fluid, which is obvious even from an external...

F. Inflammations Of The Lungs (Pneumonice): Pathologists are in the habit of recognizing only one form of pneumonia. It is true that this is by far the most frequent form; but even in regard to this there are several points in which we cannot a...

Inflammations Of The Lungs (Pneumonice). Part 2: Pneumonia passes from the stage of red hepatization through several scarcely distinct transition-stages till it finally attains the true third stage. These transition-stages are characterized by alter...

Inflammations Of The Lungs (Pneumonice). Part 3: (a.) If the granulations were regarded as swollen, and consequently obliterated, air-cells, they could neither exhibit the above anatomical relations, nor could they present the metamorphoses which, r...

Inflammations Of The Lungs (Pneumonice). Part 4: Pulmonary Abscess We have already described the termination of pneumonia in purulent infiltration, that is to say, in purulent solution of the inflammatory product, which occurs without any separat...

Inflammations Of The Lungs (Pneumonice). Part 5: Induration There are certain conditions under which hepatization does not pass into a state of purulent solution, but into induration. The red inflammatory product becomes of a grayish-red tint, an...

Inflammations Of The Lungs (Pneumonice). Part 6: Lobular and vesicular pneumonias are usually secondary processes. It is very important that we should understand the differences presented by the inflammatory product in regard to its plasticity, i...

Inflammations Of The Lungs (Pneumonice). Part 7: Primary Pneumonia Primary Pneumonia especially attacks vigorous adults, although delicate persons are also liable to this disease, and, indeed, not unfrequently seem decidedly predisposed to it; up...

Typhus Pneumonia (Pneumotyphus): The pneumonic process is very frequently associated with the typhous; but its relation to the latter, and especially to the local typhous process on the mucous membrane of the ileum, is not always the...

2. Catarrhal Pneumonia: Catarrhal pneumonia has hitherto received little attention, in consequence of its resemblance to the croupous variety, for which it may easily be mistaken, and on account of its rare occurrence in adu...

3. Inflammation Of The Interstitial Tissue Of The Lungs. Interstitial Pneumonia: This is a disease whose anatomical characters are not properly recognized in pathological treatises, for it is commonly described as chronic inflammation of the lungs consequent on ordinary croupous p...

G. Deposits In The Lungs. Metastatic Processes: As a consequence of the absorption of a pseudoplastic process into the living blood, or, more rarely, as a consequence of the spontaneous disease of that fluid, there is a process developed which is f...

Circumscribed Or Partial Gangrene Of The Lungs: Circumscribed Or Partial Gangrene Of The Lungs appears in the form of gangrenous eschar, and is incomparably more frequent than the former variety. We find the parenchyma, at some spot of varying size...

I. Softening Of The Lung-Tissue: Softening of the lung-tissue is of very rare occurrence; it is altogether distinct from pneumonia, and must not be confounded with Andral's ramollissement (red and gray hepatization); like softening o...

K. Adventitious Products Of The Lungs: 1. Cysts Cysts are of extremely rare occurrence in the lungs, which in this respect present a marked contrast with many of the other parenchymatous organs. Simple Serous Cysts may, doubtless, oc...

5. Tubercle In The Lungs: Pulmonary tuberculosis, which is the most frequent of all the tuberculoses, is one of the most common and likewise the most fatal of the diseases of the lungs. For general information on tubercle a...

Pulmonary Tubercles: Pulmonary Tubercles originally appear either (1) as the well-known gray, semi-transparent granulations of the size of a millet or hemp-seed, or in many cases of acute tuberculosis as still smaller-siz...

The Capillary Bronchi: The Capillary Bronchi undergo the same softening as the true lung-substance, for they, or at least their walls, are the seat of tuberculous deposition, and their mucous membrane, becomes the seat of t...

Tuberculous Infiltration: Tuberculous Infiltration, when associated with the above-described metamorphosis of interstitial tubercle, usually softens with very great rapidity, and by hastening the progress of the disease, const...

The Mucous Membrane Of The Alimentary Tract: The Mucous Membrane Of The Alimentary Tract, especially of the stomach and large intestines, is also in a state of more or less developed blennorrhoea; and, towards the end of phthisis, an acute softe...

The Mucous Membrane Of The Alimentary Tract. Continued: Osseous laminae are sometimes developed under the serous investment, in like manner as in the cellular tissue beneath normal serous membranes. In these caverns an event not unfrequently takes place...

Chronic Tuberculosis: Chronic Tuberculosis either deposits its product imperceptibly, or else as crises of a mild general disease, with symptoms of moderate vascular excitement, and recurring at intervals. In accordance wi...

6. Cancer Of The Lungs: Cancer occurs in the lungs both in the form of carcinoma medullare and carcinoma fasciculatum, seu hyalinum. The latter is extremely rare, but the former is comparatively common, and it is to it that ...

Supplement. 1. Diseases Of The Thyroid Gland: As a general rule, the thyroid gland is liable to few diseases, and of these diseases we are almost as ignorant as we are regarding the structure and the function of this organ. It very frequently ...

2. Diseases Of The Thymus Gland: Anomalies of the thymus gland are even rarer than those of the thyroid body; the only abnormal conditions with which we are at present acquainted are a more or less considerable increase of its size i...

Part II. Diseases Of The Organs Of Circulation. I. - Abnormal Conditions Of The Pericardium: We may divide the above into Diseases of the Heart, including those of the Pericardium, and Diseases of the Arteries, the Veins, and the Lymphatics. Under the last head are included Diseases of the Ly...

4. Diseases Of Texture Of The Pericardium: a. Inflammation is the most common form of disease of the pericardium, and is of the greatest importance, not only in itself, but also from the subsequent results to which it may give rise. Inflamm...

The Milk Spots, Or Maculae Albidoe: The Milk Spots, Or Maculae Albidoe, are appearances of frequent occurrence on the heart. They are occasionally met with on the inner surface of the pericardium, but most frequently on the serous inves...

Osseous Concretions: Osseous Concretions are not unfrequently developed in the dense fibroid exudations occasioned by the process of chronic inflammation recurring in the pseudo-membranes. We shall have occasion to return...

Pericarditis: Pericarditis, more especially when of a chronic form, is important in reference to the origins of the large vessels. It would seem, according to our view, that this disease, as far as it affects the c...

4. Tuberculosis Of The Pericardium: Tuberculosis rarely manifests itself in the pericardium in any other form than as a product of inflammation. Pericarditis gives rise to an exudation, whose peripheral coagula, after passing, wholly or...

5. Anomalies Of The Contents Of The Pericardium: Besides the anomalies already treated of, it remains for us to notice, among those which exhibit special points of interest: Blood in a fluid or coagulated condition. It is almost always an arteria...

II. - Anomalies And Diseases Of The Heart: We will now proceed to consider the Anomalies and Diseases of the Heart, including those of the Valves; but wherever it may prove of great practical interest to acquire a more correct knowledge, both ...

Anomalies And Diseases Of The Heart. Continued: The following are the most important of these Anomalies of the Vascular Trunks: 1. Those Affecting The Aorta a. There may be a single arterial trunk, which may be regarded as an aorta sending of...

3. Anomalies Of Position Of The Heart: These are either congenital and original, or acquired. The former are very numerous, and admit, in part, of being referred to an arrest of development. Many depend on different adhesions of the heart ...

4. Anomalies Of Size Of The Heart: These anomalies manifest themselves either by an abnormal excess or deficiency of size. Both conditions may be either congenital or acquired, and are of great importance from their frequent occurrence...

A. Hypertrophy Of The Muscular Substance Of The Heart: Hypertrophy Of The Muscular Substance Of The Heart (hypertrophia cordis) constitutes either total or partial hypertrophy, as it affects the whole, or only some portions of the heart, and is characteri...

B. The Dimensions Of The Heart Are More Increased: The Dimensions Of The Heart Are More Increased by the dilatation of its cavities than by hypertrophy. This dilatation (dilatatio cordis, also aneurysma cordis in the old writers), may, like hypertroph...

Passive Dilatation: Passive Dilatation, in its lesser degrees, is of frequent occurrence. It attacks the ventricles as well as the auricles, especially the cavities on the right side of the heart, and the right auricle m...

1. Mechanical Obstructions Of The Heart: Mechanical Obstructions, which give rise, according to circumstances, either to preponderance of dilatation or preponderance of hypertrophy. A. Mechanical Obstructions In The Ostia Of The Heart ...

2. Diseases Of The Texture Of The Heart: To these belong: a. First, and most prominently, inflammations, as for instance of the pericardium, the muscular substance of the heart and the endocardium, both in their primary and secondary charact...

B. Abnormal Smallness Of The Heart: Anomalous smallness of the heart appears under two essentially different forms, being either congenital and original, or the result of atrophy - atrophied. Abnormal smallness from either of these caus...

5. Anomalies Of Consistence Of The Heart: We have already acquired some knowledge of several of these anomalies, to which belong: An increase of consistence in the muscular substance of the heart in hypertrophies, which is occasionally ver...

6. Separations Of Continuity Of The Heart: To this class belong: a. Wounds of the heart produced by sharp thrusting instruments, as well as by the penetration of fragments of the ribs, sternum, etc. Such wounds, whether superficial or sufficie...

Penetrating Heart-Wounds: Penetrating Heart-Wounds are not, however, invariably rapidly fatal; life being in some cases considerably prolonged, while it would even appear, in accordance with some observations selected from a l...

7. Diseases Of Texture Of The Heart: A. Hyperoeemia, Anoemia We are not acquainted with any special condition characteristic of hyperoemia of the heart. Occasionally however, hyperaemia, as it manifests itself in the hypertrophies and...

Diseases Of Texture Of The Heart. Continued: 1. Redness And Injection In order that these conditions may be regarded as the manifestation of inflammation, it is necessary that the former should be the result of the latter (inflammatory inject...

Vegetations Or Fibrinous Coagula: 5. The so-called Vegetations or Fibrinous Coagula which occur under the most various forms, more especially when they appear on the valves of the heart, are generally, and without exception, regarded ...

E. The Vegetations On The Valves Of The Heart: The Vegetations On The Valves above referred to undergo different metamorphoses, as we have already seen, and as will be made more apparent in the sequel. We will here specially notice: 1. Their Gr...

G. Endocarditis By Its Proximate: Endocarditis By Its Proximate, no less than its secondary results, and therefore by a twofold local cause, may give rise to Dilatations of the Heart. As we have already observed in treating of these d...

Hypertrophy And Atrophy Of The Endocardium: By these conditions we purpose indicating a thickening of the true endocardium (which, in respect to the main character of its composition, corresponds to the inner coat of the vessels), by a morbid d...

Endocarditic Hypertrophy: Endocarditic Hypertrophy, like that of the aorta and its ramifications, especially occurs in advanced periods of life, and undoubtedly constitutes the source from whence arise a great number of those ...

2. Inflammations Of The Muscular Substance Of The Heart, Carditis (In The Strict Sense Of The Word), Myocarditis: Although inflammation of the Muscular Substance of the Heart is less frequent than endocarditis, it is much more frequent than is usually supposed. Its anatomical characters and its terminations are t...

Inflammations Of The Muscular Substance Of The Heart, Carditis, Myocarditis. Part 2: The termination of carditis in Suppuration, which is much less frequent, gives rise to Abscess of the Heart. In accordance with what has been already stated, abscess of the heart is almost entirely...

Inflammations Of The Heart Muscular Substance, Carditis, Myocarditis. Part 3: 2. The second form of aneurism of the heart is either the remote consequence of the combined inflammation of the endocardium and of a somewhat thick layer of the muscular substance, or more frequently...

Inflammations Of The Heart Muscular Substance, Carditis, Myocarditis. Part 4: These two species, comprising an acute and chronic form, both of which depend on inflammation, embrace the numerous observations we ourselves have made, and will very probably, on an unbiassed inquiry...

E. Adventitious Products of the Heart: Although adventitious products, with the exception of the adventitious tissue developed from inflammation, are generally of rare occurrence in the heart, yet some forms are not unfre-quently met with;...

B. Actual Fatty Degeneration Of The Heart, - Fatty Metamorphosis Of The Muscular Substance: The fat surrounding the heart penetrates inwards, and by gradually insinuating itself between the muscular fibres, tends in this way to displace the muscular substance. The apex of the heart and the r...

2. Cysts Of The Heart: These formations are very uncommon in the muscular substance of the heart, especially if we refer to cysts containing entozoa. In treating of them, we will limit ourselves to acephalocysts, deferring ...

3. Fibroid Tissue Of The Heart: Fibroid tissue very frequently occurs in the form of a fibroid thickening of the endocardium on the inner surface of the heart, as a fibroid thickening of the valves and their tendons, in the heart's ...

4. Anomalous Osseous Substance Of The Heart: Osseous structures are frequently found within and upon the heart in the form of bony concretions. They invariably originate in the fibroid tissue which is produced, as we have already mentioned, by i...

5. Tubercles Of The Heart: If we except those cases of tuberculosis which have originated in the neighboring tissues and have extended to the organic muscular coats of other structures, as the intestine, etc, tubercles occur in...

6. Cancer OF The Heart: Cancer of the heart is an extremely rare disease, and its occurrence is, probably, invariably owing to a highly developed cancerous dyscrasia, or to the proximity of a cancerous formation, as for inst...

7. Entozoa Of The Heart: In addition to acephalocysts, to which we have already referred, the Cysticercus is by no means of rare occurrence in the heart, being then also simultaneously present in some of the voluntary muscles...

8. Coagula, Polypi, Vegetations In The Cavities Of The Heart: 1 - The above terms have, at different times, been applied to this class of concretions. We refer our readers to the general remarks on the diseases of the blood and its fibrin for all that relates to...

The Coagula In The Heart: The Coagula In The Heart may be classed in the following order in reference to their form. Many have only recently been recognized and duly characterized as fibrinous concretions, and these have recei...

B. Globular Vegetations (Vegetations Globuleuses Of Laennec): Globular Vegetations (Vegetations Globuleuses Of Laennec) in the cavities of the heart constitute a second form. The formations distinguished by this designation are generally round concretions, varyi...

Globular Vegetations (Vegetations Globuleuses Of Laennec). Part 2: The form of these vegetations is partly influenced by their mass or size. Smaller vegetations occasionally exhibit a superficial roughness, only appreciable to the sight and touch on a close invest...

Globular Vegetations (Vegetations Globuleuses Of Laennec). Part 3: c. These vegetations on the valves - in perfect analogy with other fibrinous coagula - undergo, although less directly, a bony and chalky metamorphosis, constituting a special form of valvular ossific...

The Size And The Metamorphosis Of The Vegetations: The Size And The Metamorphosis Of The Vegetations afford evidence of the intensity of the endocarditis, and more especially of the quality of its products, when, besides these, other essential phenome...

Abnormal Conditions Of The Valves, And Especially Of Their Ostia: 1. Deficient And Excessive Formation We have already considered this subject at p. 117, where we treated of the most important anomalies. 2. Anomalies Of Size - Hypertrophy And Atrophy Of The Va...

Abnormal Conditions Of The Valves, And Especially Of Their Ostia. Part 2: Atrophy Of The Valves This disease is manifested by attenuation, unusual delicacy and transparency of the valves, and in its more intense forms by the formation of apertures within them. We have al...

Abnormal Conditions Of The Valves, And Especially Of Their Ostia. Part 3: 5. Separations Of Continuity Separations of continuity occur under the forms of laceration of varying depth at any part of the valve, from the margin towards its insertion - as perforation of the v...

Abnormal Conditions Of The Valves, And Especially Of Their Ostia. Part 4: 5. Vegetations Vegetations, as we have already seen, are deserving of attention, although they cannot be regarded as absolute characteristics of endocarditis. In the course and as consequences o...

Aneurism Of The Valves: Some writers (Thurnam) have applied this designation to a morbid condition of the valves, which has indeed some affinity with aneurism, more especially if we adopt Scarpa's theory of spurious Aneurism...

B. Adventitious Structures Of The Valves: These are almost entirely limited to the occurrence of fibroid tissue and anomalous osseous substance (ossification), both of which are of very frequent occurrence. 1. The fibroid tissue presents v...

Supplement. Cyanosis: Cyanosis has so long constituted a special subject, of anatomical inquiry, that our work would be incomplete were we to omit stating our views in reference to this affection, and the relation it bears...

The Anomalies Of The Vascular Trunks: The Anomalies Of The Vascular Trunks most commonly associated with absence of the ventricular septum, are a more or less striking narrowness and obstruction, or even the complete closure of one or oth...

Cyanosis, Or The Abnormal Formation Of The Heart: Cyanosis, Or The Abnormal Formation Of The Heart on which it depends, may terminate in death, either suddenly and rapidly, or slowly, in the same manner as in acquired heart-diseases. There is an a...

III. - Abnormal Conditions Of The Arteries: 1. Deficiency And Excess Of Formation We have already treated, in their connection with anomalies of the heart, of all anomalies or other defects of structure of the two arterial trunks, in so far ...

A. Inflammation Of The Arteries. Arteritis: In the first place it will be necessary clearly to comprehend whether there actually exists a spontaneous arteritis, and whether that special form of arteritis ever occurs which is commonly supposed t...

Inflammation Of The Arteries. Arteritis. Part 2: 7. In Rare Cases Arteritis In Rare Cases Arteritis gives rise to a partially or wholly purulent exudation, which may be recognized by the following appearances: a. The inner surface of the vessel s...

Inflammation Of The Arteries. Arteritis. Part 3: General Arteritis General Arteritis, like general phlebitis, has no existence. The above remarks apply to the inflammation of the arteries of the aortic system. In the system of the pulmonary ar...

B. Ulcerous Processes Or Destructive Ulcerations Of The Arteries: Ulcerous Processes Or Destructive Ulcerations occur under different conditions in the arteries. They are somewhat frequent, considering the very striking integrity exhibited by the arteries in the mid...

C. Excessive Deposition Of The Lining Membrane Of The Vessels: We rank with the above anomalies a process which, although it does not originally exhibit a diseased textural condition of the arterial coats, at all events results in such, and moreover stands in a n...

1. The Atheromatous Process Of The Arteries: The atheromatous process consists in the metamorphosis (disintegration) of the deposit into a pulpy mass, compared by the French to a purée of peas, consisting of a large number of crystals of cholest...

2. Ossification Of The Arteries: Ossification is the second form of metamorphosis of the deposit. This includes the well-known ossification of the arteries. It presents many essential points in common with the atheromatous process, a...

2. The Cellular Sheath Of The Vessel: The Cellular Sheath Of The Vessel, in the majority of cases, is found to be in a state of chronic inflammation - that is to say, in a state of vascularity, redness, infiltration, and puffiness, or has...

D. Adventitious Products In The Vascular System: A very few of these forms occur in the vascular system generally, and especially in the arteries. 1. Among the productions of fibroid tissue we may include sclerosis of the cellular sheath in conse...

4. Anomalies Of Calibre. A. Dilatation Of The Arteries (Aneurism): As we purpose limiting ourselves, in the following pages, to the consideration of the conditions of actual dilatation of the artery, we will postpone to another chapter the consideration of false, var...

2. Chronic Inflammation Of The Cellular Sheath: Chronic Inflammation Of The Cellular Sheath of the arteries gives rise, as has been already remarked, to dilatation of the vessel, in consequence of its paralyzing the elastic coat. This is especially...

3. Most Forms Of Dilatation Of The Arteries: Most Forms Of Dilatation commonly included under Aneurism (spontaneous aneurism), and at the same time the most important of all, are owing, as we have already shown (p. 199), to the deposition of a t...

Saccular Aneurisms: Saccular Aneurisms are commonly of a round form, although they are occasionally oval or conical in shape, even from their commencement; more frequently the form loses its roundness in consequence of e...

1. The Cavity Of The Aneurism: The Cavity Of The Aneurism very frequently contains fibrinous coagula, which usually form very distinctly stratified masses. The external and older layers consist of a whitish fibrinous substance, gen...

Yielding Membranous Expansions: Yielding Membranous Expansions in part give way to strong pressure, while their fibres admit of being separated; and in part they become gradually atrophied like cellular tissue, serous and fibrous me...

Yielding Membranous Expansions. Part 2: Aneurisms very frequently open into canals, as the trachea, the bronchial tubes and their large branches, and oesophagus, and more rarely into the intestinal canal and the cavities of the urinary pass...

Yielding Membranous Expansions. Part 3: However unfavorable the ordinary termination of an aneurism may be, instances are occasionally observed in which the disease takes a more favorable turn, and nature brings about a spontaneous cure of ...

Aneurism Of The Aorta: The aorta is more frequently the seat of aneurism than any other vessel, and the parts most commonly affected by aneurismal formations, are the ascending aorta, and the arch. The aneurisms most com...

On Dilatations Of The Ductus Botalli: The dilatations which in rare cases are observed in the Ductus arteriosus, in every period of life, from the earliest infancy, are simple, and not dependent upon any alteration of texture in the coats...

On Traumatic Aneurisms: These are aneurisms which patients refer to some traumatic influence, such as a contusion, shock, or some unusual muscular effort, etc, and which the physician, in the absence of all disease in the co...

On Hernial Aneurism: The existence of a hernial aneurism, or of an internal mixed aneurism, has formed the subject of numerous investigations, from the time of Haller to our own day. We have already become acquainted w...

B. Abnormal Narrowness - Contraction - Obliteration Of The Arteries: The arterial system presents numerous varieties of irregular narrowness, and, moreover, exhibits many differences in respect to its extent and degree. To this class belong congenital anomalies. 1. ...

1. Contractions And Obliterations In The Form Of Simple Involution Of The Artery: To this class belong the following: a. The contraction and subsequent atrophy which affect the arteries of organs that are becoming atrophied through accidental or intentional (operative) injuries inf...

Contraction, Writh Almost Complete Oliteration, Of The Thoracic Aorta: Potier, a shoemaker, aged 38 years, was received into La Charité on the 29th of March, 1838. He had been seized, in the October of the preceding year, with violent bleeding from the nose, which contin...

Contraction, Writh Almost Complete Oliteration, Of The Thoracic Aorta. Continued: On opening the body, pneumonia of the right lung was discovered. The heart was somewhat large; the cavity of the left side, however, was small, although its walls were upwards of an inch in thickness;...

2. Contraction And Obliteration In Consequence Of Disease Of The Coats Of The Vessel: To this class belong: a. Obliteration of the mouths of a vessel, occasioned by the excessive formation of a tissue, analogous to the lining membrane, within a trunk. - This condition, which is followe...

3. Occlusion Of The Arteries: To this class belongs the occlusion of the vessel arising from different varieties of coagulation of blood. A. Occlusion Of An Inflamed Artery According to our definition of arteritis, this cond...

4. Contraction And Obliteration Arising From Persistent Pressure On The Artery: Such a continued pressure may be exerted by different tumors, as goitres, encysted tumors, cancerous products, and aneurisms of neighboring arteries. Complete obliteration is very rarely induced by th...

5. Mechanical Separations Of Continuity: To these belong lacerations and wounds of the arteries produced by cuts, thrusts, or gun-shot wounds. Spontaneous lacerations are the most important of any, especially those of the trunk of the aor...

A. On The Lacerations Of The Larger Arteries. Dissecting Aneurism: Lacerations of the larger arteries, arising from traumatic influences, as from concussions and contusions of the body, are only interesting in a scientific point of view, when the different mechanical...

On The Lacerations Of The Larger Arteries. Dissecting Aneurism. Part 2: Aorta The ascending aorta, like the pulmonary artery, was very wide; the valves of the former were thickened at their insertion and their nodules, and were partially ossified. The cellular sheath (...

On The Lacerations Of The Larger Arteries. Dissecting Aneurism. Part 3: These lacerations are generally transverse, and only rarely take a longitudinal direction. Lacerations are much more frequent in the ascending aorta, at a short distance above the valves, than in t...

B. On Incised, Penetrating, And Gunshot Wounds Of The Arteries: Such injuries of the artery as are inflicted by sharp-pointed instruments, even where it is only opened at the side, and shot-wounds which merely remove a small portion of the wall of an artery, are, ...

On False Aneurism: When an artery of one of the extremities has been injured in any of the above ways, the blood is effused into the surrounding cellular tissue, forming an extravasation, if unable to escape from the ou...

Spontaneous Varicose Aneurism: Spontaneous Varicose Aneurism is the opening or rupture of an aneurism into a vein that has coalesced with it. Cases of this kind have been noticed by myself and many foreign observers in the femoral ...

The Thrombus: The Thrombus begins to be formed at the termination of the vessel, and from thence extends onwards in its axis to the point where the first lateral branch is given off; it possesses a conical shape fr...

The Thrombus. Continued: The Circulation is established, after the application of the ligature, in the same manner as in obliteration of an artery generally, by the dilatation of the lateral branches and their anastomoses, - ...

IV. - Abnormal Conditions Of The Veins: 1. Deficiency And Excess Of Formation We have already noticed, under the head of Anomalies of the Heart, the most important anomalies and other deficiencies of structure affecting the trunks of the...

1. Phlebitis (Inflammation Of The Coats Of The Veins): Phlebitis (Inflammation Of The Coats Of The Veins) is the primary disease, although it may be owing to various causes, while every anomaly of the blood within the inflamed tube of the vessel, and stil...

8. Further Evidence Of The Phlebitic Process: Further Evidence Of The Phlebitic Process, both in reference to its own nature and that of its products, and to its highly important character, is afforded by numerous secondary conditions, which we s...

The Coagulation Of The Veins: The Coagulation is effected in a simple manner, above and below the inflamed vein, and around the coagulum which originally filled it. The blood is coagulated below the inflamed vein (at its circumfer...

The Coagulation Of The Veins. The Terminations Of Phlebitis: The following are the terminations of phlebitis: it may end in resolution; in chronic inflammation, with persistent thickening; in coalescence of the vein with contiguous structures; and in dilatation...

B. The Phlebitis: The Phlebitis depending on coagulation of the blood differs from the form of acute phlebitis hitherto treated of, inasmuch as the coagulation within the vessel is the primary phenomenon, whilst the in...

The Division Of Phlebitis: The Division Of Phlebitis into an adhesive and a suppurative form is well known, and has been generally followed. The two forms we have established may participate in either of the above characters. W...

1. Inflammation Of The Sinuses Of The Dura Mater: Inflammation Of The Sinuses Of The Dura Mater arises from injuries of the cranium, in consequence of a concussion of the dura mater near the sinus, or of a direct injury of the latter from fragments ...

3. Inflammation Of The Trunk And Branches Of The Portal Vein In The Liver: Inflammation of the portal branches within the liver, and their adhesive inflammation, resulting in obliteration, are not of uncommon occurrence, as will be seen from the following remarks: We not ...

4. Inflammation Of The Uterine Veins: Inflammation Of The Uterine Veins, especially after delivery, is the most common form of this affection. It attacks the gaping venous sinuses at the points where they are torn from their insertion ...

5. Inflammation Of The Umbilical Veins Of Newborn Infants: Inflammation Of The Umbilical Veins Of Newborn Infants - a phenomenon somewhat frequently combined with ulceration of the navel, and accompanied by erysipelatous redness of the skin of the abdomen, ...

6. Inflammation Of The Vena Cava Ascendens: Inflammation Of The Vena Cava Ascendens is induced in puerperal women by the coagulation of blood, extending from the inner spermatic vein into the vena cava. Under other conditions, it also appears ...

A. Phlebitis: Phlebitis from a wound complicated with the introduction of a deleterious substance. The wound, besides involving other structures, affects either a large vein or only capillaries. In the former case,...

B. Hypertrophy Of The Venous Coats, Especially Of The Lining Membrane: We shall treat of this subject in the present place with the diseases of texture as in the case of the arteries, and shall allow it to follow phlebitis, because on the one hand, hypertrophy of the ven...

C. Adventitious Structures Of The Veins: These formations are in general alike rare in the veins and the arteries (see p. 207), although cancerous disease of the veins presents an exception to this rule. 1. A fibroid tissue occurs as an i...

4. Anomalies Of Calibre Of The Veins: A. Dilatation of the veins, Phlebectasis, or Varicosity in its wider sense, is, as is well known, an anomaly of great importance in medicine, whether it be general, occurring as a preponderance of the...

Varices: Varices, moreover, sometimes begin to ulcerate from their cellular coat, and from the contiguous cellular tissue; the ulcerous perforation of the varix from without commonly impinges on a coagulum of ...

The Causes Of Phlebectasis: The Causes Of Phlebectasis are usually sufficiently obvious; as, for instance, mechanical impediments to the circulation of the blood in consequence of contractions in the openings of the heart; or pr...

Varicosity: Varicosity is followed by oedema, hypertrophy, repeated inflammations of the cellular tissue terminating in indurations, and inflammations of the skin, which cause it to coalesce with the subjacent ce...

C. Varicosity Of The Veins Of The Rectum: Varicosity Of The Veins Of The Rectum, constituting Hemorrhoids, is, next to the preceding, undoubtedly the most frequent form, and is that which has been commonly regarded as the expression or crisis...

Hemorrhoidal Varices: Hemorrhoidal Varices usually contain coagula of considerable size, which dissolve, without, however, often giving rise to the formation of phlebolites. The stasis to which we have referred is gradu...

D. Varicosity Of The Vesical Veins: Varicosity Of The Vesical Veins (known also as hemorrhoids of the bladder) in the male sex affects the veins of the prostatic and vesical plexuses; the branches of the latter on the neck of the bladde...

E. Varicosity Of The Upper Extremities, And Of The Head And Neck: Although varicosity of the upper extremities, and of the head and neck, is less frequent than the above species, we yet occasionally observe this condition very highly developed in the lips. It is mor...

F. Varicosity Of The Veins Of The Pia Mater: Varicosity Of The Veins Of The Pia Mater is an important condition. It has been frequently noticed in the case of drunkards, and more especially after repeated attacks of delirium tremens, and is ofte...

G. Another Form Of Varicosity Of The Trunk: g. It still remains for us to notice another form of varicosity of the trunk, which affects the subcutaneous abdominal veins, and originates in a congenital anomaly of the vascular system. Thus, for i...

B. Occlusion, Contraction, And Obliteration Of The Veins: To this class belong several anomalies to which we have already referred in the preceding pages; and of which we now proceed to consider the most important. 1. Contraction and final obliteration of...

Supplement. Anomalies Of The Small Vessels And Capillaries: Although we deem it necessary to refer specially to the anomalies of these vessels, we must observe that we are entering upon a field of inquiry which has hitherto only been partially cultivated in re...

Supplement. Anomalies Of The Small Vessels And Capillaries. Continued: 3. Anomalies Of Texture We have already considered the relation of the capillaries in hyperemia, stasis, and exudation (inflammation), as well as in their modes of termination, in induration (atrop...

V. - Abnormal Conditions Of The Lymphatic System. A. The Lymphatic Vessels: We shall pass over the anomalies which the great lymphatic vessel, the thoracic duct, presents at its origin, in its course, and at its mouth, and proceed at once to: 1. Anomalies Of Texture. A. In...

Abnormal Conditions Of The Lymphatic System. B. The Lymphatic Glands. 1. Anomalies Of Volume - Hypertrophy - Atrophy: The lymphatic glands are abnormally enlarged in consequence of various conditions. We have here to consider more fully the anomalies induced in these structures by hypertrophy. This condition consists...

2. Anomalies Of Texture Of The Lymphatic Glands: A. Inflammation Inflammation of the Lymphatic Glands [Lymphadenitis) especially when it depends on the absorption from within of heterogeneous substances into the lymphatic vessels, is of frequent ...

B. Acute Swellings Of The Lymphatic Glands: These are morbid conditions of the lymphatic glands (more especially those of the mesentery), which occur in the form of acute intumescence, associated with some degree of vascularity, and with loosen...

C. Adventitious Products Of The Lymphatic Glands: The most frequent and important of these are tubercle and cancer. 1. Formation Of Cysts This is of very rare occurrence, more especially when we except the formation of cysts in the lymphatic gl...

3. Tuberculosis Of The Lymphatic Glands: Tuberculosis of the lymphatic glands is next to that of the lungs and the intestinal canal, the most frequent form of tuberculous disease, and more especially affects some portions of the lymphatic sy...

4. Cancer Of The Lymphatic Glands: Cancer frequently occurs in the lymphatic glands, sometimes as a primary, but more commonly as a secondary formation. The medullary is the ordinary variety, either in its genuine white form, or in ass...

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