Cases and observations illustrating inflammatory effusions into the substance of the lungs, particularly as modified by contagious fevers / by William Aitken, M.D.

  • Aitken, William, 1825-1892.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: Cases and observations illustrating inflammatory effusions into the substance of the lungs, particularly as modified by contagious fevers / by William Aitken, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    My remarks upon this subject will be illustrated by a series of cases which lately came under my observation in the Royal Infir- mary of Edinburgh, in the description of which it will be my object principally to direct the attention of the reader to the manner in which the exuded matter may be traced into the mi- nutest parts of the pulmonary texture ; the circumstances modify- ing the elementary forms which the exuded liquor sanguinis may assume during its organization ; and the different stages of pro- gression by which this morbid affection may terminate in resolution, in permanent organic mischief, or in death. In the examination of a lung not presenting all the appearances of health, it is impossible to ascertain with the unaided eye whether or not the morbid degeneration it may have undergone is of the nature of exudation; and still less to determine the nature of the exuded matter without the employment of the microscope. In the lung, as in every other organ of the body subject to the exudation of liquor sanguinis, the matter resulting from the exu- dation is liable to various modifications, according to the structure of the part affected. The question then presents itself at the outset of this inquiry ; Under what circumstances is a lesion in the substance of the lung to be regarded as an exudation resulting from inflammatory action ? Such a lesion will be found to exist when an exudation of liquor sanguinis has taken place and becomes organized in various forms ; and it is my object to describe some of the conditions which ap- pear to modify the forms of organization assumed by this exuded matter. The coagulated matter of exudation exhibits in the pulmonary substance a general tendency to become organized, and it is only under more rare circumstances that it tends to undergo rapid dis- integration or decomposition, and to involve the substance of the lung itself in death. Like other morbid processes, the organization of the exuded matter will be most conveniently considered with reference to its several stages; which have been well determined by Laennec. In the first stage, no exudation takes place ; but the excess of blood in the part is followed by a serous effusion, and a decrease in the firmness of the parenchyma. This condition of hypersemia appears to exist occasionally, under three circum- stances, It may exist, (1) as the invariable condition of a part in which exudation of liquor sanguinis is about to take place ; (2) as the result of deficient nervous energy, and the conse- quence of gravitation ; (3) in the phenomena of blushing, and the vascularity of erectile tissues. A question here suggests itself, namely, Is it possible to distinguish congestion in a part about to be the seat of an exudation of liquor sanguinis^ from those other congestions which are stated to exist? Almost