The pathogenesis of secondary tumors / by Henry Wile.

  • Wile, Henry.
Date:
1882
Catalogue details

Licence: Public Domain Mark

Credit: The pathogenesis of secondary tumors / by Henry Wile. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    right lobes of the lung ; if in the left vein, they were found on the left side. This observation, though not pertinent, is in- teresting to record, as it would seem to indicate a division in the current of blood. Most of the emboli were found on the sur- face of the lobes, and seem to have been forced to that position by the pressure of the blood. Some of them found their way to the very edge of the lobes. Macro- scopically they were sharply circumscribed, and projected somewhat from the surface of the lobes in the form of nodes. The experiments are of different duration, and the emboli thus present differences in size and outline. Thus, the experiment of nineteen days’ duration shows a thin la- mella of bone, while the experiment of thirty-three days shows already a distinct small centre of ossification. The ossification always taking place from the proliferating or internal layer of the periosteum, it naturally followed the line of that layer, which was in many cases tortuous, for, as the periosteum was being swept along through the blood-vessels, it became rolled up and twisted. This ac- counts for the twisted appearance of some of the nodules. In the next chapter the microscopic details will be considered. CHAPTER V. THE FATE AND MICROSCOPIC STRUCTURE OF PERIOSTEUM AND OTHER PARTICLES OF NORMAL TISSUES EXPERIMENTALLY TRANSPLANTED. The gradual development of the perios- teal embolus introduced into the lung of dogs by means of the jugular vein can be perfectly studied, as my preparations rep- resent the different stages. In all the ex- periments I was careful to take periosteum only, and not to take any bone-structure with it; so that, while removing a frag- ment of periosteum from the bone, I occa- sionally examined a similar fragment as to its histological structure, and found it to present appearances which may be thus briefly described. It was composed of two layers,—an outer or fibrous layer, com- posed of dense fibrous connective tissue, and an inner or so-called osteogenetic layer, made up of areolar connective tissue, rich in cellular elements, also containing some yellow elastic fibres. Both layers were freely supplied with blood-vessels, which carried the blood to and from the bone. Before introducing the periosteum, I took particular pains to squeeze it, so as to free the blood-vessels from clotted blood, in order that, when the embolus finally be- came lodged in some vessel, the blood might gain access to the interior of the embolus, and in this way give good sup- port and nutrition. The fate of the embolus was to get lodged in some branch of the pulmonary artery, just as in the case of the tumor em- boli. Here, as there, the embolus pro- duced thrombosis; and, if examined a few days after its introduction, it showed itself to be intimately enveloped by a blood-clot, indicating a tendency towards organiza- tion. In sections made still later, the or- ganization of this blood-clot demonstrated the higher phases of organization analogous to those seen in ligation of arteries.* In experiments of fourteen days after preparing the specimens, a section, stained in carmine and mounted in Canada bal- sam, presented the following appearance. Fig. 5. Ossification of periosteal embolus in lung of dog, showing detailsof the ossifying process. (Experiment No. 34, of 14 days’ duration. Drawing reduced to one-fourth of actual size.) a. Inner layer of periosteum changed into osteoid tissue, a'. Unchanged periosteum, a. Outer layer of periosteum. 6. Osteoblasts, c. Organized thrombus tissue filling interspaces. d. Wall of mother vessel in intimate union with embolus. e. Band of tissue leading vasa vasorum of mother vessel to the centre of the embolus. The artery is seen in transverse section, and exhibits slight evidences of inflamma- * I would even suggest to those who make studies of the healing of arteries to extend their experimentation to similar artificially-produced embolisms of lung.