Statistical and pathological report of the Royal Infirmary of Edinburgh, for the years 1833, 34, 35, 36, and half of 1837 / by John Home.

Date:
[1837?]
Catalogue details

Licence: Public Domain Mark

Credit: Statistical and pathological report of the Royal Infirmary of Edinburgh, for the years 1833, 34, 35, 36, and half of 1837 / by John Home. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    cases. What relation these bear to those in which they were healthy is not known,as the numberof cases in which they were exa- mined isnotmentioned. They were much less seldom founddiseased than might have been supposed, from the frequent occurrence of ulcerations. The substance of the glands when enlarged was ge- nerally red, softened, and contained numerous yellow points which, gradually coalescing, the whole gland was converted into tuber- cular matter. This in some went rapidly on to suppuration, in others slowly. The pus was collected in an abscess, the walls of which were formed by the thickened enveloping capsule of the gland. The contained matter by absorption of its liquid parts seemed sometimes to be converted into a matter like putty, which afterwards became hard and calcareous. They were reduced to this latter state in one of the cases. This mode of cure in these glands is exactly similar to the healing up of tubercular cavities. Three of the cases in which these glands were found affected occurred in chil- dren, in whom they produced symptoms of tabes mesenterica, masking in a great measure the phthisical. In adults they produced no symptoms. A lardaceous tumour existed in the folds of the mesentery in one case. 5. The Liver was very commonly diseasedin the cases. Outof 65 cases in which it was examined it was found healthy in 14 only. In 23 it exhibited different forms of the early stages of cirrhosis, in which the organ becomes enlarged, hardened, and variegated in colour like a section of the nutmeg, with dark red spots scattered over a light yellow ground. The cellular tissue was occasionally thickened and indurated, as well as the peritoneal covering, which had contracted adhesion in some with the lower surface of the diaphragm. In none of the cases had it attained the advanced stasre of that disease, when it becomes lobulated and diminished in size. In many cases this disease of the liver was no doubt owing to obstructed circulation through, and diminished function of, the lungs ; but I would ascribe its origin in most of the cases to the abuse of spirituous liquors, to which many of the individuals in whom it was found were addicted; hence we may account for its more frequent occurrence among men than among women. Neither Louis nor Andral take notice of such an affection of the liver in their cases. They mention the fatty state of the liver as hav- ing occurred in one-third of their cases. It occurred in a smaller proportion in our cases, in 10 out of 65. Its characters corre- sponded very exactly with the description of it given by M. Louis.* The colour was a light reddish-yellow, or salmon colour, dotted over with brownish-red irregular spots ; its consistence was soft, and the organ had a very unctuous feel. It occurred more fre- Loui9, op. citat, p. 115. Andral, op. cit. p. 346.