Lymph-stasis, or, Retardation of lymph, as an element in the causation of disease : especially in regard to scrofula and tuberculosis / by Wayland C. Chaffey.

Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Lymph-stasis, or, Retardation of lymph, as an element in the causation of disease : especially in regard to scrofula and tuberculosis / by Wayland C. Chaffey. 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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    and tubercles tend to form, though in some cases of choroidal tubercle no obvious changes in the disc, or meninges of the brain, can be detected, in which case they are comparable to disseminated miliary tubercles arising elsewhere in the last days of tuberculous disease of some organ. One would perhaps be justified in calling it “tubercular choroido-lymph-stasis” rather than “ optic neuritis.” Atheroma. It appears to me probable that atheroma may originate in lymph-stasis. Scroll-like buffy markings* are com- mon about the internal lining of the root of the aorta in young children dying from various forms of disease, but they are more markedly developed in diphtheria,f and such diseases as are attended by general enlargement of the mediastinal glands. I have seen this condition well marked in a case of mediastinitis with caseous glands. It will be seen that these are all conditions in which the return of lymph from the heart and great vessels would be hindered. Granulo-fatty changes in the heart-muscle may be one effect, though this is usually attributed to non- oxygenation. Probably both factors are at work. Mechanical strain has been spoken of by some authorsJ as one of the factors in the causation of atheroma of the aorta, but the question which has arisen in my mind is whether lymph- stasis is not accountable for an initial weakening of the wall of the vessel. At any rate, we find that the scroll-like markings alluded to above occupy almost identical situations with those commonly affected by atheroma; and, as the former appear to be due to lymph-stasis as a predisposing factor, I think we are entitled, on logical grounds, to attribute to lymph-stasis a share in the causation of atheroma also. A careful examination of the mediastinal glands will perhaps decide the point in cases of atheroma, for I am not aware of any investigation of the kind having been made. Fibroid As the case the lungs> fibroid changes in degenera- various other organs may be found, on careful tion of inquiry, to be the result of lymph-stasis. We know organs. that c^-hogis 0f the liver follows thickening of its capsule, in which case the superficial network of lymphatics * Usually designated simple fatty degeneration.” f Vide paper by the author, ‘Brit. Med. Journ.,’ July 16tli, 1887. J Wilks and Moxon, ‘ Pathological Anatomy and llindfleisch,' Patholog- ical Histology.’