Lectures on the principles and practice of physic : delivered at King's College, London / by Thomas Watson.

  • Watson, Thomas, Sir, 1792-1882.
Date:
1845
Catalogue details

Licence: Public Domain Mark

Credit: Lectures on the principles and practice of physic : delivered at King's College, London / by Thomas Watson. Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    masses, the ulcer is said to be a sloughing ulcer. When the process is slow, the lymph effused at the base and round the edge of the ulcer is hardened, and the granulations on its surface are deficient, the ulcer is then said to be callous or indolent: and when the granulations are larger and softer, and more flabby than usual, and require to be repressed before the ulcer will heal: to this variety of ulcer the name of fungous ulcer is given; and the coarse and too luxuriant granulations are called, by the vulgar, proud Jlesh. These several terms, in the senses now assigned to them, you will please to remember. It is by regulating the three processes now described—so far as they are capa- ble of being regulated by art—that the surgeon and the physician endeavour to obviate the threatened ill consequences of ulceration, and to promote the repair of the textures which have been destroyed. I explained to you, in a former lecture, that inflammation may lead to a wast- ing of parts, although there is no suppuration or ulceration. The testis some- times withers as a consequence of inflammation : interstitial absorption takes place. Jjtrophy, in short. LECTURE XI. Mortification, as an -event of Inflammation. Inflammatory Fever. Hectic Fever. Typhoid Fever. Modification of Inflammation by differences of Tissue; Areolar Tissue; substance of Glands and Solid Viscera; Serous Membranes; Synovial Membranes; Tegumentary Membranes—Skin— Mucous Membranes ; Muscular Tissue ; Jlrteries ; Veins ; substance of the Brain. We were occupied, when last we met, with what may be properly called the events of inflammation. We passed in review, 1st, resolution as an event of inflammation; 2dly, serous effusion; 3dly, the pouring out of coagulable lymph, constituting the adhesive form or stage of inflammation; 4thly, the formation of pus, or suppuration; and 5thly, ulceration. The pathology of these several events, so far as it is understood, and the change of symptoms to which they may respectively lead, were also treated of as fully as the limits of my course allow. At the close of the lecture I was about to speak of the sixth and last event of in- flammation that requires to be noticed : viz., gangrene, sphacelus, mortification. When mortification thus succeeds to inflammation, the part dies; it becomes cold; all circulation through it is at an end ; all sensation in it is over. If it be an external part, its colour changes; from being red, it becomes mottled, pur- plish, green or black ; decomposition takes place ; vesications appear, filled with dark-coloured liquids; air is extricated also. If there be a great accumulation of fluid in the part there will still remain tension; but usually the mortified part is flaccid and boggy ; and it emits a cadaverous smell. When internal parts mortify under inflammation, they do not always assume this black appearance: often they are yellowish; or the soft tissue of the dead part readily imbibes fluid, and takes the colour of the substances with which it has been in contact. We see sloughs of the mucous membrane of the intestines presenting the ochrey hue of the faecal matters which had rested upon them. What I have described as mortification, occurring externally, and succeeding to inflammation, is such as the surgeon witnesses. Sometimes it spreads, and loses and confounds itself, insensibly, with the adjoining parts, which still retain life; and which may continue actively inflamed, and subsequently perish also. Under more favourable circumstances, a distinct boundary line is formed between the dead and the living parts ; and nature proceeds to amputate the portion which has lost its vitality. The process by which this is effected is extremely interest-