Status thymo-lymphaticus and its relation to sudden death / by Gerhard Hutchison Cocks.

  • Cocks, Gerhard Hutchison.
Date:
1910
Catalogue details

Licence: In copyright

Credit: Status thymo-lymphaticus and its relation to sudden death / by Gerhard Hutchison Cocks. 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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    the cases of meningitis reported by the writer, death occurred eailv in the disease, distinctly modifying its course. Daut, quoted by Blumer, states that in a series of patients dying from diphtheria, over 25 per cent had status Ivmphaticus. He says that “distinct modifications of the clinical picture of the disease (diphtheria) were present in these cases. In seme instances the patients had a hoarse barking cough, and a hoarse voice, associated with attacks of spasmodic suffocation, weakness of the heart and rapidity of the pulse. These attacks were altogether out of proportion to the severity of the membrane formation as shown post-mortem. In other cases the patients died suddenly, having shown no unusual symptoms during life referable to status lymphaticus.” Theories of Death: There are three theories advanced to account for sudden death in status lymphaticus: x. Theory of mechanical compression; 2. Paltauf's theory; 3. Theory of hyper- thymization. 1. Compression Theory. It has been proven that in rare in- stances the enlarged thymus gland may compress the trachea suf- ficiently to cause death by-suffocation. The relief afforded by thy- mectomy is proof of this fact. In this connection the thickness of the thymus is of more importance than its other dimensions, as the following figures of von Sury show: Average thickness of thymus Average sterno-vertebral distance Newly-born 1.1 cm. 1.6 cm. Child in 1 month 1.4 cm. 1.7 cm. Child in 2-9 months 1.5 cm. 2.0 cm. Thus we see that at the superior aperture of the thorax there is normally only a space of one-half cm. between thymus and the bony walls of the chest, measuring from before backward. Forc- ible extension of the head decreases this distance. In rickets this sterno-vertebral distance is apt to be small, owing to the frequent occurrence of lordosis. 2. Paltauf's Theory. Paltauf believes that the hyperplasia of the thymus and lymphatic apparatus is due to an intoxication of the organism caused by faulty tissue changes, or by such common causes as infection and hereditary syphilis. The nerve centers governing the movements of the heart become affected, and a lessened resistance of the individual toward harmful external in- fluences is induced. Under such circumstances the heart may sud- denly become incapable of functionating. 3- Theory of Hypsrthymisation. There is thought to he a pathological increase of the internal secretion of the hyperplastic