Essay on tubercles / by Nathaniel Rogers.

  • Rogers, Nathaniel.
Date:
1832
Catalogue details

Licence: Public Domain Mark

Credit: Essay on tubercles / by Nathaniel Rogers. Source: Wellcome Collection.

    18/28
    merit of the disease. The walls then become lined with a false membrane of very slight consistence, replaced after a time by another of a less friable nature, gradually acquiring, as is stated by Louis, a semicartilaginous hardness. Bayle consider¬ ed that pus was secreted by this false membrane; but Laennec found that excavations so lined were generally empty. Some¬ times, as in a fourth part of Louis’s cases, no membrane exists at all; and then the naked pulmonary tissue, condensed, red, and infiltrated, formed the walls of the excavation. * * * § Tuberculous excavations are often traversed by bands, which, from their being more slender in the middle than at the extremi¬ ties, have been compared to the columnar carnece of the heart. They consist of condensed pulmonary tissue, and were consider¬ ed by Bayle and others to be vessels ; but Laennec states, that he has never found them enclosing a vessel of any conse¬ quence ; and Louis has met with only five such instances. -f* This must be understood, however, as applying rather to their not existing as vessels at present, than to their never having had that form ; for there seems good ground for believing, that, by an admirable arrangement, of which the animal economy presents to us so many instances, tvhile the bronchial tubes are cut across, (thus allowing free exit for the morbid deposit,) the blood-vessels, where a similar occurrence would produce fatal haemoptysis, are insulated from the surrounding tisue, and be¬ coming gradually obliterated, form the bands in question, j The situation commonly chosen by these cavities, is the top of the lung; and, according to Louis and Stark, nearer the posterior than the anterior surface. The former of the two last named authors observes, that he has never met with great excavations in the centre of the inferior lobes. The situation which cavities are thus generally found to occupy, corresponds with that where the tubercles from which they spring, are ob¬ served to be first and most abundantly deposited ; for all writers agree, that making the first invasion at the summit, every crop as it successively appears, takes a lower and lower position, till the whole lung is gradually pervaded. § Of all the cases de- * Forbes’s Laennec, 3d edition, p. 284 to 280. Louis's Recherches Anatomico- Pathologiques sur la Phthisie, Paris, 1825, p. 11 and 12. Bayle’s Recherches, &c. Paris, 1810. f Ibidem. $ A very interesting observation on this subject, I remember to have heard from Dr William Stokes of Dublin ; to whose zealous and enlightened devotion to patho¬ logical researches, I am happy to have this opportunity of bearing my unfeigned tes¬ timony. The fact I allude to was this, that in the bands which traverse tubercu¬ lous excavations, vessels had been found not only pervious, but actually conveying blood to the parts beyond. § Dr Stark, in Medical Cummunications, Vol. i. 1784, p. 309. Louis’s Re¬ cherches sur la Phthisie, Paris, 1825, p. 13. Forbes’s Laennec, 3d edition, p. 288 and 289.
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