Lectures on surgical pathology, delivered at the Royal College of Surgeons of England / by James Paget.
- James Paget
- Date:
- 1870
Licence: Public Domain Mark
Credit: Lectures on surgical pathology, delivered at the Royal College of Surgeons of England / by James Paget. Source: Wellcome Collection.
88/900 page 66
![many, and take next, tliose which display the formation of corns ; a subject which, while Hunter deemed it worth consideration, we shall not be degraded by discussing. He made many preparations of corns, to show not only the thickening of the cuticle, but the for- mation of the little sac of fluid, or bursa, between the thickened cuticle and the subjacent joint. His design appears to have been, mainly, to illustrate the different results of pressure; to show how that which is from without produces thickening ; that from within, thinning and absorption of parts. He says, having regard to these specimens, ' The cuticle admits of being thickened from pressure in all parts of the body: hence we find that on the soles of the feet of those who walk much, the cuticle becomes very thick ; also on the hands of labouring men. We find this wherever there is pressure, as on the elbow, upper part of the little toe, ball of the great toe, etc. The immediate and first cause of this thickening would appear to be the stimulus of necessity given to the cutis by this pressure, the effect of which is an increase of the cuticle to defend the cutis under- neath. Not only the cuticle thickens but the parts underneath; and a sacculus is often formed at the root of the great toe, between the cutis and ligaments of the joint, arising from the same cause, to guard the ligaments below.'* In another place he says, ' When from without, pressure rather stimulates than irritates ; it shall give signs of strength, and produce an increase of thickening : but, when from within, the same quantity of pressure will produce waste ' [as illustrated in Nos. 120 and 121 in the Pathological Museum] ; ' for the first efiect of the pressure from without is the disposition to thicken, which is rather an operation of strength; but if it exceeds the stimulus of thickening, then the pressure becomes an irritator, and the power appears to give way to it, and absorption of the parts pressed takes place; so that nature very readily takes on those steps which are to get rid of an ex- traneous body, but appears not only not ready to let extraneous bodies enter the body, but endeavours to exclude them by increasing the thickness of the parts.' It is evident from these passages that Mr. Hunter was aware that pressure from without might produce atrophy; though he may appear to favour the belief, wliich, I think, is commonly adopted as on his authority, that the direction of the pressure is that which detennines its result. Eeally, the result seems to depend on whether the pressure be occasional or constant. Constant extra- i Hunter's Worlcs, i. p. 560. « Ihid. iii. p. 466.](https://iiif.wellcomecollection.org/image/b20390518_0088.jp2/full/800%2C/0/default.jpg)
