A treatise on the principles and practice of medicine : designed for the use of practitioners and students of medicine / by Austin Flint.
- Austin Flint I
- Date:
- 1884
Licence: Public Domain Mark
Credit: A treatise on the principles and practice of medicine : designed for the use of practitioners and students of medicine / by Austin Flint. Source: Wellcome Collection.
Provider: This material has been provided by the University of Massachusetts Medical School, Lamar Soutter Library, through the Medical Heritage Library. The original may be consulted at the Lamar Soutter Library at the University of Massachusetts Medical School.
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![increased tunctioiiul and nutritive activity, and tliat liyperaBmia and fluid ex- udation t'rom the blood are secondary to tliis excitation. When Virchow made his researches on intiammation, nothing was generally known concerning tlie emigration of wdiite blood-corpuscles or their wandering powers, and he nat- urally concluded, in the application of tlie law omnis cellula e cellula, that all cell-elements present in inflammatory exudations Avere produced by proli- feration from the pre-existing tixed cells, most frequently from the connective- tissue cells. The discovery by Recklinghausen, in 1863, of the existence of wandering cells, resembling pus-cells, in the tissues, rendered doubtful the interpretation which Virchow had given to many of his observations. A new era was introduced in the history of inflammation by Cohnheim's discovery, in 1867, of the emigration of white blood-corpuscles from the vessels, and by his studies of the inflammatory process on living frogs. It is true that, as long ago as 184G, Waller, an English observer, saw the passage of white blood-corpuscles tlu'ough the unruptured vesseUwalls, but this isolated obser- vation liad remained fruitless, and had fallen into forgetfulness when Cohn- heim repeated the discovery. The phenomena of inflammation were observed first by Cohnheim, micro- scopically, upon the mesentery and tongue of the curarized frog. The first offect of the application of an inflammatoiy irritant (the mere exposure of the mesentery to the air suflUces) is a dilatation of the arteries, then of the veins, and,leastof all, of the capillaries. At the same time the velocity of the blood- cnrrent is increased. After a variable time, the blood begins to flow less rapidly, although the calibre of the vessels remains unchanged. In some of the capillaries it may come to complete stagnation or stasis, but this is not essential, nor usual except Avhen the action of the irritant is intense. As the rapidity of the blood-current lessens, the white blood-corpuscles accumu- late along the iiuier surfjice of the veins, where they remain nearly stationary. The remarkable phenomenon of emigration now takes place. A portion of a Avhite blood-corpuscle soon ap[)eai's upon the outer surface of a vein or a capil- lary, as a bud-like process connected by a delicate thread of protoplasm with the remnant of the corpuscle inside. As the outer portion of the cell increases in size, the inner diminishes, until, finally, the entire corpuscle lies free out- side of the vessel. The corpuscle passes through the cement-substance between the endothelial cells lining the vessel. The evidence is not conclusive that it passes through preformed stomata or pores. Nor is it certain wliether the corpuscles make their way through the vascular walls by their active amoeboid movements, as the name emigration would imply, or whether they are pressed through by a passive process of filtration. Outside of the vessels they assume amoeboid movements and change their shape and place. AVhile the inner surface of the veins becomes plastered, as it were, witii stationary white blood- corpuscles, the current of red blood-corpuscles continues unabated in the central part. White blood-corpuscles migrate from the veins and the capil- laries, but not from the arteries. Red blood-corpuscles also pass through the capillary walls by the passive process of dia])cdesis. Their number is not usually great, but, exceptionally, may be so considerable as to give a hemor- rhagic character to the exudation. Coincidently with the processes of emi- gration and of diapedesis, the fluid constituents of the blood filter through the walls of the vessels. This fluid exudation resembles in its composition the plasma of the blood, but it contains less albumen. It contains the fibrin- generators, and, in most places, finds the conditions necessary for the spon- taneous coagulation of the fibrin. A fibrinous effiision is, in the vast majority of cases, an inflammatory exudation. In sim{)le inflammations of mucous membranes and in supj)urative inflammations (abscesses), no filjrin is i'ormed. By a process of reasoning which cannot be entered into here, Colmheim con-](https://iiif.wellcomecollection.org/image/b21198135_0046.jp2/full/800%2C/0/default.jpg)
