A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases ... with numerous prescriptions ... a classification of diseases ... a copious bibliography, with references; and an appendix of approved formulae / ... By James Copland.
- James Copland
- Date:
- 1844-58
Licence: Public Domain Mark
Credit: A dictionary of practical medicine : comprising general pathology, the nature and treatment of diseases ... with numerous prescriptions ... a classification of diseases ... a copious bibliography, with references; and an appendix of approved formulae / ... By James Copland. 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.
1061/1070 page 1053
![cysls cannot be detected ; and that, even where cysts have existed, their formation in the cellulai- tissue external to the cysts lias been demon- strated. — The views of JM. Andrai. have been stated in the article just referred to, and in that on Disease, § 138. M. CnuvEiLHiEn beheves that this, as well as some other lesions, are the results of the deposition of morbid products in the cellular tissue of organs, the venous capillary system furnishing these products, 19. Dr. Carsvvell is of opinion that the form- ation of the fungoid and carcinomatous substance takes place in the blood, whether it be found in this fluid alone or in other parts of the body at the same time ; and he adduces the facts— 1st, That the morbid substance is found in the vessels which ramify in these malignant tumours, or in their vicinity ; — 2dly, That it is found in those vessels which communicate with the diseased part of an organ ; —and, 3dly, That it is met with in vessels having no direct communication with an or^an af- fected with the same disease. The veins, however, and venous capillaries, are the only parts of the vascular system in which the diseased substance is found — sometimes in contact with the internal surface of the vein, or occasionally united with it by means of thin colourless fibrine, or even of very minute blood-vessels, as in the case of the cerehriform matter. In the articles referred to, I have stated that, when this morbid substance is detected in the blood, it has been absorbed, as in the case of other morbid secretions; and the accuracy of the opinion seems to be supported by the fact, that it is found only in the veins and absorbents; but Dr. Carswell believes that this is not the case, as there are instances in which the venous blood alone was the seat of the disease. If such be actually the case, an obvious difficulty presents itself; but various sources of deception arise in the course of minute researches, and mislead even the most careful. That the blood is early aflected in this and other malignant diseases, I fully believe ; but that the cerebriform matter is formed in it, and afterwards deposited in the parts which are its seats, cannot be supported by the history and progress of the local and constitutional affections. If it were previously formed in the blood, wherefore is it often deposited only in one situation]—where- fore is it not excreted by the emunctoriesT — wherefore does it not always affect a number of parts simultaneously'! — wherefore is it never found in the arteries, and so frequently in the ab- sorbents and veins proceeding from the seat of disease? — These and other questions that may be asked, cannot be answered consistently with this doctrine, I therefore entertain the same opinion as was stated by me in the articles al- ready referred to, and believe that, like carcinoma', it essentially depends upon a debilitated and other- wise morbid state of the system generally; and that the vital actions of the part or parts primarily and especially affected are depraved—that the nutrition, organic sensibility, and the secreting function of these parts are remarkably altered, and that the morbid product which results is par- tially absorbed into the circulation, and contami- nates the fluids and soft solids, sometimes exciting a similar morbid action in other situations, 20. Conformably with the best ascertained facts connected with the appearance of the cere- FUNGOID DISEASE —Treatment. 1053 briform niatter in the vessels, it would seem, that at a somewhat advanced stage of tlie disease, or when this structure becomes more or less softened, the molecules of it pass into the veins and ab- sorbents leading from the part in which they have been formed; that they there sometimes are aggregated into masses sufl^ciently large to admit of their recognition ; that, although these masses are generally found merely in contact with the internal surface of the veins, they sometimes ad- here to it by means of the fibrine which collects around them, as in every other instance in which a semifluid or partially concrete substance, or a secreted matter of greater consistence than the blood, passes into the circulation; and that, when they thus adhere to the internal surface of the veins, minute vessels are ultimately developed in the fibrinous envelope which has been formed around them. — The principal changes observed in the blood of those affected by this disease, and which I have had an opportunity of remarking in two cases after death, are, an unusual thinness — a deficiency of fibrine and red particles — a state of partial anaemia — and imperfect coagulation. This state has been also remarked by Beclard, Vei.peau, Andual, and Kerr, whose observ- ations respecting the presence of the cerebriform matter, surrounded by a fibrinous envelope, in the venous blood, fully confirm the view I have taken of its origin in this situation, and militate against its primary formation in this fluid. (See articles Cancer, §26.; and Disease, § 141.) 21. vii. Treatment. —This is a subject on which much cannot be said with any hope of ad- vantage. Surgical treatment is of no avail, and strictly medical means of very little more. What- ever excites pain, or irritates the local disease, tends to promote its growth ; and whatever lowers constitutional power, only lays the system more open to contamination. The intentions, there- fore, which we should propose to ourselves', when entering upon the ti-eatment of this malady, are 1st, to support the powers of life, and thereby to resist as long as possible the extension of the dis- ease; — 2dly, to promote the secretions and excretions, as auxdiary to the first indication ; and, 3d]y, to palliate the sufferings of the patient. 22. A. The frst of these is founded upon the evident and admitted fact that the disease is dependent upon, and associated with, debility; and upon the results of observation ; and the means which may be employed to fulfil it need not be materially different from those specified in the article Cancer, § 29. et seq. Although no medicine has hitherto proved successful in curino- the malady, yet new remedies, or novel combin- ations of those that are old, should nevertlieless be directed against it. Besides, judicious means have often prolonged life, or enabled the system to resist its progress for a time. Conformably with these views, the preparations of cinchona ; the sulphate of quinine ; the preparations and compounds of iron, particularly the ferri ammo- nio-chloridum, and the tincture of the sesqui- chloride ; sarsaparilla ; bitter tonic infusions or de- coctions, with liquor potassae, or the alkaline car- bonates ; and the preparations of iodine,— may be severally used, and combined with some one of the more energetic narcotics, particularly the acetate or hydrochlorate of morphia, or conium, or bella- donna, or aconitum. —The preparations of iodine](https://iiif.wellcomecollection.org/image/b2119709x_1061.jp2/full/800%2C/0/default.jpg)
