Surgical pathology and morbid anatomy / by Sir Anthony A. Bowlby and Sir Frederick W. Andrewes.

  • Bowlby, Anthony A. (Anthony Alfred), Sir, 1855-1929.
Date:
1920
Catalogue details

Licence: Public Domain Mark

Credit: Surgical pathology and morbid anatomy / by Sir Anthony A. Bowlby and Sir Frederick W. Andrewes. Source: Wellcome Collection.

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    hypertrophies are common, and good instances are supplied in the hypertrophy of one kidney when the other is diseased, the increase in size of the fibula when the tibia is congenitally absent, and the thickening of the muscular walls of the heart in cases of valvular disease, or of those of the bladder in obstructions caused by enlarged prostate or stricture of the urethra. The hypertrophy which results from increased blood-supply may occur in tissues which are otherwise normal, but is most often seen in connection with irritative or inflammatory lesions. Hunter’s experiment of transplanting the spur of a cock on to its comb affords an excellent example of the former, for the spur, nourished by a greatly increased vascular supply, grew to many times its original size. In the same way, the hair in the neigh¬ bourhood of a chronic ulcer or an inflamed joint, though itself healthy, often grows longer and becomes more thick on account of the vascularity of the skin in the neighbourhood of the inflamed area. More often, however, the overgrowth which is dependent on increased blood-supply is the result of some abnormal condition of the tissue itself. Thus, the irritation of a badly fitting boot, or the intermittent pressure of a tool on the skin of the palm, often results in the thickening of both the derma and epidermis, and the effect of intermittent pressure on a bone is similarly shown in the formation of new bone from the periosteum. Hypertrophies such as these are called irritative. It is worth while to mention yet one other instance, for the results are sometimes very striking. In cases of chronic inflammation kept up by any cause in the neighbourhood of the epiphysis of a growing bone, the increased supply of blood to the developing tissue is followed by a corresponding increase in growth, and thus the limb on the diseased side may become longer than its fellow. In the tibia such overgrowth is accompanied by curva¬ ture, for, being fixed to the fibula, it is unable to grow in length more rapidly than the latter bone, unless at the same time it yields to the resistance offered by the fibula. In some cases parts become hypertrophied without any apparent cause, and a toe or a finger may continue to grow after the growth of its fellows has ceased, till it becomes more than twice the normal size. In other cases whole limbs become hyper¬ trophied, but we know no more what is the cause of this over¬ growth than we know why the growth of any one part of the body ceases when its natural development has been attained.
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