A treatise on the theory and practice of medicine / by John Syer Bristowe.

  • John Syer Bristowe
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: A treatise on the theory and practice of medicine / by John Syer Bristowe. Source: Wellcome Collection.

    72/1322 page 26
    this process, but partly also by the appearance of new foci of disease in the vicinity of the primary focus, and by their gradual coalescence with it and with one another. It is sometimes determuied by the lines of capil- lary lymphatics and blood-vessels. e. Tendency of morbid growth to become generalised.—The tendency to the simultaneous or consecutive occurrence of the same kind of morbid proliferation in different, and even remote, parts of the organism is trace- able to a variety of causes, presents obvious and characteristic differences, and has therefore a widely different significance in different cases. The matter is one which deserves, and indeed demands, consideration; and we proceed, therefore, to discuss it in some detail. A person in appar- ently the best of health finds that he has a fibrous or fatty tumour in the subcutaneous connective tissue, or an osseous or cartilaginous tumour growing h'om the shaft of some bone ; and probably in a short time it is ascertained that many other tumours, identical in character with the one first detected, are making their appearance in the connective tissue or the bones (as the case may be) of different parts of the body. Now it is indu- bitable that we have here a curious tendency in certain tissues of the body to undergo special morbid changes. To what is this tendency due ? The first formed tumour may be distinctly traceable to some local injury; has the growth which resulted from that injury so infected the system as to have led to the multiple development of similar growths throughout the same tissue as that which was primarily involved ? Or have all the tumours (including the first) resulted from the common operation of some independent morbid irritant or poison diffused generally throughout the system ? Or is there some inherent weakness or vice in the particular tissue, which has become thus largely affected, rendering it liable to take on specific morbid proliferation under the influence of mechanical violence or any other indifferent cause? In the examples which have been adduced (and many similar ones might be added], the last of the three suggested explanations will doubtless be regarded as the only tenable one; and probably it is the correct one. At all events, we have no grounds for assuming, from the presence of cachexia or other associated abnormal conditions, that any poisonous matter either is or has been present in the system ; or from the presence of lymphatic implication, that the primary seat of disease was the source of infection. The case, however, is not quite so simple as it appears to be at first sight. The skin, like the bones or connective tissue, constitutes a special constituent of the organism, and like them (though in a still higher degree) is liable to many morbid conditions which are peculiar to itself, and which may be distributed at intervals over its surface. A patient may have psoriasis, beginning perhaps in a patch on the elbow or knee, and diffusing itself in spots over the greater part of the body. His father may have suffered from the same disease, and his brothers and sisters also may be subject to it. The case is one of hereditary predisposition. Now, probably no one would dream of suggesting that the spread of the disease was due here to the infecting influence of the patch which first
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