On congestion of the heart, and its local consequences / by William Jenner, M.D.

  • Sir William Jenner, 1st Baronet
Date:
1860
Catalogue details

Licence: Public Domain Mark

Credit: On congestion of the heart, and its local consequences / by William Jenner, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    indistinctly seen, though here and there they are as perfect as in health. 2d. The muscular fibres are more firmly united to each other than in the healthy heart. 3d. Both between and within the muscular fibres are innumerable molecular granules, chiefly protein. 4th. Lymph which has a granular form exhibits in the heart, as elsewhere, a tendency to undergo fatty degenera- tion, and the muscular fibres of the heart, damaged by the congestion and the presence in and among them of the lymph, are prone to the same change; the consequence is, that it is common to find here and there a considerable number of particles of free olein as well as muscular fibres which have undergone fatty degeneration.^ 5th. In some cases the cellular or connective tissue seems to be increased in quantity. When the exit of the blood from the right auricle is sud- denly or greatly impeded, it is not unusual to find small crimson spots studding the external surface of the heart, and less commonly the internal surface. These spots are evidently extravasations of blood, the result of capillary haemorrhage from mechanical obstruction to the onward flow of the blood.^ Under like conditions there is often found a considerable excess of serosity in the pericardium, and oedema of the loose cellular tissue at the base of the ventricles; the latter especially, if the patient is much emaciated. When the congestion has been extreme and long con- tinued, the coronary sinus is found to be more capacious than natural. In studying the eflFects of congestion on tissues and organs, it is necessary to separate not only slight from extreme congestion, but also continuous from intermitting 1 When the fatty metamorphosis of the muscular tissue and lymph is ex- tensive and extreme, softening of the walls of the heart may uliiinately occur; theparietes of tlieheart being first indurated, and subsequently soft- ened, in consequence of the indurated tissue undergoing fatty degeneration. See Rokitansky, in previous note.