Discussion on the pathology of phthisis pulmonalis.
- Gairdner W. T. (William Tennant), Sir, 1824-1907.
- Date:
- 1881
Licence: Public Domain Mark
Credit: Discussion on the pathology of phthisis pulmonalis. Source: Wellcome Collection.
Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.
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![many cases, to destructive excavation of the lungs, as well as to a number of other local lesions similarly characterised by a tendency to ulcerate. Laennec unquestionably believed that the tubercular processes, taken as a whole, were specific, and distinct from, though they might be associated with, inflam- mation.* He was, however, familiar with the secondary eruptions, as he called them, of miliary tubercles occurring as the result of localised caseating deposits of older date, only he regards these older deposits also as a part of the general disposition which presides over all the local manifestations alike.f So with regard to htemoptysis, Laennec does not main- tain that the ancient doctrine of phthisis ah haimoptoe is absolutely and in every ease wrong, but only that there is no positive fact which proves that hgemoptysis can, per se, originate tubercles, while the presumptions are, on the whole, the other way, and the majority of cases of haemoptysis occur in the course of tubercular disease already in progress..]: It will thus be seen that Laennec, even when his opinions are not in accordance with more modern pathological ideas, has stated them in such a way as not to be open to the censures that have sometimes been pa-ssed upon him. The second epoch which requires notice is that of the first impetus of pathological histology in relation to tubercles, b}^ the application of the microscope to the analysis of tubercular and scrofulous structures, in the hands of Lebert, whose work on the subject was published in 1849. The successors of Laennec had so insisted on the specificity of tuberculosis, that it was almost inevitable that the microscope, in the first enthusiasm of its application, should be expected to disclose a specific form corresponding with the assumed specific nature of the deposit, or exudation (as it was then commonly called). This Lebert assumed to have done by the discovery of the tubercle-corpuscle ; and for a time morphological specificity was in the ascendant, and not only tubercle, but inflammation, cancer, and almost all kinds of tumours, were supposed to be demarcated absolutely in nature by the cell-forms contained in them. This pathology, however, did not hold its ground * He maintains this at great length in opposition to Broussais, in a special article Les tubercules sont ils un produit de 1'inflammation. Ausc. Jl^d., p. 562. Une multitude de faits prouvent, he concludes, que le developperaent des tubercles est le resultat d 'une disposition gendrale, qu' il 3e fait sans inflammation pr^alable, et que, loraque cette derniere coincide avec 1 'affection tubei'culeuse, elle lui est le plus souvent post^rieure en date. P. 578. t Ausc. MM., aieme edition, 1826. T. I, pp. 553 and 579. X Ibid., p 645. D](https://iiif.wellcomecollection.org/image/b21720319_0037.jp2/full/800%2C/0/default.jpg)
