A manual of pathological anatomy (Volume 1-2).

  • Carl von Rokitansky
Date:
1855
Catalogue details

Licence: Public Domain Mark

Credit: A manual of pathological anatomy (Volume 1-2). Source: Wellcome Collection.

Provider: This material has been provided by the National Library of Medicine (U.S.), through the Medical Heritage Library. The original may be consulted at the National Library of Medicine (U.S.)

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    I. The said anomalies, being simple alterations of the normal being and of its parts, appear as abnormal conditions, excluding the idea of an independent parasitic organism of disease. II. No formation is incapable of becoming diseased in one or more ways. Several anomalies coexisting in an organ commonly stand to each other in the relation of cause and effect. Thus, deviations in tex- ture very frequently determine deviations in size, in form,—and these again deviations in position. Deviations in position give rise to anoma- lies of volume and of texture. III. Pathological anatomy, proximately concerned with anomalies of individual organs and systems—with local anomalies—has often reserved for it the task of revealing by experiment and deduction the existence of general disease, as also of establishing the mutual relations which exist between the two. The seat of general diseases may now be refer- red, almost without exception, to the blood [the fluids]. They appear, therefore, as anomalies of admixture or crasis, either primary or secon- dary. IV. This demonstration of general disease is indeed a step in advance for pathological anatomy. It threatens, however, to mislead us into the error of exclusive, transcendental, all-pervading humoralism—into the error of denying all local disease, by deducing the latter in every in- stance from a corresponding general affection,—not but that many dis- eases really are but the localization of a pre-existent general disease. V. The existence of purely local—independent of general—disease, from the simplest inflammation—from blennorrhcea, to tubercle and cancer, we look upon as grounded— (a.) In the self-vitality of organs, and their independent relations to the external world. (b.) In the local influence of direct or reflected stimulation. Either directly, or through the medium of the nervous system, stimuli effect a local modification in the vital processes of absorption and secretion—in the interchange of matter,—an anomalous reciprocity between bloodves- sels and their contents on the one side, and the parenchyma-engendering products, abnormal both in quantity and in kind, on the other. Normal nutrition and secretion are no doubt mainly dependent upon a normal crasis; but they are also based upon the perfection of the spe- cific vital action proper to individual parenchymata. Anomalous secre- tions often arise out of influences which modify the vital action of the parenchyma, and consequently its reciprocity with the unchanged gross material, the blood: as, for example, augmented or otherwise altered secretion of milk, produced by local irritation or by anomalous innerva- tion, the effect of mental operations. In like manner, local diseases are but a consequence of qualitative and quantitative alienation of the tex- tures and organs,—the formative material (the blood), notwithstanding its reciprocity with the latter, not becoming sensibly contaminated. Influences, especially of a mechanical kind, are often so strictly local that it would be far-fetched to derive all local disorder from a general causal disease. Even the latter would be but secondary, a mere transfer of the alienation locally produced.
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