Surgery : its theory and practice / by William Johnson Walsham.

  • William Walsham
Date:
1897
Catalogue details

Licence: Public Domain Mark

Credit: Surgery : its theory and practice / by William Johnson Walsham. Source: Wellcome Collection.

    22/898 page 6
    i.e., they can digest and, peptonize albuminous substances, and even dissolve metallic particles. So that it is evident that the [ activity of leucocytes is twofold, both intracellular or phagocytic, y and extracellular or chemical. It may be remarked here, that besides certain forms of leucocytes, the endothelial cells of the capillaries and many fixed and wandering connective-tissue cells also possess phagocytic properties. The latter, being large in size, were formerly called macrophages, in contradistinction to the micro- phages or leucocytic phagocytes. Another important phenomenon of inflammation, which has abeady been mentioned, is the exudation or transudation of fluid from the blood-vessels. The amount of fluid exuded varies with the density and structure of the tissues, being generally copious in serous membranes and also in loose vascular tissues, but scanty in dense tissues. The_purport of the exudation is partly to dilute the irritant, partly—where an inflammation is superficial—to wash it away. In its chemical constitution it re- sembles plasma, but it generally also contains proteolytic ferments, peptones, and where bacteria are present also their products. Pibrin is also present as a rule, and sometimes in such quantity, that the exudation, instead of being serous, becomes fibrinous. The ferments capable of digesting proteids are secreted not only by bacteria which may be present, but also by the leucocytes ; these no doubt assist in the removal of the dead tissues. Bactericidal substances also derived, from leucocytes, and capable of destroying or inhibiting bacterial growth, may frequently be found in the inflammatory exudation. There can be no doubt that the vascular changes, the exudation, and leucocytic phenomena accompanying inflammation can occur indejjendently of central nervous influences, for in a rabbit's ear, after section of all its nerves, irritation will produce an intense inflammation. It would, however, be incorrect to say that the nerves have no direct influence, for it is well known that when all the nerves of a part have been divided, the stages of inflammation succeed each other with greater rapidity, because in such a case, the vaso-dilators are especially called into action, the injury of the nerve producing a marked hypersemia. Speaking generally, however, the vessels of an inflamed area react independently of the central nervous system, but respond rather to the control of peripheral nervous filaments or to a direct stimulus applied to the endothelium or muscular wall. Terminations oe inflammation.—We have already seen that if the cause of the inflammation ceases to act before the tissues have become irreparably damaged,'the process may terminate and the part resume its normal condition, when resolution is said to occur. Failing this, however, the following terminations may ensue. Thus, under favourable circumstances, the cells constituting the
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