Cases and observations illustrative of the nature of gangrene of the lungs / by David Craigie.

  • Craigie, David.
Date:
[1843?]
Catalogue details

Licence: Public Domain Mark

Credit: Cases and observations illustrative of the nature of gangrene of the lungs / by David Craigie. 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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    The kidneys were vascular upon the surface ; and on nuiking- an incision, they were found to be penetrated by granular matter. The mitral valve was thickened, irregular, and cartilaginous. The semilunar valves were perforated by small holes. The cavity in the right lung measured 3^ inches in the long diameter, and 2| in the transverse. Epicrisis.—I have already anticipated m my remarks on the previously-related cases most of the observations suggested by the one now given. Only a few points may be adverted to as im- portant either in pathology, diagnosis, or treatment. This case, I think, may be employed as confidently as the se- cond one, in order to confirm the conclusion already stated, that pneumonic inflammation precedes and may terminate in gangrene. This inference is, I think, strongly corroboiated, both by the na- ture and course of the symptoms during life, and also^by the ap- pearances disclosed by inspection. The disease presented at the time of admission all the characters of an intensely inflammatory disorder of the lungs, not quite acute, but certainly much less in- sidious and latent than any of the other cases. There were at the lime of admission evident symptoms of inflammation and he- patization of the upper and middle part of the right lung; and the remedies employed to abate these symptoms were for several days effectual in doing so. Upon inspection of the body after death, the right lung pre- sented a most exquisite and perfect specimen of circumscribed gangrene taking place in the middle of inflammatory indura- tion. The cavity, which was not less than an orange or pip- pin, was filled with the usual contents of gangrenous cavities, viz. blood, serum, fragments of broken down lung, blood-vessels, shreds, filaments, and fragments of truncated bronchial tubes. The ca- vity was bounded by, and contained within, a new membrane, evidently the result of inflammation ; and besides this, the adjoin- ing lung, both above, below, behind, and before the cavity, was all indurated and solidified in consequence of inflammation. The gangrenous portion was not, as is often the case, and as takes place in diffuse gangrene, insensibly and gradually lost in lung that was sound, or at least not much diseased; but it was at once strongly, clearly, and suddenly separated from the solidified lung by the former constituting a cavity representing, and left in ])lace of, the destroyed lung, and by the latter presenting the usual characters and structure of simply red hepatized or solidified lung. There seemed, in short, in this large spheroidal cavity to be something peculiar and dissimilar to the usual characters of lung affected with circumscribed gangrene. In most of the instances of cir- cumscribed gangrene, an eschar, definite in shape and limited in size, is formed of a portion of the lung,—often near the surface, and at length usually involving the pleura ; and on inspccliou