Dr. J. Burdon Sanderson's reports of an experimental study of infective inflammations.

  • Burdon-Sanderson, John Scott, 1828-1905.
Date:
[1875]
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Licence: Public Domain Mark

Credit: Dr. J. Burdon Sanderson's reports of an experimental study of infective inflammations. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    10/34 (page 56)
    On Infective Inflammations, by Dr. Burdon Sanderson. Comparison of the lesions ob- served in animals inoculated with pycemic pro- ducts, with those produced when the material inoculated was derived from chronic second- ary indurations. 5G minute abscesses disseminated under the integument in their neighbour- hood. Another group of abscesses surrounds the internal inguinal ring. The peritoneum is distended with sero-sanguineous liquid, in which are seen active bacteria of small size but very distinct form. The omentum is beset with minute nodules. The centrum tendineum of the diaphragm also exhibits a few nodules. The liver weighs 35 grammes: it is very pale and beset here and there with nodules, some of which are purulent. The spleen is enormously enlarged. [Condition of mesenteric glands not noted.] The pleurae and the pericardium contain exudation liquid. Groups of opaque grey nodules are scattered throughout the lungs, both in the depth and at the surface. The observations related in the preceding paragraphs show that although, as already stated, there is a close correspondence as regards the distribution of the infective nodules of the internal viscera between animals infected with pyaemic products and those inoculated with equally small quantities of the material derived from chronic secondary indura- tions, the contrast between the results is very marked. I will refer first to the lesions, and secondly to the development and mode of termination of the two processes. — Subcutaneous lesions. When an extremely small quantity of chronically enlarged lymphatic gland is inserted under the skin, in the manner described in my former paper, no abscess is produced either at the seat of inoculatiou or in any other situation. The wound to all appearance heals; but if it is carefully examined many weeks after, it is fonnd, provided that the ingrafting has been successful, that a group of semi-transparent nodules exists under the skin, which represent the centre of infection. In the pyaemic cases there may also be induration of the same nature, but the nodules assume from the first the character of abscesses, and are accompanied by groups of smaller abscesses, disseminated in the neighbouring tissue. In a considerable proportion of the pyamiic animals these primary and secondary metastatic subcutaneous abscesses were the only lesions found, even though the dissections were made many weeks after inoculation. Visceral lesions. In chronically infected animals (using the term for animals infected by the insertion of minimal quantities of fresh indura- tion material in the manner set down in the preceding paragraph) the visceral changes are much more uniform and characteristic. To judge of the difference between them and the corresponding pyaemic lesions, the several organs must be separately referred to. (1.) The chronically infected liver (see Eleventh Report, p. 110) does not usually present any morbid appearance to which the term nodule ” could be applied. The organ enlarges uniformly by the growth of a semi-trans- parent glisteuing interstitial substance, which, as it follows in its distri- bution the portal canals and occupies the spaces between acini and groups of acini, has an arborescent, not a nodular form, although the. tracts of adventitious tissue exhibit nodular enlargement. Even when the change does not extend to the whole organ, but affects only a certain number of lobes, the newly formed tissue retains what descriptive pathological anatomists call the infiltrated as distinguished from the disseminated arrangement. In the acute affection the liver lesion is characterized by the presence of disseminated nodules, firm externally, purulent internally. (2.) The difference between the tuberculous lung and the pyaemic lung is perhaps not so obvious, but the characteristic appearance of the semi-transparent “ iron grey nodules ” (loc. cit., p. 114), their uniform distribution throughout the parenchyma of the lungs, and the absence of 'concomitant pleuritic exudation or false membranes, are