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

  • William Walsham
Date:
1887
Catalogue details

Licence: Public Domain Mark

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

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    ULCERATION AIO) ULCERS. process are as follows : the tissues at tlie focus of inflam- mation where stasis has already occurred become infiltrated with serum and leucocytes; this leads to the increased proliferation of the cells of the cuticle, which are pushed forward before they have had time to assume their horny character, and the cuticle thus softened readily separates or is rubbed off, leaving the dermis raw and exposed. The infiltrated and softened tissues become disintegrated by the pressm-e of the leucocytes, which together with the dead tissue are cast oiS in a molecular and partly liqmd Fig. 3.—Diagram of ulceration. Formation of granulation tissue. foiin. When the cause of the ulceration is removed the circulation around becomes nonnal, the infiltration of leucocytes and serum ceases, loops of capillaries (Fig. 3) grow out from the neighbouring vessels among the small round cells which arc derived either from the leucocytes or from the cells of the original tissue, and together with them form the gi'anulation tissue. The supci'ficial layers of these cells at first degenerate and are cast off as pus, but under healthy conditions the granulation tissue outbalances in its growth the super- ficial disintegration and thus fills up the ulcer. Now epithelium is formed from the old ejiithelium at the margin of the ulcer, and gradually sprc^ads over the surface of the granulations till the ulcer is finally skinned over. The granidations develop into fibrous tissue which slowly contracts, helping to reduce the size of the wound. Causes.—Ulceration, oxcoiit in tho case of now growths, where it is brought about by tho ])ressuro of tho in- I filtrating cell-growth, is tho result of inllammation. Eor a fuller ac(x)unt of tho causes of idceration wo nuist therefore rcfcn- tho student to tho causes oi' inllammation. Here it may briefly bo said that tho ulcerations of tho in- teguments so common in surgical practice are generally
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