An introduction to surgery.

  • Morison, Rutherford, 1853-1939.
Date:
1911
Catalogue details

Licence: Public Domain Mark

Credit: An introduction to surgery. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    2. Underneath this, capillary buds develop, and form capillary loops, surroimded by round cells (granulation). 3. The capillary loops of one side join similar loops on the opposite side, and the round cells become spindle-shaped (fibroblasts). 4. The surface is covered by new epidermis derived from the rete ]\Ialpighii. 5. Formation of fibrous tissue (scar). The cells of which the granulation tissue is coniposed, do their best to reproduce the tissue from which they spring. Epithelium, fibrous tissue, and bone are reproduced to perfection. Liver cells and kidney cells are not infrequently replaced by new liver or kidney cells. Hair and nails grow only from remnants of their roots. Muscle, tendon, brain, and spinal cord cannot be reproduced, they are replaced by scar tissue. That which occurs in a wound healing by first intention is typical of healing in every other uncomplicated wound. Without sepsis, granulations form ; no pus, only more or less fibrous tissue, according to the size of the gap to be repaired. Pathological Inflammation.—All pathological inflammations are the result of infection by microbes, and are characterized by these phenomena. The first minute change observable in the damaged tissue is occasionally a transient contraction of the smaller blood-vessels. The next is invariably dilatation of the blood-vessels, and increased vigour of the circulation within them. Then follow gradual slowing of the circulation, oscillation of the blood in the vessels, and finally— Stasis and thrombosis. While retardation of the local circulation is proceeding, examine the contents of a blood-vessel : they will be seen to divide into a central current of red colour, in which movement is the more rapid, and a peripheral current, lighter in colour and moving less quickly. The central consists chiefly of red corpuscles ; the peripheral of liquor sanguinis and leucocytes. When stasis is complete the red corpuscles cohere, and form a bright central axis. Tlic leucocytes tend to attach themselves to the vessel walls. Diapedesis follows adhesion of the leucocytes. They crawl through the vessel wall by means of amoeboid movement, and escape. In a short time the connective tissue surrounding the smaller blood-vessels is crowded with leucocytes, and distended by fluid exudate, which, when confined, causes swelling. When discharging into a cavity it implies the outpouring of a serous, sero-fibrinous, or