Volume 1
A system of practical medicine / by American authors ; edited by William Pepper ; assisted by Louis Starr.
- Date:
- 1885-1886
Licence: Public Domain Mark
Credit: A system of practical medicine / by American authors ; edited by William Pepper ; assisted by Louis Starr. Source: Wellcome Collection.
27/1084 page 43
![inflammatory exudation is found to contain less albumen than usual, the existence of a transudation with secondary inflammation is suggested, or the exudation may have taken place in a hydrtemic individual. A suf- ficient number of exceptions are met with, however, to interfere with the absolute nature of this test. The coagulation of an inflammatoiy exudation apparently depends upon the contained white blood-corpuscles; the more numerous (within certain limits) these are in a serous exudation, the more abundant is the formation of fibrin. The cellular element likewise is that which in abun- dant liquid exudations characterizes them as purulent. Although it is o-enerally agreed that most of the corpuscles of pus are emigrated white blood-corpuscles, it is not necessary to admit that all are of this nature. The cells present in an inflamed part include those pre-existing, as Avell as those which escape from the vessels. The former are the Avanderiiig cells of the connective tissues, as well as the fixed variety, the epithelial cells of the surface of a mucous membrane in addition to the subjacent con- nective-tissue cells. Amoeboid cells outside the blood-vessels have been seen to divide, and it is possible that such duplication may serve as the method of formation of a certain number of pus-corpuscles. The state- ments concerning the proliferation of the fixed connectiye-tissue cells and of epithelium are derived from appearances, and are interpretations of these appearances, not observations of a process. The changes taking place along the walls of the blood-vessels bemg the feature of prime importance in the observation of tlie progress of an ni- flammation, numerous investigators have directed their attention to the determination of the nature of the changes in the vessel Avail by means of which the escape of the corpuscles is permitted. Arnold represents the most strenuous advocates of the stomata theory, according to which the leucocytes pass through canals normally existing in the wall. By means of the silver method of staining, and by injections of various insoluble pig- ments into the blood-current, certain results are met with, which give color to the view that pores and canals are present upon and m the walls of the vessels, analogous to those found in the diaphragm. As the latter have been show to be in direct communication with the lymphatic systena of tubes and spaces, so the walls of the blood-vessels have been assumed to present similar channels of communication. ^ •« • i The ]jrevailing views at the present time are in favor of the artificiaf nature of the stomata and pores in the walls of the blood-vessels. An in- creased porosity of the vascular wall in inflammation is necessary for tlie occurrence of the exudation, but such porosity is regarded rather as a physical condition permitting an observable filtration, and a filtration ot solids as well as liquids. , i e In tliis connection reference should be made to the observation of Winiwarter, who has demonstrated that colloid material, a solution of gelatin, passes through the vascular wall in inflammation more readily —i. e. under less pressure—than through the normal wall of the blood- vgssgI The causes of inflammation are to be regarded as those which produce an increased porosity of the vessel wall without causing its death, for no exudation escapes from a dead vessel, its contents becoming clotted. These causes may act from without or from within, primarily aflecting](https://iiif.wellcomecollection.org/image/b20415023_001_0027.jp2/full/800%2C/0/default.jpg)
