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.
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![the proo-ress of an inflammation, when it is present as cicatricial tissue— the scar which is usually met with upon the surfaces of the body or of certain of its organs. When opposed surfaces are united by the new- formed tissue, the term adhesion is applied; the adhesions bemg pres- ent as fibrous bands, cords, or membranes. The pericardial milk-spots and thickeniugs, the tendinous or semi-cartilaginous, indurated patches of serous membranes and of the intima of arteries, are all regarded as manifestations of a chronic inflammation of these tissues. With the local- ization of the mflammation m the outer walls of the bronchi and blood- vessels a thickening of the external sheath results, called a peri-bronchitis, arteritis, or phlebitis, as the case may be. . , ^ , , The new formation of blood-vessels is essential for the production and preservation of this connective tissue, and both arise from pre-existing tissues Pus-corpuscles represent the simple cellular product ol an m- flammation, and theii- existence is but transitory. With the new forma- tion of blood-vessels imbedded in abundant cells there exists a granulation- tissue, Ukewise transitory, but out of which arises the permanent fibrous tissue The question is still mooted as to the part played by exuded white blood-corpuscles in the production of the permanent results ol inflammation. It is generally conceded, especially since the observations of Ziegler, that they are capable of transformation into lasting constituen s of tissue, into blood-vessels as well as into cells and fibres Whether all the resulting permanent products of inflammation are dependent upon their activity, or whether the pre-existing fixed elements participate, is still to be considered undecided. . ■, ^ i i i +„o What, at present, appears most probable is, that from exuded leucocytes there ar se, in the course of several days, larger cells-epithelioid or endo- ;heUoid-;hich are eventually associated with still larger ceBs^^ mon. irregular in shape, and provided with W^^^^^'^^ .^]^'^^''\^Z^^^ Both varieties may result from the enlargement of leucocytes by W or by the assimiktion of nutriment. The epithelioid eel s eventua y become fusiform or stellate, and their prqjections as well as those of many of the giant-cells, become fibrillated. The fibrils of ^^Ij^^j^^g ' coming^'united, a^ thus transformed into a_ mesh work of fil;^^^ ^^^^^ enclosing irregular spaces, while the nuclei of he ^f'^^^'^''^\;^'^^ diatelv surrounding protoplasm, remain upon these bundles as the pei- manent cells of the^ew-fo'rmed tissue The existing vessels, chiefly capillaries, and probably are also formed liom the ceCpfelen in the exudltion. The former method is -^icated bj^^^^^^^ pro^cdon of solid sprouts from the wall ^ flf^'^y formino- arches and communicate witli sprouts from ne ghboiing capi a S thu fon;rng bridges. Both arches and bridges then become hol- W' and ihnit the circulating blood. Ziegler -^T^^J^ iections of the larger epithelioid cells and g.ant-cells become ^-loi galul, fnd eventually fuse'd with capillaries, or the projcct.ons -P' - When this fu.4n is accomplished tlie cells become l^^f^^^^^ communicating with those of the_ blood-vessels. _ ^'^^^^ ; ^'^^ whose formation and transformation are o ^/^^^y.^^P^^^^^f J^, ^^^^ of productive inllammation, are designated by Ziegler as ^o'-^twe ec b^^ and are frequently derived from the exuded white blood-corpuscles, though not identical with them.](https://iiif.wellcomecollection.org/image/b20415023_001_0039.jp2/full/800%2C/0/default.jpg)
