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

  • William Walsham
Date:
1890
Catalogue details

Licence: Public Domain Mark

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

    66/902 page 50
    Predispo&ing cfutse.s.—For the bacillus to take effect a lowering of the \-itaHty or resisting power of the tissues ap- pears to be necessary. Such a condition of the tissues may be present :~(1) lu children Ijorn of phthisical parents. Hence, heredity in this sense may be said to be one of the chief predisposing causes, but it must be remembered that tubercle is not transmitted from the parent to the offspring as is syphilis; (2) In the so-called sirvmnn^ dlatliesh ; and (3) In certain states of the systein induce(l by bad hygiene and food, and imperfect assimilation of food and consequent impairment of nutrition. Tubercle is most common in the young, but adults and even o d people are liable to it when exposed to like unfavourable conditions, a slight inflammation or injury then generally forming the starting point. , •„ , • • i Disseminntmn of TukTc/e.—The bacillus having -arned admission in one or other of the above-mentioned ways is believed to set up the tubercular process as previously described. The tubercular process may then (1) remam confined to the seat of inoculation, as m some forms of tubercle of the skin. Or (2) with or without any loc^al manifestation it may spread by the hnnphatics to the nearest lymphatic glands, and there become arrested. As an example of this may be mentioned the tuberculous or so-called strumous enlargement of the ghmds oi the neck, in which the bacillus is believed to gam admission through a small ulcer of the mucous Biembran.. ..t he mouth or through an inflamed tonsil. Agam ^.)) the ba<-i lu^ may pass the glands and enter the circulation, and then (a) either become lodged in some organ or distant part of the body, as the testicle, a bone or .pant ore se i/- be- come disseminated, setting up general acute tuberculosis. The brunt of the affection falls m the latter case rither on the lungs, aade tuherrular phthlsi.^. or on tlje membranes of the brain, .,r,te iMheradnr meniu<iiil^. ^\hen anectmg an organ or tissue, as a testicle or .iond. i may remain locali/.Ml for a, longer or shorter tune, and even become ,.„r..,l; .n- it m:,y s,>t up inilammat.on and mv.dve and .p.stroy the whole .>rg;ni; or finally brconH. generally dlssennnatcd througlt]>e system, leadn.g to general *^WS?^.../-VW.W, . Tnln.nh. has a special aninity I',,, ,,,,tain or-.ns and tissues to the ex.Iusu-n ..t o1].er.s. S,.n.us nu.nbrancs, snch as Vl'-^^/;'-' '•'■;;'!;• mater, and iijinhnoid, are ..spemiUy liaMe\n be alb. ted.
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