Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis.

  • Pierre Charles Alexandre Louis
Date:
1844
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Licence: Public Domain Mark

Credit: Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis. 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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    —^the lower twenty-nine inches [72 centimeters] in the ma- jority of cases. (Cases xxii, xivi.) In none did the mesenteric vessels appear highly injected; the redness of the membrane consequently depended in all probability most commonly on some other cause than simple stasis of blood. The granulations presented themselves with all the attributes of tuberculous matter; in some cases they appeared white, and much harder than in others, and exhibited almost the firmness and aspect of cartilage. Both kinds were of small size—that of a medium-sized pea, or generally speaking much less than this; originated under the mucous membrane, and were scarcely ever seen, unless when some ulcerations were discernible at the same time. The hard, semi-cartilaginous-like granulations (Cases xxi, xl, Lii,) were generally accumulated in great numbers, sometimes appeared through the entire tract of the intestine, at distances of an inch and two lines, two inches and four lines, or three inches and seven lines [3, 6, or 9 centimeters], more or less. When thus scattered over the entire surface, their number and size gradually increased towards the caecum. In other cases they were much more abundant near the duodenum, and in the upper than in the middle third of the intestine, and were altogether absent in the lower third. When small, they scarcely equalled a small pin's head in bulk, and adhered firmly to the cellular coat,—^the mucous membrane lying upon them and retaining the characters of health. When they equalled a pea or thereabouts in size, the mucous membrane was generally more or less red, thickened and softened, or even destroyed, where in contact with the adventitious productions. Soon after they themselves began to undergo destruction, which advanced daily; until this was completed the edges of the ulceration remained hard, white, and opaque, retaining very closely the chai'acters of the original morbid formation, the primary cause of ulceration, and thus exhibiting the proof of their origin. Granulations of the hard semi-cartilaginous kind were some- times seated in the patches, more commonly in their interspaces, and equably distributed over the entire surface of the intestine. I have never found them in any other situation than immedi- ately under the mucous membrane; and in no single case did they occupy the interstices of the musculai* fibres.