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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    to pulpy softening of the mucous membrane of the large intes- tine, very frequently originates during the closing days of life,— just in the same manner as that of the parenchyma of the lung, the pleurae, and the mucous membrane of the stomach. Tuberculous granulations were present in thirteen cases, or in about the eighth part of the whole number,—seated in the middle, or on the edges, of the ulcerations, never in the spaces between them. The paucity of cases of tuberculous development in the large intestine, becomes remarkable, when considered in con- nexion with the frequency of that development in the small intestine. The difference cannot be regarded merely as acci- dental, for, among one hundred and twenty cases of phthisis, observed since the publication of the former edition of this work, in all of which the state of the large intestine is carefully described, I only found eight examples of tuberculization;—a still smaller proportion than that ascertained from my former series of facts. The difference now pointed out is the more difficult of comprehension, as ulcerations of the large intestine are almost as common as those of the small; and it demonstrates, like other facts previously described, that the presence of tuber- cles, is far from being the sole cause of intestinal ulceration. Ulcerations, as I have just said, were of frequent occurrence, —almost as much so as in the small intestine : seventy indivi- duals presented these ulcerations. Now, as softening of the mucous membrane existed in several instances when there was no ulceration, it is easily inferrible that I must very rarely, in- deed, have found the membrane perfectly sound throughout its entire extent. I, in truth, found it so in three cases only. Generally speaking, these ulcerations were of small size, from three to six lines [6 to 12 millimeters] in diameter, sometimes less: those of larger size (and we have already seen that their dimensions were sometimes enormous) existed in only a fourth part of the cases. Those of the small variety were, in ten eases, almost uniformly distributed over the entire tract of the intes- tine ; when belonging to the larger variety (which includes those of a superficial extent, varying from about three inches and seven lines to seven inches and two lines [9 to 18 centimeters], or something more,) this uniformity of distribution was observed in but one case. In the others, the number of ulcerations di-