A note on the role of conservative vital reaction in pathological anatomy, particularly in regard to certain chronic rheumatoid and gouty changes / by F. Parkes Weber.

  • Weber, Frederick Parkes, 1863-1962.
Date:
1908
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Licence: In copyright

Credit: A note on the role of conservative vital reaction in pathological anatomy, particularly in regard to certain chronic rheumatoid and gouty changes / by F. Parkes Weber. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    b ing less suddenly than the tissues of young persons to certain diseases, such as tuberculosis. It is especially in chronic tuberculosis in adults, where the battle has been very slow and pro- longed, that the anatomical results of morbid action are most intimately mingled with the conservative changes due to reaction. I will now return to the question ol the sub- cutaneous fibrous nodules occasioiiaily met with in rheumatoid conditions in adults. These differ from the well-known “ rheumatic ” nodules ” met with in children suffering from true articular rheumatism, chorea, or rheumatic endocarditis. I'hey are some- itimes larger and disappear less readily. The “rheumatic nodules of children, at least the cen- tral portions of th.e nodules, seem to consist of a more fluid, less organised exudate (a), and can, therefore, be more readily absorbed. These dif- ferences may, however, be due to differences in re- action towards irritation, that is to say, whatever »^he nature of the local irritation may be (microbes of rheumatism, necrotic foci, etc.), and irrespective of the question whether there are one or several different causes for the irritation, the tissues of adults may react in a more persistent and “fibrous” manner than those of children. The local reaction resulting in the development of the subcutaneous nodules might in both instances be supposed to be “conservative” in nature, that in adults, how'ever, m.ore nearly resembling the;_ local “fibrous” reac- tion so often seen about chronic tuberculous foci. One might further suppose that many gouty to- phaceous nodules are really of the same nature, the only difference being that, owing to some pecu- liar local or general chemical state, more or less uratic deposit has occurred into the devitalised tissue of the nodule. It seems to me also that the lipping, synovial overgrowth, and capsular or periarticular fibrous thickening met with in chronic rheumatoid and gouty joints are to be explained in essentially the same' way, that is to say,-as representing a chronic vital reaction (of a “conservative” nature) towards (a) S'‘e K. ,T. Povnto'i and O. l'\ Still, “The Histolosjy of the llhenmatic Nodule.” “ Transactions of the Pathological Society,” T.ondon, 1899.vol. 50, p. 324.