Descriptive catalogue of the pathological specimens contained in the museum of the Royal College of Surgeons of England.

  • James Paget
Date:
1883
Catalogue details

Licence: Public Domain Mark

Credit: Descriptive catalogue of the pathological specimens contained in the museum of the Royal College of Surgeons of England. Source: Wellcome Collection.

Provider: This material has been provided by UCL Library Services. The original may be consulted at UCL (University College London)

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    The apex of the left ventricle, to the inner surface of which one of the largest bodies is attached, is thin and partially white, from fibroid changes in the muscular tissue. Of the appearances on opening the bodj/ of Colonel Graham. On taking off the skull and dura mater we found the cellular membrane of the pia mater everywhere on the upper part of the two hemispheres loaded with a very limpid water. On sHcing off the upper part of the two hemispheres, and exposing the two lateral ventricles, we found them fuller of water than what is common in a perfect sound state ; and also these cavities larger than common, so that the quantity of water might be three or four ounces, but perfectly clear. Some of the arteries of the pia mater were ossi- fied in some parts, but not remarkably so. Every other part of the brain appeared to be perfectly sound. The lungs did not adhere in any part to the pleura excepting at their upper points. They appeared sound everywhere, excepting on the right side, [where] a part on the lower lobe was more dense than common, or even any other part of the same lungs : however, this appeared to be owing only to extravasated water in the cellu- lar membrane of that part. The posterior part of the cavity of the chest on the same side was smeared over with red blood, bnt we saw no appearance of ruptured vessels. On examining the heart, we found, at the apex of the left ventricle, and for about an inch further on, that the substance was thinner, more flabby than usual, and of a more livid colour. Within the cavity, and near the apex, it was filled up with a substance for a considerable way. The surface of this, next to the cavity of the ventricle and circulating blood, was firm, like coagulating blood of long standing, in the centre of which was half coagulated blood. In many places be- tween the fasciculi near the apex were a number of small bodies, as it were peeping through between them, which were of the same substance with the former. Something of the same kind we found in the right ventricle, which showed the nature of the disease better than the left. It would almost seem to be a circumscribed portion of blood entan- gled in the fasciculi of the ventricle ; the ontsides of it coagulating whilst the centre kept almost fluid, which formed a kind of cavity. The external surfaces of all of them were smooth and white, as if washed clean of the red blood, by the motion of the circulating blood. Perhaps after they were once formed, they accumulated by attaching the coagulable part of the blood as it was passing in and out of the heart. But how the blood could stagnate at the first IS not easily explained; or was it an exudation of the coagu- lable lymph, as we find in other cavities, and even in the veins, where the blood is also in motion ? The abdominal viscera a])poarod to bo tolerably sound.— Uiinterian Manuscript; Account of the Dissections of Morbid Bodies,