The theory and classification of inflammations of the skin / by A. B. Buchanan, M.D.

  • Buchanan, Andrew Bogle.
Date:
1863
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Licence: Public Domain Mark

Credit: The theory and classification of inflammations of the skin / by A. B. Buchanan, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    small-pox. Or, again, we know of the existence of a cause, but can neither isolate it nor recognise it; as in the case of the majority of contagious fevers. Still, in none of these cases is the actual exist- ence of the cause in the slightest degree doubtful or hypothetical. With regard to the diseases which are not defined by uniformity of cause, we do not know the cause of them, and so we must arrange them into groups according to another principle, and, if possible, according to that which is of next greatest importance in determining their real nature and affinities. Now, a disease is best determined, if we do not know its cause, by the process immedi- ately induced by the action of that catise on the body. The patho- logical processes determining lesions in the skin enable us, when we consider them, to separate three groups: the injlammationsj the new formations^ and the hcemorrliages. I do not mean to say that there are not other pathological processes besides these. We have, for example, hypersemia or congestion; anaemia or inanition ; but these do not lead to results which are fairly to be considered as diseases of themselves. Thus, unless hyperaemia be sufficiently intense to pass into inflammation, or unless it be secondary, from the influence of another distinct lesion, as in acne rosacea, it is merely a transient symptom, which does not rise to the rank of a skin disease. What is inflammation of the skin ? A disease of the local circu- lation, say some ; and, no doubt, when a part is inflamed there is generally a rush of blood towards it, which, however, does not make it necessary that the rush of blood should be the cause of the part inflaming. It afiects the pars papillaris of the corium as well as the pars reticularis and the subjacent cellular tissue ; and it occurs, according to Virchow, in the papilla? in which there are no bloodvessels in exactly the same way as in the papillte in which these are present. It occurs also in the papilla? in which there are no nerves just as much, and in the same fashion, as in those in which there are. But, more than this, it occurs in the epidermis, where there are neither vessels nor nerves; and there we see that it is an affection of the cells, which, in consequence of some u-ritation, become morbidly active ; imbibe a greater quantity of plasma from the blood for their niitrition; enlarge, by which they cause swelling of the parts; and even, when the process is sufficiently intense, pour out an exudation from their walls, giving rise to what is called infiltration. How much of this infiltration is, in a given case, due to exudation from the cells, and how much to direct transudation from the vessels, is, in the present state of our knowledge, not easy to determine. Suffice it to bear in mind, that an exudation probably proceeds in part from the walls of the capil- laries, and in part from the inflamed cells which enter into the com- position of the infiltrated tissues. When the elementary cells of a part, in place of merely demand- ing more nutriment, swelling up, and pouring out exudations from