Selected monographs.

Date:
1861
Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

    119/368 (page 99)
    purulent plugs iu the arachnoid veins of the left side, which extend as far as the longitudinal sinus, appear to have a special origin, pro- bably in the extensive meningitis. Cases 31 and 32.1—Hasse observed two cases, in one of which l he phlebitis of the sinus resulted from phlebitis of the jugular vein ; in the other, from a purulent exudation upon the arachnoid. If we cast a retrospective glance at the whole of the facts given above, we may assume positively for all the cases—with some exceptions, already alluded to in the proper place, in which a diffé- rent explanation is admissible—that the thrombosis and phlebitis of the sinuses stand in a causal connection with the inflammations existing within their radius of vessels, and both the course of events during life and the post-mortem appearances favour the view that the affections of the sinuses occurred later, in point of time, than the inflammations in the parts around them. We might, therefore, easily be disposed to regard the thrombosis in tlie sinuses as a consecpience of inflammation of their walls, i. e. as a secondary one. Independently, however, of the circumstance that the outer surface of the walls of the sinuses is, in very many cases, found unchanged, and does not stand in any direct contact with inflamed tissues, I believe, for further reasons, that another explanation is possible, which I consider the more admissible because the theory that the coagulation of the blood is a consequence of inflammation of the coats of the vessels is founded upon very unre- liable data. We are compelled to explain it by altered molecular attraction between the coats of the vessels and the blood flowing through them, or, in a word, by a contact influence (catalytic action) ; a kind of explanation which is rather suspicious, and which we should only be justified in adopting if hard pressed. I need scarcely remind my readers that an exudation of coagulated inflammatory products upon the inner surface of the walls of the vessels does not take place; that neither the purely fluid nor the cellular products of inflammation cause coagulation of the blood ; and we see in the case communi- cated by Heusinger,2 a fresh proof how, when an abscess pierces the u ;ills of a vessel, a ready formed thrombus may have long been present. 'Patholog. Anat.,' i, 39. : Tjoc. citat.