On spontaneous gangrene from arteritis and the causes of coagulation of the blood in diseases of the blood-vessels / by Joseph Lister.

Date:
[1858?]
Catalogue details

Licence: Public Domain Mark

Credit: On spontaneous gangrene from arteritis and the causes of coagulation of the blood in diseases of the blood-vessels / by Joseph Lister. Source: Wellcome Collection.

Provider: This material has been provided by the Royal College of Physicians of Edinburgh. The original may be consulted at the Royal College of Physicians of Edinburgh.

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    tlie evolution of ammonia, just as would be the case were they tubes of dead matter of the same degree of permeability. And all cases of coagulation within the living body are supposed, by him, to be expli- cable on simple chemical principles. Here, however, I find myself quite unable to follow him. Thus, he believes that the coagulation in an aneurism is the result of the blood which is at rest in the tumour giving up its ammonia to the current which is flowing past the mouth of the sac. This theory was suggested to him by the following cir- cumstance :—In one of the experiments of transmitting air through successive portions of blood, the longer tube in the last Wolfe's bottle was accidentally too short, so that it did not reach farther down than to about an inch from the bottom of the vessel. The result was, that while the upper pnrt of the blood in this last bottle was re- tained fluid for a considerable time, that below the level to which the tube reached speedily coagulated. Dr Kichardson infers that the lower portion of blood gave up its ammonia to the air which was bubbling through the upper part sufficiently charged with the alkali to retain that part in a state of fluidity. But, surely, this implies a mistake in chemistry. The lower portion of blood coagulated, I imagine, for the same reasons that it would have done had it been put in a stoppered bottle^ after passing through the air, though probably not quite so rapidly, while the other part was prevented from coagulating by the ammoniacal vapour bubbling through it. But if the ammonia tiieory fails to explain the coagulation that occurs in aneurism, still more inadequate does it appear to account for the phenomenon in arteritis or phlebitis. How can the fact that the wall of the vessel is inflamed determine, on simply chemical principles, the evolution of ammonia from the blood within it ? Being convinced that in these and other cases of coagulation of the blood in local diseases of the vessels something remained quite unexplained, I have, during the last fortnight, made several experi- ments, with a view to throwing further light upon the subject, and will now communicate to the Society the results at which I have arrived. In reflecting upon the matter, some circumstances in physiology and pathology appeared to me to indicate that, on the hypothe'tsi's that the blood does contain free ammonia in the living body, the healthy vessels must have a special power of preventing its escape. Thus, the blood in the capillaries of the lungs, is separated from the air in the air-cells only by an excessively thin partition of permeable living tissue; yet Dr Eichardson's experiments have shown that there are times in the day, as, for instance, early nK.rn- ing, in which not a trace of ammonia is given off in the breath. Again, in surgical emphysema, the tissues of the body may be enor- mously distended with air, without any special tendency to coagula- tion of the blood in the vessels, such as might be anticipated unless