Contributions to the pathology of diphtheritic sore-throat and other kindred affections / by John Burdon Sanderson, M.D.

  • Burdon-Sanderson, J. (John), Sir, 1828-1905.
Date:
[1860]
Catalogue details

Licence: Public Domain Mark

Credit: Contributions to the pathology of diphtheritic sore-throat and other kindred affections / by John Burdon Sanderson, 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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    that the essential change which is common to all those processes which are accompanied with the signs of inflammation, as well as to others to which those signs are wanting (as, e.g., the deposition of tubercle), is exudation, which consists in a pei-version of the function of tlie living part, so that the liquid plasma which the pai't in its natural condition uses for the purposes of its own life, is diverted into another channel. In order to the existence of inflammation, a network of capillaries is necessary ; for one of its elements—redness—is expressive of a change in the condition of those vessels ; but exudation may have its seat in any living stiuctiire, for it is a perversion of a function essential to life. In whatever direction the stream of plasma normally passes from the blood to the living cell or fibre, it may, by perversion from that course, give rise to fibrinous or albuminoid concretions, or serve as the germ fluid of a morbid growtli, so that although it is uttei'ly meaning- less to draw any distinction whatever between the inflammation of the epithelium and inflammation of the sub-mucous tissue, both being, in fact, unmeaning expressions, we can speak of either separately as being the seat of exudation. Between every cell, or series of cells, or other structural elements, and the blood, exchanges of material are in constant operation, which in each instance form a system as special and distinct as the structure itself; and each such system is capable of being independently perverted, and so giving ristj to a separate morbid process. So that whenever we have to do with a plurality of structui'es distinct and unconvertible into each other, we may pre- sume that we are likely to have as many varieties of exudation. 2. Preliminary anatomical comidei'ationn.—The mucous membrane, whether digestive or respiratory, consists of two distinct structures— viz., the membrana j^ropria, or submucous tissue, and the epithelium. As these structures differ very materially in the mouth, pharynx, and air-passages, in their relations to each other, and as these differences are important pathologically, it becomes necessary to remind the reader of some of them. In the mouth, the membrana projiria is from 0 01 to 0-015 inch in thickness, but at some parts it is mujh thicker, as in the gumi?, soft palate, and uvula. It consists of a dense felt of white fibres so plose together that they can scarcely be distinguished as such. The density of the structure is greatest at its superficial aspect, where its fibrous constitution is so completely indistinguishable that it appears under the microscope perfectly homogeneous. But on ex- amining the deeper layer.s, especially after the addition of acetic acid, the most marked characteristic of the structure atti'acts the attention of the observer—viz., the highly refractive minute nuclear fibres which form an intricate network throughout its substance. There is no dif- fei'ence whatever between the membi'ana propria of the pharynx and larynx and that of the mouth, excepting that both the former contain a larger proportion of the reticulated elastic fibi-es above described. The epithelium of the mouth and that of the air-passages, on the other hand,' differ widely ; the one resembling more or less the struc- ture of the skin, the other having a structure peculiar to itself. Im-