Hypertrophy of the muscular walls of the minute arteries in cases of chronic Bright's disease / by George Johnson, M.D.

  • Johnson, George, 1818-1896.
Date:
[1870]
Catalogue details

Licence: Public Domain Mark

Credit: Hypertrophy of the muscular walls of the minute arteries in cases of chronic Bright's disease / by George Johnson, 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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    the trachea of a dog destroys life in a few minutes. The immediate cause of death is the arrest of blood in the lungs. The left cavities of the heart are found after death nearly empty; the right cavities, the pulmonary artery vs^ith its branches, and the systemic veins, are much distended; the pulmonary capillaries are nearly bloodless; and the lungs, consequently, collapse to an extreme degree -when the chest is opened. The theory is, that, when the respiratory changes are suspended by the exclusion of air, the minute pulmonary arteries, under the influence of the vaso-motor nerves, by their contraction arrest the flow of blood. Similar phenomena occur during a fit of spasmodic asthma. Bronchial spasm lessens the supply of air; then the contraction of the minute pulmonary arteries, in a corresponding degree, checks the circulation. The skin becomes cold and blue, the pulse small and feeble; and the patient is apparently at death's door. When the bronchial spasm re- laxes, the air gets ready access to the pulmonary cells, then the arterial resistance ceases, and respiration and circulation again become free. In like manner, when the secreting tissue of the kidney is partially dis- organised, the working power of the gland is lessened, and it requires less blood. The minute renal arteries regulate the blood-supply in ac- cordance with the diminished requirements of the gland. This con- tinues and increases month after month, year after year; and the result of the persistent overaction of the minute renal arteries is, that their muscular walls become hypertrophied. This hypertrophy of the mus- cular walls of the minute renal arteries occurs in all forms of chronic Bright's disease; in the small, red, granular kidney; and in the large, white, smooth kidney. The hypertrophy of the muscular walls is quite distinct from the degeneration of the arterial tunics which occurs during the progress of that form of disease of the kidney to which the term *' lardaceous is commonly applied. In conclusion, I may mention some of the phenomena of chronic Bright's disease which are explained by the facts to which I have re- ferred. 1. The hypertrophy of the left ventricle is explained. That which Dr. Bright long ago surmised is now a demonstrated fact. There ts an impediment to the passage of the altered blood through the distant subdivisions of the vascular system; hence arise greater action of the heart, and hypertrophy of its walls. 2. The full, liard, radial pulse, and the increased pressure on the arterial walls indicated by the sphygmngraph, are explained by the co-