Elements of surgical pathology / by Augustus J. Pepper.

  • Pepper, Augustus J. (Augustus Joseph)
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Elements of surgical pathology / by Augustus J. Pepper. Source: Wellcome Collection.

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    and chlorides are diminished. Biliary constituents are occasionally present. Colour of the skin.-—The skin has a dusky earthy tint, or it is distinctly yellow. This may be from bile-staining, but it is probably tinted with blood pigment set free by disintegration of the red cori)uscles. Post-mortem signs.—Bigor mortis sets in early and soon disappears. Decomposition is very rapid. The blood coagulates imperfectly. It may be almost fluid. It is said sometimes to be tarry, but I have never seen this. Disintegration of the red corpuscles goes on during life; this is shown by the staining of the endo- cardium and the intima of the vessels, observed directly after death. The serum, too, is more or less deeply tinged, and dark from deoxidation of the hfemoglobin. Micro- cocci are sometimes present (septic infection). The internal organs show marked congestion, especially at the most dependent parts. Thrombosis is very common, and capillary ex- travasation far from rare. The latter is most marked in the mucous and submucous coats of the intestine, and beneath the serous membranes in the form of petechias or more diffuse extravasations. Meningeal h£emon-hage is less frequent. Tliere are several factors at work in causing the coagulation in the vessels : 1. A ferment is supposed to be liberated by the breaking up of the white corpuscles (Kohler). 2. The chemical composition of the blood is greatly altered. 3. Stasis from weak pro- pelling power of the heart. 4. Swelling and shedding of the endothelium of the vessels, the deV)ris obstruct- ing the lumen. 5. Encroachment of the thickened mtima upon the vascular channels. The hyperplasia 13 found in the small arteries ( oblitcrative end-