Pulmonary consumption; its etiology, pathology and treatment : with an analysis of 1000 cases to exemplify its duration and modes of arrest / by C. J. B. Williams and Charles Theodore Williams.

  • Williams, Charles J. B. (Charles James Blasius), 1805-1889.
Date:
1887
Catalogue details

Licence: Public Domain Mark

Credit: Pulmonary consumption; its etiology, pathology and treatment : with an analysis of 1000 cases to exemplify its duration and modes of arrest / by C. J. B. Williams and Charles Theodore Williams. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    Douglas Powell' has well pointed out, by a gelatinous material consisting of connective tissue, apparently provided to fill up any void that might arise from the contraction of the lung. In the ordinary form of phthisis, limited, dry, or fibrinous pleurisy is found commonly overlying tubercular masses, if they are superficial, and often extending over the whole apex of a lung and forming over it a fibrinous cap. Not uncom- monly the friction sound of dry pleurisy in the supra-scapular region is the first sign of the presence of tubercle at the apex, which, later on, is abundantly verified by signs of consolida- tion in the anterior regions, and in these the existence of adhesions can be traced by the retraction of one or more intercostal spaces during expiration. The pleura, peritoneum, arachnoid, and even the peri- cardium, may become the seats of miliary tubercle in the most acute form of phthisis, viz., miliary tuberculosis; but it is generally noted that the lungs are the first organs attacked, and it is extremely rare for tubercle to exist in any organ without being also present in the lungs. The morbid changes noticed in the larynx will be described under the head of laryngeal phthisis, and the various lesions which give rise to diarrhoea in phthisis will be included in a special chapter. As regards other organs, the liver is rarely normal, but generally undergoes either fatty or lardaceous degeneration, the spleen is sometimes softened, and very commonly lardaceous. The kidneys are not generally affected, but where albuminuria has prevailed towards the close of the disease, fatty or larda- ceous changes are generally detected, and these will be con- sidered in the chapter on phthisis and albuminuria. The heart is usually small, and the muscular tissue pale, and very often in a state of fatty degeneration (Quain). Fatty growths are sometimes found on the external surface. Having now described the principal elements of the morbid anatomy and histology of phthisis, we can pass on to con- sider the organism which plays so important a part in the etiology of the disease.