On a Somewhat Rare Form of Chronic Inflammation of the Serous Membranes (Paperback)

Purchase of this book includes free trial access to www.million-books.com where you can read more than a million books for free. This is an OCR edition with typos. Excerpt from book: last from two to sixteen years, and usually end from some acute complication such as lobar pneumonia, acute peritonitis, either simple, suppurative or tuberculous. VI. MORBID ANATOMY OF CHRONIC HYALINE PERIHEPATITIS. The feature common to all the cases here noted and which gives the disease its name is the formation upon the various serosae of a smooth and glistening pearly white membrane of cartilaginous consistency. All the authorities comment on the remarkable appearance of this material and by many it is compared to porcelain or the icing upon a cake (Zuckerguss). The layer varies in thickness from .5 to 5-10 mm. or more; the membrane can be readily stripped off from the subjacent organs in a continuous sheet. The process affects by preference the upper part of the peritoneum, the bases of the pleural sacs, and the pericardium. While it is true that more than one serous sac is involved in the process, they do not all necessarily present the " icing " appearance; various grades of the affection are met with in different regions. The pleurae and the pericardium are most usually deformed by firm adhesions of the common fibrous type, and even where the hyaline membrane is typically developed it is not infrequently combined with adherent fibrous bands anchoring the affected organ to the adjacent structures. Sometimes one of the serous sacs or some part of it is attacked by an acute exudative inflammation; fibrinousor fibrino-purulent exudates are not rare. Thus acute fibrinous pericarditis was noted by Schmalz and Weber; acute pleurisy by Weiss, Curschmann, and Hale White; and acute peritonitis by Curschmann, Vierordt, and Rose. The post-mortem appearances are striking. The body is much emaciated, although this is usually somewhat masked by the general anasarca; asci...