710 



SOFTENING AND INDURATION. 



rapidly, that, unless perfectly fresh specimens 

 be used, no microscopic structure can be dis- 

 tinguished in the stomachal mucous mem- 

 brane. I have noticed the same thing to 

 occur in caterpillars : their stomachs, which 

 contain both globular and columnar cells, 

 after a time become softened and are per- 

 forated, so, subsequently, is the external 

 cuticle ; nature seems to have taken this ori- 

 ginal method of doing away with useless 

 organisms. 



In ulceration of the stomach the affected 

 part is generally circular, and if it reaches the 

 peritoneum excites inflammation in the re- 

 flexion contiguous to it ; by this means per- 

 foration is rarely accomplished. Now, in 

 post mortem perforations the softened part, 

 said by some to be the seat of ulceration, is 

 diffuse and the perforation large and irregular, 

 and no part of the neighbouring peritoneum 

 presents the slightest trace of recent inflam- 

 mation ; shreds of muscular tissue and cellular 

 membrane, moreover, form an irregular fringe 

 around the opening, and, by their presence, 

 detract greatly from the theory which calls 

 such phenomena pathological and not pseudo- 

 morbid. 



Generally speaking, the fund us is most fre- 

 quently the part of the stomach most afl'ected 

 by the gastric juice ; but every thing depends 

 upon its being the most depending part, and 

 upon its containing more or less semi-digested 

 food. 



The solvent matter is secreted by the tubes 

 of the stomach, and consists of pepsin in com- 

 bination with lactic acid and water : it pos- 

 sesses the power of disintegrating all dead 

 structures, but cannot influence the living 

 tissues. It is not secreted when the stomach 

 is empty, a stimulus to the mucous coat, in 

 the form of some matter foreign to the 

 stomach, is necessary for its production ; it is 

 probably the case, that an ulcer of the mucous 

 membrane may act as a stimulus, and that a 

 certain quantity of juice may always be present 

 in the stomach ; and that when, by the de- 

 pressing effect of this lesion, the general nutri- 

 tion suffers and the tissues are less able to 

 resist decomposition, the gastric juice may act 

 locally on the surface of the ulcer, and produce 

 perforation before any peritoneal adhesion is 

 formed. Perforation of the coats of the 

 stomach sometimes occurs suddenly after a 

 meal ; it is produced generally by the giving 

 way of some small ulcer, the progress of 

 which had been enhanced by the presence of 

 a large quantity of corroding liquid. 



Post mortem softening may modify and ex- 

 aggerate softening from other causes, and 

 differs in its own appearances under various 

 circumstances. The colour which the soft- 

 ened membrane presents appears to depend 

 upon the quantity of blood contained in the 

 organ at the time of death ; if the quantity be 

 small and natural, the softened parts are of a 

 dull yellow or orange tint ; and this colour 

 increases with the quantity of the blood, and 

 is accompanied by a black colour of the vessels. 

 In infants and young children, and in an.Tmic 



patients and persons whose blood is deficient 

 in quantity and altered in quality, containing 

 a great disproportion of serum, the whole 

 stomach appears as if macerated ; it is, in- 

 deed, sometimes infiltrated with serosity, and 

 is so completely deprived of blood that no 

 trace of this fluid is perceived except in some 

 of the larger veins. 



Post mortem softening and perforation of 

 the intestines may occur from the presence of 

 an acid fluid, either within them or without, 

 and derived from the stomach ; in the one 

 case, softening is from within outwards, and, 

 in the other, from without inwards. 



Softening of the skin : the skin may be sof- 

 tened wholly, or one or more of its layers only. 

 In some skin diseases, especially among scroiu- 

 lous subjects, there is an alteration of the 

 cohesion of the epidermis, which is properly 

 formed by layers of cells, the row nearest the 

 basement being smallest and more liquid than 

 the others, the more distant being dry and 

 united laterally, so as to form a dense integu- 

 ment. Certain defects in the quantity and 

 quality of the fluid contained in the newest 

 made cells prevent them from progressing, 

 normally, in their development ; they do not 

 become dry, neither is any disposition evinced 

 by the basement to secrete other cells ; under 

 these circumstances the epidermis is soft, and 

 the basement tender and red, the tissue be- 

 neath being visible. 



The cutis may lose its consistence in several 

 manners. When considerable quantities of 

 serum are collected in the subcuticular cellular 

 tissue, the cutis becomes mechanically dis- 

 tended and remarkably soft ; and sometimes 

 is only represented by a thin friable tissue, 

 which breaks down with the least pressure. 

 It may gradually lose its fibrous structure 

 and degenerate into a tissue analogous to that 



O O 



usually found beneath it. 



Softening also occurs as a sequel of acute 

 active local congestion. 



The ajipendages of the skip, the nails, hairs, 

 and, in the lower animals, horns, undergo 

 softening to a certain extent in diseases of 

 long standing, attended with great emaciation ; 

 and softening of the cornea with ulceration is 

 a common symptom of starvation. 



Induration of mucous membranes, is gene- 

 rally caused by long continued sub-acute in- 

 flammatory action ; the sub-basement cellular 

 tissue is generally affected, and thickening of 

 the whole structure, with hypertrophy of the 

 papilla?, where they exist, is found at the 

 same time. Induration with hypertrophy is 

 consequent upon chronic dysentery, and upon 

 chronic inflammation of the bladder. Ulcer- 

 ation of mucous membrane is generally ac- 

 companied by surrounding thickening and 

 induration, and this last is frequent in the 

 gall-bladder, gall-ducts, uterus, and urethra. 

 Induration of mucous membranes is generally 

 accompanied by contraction of their caliber or 

 surface, from the consolidation and subse- 

 quent contraction of tymph. effused into the 

 cellular structure. Fatal stricture of the in- 

 testines is produced in this manner, and so 



