PRODUCTS, ADVENTITIOUS. 



very closely with the serum of the blood, 

 its essential protein -ingredient being albumen 

 in the state of albuminate of soda. As various 

 degrees of inspissation of the fluid occur, the 

 ratio of the solid ingredients to the water 

 varies within rather wide limits. Accidental 

 constituents are biliphaein, urea, and haematin. 

 Fat is always present ; and scales of choles- 

 tein (visible to the naked eye) are not very 

 unfrequent, especially in dropsy of the tunica 

 vaginalis. Epithelial cells are to be seen in 

 small quantities (and we have found these 

 calcified) : there is no reason to believe that 

 an excessive quantity of epithelium is necessa- 

 rily a part of the disease, though in some 

 cases milkiness or a puriform look may be 

 caused by their extreme abundance. Pus and 

 blood corpuscles may be accidentally present. 

 The fluid of true dropsy is distinguishable 

 by the deficiency of developmental power : it 

 never forms a blastema for cell-growth ; nei- 

 ther is it capable of spontaneous coagulation. 

 But in some rare instances fibrin escapes 

 along with the serum of the blood, and this 

 in notable quantity.. The fluid then becomes 

 coagulable ; but it is a mystery why (some- 

 times occurring within the body) its coagu- 

 lation sometimes does not occur until some 

 hours after its removal from the body. We 

 have seen the contents of the pleura, perfectly 

 fluid when first exposed, become distinctly 

 clotty within an hour and a half: similar oc- 

 currences have been witnessed by others. 

 When coagulation takes place within the body, 

 the coagulum may probably act as a blastema. 

 The cause and mechanism of this escape of 

 fibrin from the vessels, and its relationship 

 to inflammation are utterly unknown. In a 

 former place (p. 93) we have spoken of the 

 occasional excretion of fibrin with the urine. 



GJROUP III. 

 GASEOUS ADVENTITIOUS PRODUCTS. 



If the precise signification given to the term 

 Adventitious Product be considered, it will 

 be seen that gaseous matters are only truly ad- 

 ventitious -when foreign in nature to the textures 

 producing them. Air entering veins lying 

 within the suction-influence of the chest ; air 

 swallowed; air entering the uterus and blad- 

 der from without ; and air diffused through the 

 cellular membrane, serous cavities,, or paren- 

 chymatous organs, and derived from the air 

 passages or alimentary canal, throngh a wound, 

 ulceration, perforation or rupture of these ; 

 consequently find no place under the present 

 head. We shall here confine ourselves to a 

 notice of gases produced by () local or ge- 

 neral anti-cadaveric decomposition,, and (6) 

 an alleged process of secretion. 



(a) A man, aged twenty-five, died on the 

 sixteenth day of continued fever (Peyerian 

 type), and was examined by M. Bally eight 

 hours after death. The body was soiled with 

 blood, which had transuded through the skin 

 of the thighs and scalp, and there was uni- 

 versal emphysema. The mesenteric glands 

 contained gas which, like that in other parts 



VOL. IV. 



145 



of the body, took fire and exploded, when 

 brought in contact with the flame of a 

 taper ; in burning it formed a tuft with a 

 blue base and white apex, and appears to 

 have consisted of proto-carburet of hydro- 

 gen, one of the ordinary products of putre- 

 faction, and is presumed to have been formed 

 before death. (Art. EMPHYSEMA, Cyclopaed. 

 of Surgery, vol. ii. p. 85.) Dr. Mouat (Ed. 

 Med. and Surg. Journal, vol. liii. p. 427. 

 1840) has published a case in which gas was 

 found in the cellular tissue of the right thigh, 

 on the surface of the pericardium and pia 

 mater, and in the right side of the heart and 

 femoral vein. Accumulation of gas from de- 

 composition of fluid in the pleura, pericardium, 

 peritoneum, joints, and tunica-vaginalis, has 

 been described by various persons: hydro- 

 pneumothorax, however, it is to be remem- 

 bered, without perforation of the lung, is cer- 

 tainly of excessive rarity. 



() It occasionally happens, as was first, 

 we believe, noticed by Dr. Graves, that at a 

 certain period of the progress of pneumonia, 

 the- percussion-siiins of pneumothorax may 

 be discovered. Within the last year we have 

 had in our wards a most interesting case of 

 pure and simple pneumonia, unattended with 

 the formation even of dry plastic matter in 

 the pleura, during the progress of which a 

 perfect tynapanitie note (quite distinct from 

 an amphoric or tubular one) continued for 

 some time producible over the affected lung. 

 The only mode of accounting for it seemed 

 by admitting the presence of air iu the pleura, 



and if such were the fact,, that air must 

 have been the produce of secretion. A sin- 

 gular case is recorded by Sir F. Smith *, m 

 which a secretion of gas from the skin ap- 

 pears to have taken place. 



(c) It is not uncommon to find bubbles of 

 gas in the veins of the pia-mater, and their 

 presence is. not easily explicable. If the gas 

 be regarded as of putrefactive origin* the dif- 

 ficulty is to explain why it occurs in bodies 

 perfectly free from ordinary evidence of pu- 

 trefaction, and why it is limited to those par- 

 ticular veins. If it be regarded as natural 

 gas of the blood extricated during life, how 

 comes it, that the blood in that particular 

 part only should present it after death, and 

 how comes it that, if really extricated there % 

 it had not been carried on with the circulating 

 fluid to the heart ? The quantity of gas is 

 too small in such cases to admit of analysis, 



else perhaps a comparison between it and 

 the gases of venous blood might throw some 

 light on the matter. 



But next comes the curious fact that where 

 there is least blood there is most intra-venous 

 air, that is, where there is most of the pre- 

 sumed cause, there is least of the presumed 

 effect. It is, in fact, in persons, who have 

 died from haemorrhage, that air has beeu 

 found in greatest abundance in the veins. 

 Lieutaud-f- relates the case of a girl who died 



* Dub. Med. Journal, vol. xviii. p. 457. 

 f Hist. Anat. Med. Obs. 55. 



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