SOFTENING AND INDURATION. 



709 



of its natural covering. It is in this manner 

 that various forms of softening are produced, 

 as irregular or circular patches of various sizes. 

 It is important to notice this circumstance, 

 for, when the softening is limited to thegland- 

 ulae solitaries, as is frequently the case in dys- 

 entery, it might be overlooked ; these bodies 

 being very small, and their entire destruction 

 by softening being often unaccompanied by 

 any obvious alteration of the mucous mem- 

 brane itself, the seat and nature of the intes- 

 tinal affection might not be ascertained, were 

 it not for the presence of a number of minute 

 circular patches, which, when narrowly ex- 

 amined, are found to be the result of softening 

 of these follicles ; for it often happens that 

 enlarged follicles are seen intermixed with 

 the patches, and which, when a scalpel is 

 carried over the surface of the mucous mem- 

 brane, break down or are removed, and thus 

 other patches are formed similar to the former. 

 These circular patches, which have the sub- 

 mucous tissue for their base, are often de- 

 scribed as ulceration of the mucous membrane; 

 but in all cases of doubt, the scalpel, used as 

 above, will enable us to determine their na- 

 ture. 



Softening of the mucous membrane in the 

 form of stripes and bands, has been described 

 with great care by Louis, and has been much 

 insisted upon as a characteristic of inflam- 

 matory softening; but Carswell has proved its 

 origin from post mortem causes. 



Softening of the mucous membrane of the 

 digestive organs, may present various degrees 

 of redness, or it may be quite pale ; the red- 

 ness may be confined to the softened part, or 

 it may extend to the neighbouring parts at the 

 same time j or the latter may be red and the 

 former pale. 



The redness of the softened membrane may 

 vary from a light or a dark red to a brown- 

 ish or purple ; varieties of colour the value 

 of which it is by no means easy to estimate, 

 inasmuch as the quantity of blood in an in- 

 flamed tissue cannot be taken as a measure 

 of the degree of inflammation which had 

 caused the accumulation of this fluid. 



The pale softening presents also some va- 

 riety of tint. The softened tissue is either of 

 a pale greyish or yellowish grey tint, being little 

 altered from its natural colour; or it may be 

 paler than natural, when it generally presents 

 a milky aspect, owing to the colour of the 

 submucous tissue being seen through it. 



The pale softening is found in pthisis, in 

 tubercular disease of the mesenteric glands, 

 and in any disease accompanied by great ema- 

 ciation. 



Softening may be accompanied by thicken- 

 ing of the submucous tissues, and may pre- 

 cede and surround ulcerations. 



The inflammatory softening of the other 

 mucous membranes resembles as closely as 

 possible that which has been described ; it is 

 not however so frequently complicated with 

 post mortem effects, nor does it so often occur, 

 except in the oesophagus, stomach, and intes- 

 tines from the action of irritant poisons, which 



produce it either by their direct action, or by 

 inducing and modifying inflammation. 



Softening of mucous membranes from post 

 mortem causes, is of great importance as a 

 pathological fact, and may be produced by 

 the action of the secretions of the membrane 

 itself, or by putrefaction. This last cause is 

 of doubtful efficacy ; it is not likely to be 

 met with in post mortem examinations, made 

 at a reasonable period after death ; it may 

 however suffice to cause complete decompo- 

 sition, when the membrane has been the seat 

 of disease before death, and more particularly 

 when the lesion has been of such a kind as to 

 deprive the tissue of its vital properties sud- 

 denly. General putrefaction rapidly occurs 

 in many cases of sudden death, especially in 

 those in which the nervous system, or blood, 

 or both, happen to be the vehicles of the de- 

 structive agent. 



Softening from the action of special secre- 

 tions may occur in two manners, either by 

 simple maceration, which is long in taking 

 place, or by chemical action. The first may 

 happen in all mucous membranes, the second 

 in the stomach and intestines alone. 



Under favourable circumstances, and at a 

 greater or less period after death, we find 

 softening of the coats of the stomach, per- 

 foration, and the contents of the viscus free 

 in the cavity of the peritoneum. 



Various opinions have been given by the 

 most celebrated pathologists, to account for 

 this phenomenon; some embracing the views 

 of Hunter, and recognising a chemical and 

 post-mortem cause ; and others attributing it 

 to certain inflammatory causes, which pro- 

 duced ulceration and subsequent perforation. 



Now, Hunter's view is demonstrable by 

 direct experiment, whilst that held by the 

 others is disproved by the absence of symp- 

 toms during life sufficient to account for such 

 vast organic changes, and by the difference 

 between such ulceration and those solutions 

 of continuity wJiich we are now about to de- 

 scribe. 



The following facts tend to strengthen the 

 first, and militate strongly against the latter 

 opinion. When a rabbit, dog, cat, or any 

 animal, in fact, is killed an hour or so after a 

 meal when digestion is going on, and is al- 

 lowed to remain in one position and in a 

 moderate temperature, we find, after a few 

 hours have elapsed, that the mucous mem- 

 brane of the most depending part of the 

 stomach is softened, and can, with the sub- 

 mucous cellular tissue and the muscular coat, 

 be broken down with the greatest facility. 

 The vessels ramifying in the softened part are 

 black from the action of the solvent upon 

 their blood. 



After a greater lapse of time we find the 

 peritoneum perforated, and the contents of 

 the stomach in its cavity ; by and by the 

 tissues in the immediate neighbourhood of the 

 stomach begin to suffer, and we see the ab- 

 dominal muscles, and the cuticle covering 

 them, eaten through by the gastric juice. 



In fish, softening and perforation occur so 

 x z 3 



