356 OF NUTRITION. 



for it frequently happens that the patient sinks under the great consti- 

 tutional disturbance occasioned by a large suppurating surface, although 

 he may have survived the immediate shock of the injury. 



638. If the Fibrine of the Blood, however, be not well elaborated, it 

 does not possess its due organizability ; and thus, instead of being con- 

 verted, either when effused as an Inflammatory product, or in the ordi- 

 nary Nutritive process into solid tissue, proper to the part in which it 

 is deposited, it is liberated from the vessels in a state, which prevents 

 any but a very imperfect structure from being developed by it, and 

 which tends to very speedy degeneration. This is the condition of the 

 Tubercular substance, which is so often found to replace the proper 

 tissue, especially in the lungs ; being slowly deposited there, by a sort 

 of degradation of the regular nutritive operations ; and being effused in 

 larger quantity, when the inflammatory process is set up. There is 

 every degree of gradation between the plastic or organizable deposit of 

 well-elaborated Fibrine, the caco-plastic or imperfectly -organizable mat- 

 ter of Tubercle, and the aplastic or non-or ganizable matter of Pus. The 

 microscopic examination of tubercular deposits shows, that they some- 

 times contain fully-developed cells and fibres, analogous to those of 

 fibrinous exudations ; but that more frequently, the cells and fibres are 

 imperfectly formed, and are accompanied by a large quantity of a gra- 

 nular substance, which strongly resembles coagulated Albumen; and 

 that in many cases, there is scarcely any trace of organization in the 

 mass. The greatest degree of organization is found in the semi-trans- 

 parent, miliary, gray, and tough yellow forms of Tubercle ; the least in 

 the opaque, crude, or yellow Tubercle. It is the opinion of some emi- 

 nent Pathologists, that Tubercular matter is always deposited in the 

 first instance in the cellular form ; but that it tends to undergo a rapid 

 and complete degeneration. 



639. The constitutional state, which predisposes to this perversion 

 of the ordinary nutritive operations, and which is known as the Tuber- 

 cular Diathesis, may be the result of the continued operation of any 

 causes, that tend to depress the vital powers ; such as insufficient nutri- 

 tion, habitual exposure to cold and damp, protracted mental depression, 

 &c. ; or it may be derived from the operation of the same or other 

 causes on the ancestors of the individual, being one of those disorders 

 which has a peculiar tendency to become hereditary. The treatment 

 must be directed to the invigoration of the system by good food, active 

 exercise, pure air, warm clothing, and cheerful occupations ; and by the 

 due employment of those means, at a sufficiently early period, many 

 valuable lives may be saved, which would otherwise fall a sacrifice to 

 Tubercular disease in the lungs, or other important organs. Much 

 reason has lately presented itself for the belief, that a deficiency of 

 appropriate oleaginous constituents in the food exerts a marked influ- 

 ence in the production of the Tubercular diathesis. This would appear 

 to be indicated by the very marked benefit which has been derived in 

 the treatment of Pulmonary Consumption and other tubercular diseases, 

 from the use of Cod-liver oil, or of other easily assimilated fish-oils. 

 And the same view is confirmed by the remarkable exemption of the 

 Icelanders (whose diet is extremely oleaginous) from Tubercular dis- 



