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 |   Related post: which lie the changes venous thrombi freciuently undergo. In the veins we often liiid thrombi, the result of spontaneous coagulation of blood, or the effect of phlebitis. In the latter case we do not understand the formation of the thrombus in the sense of Hun- ter, or Cruveilhier, or llokitanski, but in the sense in which A'irchow 1865.] PEOCEEDINGS OF SOCIETIES. 369 has explained it. A41 inflamed vein, Order Oxybutynin by the deposition of the inflam- matory products in its walls, loses the evenness of its inner surface, because the epithelial layer following the inequalities of the coats exterior to it shows irregular prominences and recesses. In this way the friction of the circulating blood is increased, and the velocity of the current is retarded — circumstances favoring the deposition of layers of fibrin, which, including cruor, gives rise to the formation of the thrombus, either entirely blocking up the lumen of the vessel, Purchase Oxybutynin Online or narrowing it by lateral adhesion. If this thrombus is not organized, it becomes drier, paler, and finally softens. If the softening is very gradual, and not disturbed by mechanical influences from outside — for example, muscular action — the disintegration produces a molecular detritus which mixes with the blood, and being germane to its constituents, does not produce any deleterious influences. If larger pieces are detached, they are carried by the venous current into the heart, from thence into the pulmonary artery, and bring up at a ])rauch which they cannot pass, obliterating it partially or totally. It depends entirely upon the size of the embolus what its effect will be. For our object we are interested only in the smaller emboli that block up smaller branches of the pulmonary artery, distributing, for example, in a lobule of the lung. Their effect can be studied experimentally by insertiiig pieces of convenient size into the jugular vein of animals. If they are made of a material not irritating chemically or mechan- ically, like Buy Oxybutynin Online caoutchouc (Virchow) or wax (Panum,) and if not too large, they are borne without any symptoms. The capillaries fed by the artery which they block up are filled by degrees per anastomosin, and Buy Oxybutynin the bodies themselves are spun in like any other foreign body that does not produce suppuration. If, however, substances are selected having a rough surface, like cork, or chemically irritating, like pieces of muscle or fibrin, they set up inflammation in the artery Generic Oxybutynin and surrounding tissue more or less violent, with the termination in Order Oxybutynin Online suppuration or gangrene. We have then very nearly a coimterpart of the metastatic infiltrations and abscesses that form such a common post-mortem result in pya^mic fever. Sometimes in pysemic fever cases, in the midst of the lobular ab- scesses of the lung, small emboli are found, evidently not of local ori- gin, but by their discoloration and dryness resembling the thrombus that may be found in a vein, inflamed or not, coming from a suppu- rating wound. ■370 PROCEEDINGS OF SOCIETIES. [-^Ug., The more enthusiastic pupils and followers of Yirchow (for he never dreamed of such a thing) thought that with the emboli and the metas- tatic abscesses the whole difficulty of pysemia w^as solved. But just as little as we have seen that healthy pus mixed with the circulating blood does produce pysemia, just as little does simple em- Buy Cheap Oxybutynin bolism create metastatic abscesses; nor are metastatic abscesses and the disease called pytemia identical. Only to state one point of differ- ence: The symptoms of pyteuiic fever are declared before the haemor- rhagic infarctions or the lobular pneumonias have commenced. We are then forced to recur to a certain chemical Purchase Oxybutynin alteration of the thrombus, of which the embolus is a part; and, indeed, we see in a wound with unhealthy suppuration that the process of ulceration reaches the veins, which are thrombosed, that the veins then become discolored and ulcerating, and that the thrombus is impregnated with the unhealthy tumors, broken down and mixed in the cavity of the vessel with a sauious liquid. Yet the cases must be exceedingly rare in which the blood comes in immediate contact with a decomposing thrombus as descriljed, because higher up it is generally sequestered by fresh coagulations, and there- by the circulating blood shielded from its deleterious contact. Failing, then, to find the cause of pyaemia in admixture of pus jjcr sc with the blood, and unable to explain it, barring very exceptional cases, by the impregnation of the lAood from a decomposing thrombus, we have to seek for another cause, and we near (in surgical cases) the wound as a total, and the changes which may occur in it during the process of suppuration. When I limit myself to surgical cases, I beg not to be understood as Oxybutynin Online if pyaemia in obstetrical eases acknowledged a different origin. Either they are by the wounded inner surface of the womb, or wounds at the os or in the vagina, identical with surgical cases; or, when not showing unhealthy action in their wounded parts, they are under the operation of the same agencies that produce pyajniia in sur- gical cases without corresponding deterioration of the aspect of the wound. Yery rarely, except in hospitals, pyfleraia occurs in patients whose wounds are in full reparative progress. Generally only part of the wound is granulating, while in other parts the preparatory steps to healthy suppuration are not yet finished. The surface of a wound, for example, of an amputated limb, may show healthy suj)puration, while in its deeper layers there are still undetached particles of necrosed Related links: Cilostazol Dose, Order Amlodipine Online, doxycycline buy uk, 100 Hyaluronic Acid, Where Can You Buy Topamax, Cost Of Lamictal, buy vantin online, can you buy alligator gar, Where Can I Buy Permethrin Spray, Mometasone Furoate Spray
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