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#Thrombosis.# The term thrombus is applied to a clot of blood formed in the interior of the heart or of a blood vessel, and the process by which such a clot forms is known as thrombosis. It would appear that slowing or stagnation of the blood-stream, and interference with the integrity of the lining membrane of the vessel wall, are the most important factors determining the formation of the clot.
When the organisms become active in this way, the tuberculous tissue undergoes softening and disintegration, and the infective material, by bursting into an adjacent vein, may enter the blood-stream, in which it is carried to distant parts of the body. In this way a general tuberculosis may be set up, or localised foci of tuberculosis may develop in the tissues in which the organisms lodge.
Tuberculous disease in muscle, while usually due to extension from adjacent tissues, is sometimes the result of a primary infection through the blood-stream. Tuberculous nodules are found disseminated throughout the muscle; the surrounding tissues are indurated, and central caseation may take place and lead to abscess formation and sinuses.
A tuberculous infection may exhibit its aggressive qualities in a more serious manner by sending off detachments of bacilli, which are carried by the lymphatics to the nearest glands, or by the blood-stream to more distant, and it may be to all, parts of the body. When the infection is thus generalised, the condition is called general tuberculosis.
Further, bacteria may gain access to devitalised tissues by way of the blood-stream, being carried hither from some infected area elsewhere in the body. The Antiseptic System of Surgery. Those who only know the surgical conditions of to-day can scarcely realise the state of matters which existed before the introduction of the antiseptic system by Joseph Lister in 1867.
He pushed a button on the control-board. He pointed to a microphone. He got at an oxygen-bottle and inhaled deeply. Oxygen, obviously, should be an antidote for panic, since the symptoms of terror act to increase the oxygenation of the blood-stream and muscles, and to make superhuman exertion possible if necessary.
Syphilitic affections of bone may be met with at any period of the disease, but the graver forms occur in the tertiary stage of acquired and inherited syphilis. The virus is carried by the blood-stream to all parts of the skeleton, but the local development of the disease appears to be influenced by a predisposition on the part of individual bones.
But the worst of all is a foul condition of all the tissues, including the blood-stream, a condition in which much of the body's waste is stored up, instead of being excreted. If such a condition can not be remedied through moderation and simplicity in eating, the only thing that will prove of value is temporary abstinence.
Lastly, in patients suffering from chronic wasting diseases, bacteria may invade the internal organs by the blood-stream in enormous numbers and with great rapidity, during the period of extreme debility which shortly precedes death. The discovery of such collections of organisms on post-mortem examination may lead to erroneous conclusions being drawn as to the cause of death.
When the joint is infected through an external wound, the anatomical features are similar to those observed when the infection has reached the joint by the blood-stream, but the destructive changes tend to be more severe and are more likely to result in disorganisation. The terminations vary with the gravity of the infection and with the stage at which treatment is instituted.
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