Adhesion (medicine)

“ As a cyst develops it is very likely to contract adhesions to the organs with which it lies in contact. The most common adhesion is that of the omentum. Next to this is adhesion to the abdominal walls. Then will happen more rarely adhesions to the bowels, womb, bladder, pelvis, liver, and stomach. A loop of intestine will sometimes be found fastened to the front wall of the cyst, but usually the bowels lie packed behind the tumor. ”

“ A safe way of performing this operation, when admissible, is to destroy a portion of the mucous membrane with strong nitric acid. The blood in the vessels then becomes charred, and their cavities obstructed, till they are permanently closed by adhesive inflammation. Every means of treating a local injury which tends to produce healthy [Pg 63] union or adhesion, may be considered in some sort as a preventive mode of treatment. ”

“ Partial adhesion of the lid to the globe in which a few bands pass from the lid to the globe are best treated by division followed by union of the ocular conjunctiva over the raw surface; no external dressing should be applied. Any tendency to fresh adhesion may be prevented by daily inspection. ”

“ When inflamed, its intervals become filled up by effusion from the vessels, and an abscess may be as accurately circumscribed in the hard as in the soft structures of the body. In a healthy constitution, the adhesive inflammation will, in this way, always precede the suppurative; but where the inflammation is not circumscribed by adhesion, the secretions may permeate from cell to cell in unadhering parts. In soft structures, a remedy is at hand for allowing the escape of the matter, by a free division of the parts ”

“ Early in this article adhesions were mentioned as one of the results of pericardial inflammation, and it was stated that the exudation may appear in spots or extend over the visceral or parietal layers of the pericardium or over both, and become organized tissue filled with blood-vessels, gluing the walls together, and completely obliterating the sac. Limited adhesions are much more common than those which are extensive or complete. The intensity of the inflammation offers no indication of the probability of the formation of adhesions. ”

“ Thus, if the skin be taken off the edges of our fingers, and the side of the one be applied to the side of the other, adhesion will take place, and no inflammation will be produced. When a part is inflamed, and one portion is brought in contact with another, we uniformly find, that the inflammation is less where the parts were in contact than elsewhere. ”

“ The lobule of the ear thus adhesioned should be gradually pulled down and elongated after the complete healing of the local ulcer and the subsidence of its concomitant symptoms, and after the cicatrix has assumed the colour of the skin of the surrounding part. Otherwise the adhesioned part may be characterised by pain, swelling, inflammation, burning and suppuration, or the adhesion may again fall off. ”

“ If the wound admit of being well closed, the difficulty of breathing diminishes; adhesion may take place, and the inflammatory action within the chest may terminate; but if the inflammatory symptoms continue, adhesion does not take place, and the secretion and effusion of a quantity of serous fluid are the consequence. This secretion of fluid is the natural consequence of inflammation which has passed the stage of adhesion, whether the injury of the chest have occurred from a stab or from a gunshot. ”

“ Aderno′, a town of Sicily, 18 miles N.W. of Catania and about 10 miles W.S.W. of Mount Etna. Pop. 25,000.
Adessena′rian, one of a sect of Christians which holds that there is a real presence of Christ in the Eucharist, but denying that it is effected by transubstantiation.
Adhesion, the tendency of two bodies to stick together when put in close contact, or the mutual attraction of their surfaces; distinguished from cohesion, which denotes the mutual attraction between the particles of a homogeneous body. Adhesion may exist between two solids, between a solid and a fluid, or between two fluids. ”

“ Their action is attended with very little friction acting only when necessary to supply the deficiency of adhesion and their pressure against the flank of the teeth is only the balance of the leverage which is not sustained by the adhesion at the tread. ”

“ Under their influence a greater supply of blood is directed to the still healthy tissues enabling them to actively continue the inflammatory processes necessary to the detaching of the portion necrosed, while, at the same time, the pus organisms, stimulated by the heat, are stirred into greater activity, and the readier accomplish their purpose of destroying the adhesion still existing between the necrotic portion and the surrounding living tissues. ”

“ When, therefore, the sinus extends upwards, the ichor readily flows out from the sore, and adhesion easily takes place; but when it extends downwards the ichor by remaining within corrodes the continuous parts, and unless you first make an incision for its discharge, you will be able to effect nothing; for the sores can neither be incarnated nor the parts made to unite. But if the sinus is in any of the limbs, as the arms or legs, one may produce adhesion without a counter-division by putting the limb in a declining position. ”

“ We are then chiefly to search after, and extract foreign bodies, when we apprehend that their removal may permit the inflammation to be resolved, and adhesion to take place, and when we expect that their presence will excite a greater action than our endeavours to extract them will do. ”

“ If the closure of the wound lead, in the course of a few days, to the re-establishment of the breathing, and the antiphlogistic means employed to the cessation of all urgent inflammatory symptoms, adhesion has most likely taken place, or is about to take place, in the neighborhood of the wound, and the patient will in all probability recover without much further suffering. ”

“ In 24 to 48 hours this engorgement is followed by an exudation of sero-fibrinous fluid, the fibrinous portion of which may soon form a coating over the internal surface of the pericardial sac, and may ultimately form a union of the opposing surfaces. Generally this adhesion will only be found to occupy a portion of the surfaces. As the serous or watery portion of this effusion is absorbed, the distinctness of the friction sound recurs, and may remain perceptible in a varied degree for a long time. ”

“ Their power of adhesion is remarkable, and must have been felt by every one who has handled the species with the fingers; they cling around the flesh with the most annoying tenacity, so that it is no easy matter to cleanse one's hand of them. In what resides this adhesive power? Doubtless in the barbed threads which are sheathed in innumerable myriads in every filament. ”

“ All these conditions cannot remain after death. Hence, if we desire to form positive opinions concerning much which is unfolded by dissection, we must supply the defect by analogy. Thus, whenever, in any part of the heart or arteries, the cohesion between the internal membrane and the subjacent structure is manifestly lessened, and the membrane is unusually red at that part, we may regard these appearances as the vestiges of inflammation, without thinking that we go too far in so regarding them. ”

“ Adhesion of one or more of the fingers, even to their points, is met with occasionally as a congenital affection. Separation is readily accomplished; but the dressing requires to be carefully attended to. Adhesions may result from careless management of extensive abrasion or ulceration, or from a burn, and such are not so easily remediable. Superfluities may be abridged. Some children are born with two thumbs or two little fingers ”

“ Adhesion is commonly spoken of as existing between the particles of dissimilar bodies, but it is more accurately defined by calling it that molecular force which holds two distinct bodies together, whether they are of the same substance or not. ”

“ When the operation has been performed thus far with perfect skill and success, the most opposite measures are required according to the actual state of the organs contained in the sac. If they are agglutinated together—if portions of them are in a state of mortification, to return them into the cavity of the abdomen in that condition would in general be certain death. Preternatural adhesion must be removed ”

“ There is little chance of immediate union taking place; and the wound not being approximated when recent and bleeding, does not diminish the chance, but on the contrary augments it. Adhesion is prevented by the insinuation of air and mucus betwixt the edges, by frequent motion of the edges on each other, by the slightest change in the position of the head, either rotatory or nodding, by the action of the muscles of the os hyoides, and by attempting to swallow food or saliva. Every circumstance is opposed to complete approximation and immediate union of transverse wounds of the throat. ”

“ The free surface of the serous system differs essentially from that of the mucous, in this, that it contracts frequent adhesions. The pleura is of all the serous organs, that in which these adhesions are the most evident. We find almost as many dead bodies in which they exist, as we do those in which they do not. Next to the pleura is the peritoneum, then the pericardium, then the tunica vaginalis, then the arachnoides, which is that of all the serous surfaces in which adhesions are the least frequent,139 though I have observed them in it. ”

“ This process of adhesion takes place during the second half of intra-uterine life. A connection with the colon, produced by adhesion of the mesogastrium to the splenic flexure of the large intestine, forms the adult lig. colico-lienale, while a similar adhesion between great omentum, transverse mesocolon and phrenic parietal peritoneum just caudad of the spleen, gives rise to the colico-phrenic or costo-colic “supporting” ligament of the spleen. ”

“ Adhesiveness of corpuscles and coagulation are both brought about by the operation of noxious agents upon the tissues of the part concerned. But it by no means follows that they are in all respects analogous phenomena. We have seen that normal blood has no innate tendency to coagulate, and needs no action of the tissues upon it to ensure its fluidity. But the blood-corpuscles may he naturally adhesive bodies, possessing a viscosity only kept in abeyance by some influence exerted upon them by the living tissues in their vicinity: and such appears to he really the case. ”

“ All bleeding must be arrested, blood extravasation merely favouring the formation of fresh adhesions.
The prevention of fresh adhesions between the dura and the brain and between the scalp and the dura or brain. ‘It is useless to talk about the prevention of fresh adhesions; they form in spite of anything that may be done’ (English) . With this statement, I am in complete accord. It has been recommended that fresh egg-albumen, gutta-percha tissue, silver foil, &c., should be inserted beneath the dura or between the scalp and the brain. ”

“ In youth and adult life it is adherent only along the longitudinal sinus and about the blood-vessels; in old age it becomes more adherent. Extent, location and strength of adhesions should be noted. The normal dura should be grayish-red, smooth, symmetrically stretched, so that a small fold only can be taken up by the fingers in the frontal region, and just translucent enough to show the outlines of the convolutions and the pial vessels. An increased tension is caused by exudates, tumor, abscess, hydrocephalus, hemorrhage, congestion, œdema, etc. ”

“ When, during life, one tissue is separated from another, as the periosteum from the bone, or the cuticle from the skin, or the mutual cohesion between different tissues is sensibly weakened, we find it to be owing to the intervention of serous fluid which does not belong to their healthy state; and this, together with increased vascularity, or redness and heat, and pain, is enough to bespeak the presence of inflammation. ”

“ The results of inflammation do not vary less than its nature; if resolution does not take place, each has its own mode of suppuration. Compare the pus of erysipelas, that of phlegmon, the milky or flocculent fluid of the serous membranes, the whitish or greyish humour, of a mucous consistence, that escapes from the membranes of the same name after catarrh, the blackish sanies of the bones in suppuration, &c. We shall see that some organs, as the fibrous bodies, do not suppurate. ”

“ A very interesting observation which I made long ago, but to which I have not before directed attention in this point of view, shows that an extreme degree of adhesiveness of the red discs may exist within a blood-vessel the walls of which are in perfect health with reference to coagulation. If a horse's jugular vein, obtained in the manner I have described, is suspended vertically, the blood in it remains fluid for an indefinite period, hut the red corpuscles soon fall from the upper parts of the fluid, leaving a huffy layer of plasma, readily seen through the translucent wall of the vessel. ”

“ Our fluid is much more safe in its effects, never gives rise to the troublesome abscesses and inflammation that is common to the use of the injection fluids that have been advised on the Heatonian method. The fluid we use is a bland and healing agent, which produces an exudation behind the cords that surround the inguinal rings, and forms a well defined truss pad of moderate size in such position that the rupture cannot pass by it and appear externally. It causes also an adhesive inflammation limited to the hernial sac, that completely closes it. ”