Cariole

“ Further, if there be bone adjacent, it is possible to learn whether the fistula has entered it or not and how deeply it has caused disease. For if the part is soft which is reached by the end of the probe the disease is still intermuscular; if the resistance be greater it has reached the bone: if there the probe slip there is as yet no caries. If it does not slip but meets with a uniform resistance there is indeed caries, but it is as yet slight. ”

“ If the probe slide readily over the bone, it is free from caries, but if it does not so, and yet no inequalities are felt on it, caries has taken place, but it is still smooth: if it feel unequal and rough, the bone is eaten with caries. ”

“ So able a writer as Wm. Henry Potter (of Harvard) says: “In the first place, it may be said that caries of the teeth does not resemble caries of the bone. The term caries, as applied to the teeth, is a misnomer, given at a time when the true nature of the process was not understood.... The pathological change which occurs in caries is a decalcification and disintegration of the several tissues of the teeth.”
I confess that strikes me as a very excellent description of what surgeons usually term caries, namely, a molecular death of bone tissue. ”

“ In most cases the course of the alimentary canal from the distal end of the oesophagus to the cloaca or anus is longer than the corresponding region of the body, and the canal is therefore thrown into folds. The fundamental form of the stomach is a sac-like enlargement of the canal, the proximal portion of which is continuous with the line of the oesophagus, but the distal portion of which is bent in the proximal portion, the whole forming an enlarged bent tube. At the distal end of the tube the intestinal tract proper begins, and the two regions are separated by a muscular constriction. ”

“ It leads into a straight alimentary canal whose walls consist of a layer of ciliated cells ensheathed in a thin layer of peritoneal cells. There is no armature, and no glands, and the whole tract can only be divided into an oesophagus and an intestine. The latter runs with no twists or coils straight to the anus, which is situated at the junction of the trunk with the tail. A median mesentery running dorso-ventrally supports the alimentary canal and is continued behind it into the tail, thus dividing the body cavity into two lateral halves. ”

“ The cephalic layer, lining the “lesser peritoneal cavity” invests the ventral surface of the pancreas. The caudal layer continues over the caudal surface of the body of the gland and transverse portion of the duodenum into the parietal peritoneum and the free mesentery of the jejuno-ileum. Consequently the returning layers of the great omentum are said to surround the transverse colon and unite along the dorsal border of the intestine to form the transverse mesocolon, which membrane is continued dorsad toward the vertebral column as two layers. ”

“ The fourth species of sinuses, are those where a specific action exists39, and prevents the healthy ulcerative action from forming. Of this kind is the scrophulous sinus, which is generally accompanied with a caries bone, or diseased cartilage, and, therefore, is a complicated sinus40. This is distinguished, where the bone is diseased, by a shining or polished red skin, like a cicatrix, surrounding the fungus papilla at the orifice of the sinus, or the scrophulous-looking sore which exists there. When no caries bone exists, we have no papilla, but only the diseased ulcer at the orifice. ”

“ We medical men all know the numerous and grave symptoms exhibited by one or more organs of the body, or by all of them, from the persistent work of the deleterious gases and bacterial poisons on the system—a work going on for years, finally placing the victim beyond medical aid. All of us are agreed that the capacious gastro-intestinal canal should be clean. What, I submit, is the best means of keeping clean this long, large, tortuous, spacious, valved and flexed canal—a canal that disease has here and there pouched, dislocated, bagged, reservoired ”

“ Throughout the whole canal of intestines are numbers of little vessels, called lacteals, which lead the chyle, extracted from the aliment, into a receptacle, which is lodged in the mesentery, and from thence, by another duct call’d the thoracic duct, is carried along the back-bone upwards, and joins to the left subclavian vein, where the chyle gradually commences to be blood. ”

“ The entire intestinal canal is attached by a continuous vertical mesentery to the dorsal median line of the abdominal cavity ventrad of the vertebral column and aorta. The growth in length of the small intestine has necessitated a corresponding lengthening of the attached border of the mesentery—consequently the membrane presents a pleated or crenated appearance. The cæcum is well developed, the ileo-cæcal junction being situated within the returning limb of the loop, a little distance from the apex. ”

“ Feels himself gaining strength daily; can walk without pain; wound is contracting and hard; granulations seem to lessen the depth of the opening in the bone; there appears to be no sequestrum.”
When caries is fairly established, and the integuments have given way, the best and most successful proceeding is that pointed out by nature—destruction of the diseased portion; and the means must vary according to the particular circumstances. In many cases, nature seems to wait but for the separation of the sickly parts, either by accident, or by the interference of art. ”

“ Tomes observes that it is as yet uncertain in what way civilization predisposes to caries. But he shows that caries is caused by the lime salts in the teeth being attacked by acids from decomposing food in crevices, from artificial drink such as cyder, from sugar, from medicine, and from vitiated secretions of the mouth. It is evident that in civilized races natural selection cannot so rigorously insist on sound teeth, sound constitutions, and protective alkaline saliva. ”

“ Each angle of the pyloric sac is prolonged into a tube—the so-called "pyloric duct"—running out into the arm, where it immediately bifurcates into two forks, each beset by a large number of small pouches {439}and attached to the dorsal wall of the coelom by suspensory bands of membrane called mesenteries. These ten forks are called "pyloric caeca"; they are of a deep green colour owing to the pigment in their wall. Beyond the pyloric sac the alimentary canal is continued as the slender "rectum" to the anus. ”

“ Of such glands, the alimentary canal of the crayfish is provided with a pair, which are not only of very large size, but are further extremely conspicuous, on account of their yellow or brown colour. These two glands (figs. 12 and 13, lr) are situated beneath, and on each side of, the stomach and the anterior part of the intestine, and answer in position to the glands termed liver and pancreas in the higher animals, inasmuch as they pour their secretion into the mid-gut. ”

“ The tubules become blocked by the epithelium, and distended with the pent-up urine; this is one cause of the increase in size that the kidneys undergo in certain forms of Bright’s disease. The lesions in the tubules and in the glomeruli are not generally uniform. The interstitial tissue is always affected, and exudation, proliferation and formation of fibrous tissue occur. In the granular and contracted kidney the lesion in the interstitial tissue reaches a high degree of development, little renal secreting tissue being left. ”

“ The medullary system of the extremities of the long bones, and of the flat and short ones, certainly enjoys much more vital energy than the osseous texture itself; inflammation is much more easily developed in it, its effects are more promptly shown. Who does not know that caries is so much the more rapid, in proportion to the quantity of the texture of the cells that exists in the bones? ”

“ There the radial canals are joined by a ring-canal (c.c.) which runs round the margin of the umbrella. From the ring-canal are given off tentacle-canals which run down the axis of each tentacle; in many cases, however, the cavity of the tentacle is obliterated and instead of a canal the tentacle contains a solid core of endoderm. Oesophagus, stomach, radial canals, ring-canal and tentacle-canals, constitute together the gastrovascular system and are lined throughout by endoderm, which forms also a flat sheet of cells connecting the radial canals and ring canal together like a web ”

“ They have cilia externally, and a cutis which secretes similar hyaline tubes to those of many Annelida. The muscular system ia greatly developed, and iu definite layers, and many swini as freely as the most active leeches. The digestive system intimately agrees, having cilia on the inner surface of the canal, a muscular cesophageal region, and a sacculated intestine, while the glandular and other elements in the wall are very similar; it differs in not passing through a buccal nervous collar, although it lies beneath the nervous system in this region. ”

“ In the former this segment of the canal functions as an accessory digestive apparatus and hence, as we will see, often develops accessory structural modifications, such as a large cæcum and spiral colon, while in the latter it acts almost solely as a canal for the evacuation of the indigestible remnants.
Again, the large intestine is better developed in the higher animals, in mammalia and to a lesser degree in birds, in whom the functional demands for nutrition are active and require that a relatively large amount of food should pass through the digestive tract in a given time. ”

“ He had noted that the abdominal cavity was lined with a peculiar saclike membrane, the peritoneum, which also surrounded most of the organs contained in the cavity, and he made special note that this membrane also enveloped the liver in a peculiar manner. The exactness of the last observation seems the more wonderful when we reflect that even to-day the medical, student finds a correct understanding of the position of the folds of the peritoneum one of the most difficult subjects in anatomy. ”

“ The kidneys are two important organs in the abdomen, one on each side of the spine. They are of a reddish-brown color, and are enveloped by a transparent capsule made up of a fold of the peritoneum. Embedded in fat, the kidneys lie between the upper lumbar vertebræ, and the crest of the hip bone. The liver is above the right kidney, and the spleen above the left, while both lie close against the rear wall of the abdomen, with the intestines in front of them. ”

“ Gout, lithaemia, scurvy, rickets, lead and mercurial poisoning, and certain forms of chronic nephritis, produce dental and oral lesions which are either pathognomonic or strongly indicative of their several constitutional causes, and are thus of great importance in diagnosis. The most important dental research of modern times is that which was carried out by Professor W. D. Miller of Berlin (1884) upon the cause of caries of the teeth, a disease said to affect the human race more extensively than any other. ”

“ The entire course of the tortuous nasal canal is lined with mucous membrane, and this membrane is of a highly vascular structure. That is to say, the whole tissue is flushed with blood by a perfect network of vessels, over which the air we breathe passes, and from which it borrows the requisite heat. The mucus which is secreted by the membranes is also advantageous in rendering the atmosphere suitably moist. ”

“ When the overgrowth of fibrous tissue is considerable, the surface of the organ becomes uneven, and it is for this reason that the term granular kidney has been applied to the condition. In acute Bright’s disease the kidney is increased in size and engorged with blood, the changes described above being in active progress. ”

“ The two lateral lobes are gradually more and more constricted off from the central one, and become eventually quite separated from it; their cavities remain independent, and form in the adult the body-cavity, divided by a mesentery into two distinct lateral sections. The inner layer of each of the two lateral lobes forms the mesoblast of the splanchnopleure, the outer layer the mesoblast of the somatopleure. The central division of the primitive gastræa cavity remains as the alimentary tract of the adult. ”

“ Sometimes blood-filled cavities, as large as filberts, are found in the mucosa; each cavity enclosing one or two worms and, probably, communicating by means of a small hole with the interior of the intestine. Old extravasations are indicated by punctiform pigmentations. There may be evidence, in the shape of vesiculations and thickening of the mucosa, of a greater or lesser degree of catarrh. Occasionally, streaks or large clots of blood are found in the lumen of the bowel. ”

“ The alimentary, or intestinal, canal varies greatly in relative length and capacity in different mammals, and also offers manifold peculiarities of form, being sometimes a simple cylindrical tube of nearly uniform calibre throughout, but more often subject to alterations of form and capacity in different portions of its course—the most characteristic and constant being the division into an upper and narrower and a lower and wider portion, called respectively the small and the large intestine ”

“ The indications for treatment are obvious. Quinine and local anæsthetics relieve the symptoms of the functional forms of the disorder. Caries may be prevented, to a certain degree, by extreme attention to the teeth and secretions of the buccal cavity and a free, generous mixed diet. Doubtless, the popular belief, that an absolute fruit diet will limit the deposition of ossific material in the foetal skeleton and render labor easier, is responsible for much of the caries observed in American women. It is needless to say that such a belief is utterly without foundation in fact. ”