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The abscess may be directed downward or to the side of the liver. In such a case the process is the same except the liver becomes united to the stomach, the intestines or the walls of the abdomen by adhesions produced by inflammation. If it adheres to the stomach or intestine, the abscess will perforate into these and the pus will pass out in the stools. If it becomes adherent to the wall of the abdomen, the abscess will “come to a head” under the skin and the pus will be discharged on the surface of the body. In either case cicatrization follows and the patient is well. In some cases the abscess discharges into the gallbladder and passes from there into the intestine. It has also been known to “point” on the back.
 
The abscess may be directed downward or to the side of the liver. In such a case the process is the same except the liver becomes united to the stomach, the intestines or the walls of the abdomen by adhesions produced by inflammation. If it adheres to the stomach or intestine, the abscess will perforate into these and the pus will pass out in the stools. If it becomes adherent to the wall of the abdomen, the abscess will “come to a head” under the skin and the pus will be discharged on the surface of the body. In either case cicatrization follows and the patient is well. In some cases the abscess discharges into the gallbladder and passes from there into the intestine. It has also been known to “point” on the back.
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It sometimes happens in weak individuals that nature is not able to make proper con- nections along the line of march and the pus ends up in the pleural cavity, resulting in empyema, or in the abdominal cavity, where it results in peritonitis and, usually, death.
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It sometimes happens in weak individuals that nature is not able to make proper connections along the line of march and the pus ends up in the pleural cavity, resulting in empyema, or in the abdominal cavity, where it results in peritonitis and, usually, death.
    
Another daring engineering feat is often accomplished by nature in the case of gall- stones that are too large to pass through the bile duct directly into the small intestine. She frequently causes the gallbladder to adhere, by means of inflammation, to the wall of the intestine. An ulcer forms, making a hole through both the wall of the gallbladder and the wall of the intestine. The stone slips through into the intestine and passes out with the stools. The hole heals up and all is well again. In other cases the stone may be sent out through the abdominal wall and skin, on the outside of the body.
 
Another daring engineering feat is often accomplished by nature in the case of gall- stones that are too large to pass through the bile duct directly into the small intestine. She frequently causes the gallbladder to adhere, by means of inflammation, to the wall of the intestine. An ulcer forms, making a hole through both the wall of the gallbladder and the wall of the intestine. The stone slips through into the intestine and passes out with the stools. The hole heals up and all is well again. In other cases the stone may be sent out through the abdominal wall and skin, on the outside of the body.
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An unusual piece of engineering which shows, in a remarkable manner, the ingenuity of nature in her efforts at prolonging life in spite of every obstacle, is recorded by J. F. Baldwin, A.M., M.D., F.A.C.S., in a surgical paper dealing with blood transfusions. He performed an operation on a middle-aged woman who had been having frequent hemor- rhages from her bowels for several years. He says:
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An unusual piece of engineering which shows, in a remarkable manner, the ingenuity of nature in her efforts at prolonging life in spite of every obstacle, is recorded by J. F. Baldwin, A.M., M.D., F.A.C.S., in a surgical paper dealing with blood transfusions. He performed an operation on a middle-aged woman who had been having frequent hemorrhages from her bowels for several years. He says:
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At the operation I removed a snarl of small bowel, making the usual anasta- mosis. Examination of this snarl showed that there had been an intestinal obstruc- tion, but nature had overcome it by ulceration between adherent loops of the bowel above and below the obstruction. The ulcer persisted, however, and it was its per- sistent bleeding that caused her anemia. She made an excellent recovery and got fat and hearty.
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At the operation I removed a snarl of small bowel, making the usual anastamosis. Examination of this snarl showed that there had been an intestinal obstruction, but nature had overcome it by ulceration between adherent loops of the bowel above and below the obstruction. The ulcer persisted, however, and it was its persistent bleeding that caused her anemia. She made an excellent recovery and got fat and hearty.
    
It looks like a real intelligence at work when nature causes two folds of the bowels to adhere together and then ulcerates through them in order to make a passage around an obstruction. There cannot be the slightest doubt that the ulcer would have healed, leav- ing a passage, and the bleeding stopped, had the opportunity been afforded it. Nature probably cried out day after day in unmistakable language for the cessation of feeding long enough for her to complete her engineering feat. But this was never given her. The ulcerated surface was kept constantly irritated with food, and drugs as well.
 
It looks like a real intelligence at work when nature causes two folds of the bowels to adhere together and then ulcerates through them in order to make a passage around an obstruction. There cannot be the slightest doubt that the ulcer would have healed, leav- ing a passage, and the bleeding stopped, had the opportunity been afforded it. Nature probably cried out day after day in unmistakable language for the cessation of feeding long enough for her to complete her engineering feat. But this was never given her. The ulcerated surface was kept constantly irritated with food, and drugs as well.
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Abscesses everywhere in the body are limited and walled off by the formation of a thick wall of granulation tissue. Gangrene is also walled off in the same manner. The necrosed portion then sloughs off; nature grows new tissue to take the place of the de- stroyed tissue and the place is healed.
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Abscesses everywhere in the body are limited and walled off by the formation of a thick wall of granulation tissue. Gangrene is also walled off in the same manner. The necrosed portion then sloughs off; nature grows new tissue to take the place of the destroyed tissue and the place is healed.
    
Encapsulation is the process of surrounding a body or substance with a capsule. A cyst or capsule consists of a cavity lined according to its origin by endothelium (in pre- existing cavities of connective tissue—exudation cysts) or epithelium (in pre-existing epithelial cavities—retention cysts) with a fluid or semifluid content.
 
Encapsulation is the process of surrounding a body or substance with a capsule. A cyst or capsule consists of a cavity lined according to its origin by endothelium (in pre- existing cavities of connective tissue—exudation cysts) or epithelium (in pre-existing epithelial cavities—retention cysts) with a fluid or semifluid content.
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(a) Retention cysts, which are due to the obstruction of the excretory ducts of glands. The cavity becomes filled with the secretion of the gland which later becomes altered and circumscribed by a fibrous wall. These may develop in any glandular structure, as pancreas, kidneys, salivary glands, mammary glands, sebaceous glands (wens).
 
(a) Retention cysts, which are due to the obstruction of the excretory ducts of glands. The cavity becomes filled with the secretion of the gland which later becomes altered and circumscribed by a fibrous wall. These may develop in any glandular structure, as pancreas, kidneys, salivary glands, mammary glands, sebaceous glands (wens).
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Around a foreign body like a bullet, such a capsule forms. There is first inflammation and perhaps suppuration. But if this fails to remove the bullet, a capsule of tissue also containing fluid is formed, and the bullet is rendered innocuous. A similar thing fre- quently happens in the lungs in the case of germs. Rausse thought this fluid was a va- riety of mucus and thought that chemical or drug poisons were enveloped in this same “musus” to render them harmless and that they were then deposited in the tissues. He says with regard to the face that this theory cannot at present be demonstrated:
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Around a foreign body like a bullet, such a capsule forms. There is first inflammation and perhaps suppuration. But if this fails to remove the bullet, a capsule of tissue also containing fluid is formed, and the bullet is rendered innocuous. A similar thing frequently happens in the lungs in the case of germs. Rausse thought this fluid was a variety of mucus and thought that chemical or drug poisons were enveloped in this same “musus” to render them harmless and that they were then deposited in the tissues. He says with regard to the face that this theory cannot at present be demonstrated:
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This theory is founded upon the incontrovertible principle of nature in the al- imentary and organic world, that nature operates similarly under similar circum- stances. Hence, the theory here offered loses none of its certainty because we are unable to recognize with the unaided eye, on account of their minuteness, the inim- ical atoms and the minute network around them, and to exhibit them by section.
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This theory is founded upon the incontrovertible principle of nature in the alimentary and organic world, that nature operates similarly under similar circumstances. Hence, the theory here offered loses none of its certainty because we are unable to recognize with the unaided eye, on account of their minuteness, the inimical atoms and the minute network around them, and to exhibit them by section.
    
'''—Water Cure Manual, p. 92, 1845.'''
 
'''—Water Cure Manual, p. 92, 1845.'''
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The formation of gallstones and other stones is in itself an engineering feat that serves a useful purpose and even extends and saves life. In the lungs, for instance, in those who have tuberculosis, the affected spots are often the seat of the formation of stones. When this takes place, the disease in that part ends. Medical authorities consider that nature employs this means to wall up the tubercle bacilli.
 
The formation of gallstones and other stones is in itself an engineering feat that serves a useful purpose and even extends and saves life. In the lungs, for instance, in those who have tuberculosis, the affected spots are often the seat of the formation of stones. When this takes place, the disease in that part ends. Medical authorities consider that nature employs this means to wall up the tubercle bacilli.
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The formation of stones in the gallbladder and kidneys, just as in the lungs, is the end result of inflammation and undoubtedly serves a definite and useful purpose. Some- times, it is true, they are made so large that they are the source of much trouble, but it is safe to assume that they are never made larger than the gravity of the situation demands. Most gallstones are small enough that they pass out without causing pain, and the indi- vidual is never aware that he or she has had them. A large number of people examined at autopsies are found to have gallstones in the gallbladder and were never aware that they had them. They never cause trouble until they go to pass out and only then if they are small enough to get into the gall duct but too large to make the entire passage. A stone that may easily travel through the common duct may be forced, with extreme difficulty, through the small opening of the duct into the intestine. This causes severe pain. As soon as the stone is forced through, the pain ceases. (The sufferer then thinks that it was the last treatment he employed that relieved the pain and “cured” his troubles.)
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The formation of stones in the gallbladder and kidneys, just as in the lungs, is the end result of inflammation and undoubtedly serves a definite and useful purpose. Some- times, it is true, they are made so large that they are the source of much trouble, but it is safe to assume that they are never made larger than the gravity of the situation demands. Most gallstones are small enough that they pass out without causing pain, and the individual is never aware that he or she has had them. A large number of people examined at autopsies are found to have gallstones in the gallbladder and were never aware that they had them. They never cause trouble until they go to pass out and only then if they are small enough to get into the gall duct but too large to make the entire passage. A stone that may easily travel through the common duct may be forced, with extreme difficulty, through the small opening of the duct into the intestine. This causes severe pain. As soon as the stone is forced through, the pain ceases. (The sufferer then thinks that it was the last treatment he employed that relieved the pain and “cured” his troubles.)
    
A thrombus is a small blood clot formed inside a blood vessel. The condition is called thrombosis and the vessel is said to be thrombosed. They are the result of injury and inflammation and may completely plug the vessel.
 
A thrombus is a small blood clot formed inside a blood vessel. The condition is called thrombosis and the vessel is said to be thrombosed. They are the result of injury and inflammation and may completely plug the vessel.
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“Anastamosing” arteries would soon establish sufficient collateral or compensatory circulation to supply the part with blood.
 
“Anastamosing” arteries would soon establish sufficient collateral or compensatory circulation to supply the part with blood.
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If heat or friction of sufficient intensity and duration is applied to the skin, a blister forms; that is, a watery exudate or serum is poured out of the surrounding tissues and circulation into the “space” between the dermis and epidermis and detaches the dermis from this, raising it up and thus protecting the tissues beneath. The accumulated fluid holds back the heat or, in the case of sunburn, the actinic rays, and protects from the fric- tion. This little piece of engineering work is quite obviously a defensive work. In both burns and sunburn, inflammation and healing follow the blister, and in the case of sun- burn pigmentation occurs to protect from future sunburn.
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If heat or friction of sufficient intensity and duration is applied to the skin, a blister forms; that is, a watery exudate or serum is poured out of the surrounding tissues and circulation into the “space” between the dermis and epidermis and detaches the dermis from this, raising it up and thus protecting the tissues beneath. The accumulated fluid holds back the heat or, in the case of sunburn, the actinic rays, and protects from the friction. This little piece of engineering work is quite obviously a defensive work. In both burns and sunburn, inflammation and healing follow the blister, and in the case of sun- burn pigmentation occurs to protect from future sunburn.
    
Of a similarly defensive nature are corns and callouses that form on the feet and hands or any other surface of the body that is subjected to constant friction. The clerk who deserts the store for manual labor finds his hands are tender and blister easily when he handles tools. However, before many days have passed, the skin on his hands has be- come thickened and hardened, ultimately becoming almost horn-like. When this occurs, he finds that no reasonable amount of hard work blisters his hands.
 
Of a similarly defensive nature are corns and callouses that form on the feet and hands or any other surface of the body that is subjected to constant friction. The clerk who deserts the store for manual labor finds his hands are tender and blister easily when he handles tools. However, before many days have passed, the skin on his hands has be- come thickened and hardened, ultimately becoming almost horn-like. When this occurs, he finds that no reasonable amount of hard work blisters his hands.
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Hardening and thickening of the tissues occurs in any and all parts of the body to resist constant irritation. This can be seen in the mouth, stomach and intestines of those who employ salt and condiments. It is seen in the constant use of drugs. Silver nitrate, for instance, if repeatedly employed, converts the mucous surface upon which it is used
 
Hardening and thickening of the tissues occurs in any and all parts of the body to resist constant irritation. This can be seen in the mouth, stomach and intestines of those who employ salt and condiments. It is seen in the constant use of drugs. Silver nitrate, for instance, if repeatedly employed, converts the mucous surface upon which it is used
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into a kind of half-living leather. Other organs harden and thicken as a result of toxic irritation. Toxemia, with or without the aid of external irritation, often necessitates, at certain points of the body, the erection of greater than ordinary barriers against it. When the normal cells of a local spot become so impaired that they no longer successfully re- sist the encroachment of toxins, not only are the usual defense processes brought into activity, but also, since a more than usual condition is to be met, nature calls into play her heavier battalions. She begins by erecting a barrier of connective tissue cells. Then, with a slowly-yielding fight against the toxins, she continues to erect her barriers. This may continue until the tumor becomes so large as to constitute a source of danger itself. Were it not for the erection of this barrier, the causes against which it is erected would destroy life long before they ultimately do. The tumor actually prolongs life.
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into a kind of half-living leather. Other organs harden and thicken as a result of toxic irritation. Toxemia, with or without the aid of external irritation, often necessitates, at certain points of the body, the erection of greater than ordinary barriers against it. When the normal cells of a local spot become so impaired that they no longer successfully resist the encroachment of toxins, not only are the usual defense processes brought into activity, but also, since a more than usual condition is to be met, nature calls into play her heavier battalions. She begins by erecting a barrier of connective tissue cells. Then, with a slowly-yielding fight against the toxins, she continues to erect her barriers. This may continue until the tumor becomes so large as to constitute a source of danger itself. Were it not for the erection of this barrier, the causes against which it is erected would destroy life long before they ultimately do. The tumor actually prolongs life.
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A process similar to this is seen in plants that have been invaded by parasites. The large, rough excrescences seen on oak trees form about the larva of a certain fly. This fly lays its eggs beneath the bark of the tree. The larva which develop from the eggs secrete a substance that results in the formation of the huge tumorous mass. Large tumor-like masses form on the roots and stalks of cabbages as a result of parasitic invasion. The olive tree also develops tumors from a similar cause, while cedar trees present peculiar growths called “witches’ brooms” as a result of a fungus growing on them. There are many other examples, and they are all quite obviously protective measures. Tumor for- mation is undoubtedly due to a variation in the complex relations determining normal growth and is of a distinctively protective nature. A tumor is not a source of danger until it begins to break down.
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A process similar to this is seen in plants that have been invaded by parasites. The large, rough excrescences seen on oak trees form about the larva of a certain fly. This fly lays its eggs beneath the bark of the tree. The larva which develop from the eggs secrete a substance that results in the formation of the huge tumorous mass. Large tumor-like masses form on the roots and stalks of cabbages as a result of parasitic invasion. The olive tree also develops tumors from a similar cause, while cedar trees present peculiar growths called “witches’ brooms” as a result of a fungus growing on them. There are many other examples, and they are all quite obviously protective measures. Tumor formation is undoubtedly due to a variation in the complex relations determining normal growth and is of a distinctively protective nature. A tumor is not a source of danger until it begins to break down.
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In inflammation of the kidneys due to the impairment of kidney function, the normal constituents of the urine are decreased. They remain in the blood instead of being elimi- nated. Due to the necessity of removing from the circulation, the salts, etc., that are nor- mally eliminated through the kidneys, and due also to the necessity of keeping these in dilute solution so long as they remain in the body, and to the equal necessity of removing them from the circulation, drospy develops in various portions of the body, particularly in the tissues immediately under the skin. It may also collect in the cavities of the body. When kidney function is restored, the dropsical fluid is gradually absorbed into circula- tion and eliminated.
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In inflammation of the kidneys due to the impairment of kidney function, the normal constituents of the urine are decreased. They remain in the blood instead of being eliminated. Due to the necessity of removing from the circulation, the salts, etc., that are normally eliminated through the kidneys, and due also to the necessity of keeping these in dilute solution so long as they remain in the body, and to the equal necessity of removing them from the circulation, dropsy develops in various portions of the body, particularly in the tissues immediately under the skin. It may also collect in the cavities of the body. When kidney function is restored, the dropsical fluid is gradually absorbed into circulation and eliminated.
    
An aneurism is an inflated portion of an artery. If the walls of an artery become weak at a given place, they either burst, some of its coats are strengthened or else it becomes bulged out due to the pressure of the blood from within. The body at once sets about to protect itself by forming a vail of new tissue around the aneurism. Should it rupture so that the blood finds its way along between other organs, a wall of scar tissue is thrown up around the aneurism to limit the escape of blood. This is called a dissecting aneurism.
 
An aneurism is an inflated portion of an artery. If the walls of an artery become weak at a given place, they either burst, some of its coats are strengthened or else it becomes bulged out due to the pressure of the blood from within. The body at once sets about to protect itself by forming a vail of new tissue around the aneurism. Should it rupture so that the blood finds its way along between other organs, a wall of scar tissue is thrown up around the aneurism to limit the escape of blood. This is called a dissecting aneurism.
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Thus we might continue giving example after example of the wonderful engineering feats of the body and show with what marvelous powers and works it meets emergencies and protects its own vital interests. When we consider the wonderful mechanism of the human body, the certainty with which all organs perform their allotted work, the mar- velous ingenuity with which the body meets emergencies, its almost limitless powers of repair and recuperation, we develop a large respect and admiration for the healing pow- ers of the body and learn to view with contempt and disgust the means that people em- ploy in unintelligent efforts to “cure.”
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Thus we might continue giving example after example of the wonderful engineering feats of the body and show with what marvelous powers and works it meets emergencies and protects its own vital interests. When we consider the wonderful mechanism of the human body, the certainty with which all organs perform their allotted work, the marvelous ingenuity with which the body meets emergencies, its almost limitless powers of repair and recuperation, we develop a large respect and admiration for the healing powers of the body and learn to view with contempt and disgust the means that people em- ploy in unintelligent efforts to “cure.”
    
Well did Jennings affirm:
 
Well did Jennings affirm:
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But at every step of her (nature’s) downward progress (in the face of pathoferic caus- es she cannot overcome), her tendency and effort have been to ascend and remount the pinnacle of her greatness; and even now, in the depth of her degradation, the tendency of all that remains of her, of principle or law, power and action, is still upwards.
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But at every step of her (nature’s) downward progress (in the face of pathoferic causes she cannot overcome), her tendency and effort have been to ascend and remount the pinnacle of her greatness; and even now, in the depth of her degradation, the tendency of all that remains of her, of principle or law, power and action, is still upwards.