Atrophy

Atrophy (Gr. ἀ- priv., τροφἠ, nourishment), a term in medicine used to describe a state of wasting due to some interference with the function of healthy nutrition (see Pathology). In the living organism there are always at work changes involving the waste of its component tissues, which render necessary, in order to maintain and preserve life, the supply and proper assimilation of nutritive material. It is also essential for the maintenance of health that a due relation exist between these processes of waste and repair, so that the one may not be in excess of the other. When the appropriation of nutriment exceeds the waste, hypertrophy (q.v.) or increase in bulk of the tissues takes place. When, on the other hand, the supply of nutritive matter is suspended or diminished, or when the power of assimilation is impaired, atrophy or wasting is the result. Thus the whole body becomes atrophied in many diseases; and in old age every part of the frame, with the single exception of the heart, undergoes atrophic change. Atrophy may, however, affect single organs or parts of the body, irrespective of the general state of nutrition, and this may be brought about in a variety of ways. One of the most frequently observed of such instances is atrophy from disuse, or cessation of function. Thus, when a limb is deprived of the natural power of motion, either by paralysis or by painful joint disease, the condition of exercise essential to its nutrition being no longer fulfilled, atrophy of all its textures sooner or later takes place. The brain in imbeciles is frequently observed to be shrivelled, and in many cases of blindness there is atrophy of the optic nerve and optic tract. This form of atrophy is likewise well exemplified in the case of those organs and structures of the body which subserve important ends during foetal life, but which, ceasing to be necessary after birth, undergo a sort of natural atrophy, such as the thymus gland, and certain vessels specially concerned in the foetal circulation. The uterus after parturition undergoes a certain amount of atrophy, and the ovaries, after the child-bearing period, become shrunken. Atrophy of a part may also be caused by interruption to its normal blood-supply, as in the case of the ligature or obstruction of an artery. Again, long-standing disease, by affecting the nutrition of an organ and by inducing the deposit of morbid products, may result in atrophy, as frequently happens in affections of the liver and kidneys. Parts that are subjected to continuous pressure are liable to become atrophied, as is sometimes seen in internal organs which have been pressed upon by tumours or other morbid growths, and is well illustrated in the Chinese practice of foot-binding. Atrophy may manifest itself simply by loss of substance; but, on the other hand, it is often found to co-exist with degenerative changes in the textures affected and the formation of adventitious growth, so that the part may not be reduced in bulk although atrophied as regards its proper structure. Thus, in the case of the heart, when affected with fatty degeneration, there is atrophy of the proper muscular texture, but as this is largely replaced by fatty matter, the organ may undergo no diminution in volume, but may, on the contrary, be increased in size. Atrophy is usually a gradual and slow process, but sometimes it proceeds rapidly. In the disease known by the name of acute yellow atrophy of the liver, that organ undergoes such rapidly destructive change as results in its shrinking to half, or one-third, of its normal size in the course of a few days. The term progressive muscular atrophy (synonyms, wasting or creeping palsy) is applied to an affection of the muscular system, which is characterized by the atrophy and subsequent paralysis of certain muscles, or groups of muscles, and is associated with morbid changes in the anterior roots of the nerves of the spinal cord. This disease begins insidiously, and is often first observed to affect the muscles of one hand, generally the right. The attention of the sufferer is first attracted by the power of the hand becoming weakened, and then there is found to be a wasting of certain of its muscles, particularly those of the ball of the thumb. Gradually other muscles in the arms and legs become affected in a similar manner, their atrophy being attended with a corresponding diminution in power. Although sometimes arrested, this disease tends to progress, until in course of time the greater part of the muscular system is implicated and a fatal result ensues.

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