A Text-book of the practice of medicine / by James M. Anders.

  • Anders, James M. (James Meschter), 1854-1936.
Date:
1899
Catalogue details

Licence: Public Domain Mark

Credit: A Text-book of the practice of medicine / by James M. Anders. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    seat of two forms of arteritis (Barie): {a) Acute obliterating arteritis, and {b) Partial arteritis. These conditions may affect the smaller ves- sels, particularly those of the heart, but they occur most commonly in the arteries of the lower extremities. Thrombi are found in the right chambers of the heart and in the veins—most frequently in the femoral, and less often in the cerebral sinuses. The vohtntd)-)/ muscles undergo 2:)arenchymatous and, occasionally, a hyaline, change, though this is not a feature peculiar to typhoid fever. The latter form of degeneration does not affect the whole muscle, only certain fibers being involved, and as a rule the recti abdominis, the dia- phragm, the adductors of the thigh, and the pectorals are the seats of the lesion. The parts affected are pale and possess a grayish, waxy luster. Histologically, the process implies the transformation of the muscular fibers, and especially the cement substance, into a homogeneous, pliable mass. Regeneration of the fibers thus destroyed occurs durinor convalescence. The 7ieri'ous system presents no gross lesions, if we except menin- gitis, the latter occurring as a complication ; but it is exceedingly rare, having been present in only 11 of the 2000 Munich cases. In a few instances large cerebral hemorrhages have been met with, but these are apparently coincidental, while capillary hemorrhages into the cortex mav be numerous. Meningeal hemorrhages mav also occur. Slight edema of the cerebral cortex has been noted. The peripheral nerves are, not infrequently, the seat of parenchymatous change, with or Avith- out local neuritis, and the ganglia of the trunks of the vagi exhibit an inflammatory change, Avhich Levin feels is the cause of certain symp- toms and conditions, such as laryngitis, pharyngitis, pharyngolysis, arrhythmia, etc. The blood shows few important alterations. The red blood-corpuscles are relatively increased during the febrile period and markedly dimin- ished during convalescence, but the great loss of water during the former period and a reabsorption during the latter will explain these interesting facts (Henry). Leukocytosis is absent, and there is often an actual decrease in the number of leukocytes. The mononuclear forms are more numerous tlian in health. Htiologfy.—Bacteriology.—The bacterium which is the specific cause of typhoid fever was discovered by Eberth. whose researches were later confirmed by the careful investigation of Gaffky. Genei'al Characters.—It is a short, thick bacillus, about three times as long as it is broad, Avith rounded ends (Fig. 1). It is motile, due to the presence of cilia on both sides, and when stained exhibits vacuolations that have been mistaken for spores. It is easily stained with all the anilin dyes. Characteristic Growth.—Upon gelatin plates it develops in grayish translucent colonies with irregular borders and ridged surfaces. Lpon agar the growth is not characteristic; upon the potato, especially if it has been rendered slightly acid, it forms a perfectly transparent growth that is only evident as a slight apparent increase of moisture upon the surface, and as offering a greater resistance to the point of the needle when scraped across it. It neither coagulates milk, liquefies gelatin, nor produces indol. The organism never forms spores. Moreover, the