Columnae adiposae, a newly-described structure of the cutis vera : with its pathological significance in carbuncle and other affections / by J. Collins Warren.

  • Warren, John Collins, 1842-1927.
Date:
1881
Catalogue details

Licence: Public Domain Mark

Credit: Columnae adiposae, a newly-described structure of the cutis vera : with its pathological significance in carbuncle and other affections / by J. Collins Warren. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    22/34 (page 22)
    09 ill Zj Columnce Adijjosce. now seen projecting and forming a prominent pustule. It is at this point, therefore, that the pus first appears upon the surface. (Figure 2, h; Figure 4, A, m.) At this stage of development of the carbuncle the papillai of the skin covering the tumor present appear- ances which deserve special attention. (Figure 3.) At those points where cell infiltration is most abundant a change of shape is occasionally noticed, the upper part of the cone becoming greatly distended so that the nar- rowest portion of the papilla is its base, the cone be- ing converted into a balloon-shaped figure (Z). A more minute observation shows that papillas thus af- fected contain a number of wandering cells, and that the meshes of their loose tissue are distended with fluid; they have the appearance of being oedematous. The adjacent layers of the rete mucosum are greatly com- pressed by this swelling, and in some instances the interjacent projections of the deep layers of the rete are nearly obliterated, several neighboring papillae thus becoming united to form a single large one. Usually, however, we find that the number of cell elements in the papillae gradually increase, until it becomes packed solid with small round cells, which obscure all other structures. The blood-vessels, if seen, are filled with red blood corpuscles, which are also found at times in considerable numbers in other parts of the papilla. At this stage we find that the fundus of the polypoid struct- ure presents itself above the level of the surface, the epidermis forming but a thin layer above, or being rep- resented by a few adherent crusts and scales. The final stage in the development of this series of changes is an actual giving way of the ejjidermal covering, and an escajje of the contents of the “papilla. Should the