On dilation of the lacteals / by T. Grainger Stewart.

  • Thomas Grainger Stewart
Date:
[1863?]
Catalogue details

Licence: Public Domain Mark

Credit: On dilation of the lacteals / by T. Grainger Stewart. Source: Wellcome Collection.

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    The only case which I hnd closely corresponding to this is one recorded by Rokitansky in the last edition of his Pathological Anatomy/ of which case I subjoin an abstract. In a nmi^ 62 years of age, with oedema of subcntaneons cellular tissue, and very considerable effusion of a milk-like fluid, in both pleural and the peritoneal cavities, with dilatation and hypertrophy of the heart, thickening and shortening of the mitral valves, with thick¬ ening of the mucous membrane of the stomach in the pyloric half, and the walls of the intestine white and swollen, the subpleural lymphatic vessels were distended, still more the chyle vessels and the thoracic duct. They presented, from the bowel to the first series of lymphatic glands, knot-like dilatations, full of a white soapy or greasy looking matter, which became diffused in water. It consisted of fatty granules, some of them agglomerated into cell¬ like bodies, crystals of margarin and some apparently nucleated cells. In individual places the mass was more yellow, and adhered to the walls of the vessels. In the lymphatic glands there were similar small deposits, and in the thoracic duct there were some dilatations.^ Such is the only case in which I And a closely corresponding lesion described, but there are several cases on record in which a dilatation existed in other parts of the lymphatic system. Carswell and Breschet both describe one in which there was an enormous congenital dilatation of the lymphatics from both groins upwards.® H. Lebert, in his work on the diseases of the lymphatic vessels and glands,^ mentions a number of cases of dilatations of the lymphatic vessels from the works of Baillie, Soemmering, Cruveillhier, and others, and gives one or two at length. One originally recorded by l)r Fetzer of Stuttgart, was that of a young girl in whom there was a dilatation of the lym¬ phatic vessels of the abdominal wall from the umbilicus to the spinal column on one side. There were about eighteen little tumours which, from time to time, became painful, and at once relieved themselves and demonstrated their nature by discharging a milk-like fluid.^ In a case recorded by Bemarquay, there were on the left thigh groups of transparent vesicles, which were ascertained to consist of varicose lymphatics. The vesicles ultimately burst and discharged a large quantity of lymph.® Lebert himself observed a case, in Schonlein’s Clinique at Zurich, in 1833. I quote his account of it;—In the summer of that year I saw a young man, twenty-one years of age, in whom, from time to time, there ap- 1 Rokitansky’s patliologische Anatomie, band ii. s. 388. 2 Dr Craigie informs me that he, on one or two occasions, during the cholera epidemic, found the lacteal vessels distended with a whitish fluid, in bodies of those who had died from the disease. 3 Carswell’s Pathological Anatomy Hypertrophy, Plate iii. ^ Virchow’s Plandbuch der speziellen Pathologic und Therapie, band v. Abtheilung ii. ^ Lebert, op. cit., p. 134. ® Lebert, op. cit., p. 134.
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