A study of the various changes which occur in the tissues in acute diphtheritic toxaemia : more especially in reference to 'acute cardiac failure' / by Leonard S. Dudgeon.

  • Dudgeon, Leonard S., 1876-1938.
Date:
1906
Catalogue details

Licence: In copyright

Credit: A study of the various changes which occur in the tissues in acute diphtheritic toxaemia : more especially in reference to 'acute cardiac failure' / by Leonard S. Dudgeon. 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.

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    osmic acid and some have obtained excellent results, yet, if we study the literature carefully, there is obviously a degree of uncertainty about the results obtained with osmic acid in many instances. It is a matter of common know- ledge that osmic acid will stain “ droplets” dark brown or green which are not really fat, and this may at times lead to considerable difficulty. The very fine fatty changes which were present in the heart muscle and diaphragm in some examples were not detected with osmic acid, although excellent results were obtained with Scharlach E. While in a few cases, although the very fine fat droplets were stained black, it required considerable care to demonstrate their presence in the tissues. Busch’s method is excellent for the nervous system, but I found it to be of little or no value for acute fatty changes in the heart and diaphragm. I am unable to find a solitary point in favour of osmic acid, or even to show its equality with the red stains for demon- strating acute fatty changes. Doubt has been cast as to whether Scharlach E. and Sudan III. do not stain substances other than fat, simply because it is possible to obtain results with them which cannot be obtained with osmic acid. It is impossible, however, at present, to decide this point. I have made numerous investigations with these stains and the various fats and fatty acids, and see no reason to doubt, at the present time, the value of the red stains. Summary of my Observations on the Changes pro- duced in the Tissues by the Toxins of the Bacillus of Diphtheria. (a) That the most important lesion in the acute cases is a fatty change of the heart muscle and diaphragm, which is due to a direct action of the toxins on these tissues. (b) That similar fatty changes may be found in certain of the important viscera, more especially the adrenal gland and liver. (c) That the expression “ cardiac paralysis ” in acute diphtheritic toxaemia should be abolished and be replaced by “ acute cardiac failure.”