Case of fatal purpura associated with waxy degeneration of the striated muscles, and also of the vessels in the affected parts / by Wilson Fox, M.D.

  • Fox, Wilson, 1831-1887.
Date:
[1865], [©1865]
Catalogue details

Licence: Public Domain Mark

Credit: Case of fatal purpura associated with waxy degeneration of the striated muscles, and also of the vessels in the affected parts / by Wilson Fox, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    than natural. Hardly any traces of their disintegration could be found. The red corpuscles in the clot in the heart were perfectly normal in all respects. Muscles.—The pale portions above described presented a mixture of two appearances—1. Some fibres were excessively pale, had a uniform waxy look, and had lost nearly all appearance of striation. They broke ujr very easily, and in many places ruptured within the sarco- lemma. Some presented an appearance as if made up of innumerable refracting particles, but I could not succeed in breaking up these fibres, so as to examine separately the constitution of the individual particles. These fibres did not appear particularly enlarged. 2. Other fibres in the same field, which were much paler than natural, had not the glistening waxy look, but were very finely granular. The trans- verse and longitudinal striation were indistinct, but these fibres in many cases split up very easily into fibrillse. The granules disappeared for the most part with liq. potassse or acetic acid, leaving a few scattered fat drops in the field. The nuclei appeared about as distinct as usual in the more waxy specimens. They were indistinct, but not enlarged in those which were granular. The exceedingly pale spots in the rectus abdominis presented the waxy change iu the most marked degree. The changed spots before described in the neighbourhood of the hemorrhagic extravasations in the thigh, though presenting some waxy fibres, were more generally granular, but in both situations they stained of an intense reddish-brown with iodine, which deepened into an intense red on the application of sulphuric acid : I could not obtain from them a violet tint. The same reddish-brown was produced by Schulze’s reagent (chloride of zinc and iodine). The heart showed in a few parts similar waxy fibres, but in the affected spots the more general appearance was that the fibres were finely granular, with indistinctness of the transverse striation. The granular character disappeared, as a rule, with acids and alkalies. A few fibres here and there were distinctly fatty. In the vessels of the skin and muscles near the affected parts I was able to trace similar changes. I endeavoured to inject the right forearm from the brachial artery at the bend of the elbow, using Beale’s prussian blue injection fluid, but I found a very great difficulty in injecting the finer vessels of the skin ; in fact, in hardly any portions could these be said to be com- pletely injected, though the fluid returned in great quantities through the collateral circulation into the axillary arteries. As this injecting material ordinarily penetrates with great ease into the finest vessels, I was led to the belief that there must be something in the condition of the vessels themselves which caused this difficulty. Sections of the skin near, but not in the parts affected with the haemorrhagic extravasations, gave, either with Schulze’s reagent or with iodine, or iodine and sulphuric acid, a most intense reddish- brown, in portions between the fat vesicles corresponding to the course of the capillaries; this coloration did not pass much into the