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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    papill®, but was chiefly limited to the situation above described. The colour with Schulze’s reagent was somewhat evanescent, but that with iodine lasted for a considerable period of time (forty-eight to seventy- two hours), and in some preparations the marking out of the capil- laries was beautifully effected in this manner. It was not constantly met with in all portions of the skin tested, but was best marked in portions taken in close proximity to the affected spots. In some of these parts I succeeded in isolating portions of the capillaries and smaller arteries. I found that they broke up very easily, that some presented a peculiar glistening, waxy look, while others had a more granular appearance, in no respect corresponding to the appearances observed in health. In some of the small arteries taken from the muscular tissues near affected portions, I found that the middle coat stained most intensely with iodine, the adventitia being unaffected; and I found this change in one or two injected portions. In some places thei’e seemed to be an increase in size and number of the nuclei of the adventitia, but I was not able to satisfy myself of this point in a sufficient number of instances to speak very positively regarding this change. I have tested portions of skin taken from other bodies with the same reagents, and find that they do not present the same appearances. These changes in the vessels of the skin were not general, but occurred in scattered spots and patches, chiefly in the neighbourhood of tho extravasation. The vessels of the omentum presented no changes whatever. Remarks.—It will be observed that the above is not an uucompli- cated case of purpura, inasmuch as the syphilitic affection under which the patient was suffering was running at the time of the attack a very acute course, and its local expression (the angina faucium) appeared to be much complicated by the secondary affection. The blood affec- tion here does not appear to have been a very definite one; and it is difficult to associate the increase in the number of white corpuscles with any direct causation of the haemorrhage. I have already ques- tioned whether the appearance of disintegration observed in some of them be anything but a physiological phenomenon, as it has been long the opinion of many eminent histologists and physiologists that the red corpuscles are only the nuclei of the white.1 It will be observed that there was no post-mortem evidence of any liquefaction, or in- creased fluidity of the blood. The discovery of an appreciable alteration in the capillaries in this affection is, I believe, a new fact in its history, though the well-known reaction with iodine of tissues affected by the lar- daceous or amyloid degeneration has been observed by Prof. Virchow and by myself, in the rete Malpighi, in a case where there was general lardaceous disease of many of the organs of the body.2 1 See Mr. Wharton Jones On Blood Corpuscles considered in Different Phases of Development in the Animal Series. (Phil. Trans. 1846.) 2 See a paper by the author, On the Pathology of the Glandular Structures of the Stomach. (Med.-Cbir. Trans., vol. xli. p. 388.)