Actinomycosis of the colon, liver, and lung / by R.F.C. Leith.

  • Leith, R. F. C. (Robert Fraser Calder)
Date:
[1894?]
Catalogue details

Licence: Public Domain Mark

Credit: Actinomycosis of the colon, liver, and lung / by R.F.C. Leith. 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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    portal tract. I could not make out ;iijy lymphatics, and am therefore unable to speak of them. After the monolobular cirrhosis has advanced some distance it invades the substance of the lobule, producing an intercellular cirrhosis. The results of the action of the virus are obvious enough, but its nature is not so. Two alternatives suggest themselves—(1) the action of some early form of the actinomyces or other accompanying organism, which precedes the lesion, as suggested, by Samter.^ He thinks that threads or bacilli first appear, and after setting up an inflammation, again disappear without further develop- ment ; (2) the effect produced by the bacterial excretions formed at a distance and distributed throughout the part. After a most dihgent search for organisms in the vessels of the portal spaces, the intralobular capillaries, the central and sublobular veins, and hepatic lymphatics, I did not succeed in finding any, except a number of micrococci in a few of the capillaries and sublobular veins. One or two of the latter were, however, quite filled with plugs of micrococci, even at considerable distances from the invading margin of the growth. These micrococci are of much the same size and character as the cocci seen in the actinomvces colonies, and there is a possibility that they may have taken their origin from them, From these observations the following conclu- sions seem probalile r—(1) The excretions of either the actino- myces or accompanying germs or both are widely distributed throughout the immediate neighbourhood, and in advance of the actinomyces itself, leading to a formation of fibrous tissue, the arrangement and distribution of which will depend some- what upon the structure of the tissue invaded, but with a tendency towards the formation of a reticulum. (2) The actinomyces follicles sooner or later appear in this librous tissue. (3) The follicles become the seat of suiall abscesses, which, by extension, open into one another. While the follicles vary somewhat in detail, they are all built upon the same plan. The colony occupies the centre, anl around it are large connective-tissue cells, arranged with their long axes perpendicular to the periphery of the colony. Towards the margin, one or more giant cells appear; and,