Report on the etiology and prevention of yellow fever / by George M. Sternberg.

  • Sternberg, George Miller, 1838-1915.
Date:
1890
Catalogue details

Licence: Public Domain Mark

Credit: Report on the etiology and prevention of yellow fever / by George M. Sternberg. Source: Wellcome Collection.

Provider: This material has been provided by the Augustus C. Long Health Sciences Library at Columbia University and Columbia University Libraries/Information Services, through the Medical Heritage Library. The original may be consulted at the the Augustus C. Long Health Sciences Library at Columbia University and Columbia University.

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    somewhat neglected, and farther researches in this direction are desirable upon ma- terial obtained at the earliest possible moment after, death. The appearance of the liver in yellow fester is characteristic, at least so far as acute febrile diseases are concerned. Usually it contains less blood than iu the normal con- FiR. 7.—Patty infiltration of the liver cells, svith a moderate amount of small-celled infiltration, in a case of yellow fever. Material from Havana. ditlon, and is of a pale yellow or brownish yellow color, similar to that of new leather in its various shades; occasionally it is gorged with blood, and livid, deep blue, or dark purple iu color. In the victims of chronic alcoholism, it often presents the nutmeg appearance of cirrhosis. The dimensions do not differ materially f:om the normal, but the consistence is modified by the fatty change, which gives the characteristic color, and the parenchyma is easily torn and more or le.ss friable. On section it is found to be drier than in the normal state, except in the comparatively few cases in which it is hyper;emic; these arc, as a rnle, cases which have proved fatal at a very early period—a fact which indicates that there is a stage of conges- tion antedating that of au;emia and fatty degeneration. According to Crevaux, this congestion is located especially in the portal radicles surrounding the lobules, and is attended with cedema of the interlobular connective tissue. Whether this primary congestion is a constant phenomenon or not, it is certain that in a majority of the au- topsies the liver is found to be anajmic, and to present more or less evidence of fatty change iu the hepatic cells. This is not, however, a uniform proces.s, but areas of greater or less extent are seen, iu which the cells are infiltrated with fat globules, as seen in Fig. —; while in other places the cells appear normal. The fatty cells con- tain one or several fat globules of varying dimensions, and the protoplasm is reduced iu quautity according to the extent of this fatty change. The nuclei very often re- main intact in the cells infiltrated with fat, but according to Schmidt a great num- ber ofthe nuclei also undergo fatty degeneration. Often a collar of normal cells re- mains about the central vein, while those cells nearer the periphery of the lobnle con- tain numerous fat globules. In two of the livers brought back from Havana by the Yellow Fever Commission of 1879, in which there was evidence of cirrhosis. Woodward found that, in addition