On the value of experimental tuberculosis in diagnosis / by Sheridan Delépine.

  • Delépine, Sheridan, 1855-1921.
Date:
[1893]
Catalogue details

Licence: Public Domain Mark

Credit: On the value of experimental tuberculosis in diagnosis / by Sheridan Delépine. 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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    Twelve days after inoculation on lite leftside with about .»0 of a small colony of bacilli (under 1 mm. in diameter), the following' parts were found allocked:—Left poplit,e;U ganglion quite distinctly ; the left superficial in- guinal ganglia distinctly; the left sublumbar ganglion distinctly the retrohopalic ganglion was slightly ail'ected; the spleen slightly affected?. J Twenty Days after Inoculation with a Pure Cultivation.—The above organs were much more enlarged, and several ganglia were already undergoing cheesy degeneration. In addition, the following organs were also dis- tinctly affected—liver, mediastinal and bronchial ganglia. (Twenty Days after Inoculation with Certain Specimens of Sputa.—The follow- ing parts were already distinctly affected:—Left popliteal ganglion left superficial and deep inguinal ganglia, left sublumbar ganglia, the retro- hepatic ganglia, the mediastinal and bronchial ganglia, the spleen, the liver. The lungs were much congested, and possibly tuberculosis was beginning to extend to them.) Twenty-six Days after Inoculation with Pure Cultivation.—All the above organs were still more affected, and in addition there were distinct changes in the following: The subscapular ganglia, the inferior deep cervical ganglia; the lungs showed signs of becoming involved. Thirty Days after Inoculation with Pure Cultivation.—-The lungs were cer- tainly affected. The right superficial inguinal ganglia were beginning to be involved. (Forty-three Days after Inoculation with Sputum.—All the above organs were affected with the exception of the right inguinal ganglia.) Fifty-two Days after Inoculation with Sputum.—The right inguinal ganglia were enlarged. Sixty-two Days after Inoculation with a Pure Cultivation.—The same organs were affected as at the earlier dates, but the cheesy degeneration of tubercles, the enlargement and necrosis of the liver and spleen were very much more marked. Seventy-four Days after Inoculation with a Pure Cultivation.—There was a slight indication of swelling of the right sublumbar ganglion; the right popliteal was still normal in appearance. These results agree in the main with those given by Ar- loing, but there are, however, some differences. According to Arloing the mode and rate of extension are as follows: Fifteenth Day.—Superficial and deep inguinal ganglia on the side of inocu- lation. Twentieth Day.—Sublumbar ganglia. Twenty-second to Twenty-fifth Day.—Spleen, retrohepatic ganglia. After this the bronchial ganglia and the lungs would become affected. Sixtieth Day.—The tuberculosis would be general. It will be evident from this that I have found evidence of affection of the lymphatics on the same side of the body, and also of the liver, spleen, and lungs at much earlier dates than Arloing had, in fact more than a week earlier. On the other hand, I would not feel inclined to say that tuberculosis had, in my case, become general on the 60th day, nor even on the 74th or 97th or 106th day, since at those dates I have only found a few lymphatics of the lower part of the body on the side opposite to that inoculated showing any signs of tuberculosis.6 As I do not wish here to deal with any other point than the diagnostic value of inoculation, I will not discuss the facts which I have just brought forward, but I will sum- marise them as follows : Products containing even a small number of tubercle bacilli will, when inoculated under the skin of the inner aspect of the leg of a guinea-pig! at the level of the knee, cause tuberculosis of a certain number of organs m the fol- lowing order: During the Second Week.—The lymphatic ganglia on the game side of the body below the diaphragm and the spleen. During the Third Week.—The liver, mediastinal, and bronchial ganglia. . „ During tlie Fourth Week.—1\\e lungs, cervical and axillary ganglia. It must be remembered that these differences may be due to external circumstances or to the breed of animals used. I do not wish, however, to do more than indicate this slight, discrepancy in the icsults obtained by Arloing in Lyons and myself iu Manchester.