On the production of gas-containing cavities in the internal organs of the body / by J.H. Bryant and W.C.C. Pakes.

  • Bryant, John Henry.
Date:
[1898?]
Catalogue details

Licence: Public Domain Mark

Credit: On the production of gas-containing cavities in the internal organs of the body / by J.H. Bryant and W.C.C. Pakes. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

    14/26 (page 290)
    walls, some showed a thin, ssarcely visible, membrane, whilst others were surrounded by connective tissue and partly by cells, and others by liver cells alone. These former conditions the author explains by the supposition that the cavities originated in the capillaries, whose thin walls remained or burst, and that others without a membrane originated outside the vessel walls. The liver walls were swollen, cloudy, slightly granular, with indistinct nuclei which were difficult to stain; some of the cells contained hsematin granules and others showed signs of fatty degeneration. Sections treated with gentian violet and picric acid showed the tissues stained a yellow colour and numerous short regular bacilli stained a dark violet, these latter were seen to be congregated in enormous numbers at the peripheries of the cavities, around which they formed a kind of wreath, generally complete but here and there massed together. In some parts of the section clumps of bacilli were seen in the tissues without corresponding cavities or with small commencing microscopic cavities in the centre or at the end of the masses. No cavities were found without bacilli around them. In places clumps of bacilli were seen actually in the cavities. All these micro-organisms resem- bled typhoid bacilli in form and size but not in their staining properties. The fact that the bacillus stained so well, and the very free production of gas, led to the assumption that it was the bacillus coli communis, or a near ally derived from the intestinal canal. It was thought that the condition was most unlikely to have been an ante- mortem change, partly on account of the absence of any sign of hyperplasia, proliferation of connective tissue, irritation or inflammation, and partly from the fact that no objective symptoms during life, such as pain, jaundice or evidence of portal obstruction had been noticed. In favour of the change being a post-mortem one was the time after death of the autopsy, viz., twenty-eight to thirty hours, and the temperature of the room in which the corpse had been during this time, viz., 18° to 20° 0. In this case the liver was the only organ affected, and that was put down to the fact that the liver contains a considerable amount of glycogen and sugar and that the bacillus coli communis in particular has the property of producing gas from glucose. Gcfibel describes two cases in which the bacillus coli communis was found but not in pure culture, as will be seen below. II.—Cases in which the Bacillus Aeeosenes Capsulatus was pound. Case 3.—The micro-organism which has most frequently been found associated with this condition is the bacillus aerogenes capsulatus, first described by Welch and Nuttall in 1892, and obtained from the emphyse- matous tissues and blood of a man who died of aneurysm of the aorta, which had perforated by a small opening through the anterior thoracic wall, and given rise to repeated external hsemorrhages. No subcu- taneous emphysema was noticed before death. The autopsy was performed in cool weather, eight hours after death. There was no evidence of post- mortem decomposition, or of emphysema of the subcutaneous tissues of the body. The blood vessels and heart contained abundant gas. The blood was lake coloured, and the endocardium of the heart and the intima of the blood vessels were deeply stained. Gas was also found in the blood-stained serum in the pericardial sac and in the peritoneum. Gas bubbles were present in