Imagens das páginas

The cases of ulceration of the intestine in fever or phthisis, are not recorded in this Division. In the 4 fatal cases, the rectum alone was ulcerated :

1 was a case of profuse hæmorrhage.
2 were cases of acute peritonitis.

1 was a case of dropsy and atrophy of the liver. 32. Peritonitis.—The following are the 8 complicated fatal cases of acute peritonitis :

3 of ulceration of stomach or intestines.
1 , ischuria and cancer of uterus.
1 , perforation of the bowels.
1 „ miscarriage.

„ ovarian dropsy (paracentesis).

1 „ pleuro-pneumonia. Chronic peritonitis, in a fatal case, was associated with pneumonia and diabetes. 33. Diseases of Liver and Gall-bladder. 6 cases of cirrhosis connected with ascites.

general dropsy. » » »

disease of the lungs.

disease of the kidneys. Great enlargement of the liver occurred in a case of jaundice, which was fatal ; and in a case of pleurisy with malignant disease of the spleen, also fatal.

Jaundice was connected with gall-stones in 3 cases. The other death from gall-stones occurred in a woman admitted for acute rheumatism (see Div. 4).

A patient admitted with jaundice was found some weeks later to have diabetes also.

34. Diseases of Spleen.-In 3 cases which proved fatal from pleurisy, fever, and encephaloid disease respectively, the spleen was found to be more than double its natural size. 36. Diseases of Urinary Organs.—Nephritis was fatalIn a case of epilepsy with bronchitis and pneumonia. , dropsy and fatty heart.

renal calculus and acute inflammation of knee-joint. Albuminuria was associatedIn 13 cases with disease of the heart.

, 6

, phthisis
» dropsy.
, malignant disease.

diabetes. 1 case of diuresis was complicated with anasarca, another with Bright's disease.

Ischuria was fatal in a case of peritonitis (see Div. 32).

37. Diabetes.-One patient died from pneumonia and peritonitis ; 1 case was complicated with albuminuria, another with jaundice. .

38. Diseases of the Ovaries.-A patient with ovarian dropsy, had

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also cancer of the vagina. One died of peritonitis after tapping had been performed (see Div. 32).

In the obstetric physician's ward there were 6 cases of pelvic tumours, the nature of which could not be clearly ascertained.

39. Diseases of the Uterus.-In a case of non-malignant tumour of the uterus, death occurred at a later period from encephaloid disease of the neighbouring parts.

One case of amenorrhoea was fatal from pleurisy and disease of the heart.

40. Diseases of Bones and Joints.—The following cases occurred in the medical wards :

2 of chronic synovitis.
1 of acute inflammation and suppuration of knee-joint.
2 of caries of the spine.
1 of scrofulous disease of hip-joint.

1 of syphilitic caries of the frontal bone. 41. Diseases of Skin and Cellular Tissue.—A fatal case of diffuse cellular inflammation was complicated with dropsy and bronchitis.

Another patient died from sloughing bed-sores.
43. Anomalous and Accidental Cases.

1 of spasm of glottis.
1 doubtful tumour in left hypochondrium.

1 case of otorrhoea.
And three or four cases of admission without necessity,



Chronicle of Medical Science.


By John W. OGLE, M.D., F.R.C.P. Assistant Physician to St. George's Hospital, and Honorary Secretary to the Pathological Society.


NERVOUS SYSTEM AND ORGANS OF SENSE. Minute Anatomy of the Cerebellum and Spinal Cord. By Bergmann of Rostock. The author* agrees with Bidder and Hanover as to the fact of the conical cells forming the covering of the spinal cord, passing at their smaller extremities into fibres which enter the grey substance, and there partly uniting themselves with other fibres, and partly passing into areolar tissue-cells. He adduces microscopical preparations which he has made, showing the passage of very fine fibres from the epithelium-like lining of the fourth ventricle of the toad, into the medulla. On tranverse section of this ventricle, they are seen to form arches convex in an outward direction; but the author has not noticed any union with areolar tissue in their case. Bidder, however, thought that these fibres could not form a portion of any system of nerve-fibres. Bergmann says, that in one point he was at issue with Bidder. Although, he observes, the layer ont of which the fibres proceed appears to be epithelial, traces even of the cilia not failing, yet isolated fibres existed not having the character of epithelial cylinders, but of spindle cells, which project from their nucleusholding body a short process towards the ventricle, and a long one into the medulla. On looking carefully at these fibres as they lie near each other, they might be considered as limits of cells, and the nuclei as nuclei of these cells. These apparent cells are supported towards the medulla by a limitation, the fibres being united to each other by means of a delicate membrane, from which pass the tender projections. Possibly there may be between these fibres, cells, to which cilia belong. Bergmann proceeds to mention some appearances observed by him in the cerebellum of the newly-born cat when hardened by chromic acid. At the borders of very fine sections made perpendicular to the surface, a bright layer was observed between the grey substance and the pia mater, at one time more, at another less broad. This did not exist in all parts of the same thickness, but varied up to 0:007 and 0:008 Paris lines in thickness. This layer showed very fine lines drawn perpendicularly in such a way that in many places one might have thought it a non-nucleated cellular layer. It is in reality, however, only a delicate clear mass, penetrated by innumerable threads of great tenuity. These threads are the extreme branches of other and thinner ones which may be traced in the innermost layer of the grey substance. Here and there a nucleus was seen adherent, but it could not be made out whether or not it was intimately united to the fibre. Amidst isolated fibres were seen short branches at short angles, broken off. These had

• Henle und Pfeuffer's Zeitschrift, Band viii. Heft 2, p. 360. 40-xx.


partly a direction towards the periphery, and partly also into the interior of the organ : a fact adverse to the idea that the fibres pertain to the ramifications of the ganglion corpuscles. The fibres in question probably form a network in the grey substance: the end of one of them isolated could in places be seen traced into the clear substance, and separating into finer fibrils, the structure calling to mind the relation of the radial fibres of the network where they are in contact with the limitary membrane; the similarity is greater from the fact that a very fine structureless lamella, differing from the pia mater, lies on the surface of the cerebellum, representing, as it were, the limitary membrane. How far the above-named fibres enter—for instance, between the ganglion corpuscles — is not known. The author also possesses preparations from other adult animals and man. In the case of the dog, similar fibres are seen projecting out of the grey substance; the transparent layer is entirely wanting, and possibly only belongs to histological development. The limitary membrane may become increased in thickness, and connected with the pia mater.

On the Nerdes of the Intestinal Walls.-G. Meissner* looks upon the areolar tissue between the muscular and the mucous coats of the intestines as one of the parts most richly supplied by nerves in the entire body. These nerves, by numerous anastomoses, form a network, the finest twigs of which appear to penetrate the muscle. The primitive fibres for the most part, and perhaps entirely, belong to the kind without any double contour, and are beset by numerous nuclei. They form the finer and thicker branchlets, and are comprised in nucleus-holding sheaths, in numbers varying from five to twenty; whilst the finest branchlets only contain from two to three primitive fibres. The small intestines appear to be the most rich in nerves, but in the walls of the stomach the nerves are very sparing. In the walls of the intestine the number of ganglia in the nervous plexuses is immense, corresponding for the most part with the thickness of the nerve-branches in which they are found; and in the small intestines almost every nerve-branch leads to a ganglion. The largest observed by the author consisted of from thirty to fifty cells; but they ordinarily contained from five to ten, having the ordinary appearance of ganglion cells. In man, pigment granules were often to be seen as contents of the cells, but in the calf they were found to be quite clear and colourless. Many of the cells were bi-polar, and this was evident whenever a single cell was seen inserted in the course of a primitive fibre without a ganglion being formed. Such cells were generally spindle-shaped, and projected themselves at opposite poles into a fibre. Besides bi-polar cells, some were seen from which, either at one side or both poles, two fibres passed close to each other. The ganglia in the stomach are not relatively less than in the intestine. The ganglion cells in the stomach are larger than those of the intestinal walls. The author describes the best method of examining the nerves and ganglia of those parts, and speaks of the fresh intestine being sufficient, by the aid of acetic acid, for the examination; but inasmuch as this method is tedious, moderately concentrated pyroligneous acid affords the greatest help, which after some time makes the areolar tissue very transparent, leaving the nerves and ganglia unaltered. After dilute pyroligneous acid has acted for some days, acetic acid proves very serviceable.

On the Olfactory Mucous Membrane of Man.-By Professor Ecker.t-The author, speaking of the septum of the nostrils, says that the very vascular succulent Schneiderian membrane is obscurely separated from the other part

• Henle und Pfeuffer's Zeitschrift, Band viii. Heft 2, p. 264. + Zeitschrift für wissenschaftlichen Zoologie, Band viii. p. 203 : as quoted in Schmidt's Jahrbücher, No. 5, p. 167. 1857.

of the mucous membrane, poor in vessels, and of a reddish yellow colour, on which, at the upper part of the septum the olfactory nerve extends itself. This olfactory region stretches downwards about 9'' in width from the front backwards, and about 1)" in a horizontal direction. This spot is distinguished from neighbouring parts by being of a yellowish colour, less transparent, and somewhat thickened. Ecker considers this to deserve exclusively the designation of olfactory region, and calls it the “locus luteus." The undermost and most anterior part of the septal mucous membrane is covered by permanent epithelium, whilst from the line which unites the anterior free edge of the nasal bone with the anterior nasal part of the upper jaw, the ciliated form of epithelium extends upon the entire mucous membrane of the septum, with exception of the locus luteus. A definite direction of the ciliary movement could not be ascertained. Between the ciliary epithelium, measuring 0.090 millimetre in length, with clear long cilia or long peduncles, other cells were seen, whose relation to them could not be defined. They were of about the same length, but for the most part broader, often swelled out, and possessing very fine cilia. They varied at their extremities, being in some places diminished in size, and obviously closed; at other times open at their ends, cuplike. But seldom was any nucleus visible within. The cells of the locus luteus consist of both these kinds. They are elongated, and below pass into a long threadlike body, which for the most part is swollen out, and often forms bulgings out, in which the so-called compensation cells (Ersatz-cellen) exist. They are very delicate and perishable. This free end is not beset by ciliated epithelium, as the author seems formerly to have thought, but their free end contains numberless yellow pigment-granules, and it is to this colouring matter that the yellow appearance of this locus luteus is owing. The extre. mity of the thread-like projection bifurcates, and at the point of division oftentimes a finely granular swelling exists. Between these olfactory cells lie embedded the compensation cells. Immediately upon the surface of the mucous membrane, one comes to a layer of cells partly round, partly more irregular, and in places beset with projections, between which the root-threads of the olfactory cells sink. As regards the parietes of the nose, in the lowest and most anterior parts pavement epithelium is found, but its limits do not run parallel with that in the septum, for, proceeding from the anterior free margin of the nasal bone, it descends some lines behind the nasal part of the upper jaw, so that the anterior extremity of the lower turbinated bone, as well as the anterior part of the lower nasal cavity, are covered by this epithelium. The mucous membrane of the superior turbinated bone only in part is possessed of cilia; the spot which has none extends backwards from the covering of the nasal cavity about 4" wide, and, like the locus luteus, is coloured yellow, and contains the above-described olfactory cells; consequently it should also be considered as part of the olfactory region, which in the mammalia is much more extended, so much so, indeed, that the olfactory cells cover the entire non-ciliated olfactory region,

OSSEOUS AND CARTILAGINOUS SYSTEM. Upon the Ossification of Primordial Cartilage. By A. Bauer. * _The author pursues two objects for investigation - 1. The method of origin of the peculiar structure of bone-substance out of a structure so different as cartilage; and 2. The relation between the elements of cartilage and those of bone. He speaks of the origin of all bone not antecedently cartilaginous as referrible to the ossification of a blastema, which is generally looked upon as one of connective tissue, consisting of an indistinctly fibrillated basis, contain

Müller's Archiv, No. 4, p. 347. 1857.

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