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Full text of "Thrombosis in the Lymphatic Channels"

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The Effect of Salvarsan on the Circulatory and Renal Systems — 
Alvebens (Arch. f. exper. Path., 1913, Band lxxii) conducted experi¬ 
ments upon rabbits, and found that long-continued administration of 
salvarsan intravenously brought about a slight nephritis attributable 
to the arsenic contained. In the toxic doses, administered during n 
short time, marked fall of blood pressure and serious interference 
with renal function occurred, but lesions were not visible in the kid¬ 
neys. If neosalvarsan were administered for a long period, nephritis 
was not clinically observed, although definite change could be demon¬ 
strated in the kidneys. If administered for a short time, the giving 
of neosalvarsan was less deleterious to the animals than salvarsan. 
If nephritis had been previously excited by cantli(iiid>ii, rabbits showed 
marked sensitization to salvarsan, whereas if the nephritis had been 
caused by mercury or chromic salts, that is, were essentially tubular, 
no ill results were obtained till large doses were employed. Amma s 
with aortic and tricuspid incompetence were treated, with the result 
that cases of tricuspid insufficiency with resulting congestion of the 
abdominal organs bore salvarsan worse than those affected merely 
by an aortic leakage. 

Thrombosis in the Lymphatio Channels.— Oi-ie (Jour. tied. Re¬ 
search, October, 1913) details some interesting observations upon 
thrombosis and occlusion of lymphatics. Opie points out that in cir¬ 
culating blood, the blood platelets .perform an. important part by 
gathering at the site of an injury to the endothelium, so that fibrin is 
deposited upon the mass of platelets. Lymph from the thoracic 
ducts, on the other hand, coagulates very slowly because of the small 
quantity of thrombokinose present in it; the addition of blood or of 
lymph-tissue-ex tract brings about firm coagulation. There is thrombin 
present, hut thronibokioaso is deficient. _ It was thought likely that 
thrombosis might be produced by direct introduction of tissue-extract 
or tissue cells into the lymphatics, and this was done after ligation of 
the thoracic duct near its point of entry to the venous system. Tissue 
cells or tissue juices introduced into the mesenteric lymphatics will 
then produce a prompt thrombosis. It was noticed that in such a 
state edema occurs, but that there was a marked tendency to rapid 
formation of collateral lymphatic circulation. Further, it was noted 
that if occlusion of the duct was produced, followed by injection of 
bacteria into the circulating blood, thrombosis m the lymphatics 
occurred. A necrosis of cells in contact with the lymph stream favors 
thrombosis in the lymphatic vessels, because in this way thrombo- 
kinase is brought into contact with the circulating lymph. Bacteria 



are potent in bringing about, this effect, doubtless because they cause 
injury of the endothelial cells, and the suggestion i3 made that bacterial 
infection is successfully resisted partly by reason of a free flow of 
lymph which is rich in bactericidal substance. If the thoracic duct 
be occluded, or in fact any large lymphatic trunk, edema occurs which 
is relieved by the establishment of collateral circulation. In the 
experiments above mentioned, this was brought about in one ease by 
formation of a new channel which entered the proximal part of the 
ligatured duct, and in another case by collaterals which ran to the 
right thoracic duct; while in some cases no such communication 
could be mndc out, but the edema was not widely spread. If occlu¬ 
sion of the thoracic duct and injury of the mesenteric duct be produced, 
chylous ascites may occur. 

Palseopathology.— Prof. Ruffeii (Jour. Path, and Bad., October, 
1913, xviii, No. 2) has coined this unusual word to embrace knowledge 
that may be gained as to the inroads of disease upon bodies preserved 
to us from ancient times. He has had an opportunity of studying the 
pathological lesions in Coptic bodies dating from the fifth century of 
the Christian era. The bodies were not mummies in the proper sense 
of the word, but owed their wonderful preservation to the dry sand 
and to salt. They were evidently for the most part Christians, and 
many were dressed in embroidered garments. The teeth were found 
very badly diseased; caries .was common; pyorrhea alveolaris and 
periodontitis were frequent, and it is evident that little care was 
bestowed in life upon the teeth by the Copts; nor was there any evi¬ 
dence that dentistry was understood by them. Spondylitis deformans 
was frequent, usually localized to a few vertebra;. Hypertrophy of 
the middle turbinated bones was noted; enlarged spleens, supposed 
to indicate malaria, were also found. The histological observations 
will be given later. 

Tubercle Bacilli in the Feces.—So much has been written about the 
presence of acid-fast bacilli in the feces of tuberculous and non-tuber- 
culous persons, that it is n little difficult for the casual observer to 
know what he should believe with regard to the frequent presence of 
tubercle bacilli in the stools. Laird, Kite, and Stewart (Jour. Med. 
Research, October, 1913) hnvc undertaken careful experimentation 
with a view to clearing up this vexed subject. Many observers have 
shown the presence of tubercle bacilli in the stools of tuberculous 
people. By some this has been credited to swallowing the sputum, 
and by others to the presence of ulcers in the bowels. Many acid-fast 
bacilli in the stools of animals and of human beings ill with various 
diseases have been reported, and in some cases it has been definitely 
stated that these were tubercle bacilli. Tubercle bacilli are sometimes 
found in the stools, while none can be demonstrated in the sputum, 
while in a large series of casc3 with bacilli in the sputum they were 
also capable of demonstration in the stools. A series of eases was 
reported in which tubercle bacilli were found in the stools of all of 
100 patients who had tubercle bacilli in the sputum, and in more than 
20 per cent, of 1000 other persons. The above mentioned authors at 
Saranac hnvc examined a large number of persons, and have con¬ 
cluded that nearly all patients with tubercle bacilli in their sputum