A handbook of pathological anatomy and histology : with an introductory section on post-mortem examinations and the methods of preserving and examining diseased tissues

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Preface To The Fifth Edition

The aims followed in the preparation of this the fifth edition of this work are identical with those which were kept in view in former editions. It has been the intention of the authors to give to students and practitioners of medicine, first, the knowledge necessary for the making of autopsies, the preservation of tissues and their preparation for microscopic study, and to outline the methods of study of pathogenic micro-organisms; second, to describe concisely, with such illustrations as seem necessary, the lesions of the acute infectious diseases and, so far as they are known, the micro-organisms concerned in their causation, the various phases of degeneration and inflammation, the character of tumors, the special lesions of different parts of the body, of the general diseases, of poisoning, and of violent deaths. All of the sections of the book have been revised, and some of them largely rewritten in the light of recent contributions to science. Many new cuts have been added. The section on the blood has been rewritten for us by Dr. James Ewing.

Part First

THE METHOD OF MAKING POST-MORTEM EXAMINATIONS AND OF PRESERVING AND EXAMINING PATHOLOGICAL TISSUES.

The object in making post-mortem examinations. — Causes of death, 3. — External Inspection, 4. — Cadaveric lividity, 5.— Putrefactive changes, 5. — Cooling of the body, 6. — Rigor mortis, 7. — Contusions, 7. — Wounds, 8. — Fractures, scars, and tattoo marks, 9. — Internal Examination, 9. — The Head. Removal of calvarium, 10. — The dura mater, the pia mater, the brain, 11. — Methods of opening the brain, 11-18. —Base of the cranium, 18. — Tlie Spinal Cord, 19. Preservation of cord and membranes, 21. — The Thorax and Abdomen, 22. General inspection of abdominal cavity, 23. — The heart, 25. — The pleural cavities, the lungs, 28-29. — Pharynx, larynx, and oesophagus, 29. — The Abdomen, 30. Kidneys, 31. — Suprarenal capsules, 32. — The spleen, 33. — Intestines, 34. — Stomach and duodenum, 35. — Liver, 36. — Pancreas, 37. — Genito- Urinary Organs. Male organs, 38. — Female organs, 39.

Autopsies in Medico -Legal Cases and of Suspected Poisoning, 41.

Examination of the Bodies of New-Born Children. General Inspection, 42. —Internal Examination, 46.

General Methods of Preserving Tissues and Preparing Them for Study, 50. — Fresh tissues, 50. — Decalcifying, 51. — Hardening and preservation, 52. — Mutter's fluid, 53. — Formalin, osmicacid, Fleming's osmic-acid mixture, 54. — Corrosive sublimate, Long's solution, 55. — Embedding and section cutting, 56. — Staining, 60. — Preservation of museum specimens, 63.

Part Second

CHANGES IN THE CIRCULATION OF THE BLOOD.— CHANGES IN THE COMPOSITION AND STRUCTURE OF THE BLOOD.— HYPERTROPHY, HYPERPLASIA, REGENERATION, DEGENERATION, ETC.— INFLAM- MATION. — ANIMAL AND VEGETABLE PARASITES.— INFECTIOUS DISEASES. —TUMORS.

Changes in the Circulation of the Blood. Hyperaemia and anaemia, 69. — Haemorrhage and transudation, 69-71. — Thrombosis and embolism, 72-75.

Changes in the Composition and Structure of the Blood. Coagulability of the blood, 76. — Anhydraemia, hydraemia, haemoglobinaemia, anaemia, 76-77. Changes in the Red Blood Cells, 77 .—Changes in the White Blood Cells, 82-86.

VI CONTENTS.

Melansemia, 86.— Method of examination of the blood, 86-89.— Foreign Bodies in the Blood, 89.

Hypertrophy, Hyperplasia, Regeneration, Metaplasia. Hypertrophy and hyperplasia, 91. — Regeneration, 91. Direct cell division. — Indirect cell division, 92. — Metaplasia, 95.

Degenerative Changes in the Tissues. Necrosis, coagulation necrosis, 96.— Cheesy degeneration, 97. — Parenchymatous degeneration, 98. — Fatty degen eration and fatty infiltration, 98. — Amyloid degeneration, 100. — Glycogen degeneration, Mucous degeneration, 102. — Colloid degeneration, 103. — Hyalin degeneration, 104. — Calcareous degeneration, 105. — Pigmentation, 106.

Inflammation, 107. — Degeneration and necrosis, 107. — Congestion, transudation, and emigration, 108. — Production of new cells and tissues, 109.— Phases of inflammation, 110. — Exudative inflammation, 110. — Productive inflammation, 117. — Necrotic inflammation, 119. — Reparative Production of New Tissue. — Healing of wounds, 120.— Healing of fractures, 125.

Parasites. Animal Parasites. Protozoa, 127.— Worms, 130.— Arthropods, 141.— Methods of study and preparation of animal parasites, 142.

Vegetable Parasites. Bacteria, 143.— Morphology and physiology of bacteria, 144-153. — Classification of bacteria, 153.— Methods of studying bacteria. 154. — Cultivation of bacteria, 158. — Bacterial examinations of post-mortem specimens, 167. — Yeasts and Moulds, 168. — The Relation of Bacteria to Disease, 171.— Infection and Immunity, 177.

The Infectious Diseases, 183. —Infectious diseases induced by the pyogenic bacteria. 188.— Erysipelas, 194.— Pyemia and septicemia, 196 — Acute cerebro-spinal meningitis, 199. — Acute lobar pneumonia and the infectious diseases induced by the diplococcus pneumoniae, 201. — infectious pseudo- membranous inflammation of mucous membranes, 204. — Gonorrhoea, and other inflammatory lesions induced by the micrococcus GONORRHOEAE, 206.— ANTHRAX, 209. — TUBERCULOSIS, 213-216.—

Lupus, 227.— Leprosy, 229.— Syphilis, 231.— Glanders, 235.— Rhinoscleroma, 238.— Bubonic plague, 239.— Typhoid fever, 240.— Diphtheria. 250.— Tetanus, 255.— Influenza, 257.— Bacteria which may be occasional inciters of infectious disease in man, 259.— actinomycosis, 262.— asiatic cholera, 265.— Relapsing fever, 269. —Variola, 271.— Scarlet fever, 273.— Measles, 274.— Typhus fever, 275.— Hydrophobia, 276 —Yellow fever, 279.— The Malarial Fevers, 280.— Pharyngo- mycosis, 284.— Infectious DISEASES OF ANIMALS, 285.

Tumors. Section I. General characters, 286. — Cause of tumors, 290. — Classification of tumors, 293. — Cysts, 296. — Various lesions sometimes described as tumors, 297. — Nomenclature of complex tumors, 297.— Preservation of tumors, 298. Section II. Special forms of tumors, 299-343.

Part Third. Morbid Anatomy Of The Organs

The Nervous System. The membranes of the brain.— The Dur a Mater, 347. Haemorrhages, 347.— Thrombosis.— Inflammation, 348.— Tumors, 351.— The Pia Mater, 352. CEdema, hyperaemia, and haemorrhage, 353.— Tuberculous

CONTENTS. Vll

meningitis, 359.— Syphilitic meningitis, 362. — Tumors, 362. — The Ventricles of the Brain, 365. — Acute and chronic ependymitis, 365. — Congenital hydrocephalus, 367. — Secondary hydrocephalus and primary hydrocephalus in adults, 368. — Tumors, 368. — Pineal Gland and Pituitary Body, 369.

The Brain. Thrombosis and embolism, 370. — Hyperemia, anaemia, and oedema, 373. — Haemorrhage, 374. — Changes in ganglion cells in toxaemia, 376. — Secondary degenerations, 377. — Hypertrophy and atrophy, 378. — Wounds, 379. Holes or cysts in the brain, 380. — Inflammation of the brain, abscesses, 380. — Chronic interstitial encephalitis (sclerosis), 382. — Encephalitis in new-born, 383. — Syphilitic and tuberculous encephalitis, 384. — Lesions of brain in chronic paresis of insane, 385. — Pigmentation, tumors, 386. — Malformations, 387.

Spinal Cord. Dura Mater Spinalis. Haemorrhages, inflammations, 389. — Parasites, 390. — Pia Mater Spinalis. Haemorrhages, inflammations, 390. — Tumors and parasites, 391. — The Cord. Haemorrhage, 391. Haematomyeliaand haematomyelopore, 391. — Injuries, secondary degenerations, 393. — Progressive spinal muscle atrophy, bulbar paralysis, amyotrophic lateral sclerosis, 396-397. — Poliomyelitis anterior, 399. — Chronic myelitis, multiple sclerosis, 400. — Posterior spinal sclerosis, 402. — Solitary tubercles, gummata, cysts, and tumors, 403. — Syringomyelia, 404. — Malformations, 404.

The Peripheral Nerves. Changes after division, acute and chronic neuritis, 408. — Tumors, 409. — Acromegalia, scleroderma, 410. — Preparation of nerve tissue for microscopical study, 410.

The Respiratory System. Larynx and Trachea. Malformations, inflammation, 413. — CEdema glottidis, tumors, 416.

The Pleura. Hydrothorax, haemorrhage, inflammation, 417. — Pleurisy with production of fibrin, pleurisy with production of fibrin and serum, 418. — Pleurisy with production of fibrin, serum, and pus(empyaema), 421. — Chronic pleurisy, 423. — Tuberculous pleurisy, 424. — Tumors, 425.

Tlie Bronchi. Inflammations, 426. — Bronchiectasia, 429. — Tumors, 431.

The Lungs. Malformations, injuries, congestion, and oedema, 432. — Haemorrhage, 433. — Emphysema, 434. — Atelectasis, 436. — Gangrene, 437. — Inflammation, classification, acute lobar pneumonia, 438. — Broncho-pneumonia, 443. — Secondary and complicating pneumonia, 448. — Pneumonia of heart disease, 449. — Interstitial pneumonia, 451. — Tuberculous pneumonia, 452. — Acute miliary tuberculosis, 453. — Subacute miliary tuberculosis, 456. — Chronic miliary tuberculosis, 457. — Acute pulmonary phthisis, 459. — Experimental phthisis, 460. — Chronic phthisis, 469. — Syphilitic pneumonia, 475.— Tumors, 476.— Parasites, 477.

The Mediastinum, 477. Inflammation, 481. — Tumors, 478.

The Vascular System. — Pericardium. Injuries, dropsy, haemorrhage, pneumonatosis, 480. — Inflammation, tumors, 483.

The Heart. Malformations, 483. — Abnormal size and positions of heart, 485. — Wounds and ruptures, 486. — Atrophy, hypertrophy, 487. — Dilatation, 489. — Degeneration, 490. — Fatty infiltration, atrophy of pericardial fat, 492. — Myomalacia, fragmentation of endocardium, 493. — Inflammation, simple acute endocarditis, mycotic endocarditis, 494. — Chronic endocarditis. 496. — Chronic ulcerative and tuberculous endocarditis, myocarditis, 498. — Changes in heart valves, aneurism of the heart, 500. — Thrombosis of the heart, 501. — Tumors and parasites, 502.

Vlll CONTENTS.

The Blood Vessels. Atrophy and hypertrophy, 502.— Degeneration, 503.— The Arteries. Inflammation, acute arteritis, 503. — Chronic arteries, 504. — Dilatation and aneurism, 509. — Aneurism of the different arteries, 512. — Stenosis, 513. — Ruptures and wounds, 514. — Tumors, 516. — The Veins. Dilatation, 517. — Wounds and ruptures, inflammation, 518. — Tumors and parasites, 520. — The Capillaries, 520. — The Lymph Vessels, 520. Inflammation, 521. — Lymphangiectasia, tumors, 522. — The Lymph Nodes, 522. Inflammation, 523. — Pigmentation, 526. — Inflammation with cheesy degeneration, 527. — Tuberculous inflammation, 528. — Syphilitic inflammation, 529. — Degenerations, 530. — Hyperplasia, 531. — Tumors and parasites, 532.

The Alimentary Canal. The Mouth. Malformations, 533.— Hypertrophy of cheeks and lips, inflammation, stomatitis, stomatitis ulcerosa, 533. — Syphilitic and tuberculous stomatitis, gangrene, 534. — Tumors, 535. — The Tongue. Malformations, hypertrophy, 536. — Inflammation, tumors, 537. — The Pharynx and CEsophagus. Malformations, 538. — Inflammation, 540. — Ulceration, 541. — Dilatation of oesophagus, 541. — Stenosis, 542. — Tumors, 543.

The Stomach. Malformations, post-mortem changes, injuries, haemorrhage, 546. — Inflammation, 547. — Ulcers, 550. — Dilatation, 553. — Tumors, 554. — Degenerations. The Intestines. Malformations, 557. — Incarceration, 558. — Intussusception, 559. — Transposition, wounds, and ruptures, 560. — Tlie Small Intestine. Inflammation, lesions of solitary and agminated nodules, 561. — Emboli, 562. — Large Intestine. Inflammations, 563. — Tumors, 575. — Concretions, parasites, 577.

The Peritoneum. Malformations, 578.— Inflammation, 579. — Tumors, 587. — Parasites, 589.

The Liver. Malformations, acquired changes in size and position, 590. — Anaemia and hyperaemia, 591. — Wounds, rupture, and haemorrhage, lesions of hepatic artery, lesions of portal vein, 593. — Lesions of hepatic veins, atrophy of liver, degenerations, 599. — Pigmentation, 599. — Acute yellow atrophy, 600. — Inflammation, acute hepatitis (abscess), 601. — Chronic interstitial hepatitis (cirrhosis), 604. — Syphilitic hepatitis, 605. — Tuberculous hepatitis, 609. — Perihepatitis, 611. — Hyperplasia of lymphatic tissue in the liver, 611.— Tumors, 612.— Parasites, 641.

The Biliary Passages and Gall Bladder. Catarrhal inflammation, suppurative and croupous inflammation, 617. — Constriction, occlusion, and dilatation, 618.— Biliary calculi, 619.— Tumors, 614.

The Spleen. Wounds, rupture, and haemorrhage, 621. — Disturbances of the circulation, 612.— Inflammation, 624.— Perisplenitis, 628.— Alterations of spleen in leukaemia and pseudo- leukaemia, 628. — Degenerations, 629. — Pigmentation, tumors, 528.— Parasites, 630.— Malformations and displacements, 631.

The Pancreas. Haemorrhage and inflammation, 632. — Degenerations, 633. — Fat necrosis, 634.— Tumors, 635.— Malformations and displacements, 636.

The Salivary Glands. Inflammation, 637.— Tumors and parasites, 638.

The Thyroid Gland. Hyperaemia, inflammation, degenerations, and tumors, 639.— Parasites, malformations, myxoedema, 641.— Exophthalmic goitre, 643.

The Thymus Gland, 643.

The Suprarenal Bodies. Malformations, haemorrhage, thrombosis, inflammation, 644. — Degeneration, tumors, 645.

CONTENTS. IX

The Urinary Apparatus. The Kidneys. Malformations and changes in position, 646. — Bright's disease, classification, acute congestion, 647. — Acute degeneration, 648. — Acute exudative nephritis, 650. — Acute productive nephritis, 655. — Chronic congestion, 658. — Chronic degeneration, 659. — Chronic productive nephritis, chronic Bright's disease, 660. — Suppurative nephritis, 671. — Ureteritis, 672. — Pyelo-nephritis, 672. — Tuberculous nephritis, embolism, and thrombosis, 673. — Hydronephrosis, 674. — The cystic kidneys, 675. Perinephritis, 676. — Renal calculi, tumors, 677. — Parasites, 680.

The Urinary Bladder. Malformations, 680. — Changes in size and position, 681. Rupture and perforation, 682. Disturbances of circulation, inflammation, 683.— Tumors, 685.— Parasites, calculi, 687.

The Urethra. Congenital malformations, and changes in size and position, 688. —Wounds, ruptures, and perforations, 689. — Inflammation, 690. — Tumors, 691.

The Organs of Generation. Female. — The Vulva. Malformations, haemorrhage, and hyperaemia, 692. — Inflammation, 693. — Tumors and cysts, 694.

The Vagina. Malformations, changes in size and position, 695. — Wounds, perforations, inflammations, 696. — Tumors, 697. — Parasites, 698. — The Uterus. Malformations, 698. — Changes in size, 699. — Changes in position, 700. — Rupture, perforation, hypersemia, and haemorrhage, 702. — Inflammation, 704. — Puerperal inflammation, 708. — Ulceration, degeneration, tumors, 709. — Parasites and cysts, 718. — The Ovaries. Malformations, changes in size and position, hypersemia, haemorrhage, 719. — Inflammation, 720. — Tumors, 722.

The Fallopian Tubes. Malformations, changes in position and size, 730. — Haemorrhage, inflammation, 731. — Tumors, extra-uterine pregnancy, 732.

Tlie Placenta. Haemorrhage, 733. — Inflammation, degenerations, 734.

The Mamma. Malformations, haemorrhage, inflammation, 735. — Tumors, 738.

Organs of Generation. Male. Tlie Penis. Malformations, 741.— Inflammation, tumors, 743.— The Scrotum, 744. — The Testicles. Malformations, hydrocele, 745. — Haematocele, 746. — Spermatocele, inflammation, 747. — Tumors, 750. — Tlie Seminal Vesicles, 751. — The Prostate. Hypertrophy, 751. — Inflammation, 752. — Parasites, concretions, 753. — Coivper's Glands, 753. — Tlie Male Mamma, 753.

The Bones. Disturbances of circulation, injuries, 754. — Inflammation, periostitis, 755.— Osteitis, 757.— Osteomyelitis, 763.— Necrosis, 765.— Caries, rachitis, 766. — Osteomalacia, 769. — Alterations of the bone marrow in leukaemia and anaemia, 770. — Atrophy, tumors, 771.

Diseases of the Joints. Inflammation, 775.— Tumors, 778.

Muscle. Haemorrhage, infarction, wounds and ruptures, inflammation, 780. — Degenerations, atrophy, pseudo-hypertrophy, 783.— Tumors, 787.— Parasites, 788.

Part Fourth

THE LESIONS FOUND IN THE GENERAL DISEASES, IN POISONING, AND IN VIOLENT DEATHS.

Diseases Characterized by Alterations in the Composition of the Blood. Chlorosis, 791.— Pernicious Anaemia, 792.— Leukaemia, 794.— Pseudo-Leukaemia (Hodgkin's Disease), 796.

Scorbutus, Purpura, 798.— H^matophilia, 799.

X CONTENTS.

Addison's Disease, 800.

Gout, 802.

Acute Eheumatism, 803.

Diabetes Mellitus, 804.

Sunstroke, 806.

Death from Burning, 807.

Death from Electricity, 808.

Death from Suffocation, Asphyxia, 809. —Death from Strangulation, Hanging, 810. — Death from Drowning, 811.

Death from Poisoning, 814.

LIST OF ILLUSTRATIONS.

1. Side view of the human brain, showing its fissures and convolutions, . 12

2. Method of opening the brain, first incisions, 18

3. Method of opening the brain, final incisions, 14

4. View of the base of the brain, with the temporal lobes turned backward

and outward, 16

5. Drawing of the brain axis, separated from the brain mantle, . . .16

6. Brain mantle, seen from below, 17

7. Outlines of spinal cord sections, ........ 21

Plate. —Blood cells, opposite 80

8. Phases of mitosis, or indirect cell division, 92

9. Cheesy degeneration (coagulation necrosis) in miliary tubercle of lung, 97

10. Fatty degeneration of heart muscle, 98

11. Fatty infiltration of liver cells, 99

12. Amyloid (waxy) degeneration of capillaries of a glomerulus in the

kidney, 101

14. Mucous degeneration of epithelial cells, . 102

15. Mucous degeneration of fibrous tissue of mamma, 103

16. Colloid degeneration of epithelial cells, 104

17. Hyalin degeneration of capillary blood vessels, ..... 104

18. Pigmentation of connective-tissue cells of the lungs, .... 105

19. Emigration of white blood cells in inflamed bladder of frog, . . Ill

20. Exudative inflammation — pneumonia, 113

21. Exudative inflammation — appendix, . . . . . . 113

22. Pus cells from catarrhal inflammation of bronchial mucous membrane, 116

23. Omentum of dog, showing peritonitis on fourth day, .... 116

24. Developing blood vessels in new-formed tissue, ..... 121

25. Granulation tissue from wound of skin, . . . . . . . 122

26. Fibroblasts from granulation tissue, 122

27. Cicatricial tissue, 123

28. Exuberant granulations, 124

29. New-formed cartilage and osteoid tissue from callus after fracture of

the femur, 125

31. Coccidium oviforme, . . 128

32. Balantidium coli 129

33. Cercomonas intestinalis, . 129

34. Trichomonas vaginalis, . 129

35. Distoma hepaticum, . 130

Xll LIST OF ILLUSTRATIONS.

36. Head of Taenia solium, 131

37. Head and proglottides of Taenia mediocariellata, 131

38. Cuticula of echinococcus cyst, 133

39. Scolices of Taenia echinococcus 133

40. Hooklets from scolex of Taenia echinococcus, 134

41. Ascaris lumbricoides, 135

42. Oxyuris vermicularis, 136

43. Eggs of nematode worms, . .137

44. Trichocephalus dispar, . 137

45. Trichinae encysted in muscle, .139

46. Filaria sanguinis hominis, . 140

47. Sarcoptes hominis, 141

48. Pediculis capitis, 141

49. Drawing of three typical forms of bacteria, 143

50. Bacilli showing flagella, . . 144

51. Growth aggregates of bacteria, 145

52. Leptothrix buccalis with micrococcus colonies, 145

53. Sarcina, 146

54. Bacteria with capsule, 146

55. Bacilli showing spores, 147

56. A tube of solid transparent nutrient gelatin, 160

57. Pure culture of bacteria on nutrient agar, 161

58. A culture of bacteria on potato, 161

59. A Petri gelatin plate culture of bacteria, 163

60. A Petri gelatin plate culture of bacteria, . . . . . . 164

61. Petri's agar plate culture of bacteria (mouth), 165

62. Sterilized cotton swab in sterilized tube, 166

63. Yeast — saccharomyces, 168

64. Aspergillus glaucus, 169

65. Achorion Schoenleinii— favus, 169

66. Bacterial embolus in the blood vessels of the glomerulus of the kidney

in malignant ulcerative endocarditis, 172

67. Small focus of necrosis in the liver caused by toxic material of bac-

terial origin, 173

68. Colonies of micrococci in a blood vessel of the kidney, causing a small

abscess, 174

69. Staphylococcus pyogenes aureus, . 188

70. Staphylococcus pyogenes aureus in and among the pus cells, from an

abscess of the kidney, 190

71. Streptococcus pyogenes, . . 191

72. Erysipelas of the skin, 194

73. Streptococci in masses in the blood and lymph vessels of the skin in

erysipelas, 195

74. Micrococci in masses in the fibrinous exudation of pyaemic pleurisy, . 197

75. Diplococcus lanceolatus (pneumococcus) with capsules, . . .201

76. Pseudo-membranous inflammation of trachea, 204

77. Infectious croupous inflammation of the trachea,

78. Micrococcus gonorrhoeae (gonococcus), .

79. A cover-glass preparation of gronorrhoeal exudate,

80. Pus cells containing gonococci,

205 206 207 207

LIST OF ILLUSTRATIONS. Xlll

81. Anthrax — malignant pustule— of the skin, 209

82. Bacillus anthracis growing in the blood vessels of the liver of a mouse

inoculated with pure culture of the bacillus, 210

83. Bacillus anthracis containing spores, 211

84. Tubercle bacilli, with pus cells, in sputum, 213

85. Culture of tubercle bacillus on glycerin agar (bird) , 214

86. Culture of tubercle bacillus on glycerin agar (man) , 214

87. A miliary tubercle from a lymph node 216

88. A miliary tubercle from the pleura, 217

89. Tuberculous tissue, 218

90. A nodule of tuberculous inflammation (miliary tubercle) in the lung, . 219

91. Miliary tubercle in lung of child, showing tubercle bacilli, . . . 221

92. Inflammatory nodule in the liver of the rabbit, produced by dead

tubercle bacilli, 222

93. Lupus of face, 225

94. The bacilli of leprosy, 229

95. Small nodule of syphilitic inflammation (miliary gumma) in the liver, 231

96. New-formed tissue in syphilitic inflammation, 231

97. Section from a primary syphilitic nodule of the mucous membrane of

the mouth, 232

98. Section of a portion of a syphilitic condyloma of the mucous membrane, 233

99. Bacillus mallei, 236

100. Cluster of typhoid bacilli in the spleen, 247

101. Bacillus typhosus, . 248

102. Diphtheritic inflammation of the tonsil, 251

103. Bacillus diphtherias, 252

104. Bacillus tetani, 255

105. Actinomyces bovis, 262

106. Actinomyces growing in human bronchus, 263

107. Spirillum choleree Asiaticaa, 266

108. Spirochete Obermeieri, 269

109. A smallpox vesicle of the skin, 271

110. Section of spinal cord from a case of hydrophobia, .... 276

111. Hydrophobia, transverse section of small blood vessels in the spinal

cord, 277

112. The hsematozoon of malaria, 281

113. Epithelial cell " inclusions" in tumors, 292

114. Dense fibroma of abdominal wall, 299

115. Small papilloma of the skin, 301

116. Fibroma molle from subcutaneous tissue, . . . . . 301

117. Myxoma of the larynx, . . .302

118. Myxoma growing into abdominal cavity, 303

119. Mucous polyp of the nose, 303

120. Large spindle-celled sarcoma, 306

121. Small spindle-celled sarcoma of forearm, . . . . . 306

122. Small round- celled sarcoma of liver, . . . ... . 307

123. Large round-celled sarcoma of leg, 307

124. Melano-sarcoma from submaxillary region, 308

125. Giant-celled sarcoma of bone, . . . ... . . ' . 309

126. Angio-sarcoma of liver, 310

XIV

LIST OF ILLUSTRATIONS.

Fig.

127. Myxo-sarcoma of pharynx,

128. Adeno-sarcoma of parotid, ...

129. Endothelioma of upper jaw,

130. Endothelioma (endothelial sarcoma) of dura mater,

131. Endothelioma of pleura,

132. Endothelioma of upper jaw,

133. Cylindroma (adenoma) of antrum,

134. Chondroma of subcutaneous connective tissue,

135. Myxo-chondroma of cervical region,

136. Glioma of brain, .......

137. Neuroglia or " spider" cells from glioma of brain, .

138. Myoma of uterus, .

139. Neuroma ganglioniforme, .....

140. Fibroma (false neuroma) of lumbar nerve,

141. Multiple fibromata of pneumogastric nerve, .

142. Multiple neuromata of the peripheral nerves,

143. Angioma telangiectoides,

144. Angioma cavernosum of liver, ....

145. Congenital lymphangioma from arm of child,

146. Adenoma of mamma,

147. Adenoma of stomach,

148. Cancer cells infiltrating the tissue near a tumor, .

149. Metastatic carcinoma in lymph vessels of the pleura,

150. Inflammation in carcinoma,

151. Epithelioma of the neck,

152. Metastatic carcinoma (epithelioma) in a lymph node,

153. Epithelioma of back of hand, . . . .

154. Epithelioma of axillary lymph node, . . .

155. Section of a portion of a small epithelioma of the side of the

power,

156. Epithelioma of nose,

157. Carcinoma mammae (schirrhus variety),

158. Medullary carcinoma of the stomach (carcinoma molle)

159. Colloid carcinoma of rectum, ....

160. Carcinoma myxomatodes mammas,

161. Chronic pachymeningitis interna hemorrhagica, .

162. Brain sand from pachymeningitis interna,

163. Acute cellular meningitis, .....

164. Acute meningitis,

165. Acute exudative meningitis,

166. Fatty degeneration of cells along the blood vessels of the

exudative meningitis,

167. A miliary tubercle of the pia mater,

168. Miliary tubercle of the pia mater of a child, .

169. A miliary tubercle of the pia mater,

170. Miliary tubercles of the ependyma of the lateral ventricle,

171. A miliary tubercle of the ependyma of the lateral ventricle,

172. Endothelioma of the cerebellum originating in the pia mater,

173. Endothelioma of the pia mater of the cerebellum, .

174. Acute ependymitis, • nose pia mater

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LIST OF ILLUSTRATIONS. XV

175. Congenital hydrocephalus in child, 367

176. Degenerated cells, cholesterin crystals, and corpora amylacea from brain

tissue in embolic softening, 371

177. Blood vessels from an area of embolic softening of brain, . . . 372

178. Ganglion cells of the spinal cord, 377

179. Atrophy of a circumscribed portion of brain convolutions in a child, . 379

180. Syphilitic obliterating endarteritis of a cerebral artery, . . . 383

181. Solitary tubercle of cerebellum, . . . . . • . . 384

182. Haemorrhage in spinal cord, 392

183. Haematomyelopore, . 392

184. Descending degeneration, spinal cord, 395

185. Ascending degeneration, spinal cord, . . 395

186. Ascending degeneration, spinal cord, 396

187. Amyotrophic lateral sclerosis, 397

188. Degenerated tissue, spinal cord, 398

189. Poliomyelitis anterior, 399

190. Poliomyelitis anterior, 399

191. Multiple sclerosis, spinal cord, 401

192. Posterior spinal sclerosis, . 401

193. Posterior spinal sclerosis, . 402

194. Syringomyelia, . ... 404

195. Hydromyelia, 406

196. False heterotopia, .406

197. Multiple neuritis, . 408

198. Ulcer of larynx, 414

199. Tuberculous laryngitis, 415

200. Pleurisy in dog, 420

201. Tuberculous pleurisy, 425

202. Catarrhal bronchitis, 427

203. Croupous bronchitis, . . . . 428

204. Bronchiectasia, 430

205. Adenoma of bronchi, 431

206. Emphysema, 435

207. Emphysema, 436

208. Acute lobar pneumonia, 439

209. Acute lobar pneumonia with organized tissue, . . . . . 440

210. Acute lobar pneumonia with organized tissue, 441

211. Acute lobar pneumonia with organized tissue, 442

212. Broncho-pneumonia, child, ......... 443

213. Broncho-pneumonia, child, . . 445

214. Broncho-pneumonia, adult, 446

215. Broncho-pneumonia, persistent, . . * . . . 447

216. Broncho-pneumonia, persistent, . 448

217. Broncho-pneumonia, in diphtheria, 449

218. Lung of heart disease 450

219. Interstitial pneumonia, . .451

220. Miliary tubercle, lung of child, 454

221. Peribronchitic miliary tubercle, . 455

222. Aggregation of miliary tubercles, 456

223. Miliary tubercle, 457

XVI LIST OF ILLUSTRATIONS.

224. Miliary tubercle, . . . . 458

225. Miliary tubercle, 459

226. Experimental pulmonary tuberculosis, rabbit, 460

227. Experimental pulmonary tuberculosis, rabbit, 460

228. Experimental pulmonary tuberculosis, rabbit, ..... 462

229. Tuberculous broncho-pneumonia, 463

230. Coagulation necrosis and pneumonia, ....... 464

232. Acute phthisis, 467

233. Acute phthisis . . .468

235. Tuberculous inflammation of lung, . . . . . . . . 470

240. Healed phthisis, 473

242. Syphilitic pneumonia, . 475

243. Adenoma of lung, 476

244. Obliteration of pericardial sac, 482

245. Fatty degeneration of heart, 490

246. Fatty infiltration of heart, . . 491

247. Atrophic pericardial fat, . . 492

248. Vegetation on heart valve, 495

249. Mycotic endocarditis, ... . . . . . . . 496

250. Chronic endocarditis, 497

251. Chronic endocarditis, 498

252. Chronic interstitial myocarditis, 499

258. Atheroma of aorta, 510

259- Atheroma of aorta, 510

260. Tuberculous arteritis, 511

261. Tuberculous phlebitis, 519

262. Inflammation of lymph node, 524

263. Inflammation of lymph node, 525

264. Pigmentation of lymph node, 526

265. Cyst of neck, 539

267. Adenoid polyp of pharynx, 544

268. Sarcoma of pharynx, 545

269. Chronic gastritis, 548

270. Necrosis of mucous membrane of stomach, 553

271. Fibroma in wall of stomach, • 554

272. Catarrhal colitis, • • • • 563

273. Suppurative colitis, 564

LIST OF ILLUSTRATIONS. xvn

274. Catarrhal colitis, 565

275. Catarrhal colitis, . ... 565

276. Croupous colitis, 566

277. Follicular colitis, . 567

278. Amoebic colitis, 568

279. Amoebic colitis, 569

280. Amoebic colitis . . . . v 570

281. Amoebic colitis, . . 571

282. Necrotic colitis, ...... 572

283. Suppurative appendicitis, 574

284. Acute cellular peritonitis, 580

285. Acute exudative peritonitis, 582

286. Chronic cellular peritonitis 583

287. Chronic peritonitis, 585

288. Cystic papilloma of omentum, 588

289. Chronic congestion of liver, 592

290. Fatty infiltration of liver cells, 597

291. Fatty infiltration of liver, 597

292. Amyloid degeneration of liver, 598

293. Pigmentation of liver, . 599

294. Abscess of liver, 603

295. Chronic interstitial hepatitis, 604

296. Hypertrophic cirrhosis, . 605

297. Chronic interstitial hepatitis, 606

298. Syphilitic hepatitis, . 609

299. Gumma of liver, 610

300. Echinococcus multilocularis, 616

301. Adenoma of gall duct, 619

302. Congestion of spleen, 622

303. Chronic indurative splenitis, 626

304. Chronic interstitial splenitis, 626

305. Malarial spleen, 627

306. Amyloid spleen, 630

307. Fat necrosis in pancreas, . . 634

308. Colloid struma, 640

309. Thyroid gland in myxcedema, . 642

310. Acute degeneration of kidney, 648

311. Acute exudative nephritis, 650

312. Acute exudative nephritis, 651

313. Acute nephritis, 652

314. Acute nephritis, 653

315. Acute exudative nephritis, ......... 654

316. Acute nephritis, 655

317. Acute productive nephritis, , 656

318. Subacute productive nephritis, 657

319. Chronic nephritis with exudation, 663

320. Chronic nephritis with exudation, , 664

321. Chronic nephritis with exudation, 665

322. Chronic nephritis with exudation, 666

323. Waxy degeneration in kidney, 667

XY111 LIST OF ILLUSTRATIONS.

324. Chronic nephritis without exudation, 668

325. Chronic nephritis without exudation, -. . 669

326. Chronic nephritis without exudation, 670

327. Cysts of kidney, 675

328. Adenoma of kidney, 678

329. Adenoma of kidney, 679

330. Papilloma of bladder, 686

331. Vaginal epithelium, 697

332. Chronic endometritis, 704

333. Hyperplasia of uterine mucosa, ....... . 705

334. Chronic endometritis, 706

335. Uterine phlebitis, . . .708

336. Adenoma of the uterus, 713

337. Adenoma of the uterus, 714

338. Carcinoma of uterus, 715

339. Epithelioma of uterus, . . . . 716

341. Chronic oophoritis, 721

342. Chronic oophoritis, 722

343. Sarcoma of ovary, 723

344. Papilloma of peritoneum, .... ..... 724

345. Cystic adenoma of ovary, 725

346. Cells from ovarian cyst, . . ._ 726

347. Cystic adenoma of ovary, . • • • • . . • . 726

348. Papillary cysts of omentum, 727

349. Adeno-sarcoma of ovary, 728

350. Hydro-salpinx, 730

351. Suppurative mastitis, 736

352. Chronic mastitis, 737

353. Intra-canalicular fibroma, 738

354. Peri-canalicular fibroma, 739

355. Chronic orchitis, 740

356. Chronic orchitis, 748

357. Rarefying osteitis, 758

358. Condensing osteitis, . . . • • • • . . . 760

359. Tuberculous osteitis, . . . 761

360. Rachitic bone, . . 767

361. Chronic interstitial myositis, • . . 782

362. Progressive muscle atrophy, 783

363. Progressive muscle atrophy, 784

364. Pseudo-hypertrophy of muscle, 785

365. Hyal in degeneration of muscle, • • 787