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

Front matter

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MmM awnn

TO

Preface

TO THE THIRD EDITION.

In the third edition of this work, the same objects have been kept in view as in the second edition.

It is intended that the student and the practitioner shall find in it the information which they need to enable them to perform autopsies, to preserve the tissues, to prepare them properly, and to examine them with the microscope.

The work, therefore, comprises instruction in the methods of making post-mortem examinations, of preserving diseased tissues, of preparing them for microscopical examination, and of cultivating and examining bacteria. It also gives an account of the lesions of the different parts of the body, of the general diseases, of violent deaths, and of poisoning; of the changes produced by inflammation and degeneration; and of the structure of tumors.

All of the drawings have been made by the authors.

FRANCIS DELAFIELD, T. MITCHELL PRUDDEN.

Contents

PART FIKST.

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

The objects of making post-mortem examinations. Causes of death, 3. — External Inspection, 4. — Cadaveric lividity, 4. — Putrefactive changes, 5. — Cooling of the body, 5. — Rigor mortis, 6. — Contusions, 7. — Wounds, fractures, scars, and tattoo marks, 8. — Internal Examination, 8. — The Head, 9.— Removal of calvarium, 9. — The dura mater, 10. — The pia mater, 10. — The brain, 10. — Methods of opening the brain, 11-14. — Base of the cranium, 14. — Hardening and preserving the tissues for microscopical examination, 15. — The Spinal Cord, 16. — Preservation of cord and membranes, 17. — The Thorax and Abdomen, 17. — General inspection of abdominal cavity, 18. — The heart, 20. — The pleural cavities, 23. — The lungs, 23. — Preservation of lungs and bronchi, 24. — Pharynx, larynx, and oesophagus, 24. — Preservation of larynx and trachea, 25. — The Abdomen, 25. — Kidneys, 25. — Suprarenal capsules, 27. — Preservation of kidney, 27. — The spleen, 27. — Preservation of suprarenal capsules and spleen, 27-28. — Intestines, 28.— Preservation of intestines and stomach, 29 and 30. — Stomach and duodenum, 29. — Liver, 30. — Preservation of liver, 31. — Pancreas, 31. — Genito-urinary Organs. Male organs, 32.— Female organs, 32.— Bladder, 33.— Uterus, 33.— Ovaries and Fallopian tubes, 34. — Preservation of generative organs, 34.

Part Third. Morbid Anatomy Of The Organs

The Nervous System, The Membranes of the Brain, 163.— Dura mater, haemorrhages, thrombosis of venous sinuses, 163. — Inflammation, 164, 165, 166. —Tumors, 167.— Pia mater, 167. — Hyperaemia, oedema, and haemorrhage, 169.— Inflammation, acute meningitis, cellular meningitis, 170. — Exudative meningitis, 171.— Chronic meningitis, 173.— Tubercular meningitis, 173.— Syphilitic meningitis, tumors and parasites, 177.— Ventricles of the brain, ependyma and choroid

CONTENTS. Vll

plexus, 177. — Acute ependymitis, chronic ependymitis, 178. — Congenital hydrocephalus, 179. — Secondary hydrocephalus, primary hydrocephalus in adults, tumors, 180. — Pineal gland, pituitary body, 181.

The Brain, 181. — Thrombosis and embolism, 181, 182, 183.— Hyperemia, anaemia } oedema, and haemorrhage, 184. — Apoplectic foci, 185. — Secondary degenerations, 187. — Inflammation of the brain, abscesses, 187.— Chronic interstitial encephalitis (sclerosis), 189. — Wounds, 189. — Encephalitis in new-born, holes or cysts in brain, 190. — Syphilitic and tubercular encephalitis, 191. — Lesions of brain in chronic paralysis of insane, 192. — Hypertrophy, atrophy, and pigmentation, 193, 194. — Tumors, 194.— Parasites, malformations, 195, 196.

Spinal Cord, 197. — Dura mater spinalis; haemorrhages, inflammation, and tumors, 197. — Parasites, 198. — Pia mater spinalis; haemorrhages, inflammations, and tumors, 198. — The cord; haemorrhage, injuries, and secondary degenerations, 199. — Descending gray degeneration, 200. — Ascending gray degeneration, 201. — Inflammation, acute myelitis, 202. — Poliomyelitis anterior, 203. — Chronic myelitis, chronic interstitial myelitis, chronic transverse myelitis, multiple sclerosis, 205. — Posterior spinal sclerosis, 206. — Solitary tubercles, gummata, cysts, and tumors, 207.— Syringomyelia, 208.— Malformations, 209.

The Peripheral Nerves. Changes after division, acute neuritis, 210. — Chronic neuritis, multiple neuritis, syphilitic and tubercular neuritis, 211. — Leprous neuritis, tumors, 212.

Preparation of nerve tissue for microscopical study, 212.

The Respiratory System. Larynx and Trachea, 214. — Malformations, 214. — Acute catarrhal laryngitis and tracheitis, 214. — Chronic catarrhal, croupous, and syphilitic laryngitis, 215. — Tubercular laryngitis, 216. — (Edema glottidis, 217. — Tumors, 217.

The Pleura. Hydrothorax, haemorrhage, classification of inflammation, 218. — Pleurisy with production of fibrin, pleurisy with production of fibrin and serum, 219. Pleurisy with production of fibrin, serum, and pus (Empyaema), 223. — Chronic pleurisy, tubercular pleurisy, 224. — Tumors, 226.

The Bronchi. Acute catarrhal bronchitis, 227. — Chronic catarrhal bronchitis, acute croupous bronchitis, chronic croupous bronchitis, 228. — Bronchiectasia, 229. — Tumors, 230.

The Lungs. Malformations, 231. — Injuries, congestion and oedema, haemorrhage, 232. — Emphysema, 233. — Atelectasis, gangrene, 235. — Inflammation, classification, acute lobar pneumonia, 236. — Broncho-pneumonia, 241. — Secondary and complicating pneumonia, 245. — Pneumonia of heart disease, 247. — Interstitial pneumonia, 248. — Tubercular pneumonia, 249. — Acute miliary tuberculosis, 250. — Chronic miliary tuberculosis, 254. — Acute pulmonary phthisis, 256. — Chronic phthisis, 257. — Syphilitic pneumonia, 260. — Tumors, 262. — Parasites, 263.

The Mediastinum. Inflammation, 263. — Tumors, 264.

The Vascular System. Pericardium. Injuries, dropsy, haemorrhage, pneumonatosis, 266.— Inflammation, 267, 268.— Tumors, 268.

The Heart. Malformations, 268. — Abnormal size and positions of heart, 270. — Wounds and ruptures, 271. — Atrophy and hypertrophy, 272. — Dilatation and degenerations, 274.— Fatty infiltrations, atrophy of pericardial fat, myomalacia, 276. — Inflammation, 277. — Simple acute endocarditis, 278. — Mycotic endocarditis, 279. — Chronic, chronic ulcerative, and tubercular endocarditis, 280. — Myocarditis, 281, 282. — Changes in heart valves, aneurism of the heart, 282. — Thrombosis of the heart, 283. — Tumors and parasites, 284.

The Blood Vessels. Atrophy and hypertrophy, degeneration, 284. The Arteries,

Vlll CONTENTS.

acute and chronic arteritis, 285.— Dilatation and aneurism, 290. — Aneurisms of the different arteries, 291.— Stenosis, 292.— Ruptures and wounds, 293.

The Veins. Dilatation, 295. — Wounds, rupture, and inflammation, 296, 297. — Tumors and parasites, 298. — The Capillaries, 298.

The Lymph Vessels. Inflammation, 299. — Lymphangiectasis, tumors, 300.

The Lymph Nodes (Lymph Glands), 300. — Acute inflammation, 301. — Chronic inflammation, 303. — Pigmentation, 304.— Inflammation with cheesy degeneration, 305. — Tubercular inflammation, 306. — Syphilitic inflammation and degeneration, 307. -Hyperplasia, 308.— Tumors and parasites, 309.

The Alimentary Canal. The Mouth, (malformations, 310. — Hypertrophy, inflammation, Stomatitis ulcerosa, 311. — Gangrene, tumors, 312. — The Tongue, malformations, hypertrophy, inflammation, 313. — Tumors, 314. — The Pharynx and Oesophagus, inflammation, 315. — Ulceration, dilatation, 316. — Stenosis, tumors, 317.

The Stomach. Malformations, 319. — Post-mortem changes, injuries, haemorrhage, 320. — Inflammation, 321. — Croupous and suppurative gastritis, 322. — Toxic gastritis, ulcers of the stomach, 323. — Dilatation, tumors, 326. — Degenerations, 329.

The Intestines. Malformations, 329. — Incarceration, 330. — Intussusception, 331. — Transposition, wounds and ruptures, 332. — The Small Intestine, inflammation, 332. — Lesions of the solitary and agminated glands, 333. — Ulcers of the duodenum, syphilitic ulcers, emboli, 334. — The Large Intestine, inflammations, 334. — The solitary follicles, caecum, rectum, and vermiform appendix, 336. — Tumors, 337. — Concretions, parasites, 338.

The Peritoneum. Malformations, inflammation, 339. — Acute peritonitis, 340. — Chronic peritonitis, 343. — Tumors, 347. — Parasites, 349..

The Liver. Malformations, acquired changes in position, 350. — Anaemia and hyperaemia, 351. — Wounds, rupture, and haemorrhage, lesions of the hepatic artery and portal vein, 353. — The hepatic veins, atrophy of the liver, degenerative changes, 355. — Fatty infiltration, 356. — Fatty degeneration, amyloid degeneration, 357. — Pigmentation, 358. — Acute yellow atrophy, 359. — Inflammation, 360. — Chronic interstitial hepatitis, 362. — Syphilitic hepatitis, 365. — Tubercular hepatitis, 366. — Perihepatitis, hyperplasia of lymphatic tissue, 368. — Tumors, 369.— Parasites, 371.

The Biliary Passages. Inflammation, 373. — Constriction and occlusion, 374. — Dilatation, biliary calculi, 375. — Tumors, 377.

The Spleen. Wounds, rupture, and haemorrhage, 378. — Disturbances of the circulation, 379.— Infarctions, 380. — Inflammation, 381. — Perisplenitis, 385. — Alterations in leukaemia and pseudo-leukaemia, 385.— Degenerative changes, 386. — Tumors, parasites, malformations and displacements, 387.

The Pancreas. Haemorrhage, inflammation, 389. — Degenerative changes, 390. — Tumors, 391. — Malformations and displacements, 392.

The Salivary Glands. Inflammation, 394. — Tumors, parasites, 395.

The Thyroid Gland. Hyperaemia, inflammation, degenerations, tumors, 396. — Parasites, 397. — Myxoedema, 397.

The Thymus. Haemorrhages, inflammation, 399.

The Suprarenal Capsules. Malformations, haemorrhage, thrombosis, inflammation, degeneration, 400. — Tumors, 401.

The Urinary xIpparatus. The Kidney, malformations, changes in position, 402. — Bright's disease, 403-413. — Suppurative nephritis and pyelo-nephritis, 413. — Tubercular nephritis, embolism, and thrombosis, 415. — Hydronephrosis, cystic kidney, 416. — Perinephritis, 417. — Renal calculi, tumors, 418. — Parasites, 420.

The Urinary Bladder. Malformations, 420. — Changes in size and position, 421. —

CONTENTS. IX

Rupture, perforation, disturbances in circulation, 422. — Inflammation, 423. — Tumors, 424. — Parasites and calculi, 425.

The Urethra. Malformations, changes in size and position, 427. — Injuries, inflammation, 428.— Tumors, 430.

Organs of Generation. Female. The Vulva, malformations, haemorrhage, 431. — Inflammation, tumors, 432.

The Vagina. Malformations, 433. — Changes in size and position, 434. — Wounds, perforation, inflammation, 435. — Tumors, parasites, 436. — The Uterus, malformations, 436. — Changes in size, 437. — Changes in position, 438. — Rupture, perforation, hyperemia, haemorrhage, 440. — Inflammation of the unimpregnated uterus, 442. — Inflammation of the pregnant uterus, 445. — Ulceration and degeneration, 446. — Tumors, 447. — Parasites and cysts, 452.

The Ovaries. Malformations, changes in size and position, hyperaemia and haemorrhage, 453. — Inflammation, 454. — Tumors, 456.

The Fallopian Tubes. Malformations, 460. — Changes in position and size, haemorrhages, inflammation, 461. — Tumors, extra-uterine pregnancy, 462.

The Placenta. Haemorrhage, 463. — Inflammation, degenerations, 464.

Tlie Mamma. Malformations, 464. — Haemorrhage, inflammation, 465. — Tumors, 467.

Organs of Generation. Male. The Penis, malformations, 470. — Inflammation, tumors, 472. — The Scrotum, 473. — The Testicles, malformations, hydrocele, 474. — Spermatocele, haematocele, 475. — Inflammation, 476. — Tumors, 479. — Parasites, 480.— The Seminal Vesicles, 480.— The Prostate, hypertrophy, 480.— Inflammation, tumors, parasites, concretions, 481. — The Male Mamma, 482.

The Bones. Disturbances of circulation, injuries, 483. — Inflammation, 484. — Periostitis, 484, 485.— Osteitis, 486.— Osteomyelitis, 492.— Necrosis, 493.— Caries, 494. — Rachitis, 495.— Osteomalacia, 497. — Alterations of the bone marrow in leukaemia and anaemia, 498. — Atrophy, 499. — Tumors, 500. — Parasites, 503.

Diseases of the Joints. Inflammation, 504.— Tumors, 507.

Muscle. Haemorrhage, infarction, wounds and ruptures, inflammation, 509. — Atrophy, 512. — Pseudo-hypertrophy, 514. —Degenerations, 515. — Hypertrophy, tumors, 516.— Parasites, 517.

PART FOUBTH.

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

Typhoid Fever. Primary or Characteristic Lesions, 521. — The Intestines, 521. — Lesions of the lymphatic apparatus, 522.— Gangrene, 523. — Croupous inflammation, peritonitis, infarctions, haemorrhage, 524. — Lesions of the mesenteric lymph nodes and the spleen, 524.

Secondary Lesions. The mouth, pharynx, parotid, pancreas, liver, and heart, 525. — Lesions in the blood-vessels, larynx, lungs, kidneys, ovaries, testicles, and brain, 526. — Lesions in the muscles and skin, 527. — The bacillus of typhoid fever, 527. — Methods of staining the typhoid bacillus, 528.— Bibliography, 529.

Typhus Fever, 530.

Relapsing Fever, Lesions of various organs, 531. — Bacteria, 531, 532.

Acute Cerebro- spinal Meningitis, 533. — Bacteria, 534.

Diphtheria. Lesions, 535. — Bacteria found in diphtheria, 536.

Asiatic Cholera. Lesions, 537, 538. — Bacteria, 538, 539, 540.

Yellow Fever, 541.

Tuberculosis, 542.— Tubercle bacilli, 545.— Methods of staining the tubercle bacilli, 546. — Cultures of the tubercle bacilli, 547.

X CONTENTS.

Lupus, 548.

Erysipelas, 550. — Streptococcus erysipelatos, 551.

Pyaemia, 552. — Bacteria in pyaemia, 554.

Anthrax, 555. — Bacillus anthracis, 556.

Leprosy, 557. — Bacilli of leprosy, 558.

Glanders (Farcy), 559.

Hydrophobia, 561.

The Malarial Feyers, 562. — Plasmodium malarias, 563. — Method of examining malarial blood, 564.

Diseases Characterized by Alterations in the Composition of the Blood. Chlorosis, pernicious anaemia, Addison's disease, 565. — Leukaemia, pseudo-leukaemia, 567.

Scorbutus, Purpura hemorrhagica, 568.

ELematophilia, 569.

Diabetes, 571.

Sunstroke, 572.

Death prom Burning, 573.

Death from Lightning, 574.

Death from Strangulation, Hanging, 516. — Death from Drowning, 577.

Death from Poisoning. Sulphuric acid, 580. — Nitric acid, 581. — Hydrochloric acid, oxalic acid, tartaric acid; potash, soda, and their carbonates, 582.— Ammonia, potassium nitrate, phosphorus, 583. — Arsenic, 584. — Corrosive sublimate, lead, copper, 586. — Tartar emetic, vegetable irritants, cantharides, opium, 587. — Poisonous fungi, hydrocyanic acid, carbolic acid, alcohol, 588. — Chloroform, 589. — Ether, chloral hydrate, strychnia, nux vomica, conium, aconite, belladonna, lobelia innata, digitalis, stramonium, carbonic oxide, 590. — Carbonic acid, bibliography of poisons, 591.

LIST OF ILLUSTEATIOWS.

FIG. PAGE

1. Side view of human brain, showing its fissures and convolutions, . . 11

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

and outward, 13

3. Drawing of brain axis, separated from the brain mantle, ... 14

4. Hyaline degeneration of capillary blood-vessels, 68

■5. Coccidium oviforme, 70

6. Cercomonas intestinalis, 71

7. Trichomonas vaginalis, ........... 71

•8. Distoma hepaticum, 71

9. Head of Taenia solium, 73

10. Head and proglottides of Taenia mediocanellata, 73

11. Cuticula of echinococcus cyst, 74

12. Scolices of Taenia echinococcus, 74

13. Hooklets from scolex of Taenia echinococcus, 75

14. Ascaris lumbricoides, 76

15. Oxyuris vermicularis, 77

16. Trichinae incysted in muscle, . . 78

17. Filaria sanguinis hominis, . . . . . . . . . 80

18. Sarcoptes hominis, 81

19. Pediculus capitis, 81

20. Actinomyces bovis, 84

21. Drawing of three typical forms of bacteria, illustrating the three classes, 86

22. Spheroidal bacteria, 87

23. Bacilli in pairs, 88

24. Bacilli in chains, 88

25. Curved bacilli, forming spirals, 88

26. Schematic drawing of spore-containing bacilli, 89

27. Leptothrix buccalis, with micrococcus colonies, 90

28. Spirillum serpens, 91

29. Spirochsete denticola, 91

30. Bacterial embolus in blood-vessels of the kidney in malignant endocar-

ditis, 92

31. Colonies of micrococci in a blood-vessel of the kidney causing abscess, . 93

32. A potato culture, . 100

33. A gelatin tube culture, 101

34. A gelatin plate culture, 102

35. Emigration of white blood-cells in inflamed frog's bladder, . . . 105

36. Pus cells from catarrhal inflammation of bronchial mucous membrane, 106

37. Croupous inflammation of trachea, 108 xu

LIST OF ILLUSTRATIONS.

FIG.

Granulation tissue from wound of skin, .

Developing blood-vessels in new-formed tissue,

Cicatricial tissue,

Cellular peritonitis in dog, fourth day, .

A tubercle granulum from the pleura,

Diffuse tubercle tissue from acute phthisis,

A miliary tubercle from a lymph gland,

Dense fibroma of the abdominal wall,

Myxoma of subcutaneous tissue,

Myxoma in abdominal cavity, .

Large spindle-celled sarcoma, .

Small spindle-celled sarcoma, .

Small round-celled sarcoma,

Large round-celled sarcoma,

Melano-sarcoma,

Giant-celled sarcoma,

Angio-sarcoma of liver, .

Myxo-sarcoma of pharynx,

Adeno-sarcoma of parotid,

Endothelioma of dura mater, .

Chondroma of subcutaneous tissue,

Myxo-chondroma of cervical region

Glioma of brain,

Neuroglia or " spider " cells from glioma of brain,

Myxoma of the uterus, . . . .

Fibroma (false neuroma) of lumbar nerve,

Multiple fibromata (false neuromata) of pneumogastric nerve

Angioma telangiectoides of skin,

Angioma cavernosa of liver,

Congenital lymphangioma,

Adenoma of mamma,

Adenoma of the stomach,

Cancer cells infiltrating the tissue near a tumor,

Metastatic carcinoma in lymph vessels of the pleura

Carcinoma uteri, showing pus cells,

Epithelioma of the neck, .

Epithelioma of axillary lymph node

Epithelioma of back of hand, .

A small epithelioma of the nose,

Epithelioma of nose,

Carcinoma mammae, scirrhus, .

Medullary carcinoma of stomach,

Colloid carcinoma of rectum, .

Carcinoma myxomatodes mammae,

Chronic pachymeningitis interna haemorrhagica

Brain sand,

Cellular meningitis, . .

Acute purulent meningitis, ....

Fatty degeneration of cells along blood-vessels of pia mater, after exuda

tive meningitis, .

A miliary tubercle of the pia mater,

LIST OF ILLUSTRATIONS. Xlll

FIG. PAGE

88. A miliary tubercle of the pia mater, . 175

89. Miliary tubercle of the pia mater undergoing cheesy degeneration, . 175

90. Miliary tubercles of the ependyma, 175

91. Miliary tubercle of the ependyma, 176

92. Congenital hydrocephalus in child, 179

93. Degenerated cells, cholestearin crystals, etc., from brain tissue in em-

bolic softening of brain, . . . . . . . . . 182

94. Blood-vessels from an area of embolic softening of brain, . . . 183

95. Syphilitic obliterating endarteritis of a cerebral artery, .... 191

96. Solitary tubercle of cerebellum, 192

97. Descending gray degeneration, 200

98. Ascending gray degeneration, 201

99. Ascending gray degeneration, 202

100. Degenerated tissue from acute myelitis, 203

101. Poliomyelitis anterior, . . 204

102. Poliomyelitis anterior, 204

103. Posterior spinal sclerosis, 205

104. Posterior spinal sclerosis, . . . 206

105. Syringomyelia, . 208

106. Hydromyelia, 209

107. Multiple neuritis, 211

108. An ulcer of the larynx in chronic catarrhal laryngitis, .... 215

109. Tubercular laryngitis, 216

110. Artificial pleurisy in dog, twenty-four hours' duration, .... 220

111. Artificial pleurisy in dog on fifth day, 221

112. Tubercular pleurisy, . . 225

113. Acute catarrhal bronchitis, 227

114. Section of the wall of a bronchiectasia, 230

115. Emphysema, showing holes in the walls of the air vesicles, . . . 234

116. Acute lobar pneumonia, pneumococci in the exudation, . . . 237

117. Acute lobar pneumonia, with organized tissues in the air spaces, . . 239

118. Pneumonia showing organized tissue in an air vesicle, .... 240

119. Lobar pneumonia, with organized tissue in air vesicles ; blood-vessels

injected, . . 241

120. Broncho-pneumonia in a child, 243

121. Broncho-pneumonia in an adult, . . . 244

122. Persistent broncho-pneumonia, 245

123. Lobular pneumonia in a child, complicating diphtheria, showing strep-

tococci, 246

124. The pneumonia of heart disease, 247

125. Interstitial pneumonia, 248

126. A miliary tubercle in the lung, 249

127. A miliary tubercle, 250

128. A miliary tubercle, 251

129. Miliary tubercle in lung of child, showing tubercle bacilli, . . . 252

130. An aggregation of miliary tubercles, 253

131. Diffuse tubercular inflammation, 253

132. An area of coagulation necrosis surrounded by a zone of pneumonia, . 254

133. Tubercle tissue around an area of coagulation necrosis, . . . 255

134. Chronic phthisis, 256

135. Chronic phthisis, 257

XIV LIST OF ILLUSTRATIONS.

PIG. PAGE

136. Chronic phthisis, 258

137. Interstitial pneumonia of chronic phthisis, 259

138. An old miliary tubercle converted into fibrous tissue, .... 260

139. Interstitial syphilitic pneumonia, . . . 261

140. Primary carcinoma of the lung, 262

141. Fatty degeneration of the heart muscle, 275

142. Fatty infiltration of the heart, 276

143. Atrophic pericardial fat, . . . 277

144. Vegetation on aortic valve in endocarditis, 278

145. Mycotic endocarditis, . . . 279

146. Chronic interstitial myocarditis, 281

147. Chronic endarteritis, 286

148. Chronic obliterating endarteritis, 286

149. Atheroma of the aorta, 287

150. Tubercular arteritis in the lung, . . . . . . . 289

151. Tubercular phlebitis, . 297

152. Acute inflammation of lymph node in typhoid fever, .... 302

153. Chronic inflammation of bronchial lymph node, 303

154. Pigmentation of bronchial lymph node, . . . . . . 304

155. Diffuse sarcoma of the pharynx, . . . . • . . . . 319

156. Acute cellular peritonitis, . . . 341

157. Acute exudative peritonitis, , 342

158. Chronic cellular peritonitis, . . 343

159. Chronic peritonitis with adhesions, 344

160. Section of a retro-peritoneal sarcoma, 348

161. Chronic congestion of the liver, 352

162. Fatty infiltration of liver cells, 356

163. Amyloid degeneration of liver capillaries, 357

164. Pigmentation of liver in malarial fever, 358

165. Chronic interstitial hepatitis, 362

166. Chronic interstitial hepatitis, ..." 364

167. Syphilitic hepatitis, 366

168. Gumma of the liver, 367

169. Echinococcus multilocularis of the liver, . . . . . . 372

170. Primary carcinoma of the common bile duct, 376

171. Congestion of the spleen, 379

172. Chronic indurative splenitis, 383

173. Chronic interstitial splenitis, 384

174. Malarial spleen, 384

175. Fat necrosis in the pancreas, 391

176. Atrophied thyroid in myxoedema, . 398

177. Acute degeneration of the kidney, 404

178. Acute nephritis, 405

179. Acute nephritis with tuberculosis, . 406

180. Acute nephritis, 407

181. Acute diffuse nephritis, 408

182. Chronic diffuse nephritis, . . . 412

183. Waxy degeneration of vessels in kidney, 413

184. Gonococci in pus cells, 429

185. Chronic endometritis, 442

186. Chronic endometritis, . . . 443

LIST OF ILLUSTRATIONS. XV

FIG. PAGE

187. Uterine phlebitis, 446

188. Adenomatous hyperplasia of uterine mucous membrane, . . . 447

189. Carcinoma of cervix uteri, ulcerating, 451

190. Chronic oophoritis, 454

191. Chronic oophoritis, . 455

192. Cystic adenoma of ovary, . . . . ' . . . . 457

193. Fatty cells from an ovarian cyst, . . . . ' . . . . 458

194. Suppurative mastitis 466

195. Chronic inflammation of mamma, 467

196. Intracanalicular fibroma of mamma, . 468

197. Pericanalicular fibroma of mamma, . 469

198. Chronic interstitial orchitis, 477

199. Chronic orchitis, 478

200. Rarefying osteitis, 487

201. Condensing osteitis, . . . 489

202. Tubercular osteitis, . . . . . 490

203. Rachitic bone, 496

204. Cells from marrow of femur in leukaemia, 498

205. Chronic interstitial myositis, .511

206. Progressive muscular atrophy, . . . . v . . . . 512

207. Progressive muscular atrophy, 513

208. Pseudo-hypertrophy of gastrocnemius muscle, 514

209. Hyaline degeneration of muscle, 515

210. Typhoid bacilli in the spleen, 527

211. Typhoid bacilli from gelatin culture, 528

212. Spirochete Obermeieri, 532

213. Diphtheria of the trachea, 535

214. Streptococcus diphtherias, 536

215. Spirillum choleras asiaticse, . . . . 538

216. Tubercle bacilli in sputum, . . . . . . . . 544

217. Lupus of face, 548

218. Micrococci in blood and lymph vessels of the skin in erysipelas, . . 550

219. Streptococcus erysipelatos from culture, 551

220. Micrococci in pyaemic pleurisy, 554

221. Bacillus anthracis in liver of mouse, . 555

222. Bacillus anthracis, 556

223. Bacilli of leprosy, 557

224. Plasmodium malarias, 563