The Erasmus Wilson lecture on the pathology of the lymphadenoid structures : delivered at the Royal College of Surgeons of England on March 1st, 3rd, and 5th, 1897 / by W.G. Spencer.

  • Walter G. Spencer
Date:
[1897]
Catalogue details

Licence: Public Domain Mark

Credit: The Erasmus Wilson lecture on the pathology of the lymphadenoid structures : delivered at the Royal College of Surgeons of England on March 1st, 3rd, and 5th, 1897 / by W.G. Spencer. 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.

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    of relapsing fever multiply rapidly in the blood, but on reaching the spleen they are taken up and destroyed. If the cells become exhausted spirilla escape, and becoming again free in the blood rapidly increased again. Werigo noted that anthrax bacilli injected into the ear vein of a rabbit reach the spleen and liver and are there included by cells. But soon free bacteria are found in the spaces of the spleen pulp, and then they multiply rapidly and cause the spleen to swell. During the last stages of the disease the bacteria escape into the general blood stream. There are other parasitic diseases—such as typhoid fever, diphtheria, and malaria— where the spken appears also to play, in part at least, a pro- tecting role. But, on the other hand, there are conditions in which it remains un-sSected. The pathological cliangts in the spleen arise either in con- nexion with disturbances of its circulation or are due to inflammatory changes consequent upon the collection of morbid products in it. A diseased spleen affects the body generally either by producing leuoocythsemia and anasmia or by acting as an abdominal tumour. Circulatory disturbance.—Venous obstruction concurrent with obstruction to the portal circulation causes first an engoigement of tbe pulp, then a general increase of con- nective tissue which does not especially pick out tbe follicles. Embolism aflEeots the spleen according to the vessel, whether a main vessel is aSected or several small ones. In pyaemia the necrosis goes on to suppuration around the bacteria which have lodged there. Infarcts from thrombosis are a special feature of the spleen. Ttiey are met with in typhoid fever, malaria, and leucocythaemia owing to the coagulation produced by the breaking down of leucocytes. A wedge- shaped mass is .''ormed abutting on the surface, which can thus be distingiushed irom other changes. InJla,7n7natory chaiujes the result of infection.—The spleen is rarely affected by tubercle until the disease has become generalised. The bacilli have to pass through lymphatics and lymphatic glands into the blcod stieam before they can reach tbe spleen. The tubercles generally form in the sheath of the bloodvessels and in the Malpighian bodies. The Malpighian bodies appear as pale, firm masses which may easily be confounded with the changes due to lymphadenoma. Syphilis, eepecially when inbedied, affects the spleen either directly in the form of gnmmata or by :v general overgrowth of connective tissue or indirectly by starting amyloid diseafe. Amjloid disease may commence in a previously healthy spleen from some cause other than disease of lympbadenoid tissue, and by commencing in tbe follicles form the so-called sago spleen, or it may be widely diffused aronnd the 2« Werigo: Ibid., ISitl, tome viil., p. 1.
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