Variola, vaccination, varicella, cholera, erysipelas, whooping cough, hay fever / by H. Immermann [and others] ; edited with additions by John W. Moore ; authorized translation from the German, under the editorial supervision of Alfred Stengel.

  • Immermann, H.
Date:
1902
Catalogue details

Licence: In copyright

Credit: Variola, vaccination, varicella, cholera, erysipelas, whooping cough, hay fever / by H. Immermann [and others] ; edited with additions by John W. Moore ; authorized translation from the German, under the editorial supervision of Alfred Stengel. Source: Wellcome Collection.

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    in which no smallpox pocks usually occur; as, for example, in the region of the Eustachian tube, of the middle ear, in the nasal duct, in the more distal portions of the esophagus, and in the deeper and finer divisions of the bronchial tree. In addition to the signs of a terminal edema, hypostatic changes in the lungs are quite usual. For the greater part we find simple spleni- zatioii (hypostatic hyperemia and extensive collapse of the lungs), but we may find also lobular pneumonic thickenings of a catarrhal, croupous, or mixed nature. Lobar pneumonia and abscess of the lungs are decid- txlly rare occurrences. The heart, in those cases in which death occurred during suppura- tion or even later, is usually relaxed and soft, the muscle appears of a dirty color ; the microscopic examination shows, as a rule, disintegration of the fibers, besides some fatty degeneration (formation of the finest granules). The liver, like the heart, shows, under these circumstances, the phenomena of parenchymatous degeneration, and is accordingly somewhat enlarged and soft. On section it appears turbid ; the contour of the liver lobules is indistinct or obliterated. In individual cases in which the degenerative process has advanced further, we have a picture wdiich resembles an acute phosphorus-poison- ing; that is, we find a marked fiitty degeneration. A large amount of thin, bright-colored bile is generally present in the gall-bladder. The spleen presents the characteristics of an acute splenic tumor; it is enlarged to a variable extent, its capsule is tense and shining. The pulp is soft in consistency, almost liquefied; its color is reddish-gray; the Malpighian bodies are generally not to be seen. In the kidneys, lastly, we find the 'well-known picture of a parenchymatous disease ; to describe it more in detail, we find swelling, a cloudy appearance, and a more or less yellowish color (fatty degeneration of the epithe- lium). All these findings are noted especially in the pustular forms of variola (including also variola pustulosa hremorrhagica in the most fatal CJises), and especially when death occurs, as it usually does in the pus- tular forms, during the period of suppuration or of commencing desiccation. An exception may be noted in all those fatal cases that come to be examined after death which has resulted from events and complications which appear late, even after the maximal point of the disease is passed. Here ])robably compensatory processes have already taken place, and, corresponding to these, under such peculiar circumstances, heart mus- cle, liver, spleen, and kidneys have somewhat resumed their normal appearance. But the spleen, in these rare cases, is usually somewhat