A study of the various changes which occur in the tissues in acute diphtheritic toxaemia : more especially in reference to 'acute cardiac failure' / by Leonard S. Dudgeon.
- Leonard Dudgeon
- Date:
- 1906
Licence: In copyright
Credit: A study of the various changes which occur in the tissues in acute diphtheritic toxaemia : more especially in reference to 'acute cardiac failure' / by Leonard S. Dudgeon. 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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![it to be extremely fatty, and the adrenal glands to be haemorrhagic. The kidneys also showed fatty change. He mentioned that in his opinion the heart muscle is usually normal in diphtheria, hut in this instance the fatty change was very well marked. Flexner [7], in his valuable monograph on the pathology of the toxalbumin intoxications, remarks that fatty meta- morphosis is one of the most common pathological con- ditions found in the myocardium in diphtheria. I can do no better than quote his own words : “ For its detection we have employed the frozen section only. It was rarely absent, and was encountered, more especially in those cases which terminated fatally, within short periods following inoculation.” He also draws attention to the swelling and elongation of the nuclei and alteration in their shape, the fibres in the meantime showing little change. As the changes in the nuclei become more marked the substance of the fibres has disappeared, or has taken on a swollen and attenuated aspect. Pathological alterations in the inter- stitial tissue were wanting. Vascular changes were noted. The chief lesion of the adrenal gland was congestion and haemorrhage. The medulla, more especially, was full of blood. Necrosis of the tissue cells, such as has been met with in the liver, with invasion of the necrotic areas with polymorphonuclear cells, was commonly found to be present. Fatty metamorphosis of the liver cells was common. The researches by Flexner were carried out with filtered sterile cultures of the bacillus of diphtheria, and cultures freed from bacteria which bad been killed with chloroform. These observations of Flexner’s are of the utmost import- ance, and form a very considerable addition to our know- ledge of this subject; but there is no doubt, however, that many valuable points concerned in diphtheritic toxaemia are omitted. Vincent reported a case of heart paralysis in diphtheria in which the cardiac plexus showed an atrophy of nerve fibres and myelin sheaths. The pneumogastric nerve and medulla are said to have been normal. (Flexner.) Muller [13] describes abundance of fat in the splenic](https://iiif.wellcomecollection.org/image/b22428483_0006.jp2/full/800%2C/0/default.jpg)
