Selected monographs.

Date:: 1888

Catalogue details

Licence: Public Domain Mark

Credit: Selected monographs. Source: Wellcome Collection.

229/440 (page 211)

and most extensively fatal^ in which no intestinal lesion is found even on the most careful inspection. Dr. Alison, of Edinburgh (from whom I cannot quote accurately, not having access to his work), corroborates the experience of other observers.'^ I now proceed to give some more circumstantial details upon this interesting subject. Dr. West^ gives the results of ten inspections. In five (I me'rely speak of the state of the bowel) there was no morbid appearance whatever in the other five there was increased vascularity of the intestinal canal, extreme in one instance. Once the glands of Peyer appeared enlarged, and twice there was very con- siderable enlargement of the solitary glands j but I never, says he, found them ulcerated. Once the mucous mem- brane of tbe ctecum was very much softened and congested, and there was slight abrasion of the surface of some of the congested patches. Dr. Reid^ states, that of loi cases examined in the Edinburgh Infirmary, by his predecessor, the late Dr. Home, the elliptical patches were well defined m 2gj they were more or less ulcerated in 7 of that number and in 2 out of the 7, perforation had taken place. He next gives^' a summary of the morbid appear- ances in 41 cases inspected by himself.' In 24, Peyer's glands were apparent and distinctly defined; in 6, scarcely visible; in 11, invisible to the naked eye. In 4 only were they distinctly elevated; and in 2 of the 4, this elevation was to no great extent, and limited to a few patches. In 2 only was there any appearance of ulceration. In 4, the solitary glands were distinctly visible. Regarding the connection of the symptoms during life with the post- mortem lesions, he says,^ In 9 cases only out of the 24, in which the elliptical patches were distinctly visible, were there any abdominal symptoms during life, and in some of. those 1 Dr. Alison l.as published no separate work, but Observations, &c., in the twenty-eighth volume of the 'Edinburgh Medical and Surgical Journal,' p. 233.—Ed. ' ' Edin. Journal,' vol. 1, p. 132-3. » Eeport, &c., p. 33. * Ibid., pp. 30,31. ^ Ibid,, p. 34.