Report on an inquiry into the nature, causes, and prevention of splenic fever, quarter-evil, and allied diseases : made at the Brown Institution / by W.S. Greenfield.

  • William Smith Greenfield
Date:
1880
Catalogue details

Licence: Public Domain Mark

Credit: Report on an inquiry into the nature, causes, and prevention of splenic fever, quarter-evil, and allied diseases : made at the Brown Institution / by W.S. Greenfield. 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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    vessels and lead to extravasation ol blood, which of course also contains Bacilli. In the lungs they are well seen, owing to arrangement of the capillaries in the alveolar walls ; but they more rarely lead to infarction. They do not usually appear in any great number in the pleura. The liver is sometimes very free from them ; when found, they are especially seen in the hepatic veins and their intra- lobular tributaries. The kidneys usually contain them in very large numbers, chiefly in the glomeruli and their afferent and efferent arterioles, and in the parts of the vessels in immediate continuity with them. Many of the afferent arterioles are almost completely plugged by masses of them; in the glomeruli themselves, especially near the surface of the organ, they lie in parallel bundles, in such a way that the capillaries appear to be striated; and sometimes they form a mass which may occupy a consider- able portion of the glomerulus. I have in some of these masses seen the formation of spores: a fact, I believe, of great im- portance. Rupture of the glomerulus may occur, and the Bacilli, usually accompanied by some blood, escape into the con- voluted tubes, where they may grow to a considerable length. Koch states that they do not pass beyond this position, and that he has never seen them in any part of the straight tubes. It must, however, be remembered that he is speaking only of rabbits and mice. There are many considerations which lead me to believe that either Bacilli or spores must, in the majority of cases, pass into the urine and be voided with it; and that this may serve as one of the most important carriers of contagion. I shall there- fore consider it a little more in detail. First, with regard to the glomeruli. It is quite possible that after rupture of the capillary network has occurred, and a quantity of blood has been extravasated, very few of the Bacilli may traverse the tortuous channel and reach the bladder ; but what we know of the passage of blood in the urine, under analogous conditions, leads me to believe that some small quantity must pass. Again, I have frequently observed that individual Bacilli can pass through the capillary wall, and even through the walls of large vessels. Some may therefore pass into the urine whilst the network is as yet unruptured. Agmn, we know that the urine is an excellent nutrient fluid or Bacilli, and that they can go on to the formation of spores. nee escaped, therefore, into the urinary tract, one or two Bacilli may serve to contaminate the whole of the urine.
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