Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis.

  • Pierre Charles Alexandre Louis
Date:
1844
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Licence: Public Domain Mark

Credit: Researches on phthisis: anatomical, pathological and therapeutical / by P. C. A. Louis. Source: Wellcome Collection.

Provider: This material has been provided by The University of Leeds Library. The original may be consulted at The University of Leeds Library.

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    to 20 centimeters] in length, and generally become more nu- merous and larger in tlie vicinity of the caecum. They pro- trude but slightly from the general surface, yet sufficiently to render their prominence both visible and palpable; they are double, treble, or quadruple as thick as the surrounding mucous membrane, are perfectly opaque, and of white or grayish colour, sometimes studded with minute points of blue colour. They have not the villous aspect of the rest of the intestine; their surface presents a great number of granules, smaller than mil- let-seed, of a slightly yellowish white colour; and if a patch be raised up in the manner just described in respect of the mucous membrane generally, the same little granules are observed upon their adherent sm'face. Lastly, if one of the patches thus de- tached be held between the eye and the light, the intervals between the little granules appear thin and semi-transparent, very much as other parts of the mucous membrane. This structure, which is not always demonstrable with the same facility, is pecuharly obvious in certain morbid cases, when the mucous membrane is of a deep red colour,—in conse- quence of affections of the heart, for example. Under these circumstances, the little granules retain their natural white and yellowish colour, while their interspaces are almost as deeply red coloured as the surrounding mucous membrane,—hence the former are rendered peculiarly distinct, and the patches appear, what they really are, an agglomeration of minute granules, doubtless of glandular nature, set in the substance of the mucous membrane. The blue points so commonly seen on the patches, are the orifices of the grandular granules. At least this interpretation of the appearance seems placed beyond question by certain phe- nomena arising in the pathological state,—when the patches are, under these circumstances, highly developed, the blue points are replaced by open orifices, almost as large as the granules themselves in the natural state.^ The patches frequently present a somewhat different appear- ance from that just described, arising from variation in the arrangement of the crypts; I refer to cases in which the latter are confluent, the intervening spaces having disappeared. But ' The elliptical patches of Peyer have very recently engaged the attention of ob- servers, and M. Casimir Bronssais denies the glandular structure of these glands. Experience and time must decide.