A text-book of pathology / by Alfred Stengel and Herbert Fox.

  • Alfred Stengel
Date:
1915
Catalogue details

Licence: Public Domain Mark

Credit: A text-book of pathology / by Alfred Stengel and Herbert Fox. Source: Wellcome Collection.

    96/1100 page 94
    % vessels of the affected part seem especially affected with hyaline change. Ribbert says the small vessels are curiously free from change. The neighboring lymph-vessels and glands are usually attacked. The special appearances and reactions of the amyloid bodies of the nervous system will be described in connection with Neuropathology. Pathological Physiology.—As stated, amyloid substance seems to be a combination of chondroitin sulphuric acid with a protein. It is composed of hydrogen, nitrogen, carbon and sulphur, and is insoluble in weak alkalies. Chondroitic acid is normally present in bones, carti¬ lages, and elastic tissue. It seems to have been shown that an amyloid¬ like substance exists in the elastic coat of the blood-vessels—perhaps a different combination of chondroitic acid. Our present knowledge sug¬ gests that amyloid substance is not entirely abnormal, but rather an abnormal combination of normal substances. It seems to result from protein alterations in connection with the pathological processes already detailed, having as a result the liberation of large amounts of chondroitin sulphuric acid. That bacterial influences are not necessary is suggested, though not proved, by the fact that amyloid change has been produced by long-continued aseptic suppuration induced by turpentine injection. Amyloid change is an infiltration, the constituents being deposited from the blood and assuming their peculiar characters locally, for amyloid is not found preformed in the blood itself. Possibly local cellular condi¬ tions favor the deposition by reason of a loss of power to dispose of the constituent substances brought by the blood. Hyaline degeneration seems at times a preliminary stage in the process. Amyloid degeneration interferes with functional activity by pres¬ sure upon the parenchyma and by vascular disturbances. By its situa¬ tion in and around the blood-vessels it may occasion thrombosis. Reab¬ sorption of amyloid substance is possible, as it has been known to occur when part of the diseased area has been extirpated. Such reabsorption does not, however, occur when extensive amyloid change exists. GLYCOGENIC INFILTRATION Definition.—This condition consists in the presence of glycogen in cells which normally contain none, or the presence of an excess in cells which normally contain it, as in the liver, cartilages, muscles, leukocytes, in the embryo in all tissues, and in the uterus. The attempt has been made to separate glycogenic infiltration from a glycogenic degeneration, but the conversion of protoplasmic protein into glycogen has never been demonstrated. Etiology.—The condition is not infrequent. It is seen in the tissues in diabetes, especially in the kidneys (Henle’s loop in particular), muscles, liver, and circulating leukocytes. It occurs in neoplasms, especially in malignant growths of mesoblastic origin, being rare in most carcinomata. It may be said that the more cellular the tumor, the more the glycogen, except in carcinomata, where the amount is small and variable. In leukocytosis of different varieties the cells may con-
    digitised image 1
    digitised image 2
    digitised image 3