Leprosy : $b in its clinical & pathological aspects — John Shaqi
Leprosy : $b in its clinical & pathological aspectsHansen, G. Armauer (Gerhard Armauer)
Science
Leprosy : $b in its clinical & pathological aspects
Hansen, G. Armauer (Gerhard Armauer)
Leprosy
The leprous nodes have on section a smooth, white, glistening surface,
if they are still sufficiently young. If one examines, microscopically,
sections or teased preparations of fresh nodules, one sees little else
but cells, with distinct nuclei, usually of the size of a white blood
corpuscle, or rather larger. There are also a few larger so-called
epithelioid cells, with larger nuclei, and among the cells, fragments
of connective tissue and of blood vessels. With a higher power, one
sees in the fluid of the preparation small straight rods, which are not
destroyed by addition of potash. These are the lepra bacilli, and thus
were they first discovered in the year 1871.
If one teases out preparations in osmic acid solution, or soaks a
nodule in the solution some hours before teasing, the rods are coloured
faint brown, and one finds them lying mostly in the cells (_Plate VI,
Fig. 1_). If one adds water to a fresh preparation, the bacilli move
actively; even in the cells swollen up with water, one sees the bacilli
moving; and this led us to regard them as movable, although we at the
same time indicated a doubt whether the movement was not simply a
molecular one; for the movements were equally vigorous in strong osmic
acid solution as in water, and on the addition of glycerine or strong
solution of albumen to the preparations, the movements ceased. All
later observers, with the exception of Unna, regard the bacilli as
motionless. We have no ambition to decide this question, because we
know no absolutely trustworthy distinction between molecular movement
and independent movement of the bacilli.
The older the nodules become, the more large multinuclear cells are
found, and in nodules of the skin and cornea one always finds small
flat cells with processes, and with oblong nuclei, which we recognise
as the connective tissue and corneal cells (_Plate VI, Figs. 2_ and
_3_).
The protoplasm of these cells is clear, while that of the round cells
is more or less granular. The nuclei of the latter are also round, and
usually very granular; the flat cells are much less stained by carmine
than the round cells, and one sees the flat cells lying on connective
tissue bundles. The nodules are richly supplied with blood vessels; in
the nodules of the skin it cannot be determined whether the vessels
are newly formed, or only those already present in the cutis. They
are, however, always of embryonic type. One sees very plainly their
formation from cells, and in the cornea, indeed, the vessels _must_
be newly formed. Here the vessels penetrate into the cornea before the
nodule forms, and round these vessels, penetrating into the cornea,
there are always visible collections of cells which are apparently
migrated white blood corpuscles (_Plate VI, Fig. 4_).
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