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
In the skin nodules we have only once found bacilli in the epidermis;
this was in a nodule with many fissures in the epithelium, and partly
covered with exudation. We have not been able to decide from our
preparations whether the bacilli lie in the epithelial cells or only
_between_ them, possibly enclosed in wandering cells.[3] Touton found
bacilli in the epithelium of the sweat glands, and he and Unna in the
hair sheaths also; this situation of the bacilli we have never observed
with certainty, and it can only be exceptional, and can scarcely give
origin to a “constantly flowing bacterial spring,” as Unna suggests. As
a rule, no bacilli are found in the epithelium.
[3] In a nodule, with exudation, which we have recently examined, we
have found bacilli in the epithelium, and there are in several places
distinct leucocytic nuclei in the bacillary groups, thus showing
emigrated cells with bacilli in the epithelium.
Of the presence of bacilli in affections of the eye, it may be said
in general that everywhere, where infiltration is present, bacilli
are found. In the clouding of the upper part of the cornea described
above, which we recognise as keratitis punctata, there are found groups
of granularly degenerated bacilli close under the epithelium. This we
have only once been able to determine on the living by excision of
a lamella of the cornea; in this case the affection was, according
to our own view, disappearing, because the bacilli were granularly
degenerated. This corresponds with the fact that this characteristic
affection of the cornea always ultimately disappears; the granules are
probably absorbed. We have already stated that blood vessels precede
the nodule into the cornea, and that they are surrounded by round
cells. Here, as in the middle of the nodule, the corneal corpuscles
are found apparently intact or filled with brown granules (_Plate VI,
Fig. 3_, and _Plate VIII, Fig. 1_). The same is the case in nodules in
the iris, in which one finds the stellate cells intact (_Plate VIII,
Fig. 2_). Round cells are also found in the spaces in the cornea near
the nuclei of the corneal corpuscles (_Plate VIII, Fig. 3_). All this
appears to us definitely to indicate that at least most of the cells of
the growth are migrated white blood corpuscles.
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