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 bacilli appear rapidly to break down into granules, and one finds,
especially in the seminal canals, globi, sometimes enormously large,
as if they were formed by the running together of several epithelial
cells. We have found here globi where a nucleus and a little protoplasm
were evident (_Plate X, Fig. 3_), and a globus where there lay in the
vacuole small fragments stained with Bismarck brown (_Plate X, Fig.
2_). As it has been proved that a man affected with nodular leprosy may
beget children, and as the globi lie in the seminal canals, it is not
altogether impossible that these may be thrown off with the spermatic
fluid, and that in this way the ovum is infected. But as, according to
our view, these globi contain only broken down and degenerated bacilli,
it must be regarded as very doubtful whether they are still infective.
In examining the contents of the seminal vesicles, we have found in
them neither bacilli, nor globi, nor any spermatozoa. It is an old
conception that lepers suffer from satyriasis. This is, according to
our experience, certainly not the case. The leprous testicle is finally
completely destroyed by the scar-like contraction of the connective
tissue, and one finds only here and there traces of the seminal canals
around the globi which they enclose.
When the liver is severely affected with leprosy, there are evident
macroscopically, fine white, or yellow, streaks or points, which shine
through the capsule and are more evident on the cut surface (_Plate IX,
Fig. 2_); they evidently lie in the acini. One also finds round cells
with bacilli along the portal vessels and in the capsule of Glisson.
Here and there we find also scattered bacilli in the acini, and as is
evident from a specimen hardened in Fleming’s solution, the bacilli lie
in the endothelium of the blood vessels (_Plate IX, Fig. 1_). In the
liver cells we have never seen bacilli, but we have found here also, in
the vessels, white blood corpuscles containing bacilli (_Plate VIII,
Fig. 6_, and _Plate IX, Fig. 1_).
The affection of the spleen may also be recognised macroscopically
by the yellow streaks and points in its substance (_Plate IX, Fig.
3_), but the affection must be pretty severe to be recognised
macroscopically; the cut surface is then somewhat dry. The affection
has its seat in the arterial sheaths and the Malpighian bodies; and in
this organ also one can in good preparations definitely recognise the
position of the bacilli in the cells (_Plate VIII, Fig. 5_).
The glands in the hilum of the liver are, when that organ is affected
with leprosy, definitely leprous, and the affection of the glands is
often more evident than that of the liver itself. In the hilum of the
spleen we have once or twice found leprous lymph glands.
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