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will appear as a hollow chamber within which is usually a small amount 
of granular coagulum lying either against the nucleus or against the cell 
wall. By the liquefaction of the interiors of cells with the persistence 
of the cell walls, a reticular appearance is produced. Both nucleus and 
cell wall finally react to certain stains in a manner similar to fibrin. 
2. Ballooning degeneration affects the cells at the base of the vesicle; 
that is, the Malpighian layer. The cells increase in size, lose their dense 
periphery and protoplasmic bridges. The nuclei become swollen, lose 
their network, the chromatin collects at the periphery, and direct nuclear 
division begins. He points out that in this case the stimulation to 
divide is from within the nucleus, and the centrosome and cytoplasm 
takes no part. Complete cell division is prevented by the early coagula- 
tion of the cytoplasm. Through this type of direct nuclear division, 
which takes place rapidly, large multinuclear cells are formed. Later in 
the process, material taking the diffuse stain appears within cells under- 
going this form of degeneration, and finally both cytoplasm and nucleus 
stain diffusely. Thus cells presenting the ballooning as well as those 
presenting the reticulating types of degeneration finally undergo a 
“fibrinoid” transformation. In varicella lesions the ballooning degenera- 
tion is a more prominent feature than the reticulating colliquation. The 
formation of the vesicle is accounted for by the penetration of fluid 
exudate into the epidermis entering into or seperating degenerated cells 
and forming spaces in the tissue which enlarge and tend to coalesce to 
form a single chamber. 
In this paper I report thirty-eight cases of varicella occurring in adult 
male Filipino prisoners. There had occurred in the prison about three 
hundred cases at the time the last observations were made and new cases 
were continuing to appear sporadically. Attention was first directed to 
them for the purpose of establishing a diagnosis. Several cases of 
smallpox had occurred in the prison previous to the appearance of this 
disease, so that it was at first important to determine whether a mild form 
of smallpox or a different disease was present. Later on a further study 
of the disease was made. ‘This consisted of the inoculation of animals 
with the exudate from the skin lesions and of a study of the pathology 
of the skin lesions. 
In two cases first seen, a few lesions were present, scattered over the 
surface of the body. These consisted of elevated, flat-topped pustules 
which possessed a central crust; this in some cases was slightly depressed. 
They contained a whitish, semi-fluid exudate, evidently pus. There was 
but little induration at the base of the pustule and the entire process was 
quite superficial. The exudate was collected from several of these lesions 
and used to inoculate one monkey and two rabbits. All inoculations were 
made immediately after the collection of the exudate. 
Monkey No. 1.—The skin of the belly was shaved and several shallow scratches 
were made and inoculated with the exudate mentioned above. Four days after 
the inoculation the surface of the skin was elevated and slightly opaque at certain 
