, it 
SSS Pe eee SL ee 
566 
plasmic bodies. ‘They do not appear to be related to the fragments of 
disintegrated cells which are of common occurrence in the lesion. 
It is difficult to reach a conclusion concerning the nature of these 
bodies. They are associated with the earliest changes and constitute one 
of the constant characteristics of the process. In a small portion of the 
inclusions there is some evidence of internal structure, but this is so 
indefinite that it carries but little weight as to their nature. A large 
proportion of the nuclear inclusions are so structureless and irregular 
that it is difficult to believe that they are living organisms. In spite of 
the great rapidity of the process it has not been found possible to demon- 
strate a multiplicative process in these bodies. 
In the fresh preparation they appear homogeneous and a large number 
of inclusions were watched for several hours under the microscope during 
which time they did not change in outline. Furthermore, eosin-staining 
material is found within the nuclei in various other processes and in 
normal tissues. The writer is, however, familiar with no condition which 
presents inclusions closely simulating those found in varicella lesions. 
As the earliest nuclear inclusions appear as red-staining granules in the 
nuclear sap, it is possible that they represent an inerease of a substance, 
such as linin, present in normal nuclei. It seems to be certain that 
elements, readily overlooked in normal tissue, may become prominent in 
pathological conditions. Such an example is found in these same 
varicella lesions in which the epithelial fibers of Herxheimer, which are 
occasionally met with in normal epidermis, become increased to such an 
extent that they form one of the most striking features of the process. 
(PI. II, fig. 10.) In this example, however, the elements in question can 
be traced in their transition from normal structures and are always con- 
fined to the epidermis. The nuclear and cytoplasmic inclusions, on the 
other hand, present a constant morphology without transitional stages 
connecting them with normal structures and are not confined to cells of 
any one tissue or type of tissue. 
Another plausible hypothesis is that the inclusions represent the forma- 
tion in a pathological condition of some substance not found in the 
normal nucleus. The reaction of the nucleus accompanying the presence 
of the inclusion is peculiar in that only that part about the inclusion is 
affected, while the remainder of the nuclear structure appears normal. 
If the inclusions are the result of a changed metabolism, one would 
expect to find a more general change. A fact to be emphasized con- 
cerning the nature of these inclusions is that they are confined to small 
foci, even to individual cells in the epidermis and corium. There is 
not sufficient evidence at hand to interpret either the nuclear or cyto- 
plasmic inclusions and it seems preferable to suspend one’s judgment 
until new facts are acquired bearing “on this question. They are de- 
scribed because they form a constant and prominent feature in the vari- 
cella process, 
