and Laboratory Methods. 2065 



NORMAL AND PATHOLOGICAL HISTOLOGY. 



JOSEPH H. PRATT, Harvard University Medical School. 



Books for Review and Separates of Papers on these Subjects should be Sent to Joseph H. Pratt, 

 Harvard University Medical School, Boston, Mass. 



Qlogner. Ueber Frambcesia und ahnbehe Interest in tropical diseases should 



Erkramkungen in den Tropen. Virchow's kindle in us a desire to know some- 

 Archiv., Bd. loo: 443-456, 1902. 



thing concerning the pathology of 



Frambcesia or Yaws. It and other allied diseases have had a number of inves- 

 tigators. Among them is Dr. Glogner, who obtained while in the Dutch West 

 Indies six Frambcesia warts or tumors from four patients aged "20, 5, and 18 

 years, and 15 months respectively. The specimens were hardened in Miiller's 

 fluid and embedded in paraffin. The sections were cut and studied at the Patho- 

 logical Institute in Berlin. 



By Frambcesia we understand a skin affection lasting usually over a month, 

 rarely over a year. It is generally accompanied by no prodromata, but at times 

 fever and neuralgia are noted. The prognosis is favorable. Children are more 

 prone to it than adults. The eruption begins as round papules which are more 

 likely to appear on the face, especially about the mouth and nasal cavities. 

 These papules gradually increase in size and, joining with others, become con- 

 fluent and form excrescences or tumors, which project over the surrounding skin. 

 The epidermis of these tumors subsequently become necrotic and crusts are 

 formed. These tumors heal and leave no scars, but merely a very noticeable 

 mark. 



If secondary infection has occurred ulcers are formed, which healing ulti- 

 mately leave a scar. Verrugas Peruviana and Bubas are so unlike Frambcesia 

 that it is best to consider them separate and distinct diseases until more work is 

 done on them. 



Charlouis, Cornil and Renaud have worked especially on the pathology of 

 Frambcesia. The process in these tumors is generally considered to be a chronic 

 dermatitis or a granuloma. Cornil and Renaud, however, consider the tumors 

 to represent sarcoma tissue in different stages of development. Glogner noted 

 a proliferation of the connective tissue cells of the cutis, and of the endothelial 

 cells of the lymph vessels as the most prominent characteristic of the lesion. 

 Next a moderate increase in the epidermal epithelial cells, and finally a migra- 

 tion of leucocytes into the tissues surrounding the blood vessels. The migration 

 was evidently due to mechanical or chemical injuries to the tissue or to the 

 influence of bacteria, as it was not seen in the smaller tumors or papules. Glog- 

 ner, also, thinks these tumors belong to Virchow's group of granulomata. He 

 found no plasma cells, but mast cells were present in considerable numbers. 

 Some sections showed giant cells and beginning degenerative changes in some 

 of the cell's nuclei. He noted a leucocytosis in all of his cases due to an 

 increased number of lymphocytes. The average percentage of the polynuclear 

 leucocytes was 62.5 in the eight cases he examined, while the mononuclear forms 

 amounted to 38.8. The lesions in Verruga are those of an acute inflammatory 

 infiltration. In Bubas infiltration of the papillae has been found by one observer 

 with an increase in the connective tissue. Plasma cells were also observed and 

 scar formation resulted in all of the cases. 



