OF THE AMYLOID DEGENERATION. 141 



iodine even, also produced a very strong colouring. The 

 change to the naked eye was not very striking. The mucous 

 membrane in all these parts had a very pale aspect ; and in 

 the stomach and oesophagus it was somewhat thickened, un- 

 usually transparent, and in parts of almost gelatinous con- 

 sistence. 



The above case indicated a much wider range of the amy- 

 loid degeneration than was previously known, and another 

 observation showed the reliance which might be placed upon 

 the truth of the discovery. A man, thirty years of age, who 

 had long suffered from necrosis of the femur, with sinuous 

 abscesses and fistulous openings, died, also, with albu- 

 minuria and ascites, but not until a subcutaneous abscess of 

 the scrotum, suppurative inflammation of the parotid, and 

 hemorrhagic pleurisy had taken place. There was found an en- 

 larged waxy spleen, and parenchymatous nephritis, with very 

 considerable amyloid degeneration of the glomeruli, as well as 

 of the vessels and tuhuli uriniferi in the papillcB, together with 

 simple fatty liver and atrophic induration of the pancreas. 

 The right femur was the seat of extensive hyperostosis, 

 combined in the inferior third with a great loss of substance, 

 whence proceeded fistulous passages ; the surrounding parts 

 had undergone a thickening and condensation, such as is seen 

 in " white swelling." The lymphatic glands in the thigh and 

 groin were enlarged, of a clear grey colour, in parts more 

 transparent. Microscopic examination distinctly showed the 

 commencement of amyloid degeneration in the follicles, 

 some of which were wholly reduced to that condition, whilst 

 others still retained lymph-corpuscles in some of the areola ; 

 and others, lastly, presented nothing but minute corpora 

 amylacea amongst normal corpuscles. 



Virchow was unable in this case to detect any indication of 

 amyloid degeneration in the heart or anyjpartof the muscular 

 system, even in close contiguity with the diseased bone ; nor 

 in the mucous membrane of the respiratory organs and 

 kidneys. The blood, also, contained no morphological par- 

 ticles which could be pronounced to be corpora amylacea. 



Nevertheless, with respect to the course followed by the 

 morbid change, it appears indubitable that the incitement to 

 it proceeds from the diseased bones, whence it extends pro- 

 gressively to the lymphatic glands, then to the spleen, and 

 ultimately to several of the secretory organs. Among these 

 the first to suffer are invariably the kidneys, then the liver, 

 probably lastly the mucous membrane of the digestive 

 organs ; and it is a circumstance of the greatest interest, that 

 both in the kidneys and in the digestive mucous membrane 



