142 ON THE COURSE OF THE AMYLOID DEGENERATION. 



the morbid change always commences in the secretory 

 vessels, in the same way as in the lymphatic glands, the 

 spleen, and renal pajAlke, the vessels, and especially the 

 arterial, are very early affected. In all cases the normal 

 tissue is removed in proportion to the amount of the new 

 deposit, and it is not the individual elements which degene- 

 rate each separately, but the change involves all equally, so 

 that the ultimate products present a very uniform, homo- 

 geneous constitution. From all that appears therefore, it is 

 highly probable that the affection consists rather in a me- 

 tastasis of a material formed in the site of the original 

 diseased action, that is to say, in the bones, and which is 

 transported to the different parts in a state of solution. 



The constitution of the deposit is not everywhere alike, as 

 has been before remarked by Virchow (' Archiv. Bd.' iii. 

 p. 144) and Meckel. In particular, it would seem, that the 

 substance in cases of less complete deposition, though assum- 

 ing a beautiful red colour even under iodine alone, receives 

 only an indistinct violet tint on the addition of sulphuric 

 acid, and is never rendered blue. This was the case very 

 remarkably in a boy, fourteen years of age, affected with disease 

 of the lumbar vertebrae, whose liver weighed 5 lbs. 13 oz., the 

 spleen about 7^ oz., one kidney nearly 4 and the other 3^^ oz. ; 

 in whom the entire parenchyma of the liver, the spleen in its 

 pulp, the kidneys in the glomeruli^ the afferent arteries, and 

 in the papilla, exhibited the most complete waxy degenera- 

 tion. With sulphuric acid the iodine-red colour was 

 deepened, but rapidly became of a dirty violet, or rather of a 

 dark bluish-red hue, and in parts greenish. In this case, 

 therefore, the substance existed either in a less perfect form, 

 or was more mixed with other matters. 



