CHANGES OF THE SUPERFICIAL ENDOTHELIUM. 05 



have suspected nothing of the kind in the healthy condition; thus, 

 for example, there is seen on the endothelium, which covers the peri- 

 toneal side of that portion of the serosa which lies upon the tracts of 

 tendons, and on which, as we have seen in the first part, proliferation 

 is not to be observed in the normal condition, an active alteration of 

 the nuclei over extensive spaces, from the simple constriction to the 

 division into two or three small nuclei. In the case of the omentum 

 it is more difficult to furnish a decided opinion, for there, as we hav< 

 seen, an extensive proliferation goes on in the normal condition. \J 



Should, however, the inflammation be of a less degree, e.g. in the 

 case of peritonitis, consequent on the entrance of air after larger or 

 smaller abdominal wounds by which we expose the peritoneum to the 

 atmosphere, or by the insertion of threads, of small solid bodies, as 

 starch (12 c.c. of a tolerably concentrated mixture of starch and 

 water), 5-10 c,c. of a five per cent. Berlin blue solution, a few c.c. 

 of oil or oil and starch, or any similar fluid which acts readily as a 

 foreign body in these cases, we obtain an appearance somewhat 

 different from the preceding. Here, indeed, there are also seen, after 

 twenty-four or forty-eight hours and later, isolated detached endo- 

 thelial plates in the exudation. The peritoneum, however, exhibits 

 only a few places where the endothelium is loosened or has disappeared 

 in masses. On silver-stained preparations the endothelium is more 

 strongly coloured ; we recognise, in many regions, as on the centrum 

 tendineum, that the endothelial cells have become granular, are 

 somewhat swollen in diameter, the nucleus has become more pro- 

 minent ; in short, they possess more the appearance of epithelium : 

 the nucleus of many of the cells is in the state of division. On the 

 omentum, and especially on the fenestrated portion, there may be 

 demonstrated more easily polyhedral endothelial ceils whose nuclei 

 are in the state of division. What is most worthy of observation is, 

 that where we have met with germinating endothelium in the normal 

 .iuii a very active proliferation has taken place. It extends 

 over the abdominal surface of the centrum tendineum, as well as over 

 the pseudo-stomata and stomata of the omentum and the mesentery. 

 In some places the germination of the endothelium is of a very re- 

 markable extent. Not only occur there bud-like processes which 



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