ANATOMICAL CHAKACTERS. 267 



lymphangitis and lymphadenitis is that of wounds to the feet 

 from foreign bodies, as nails picked from the ground, or care- 

 lessly driven in the act of shoeing. 



In all these cases, however, the character of the inflamma- 

 tory action in both vessels and glands is considerably different 

 from what occurs in the constitutional affection. Although 

 the lymph-glands may be early involved in the morbid action, 

 they are rarely the part from which we observe the action 

 to originate; this is generally in the course of the vessels 

 themselves and in the inferior portion of the limb, not 

 as in the systemic disturbance, where the inflammation and 

 consequent pain and swelling obviously spring from the 

 inguinal or brachial glands, and steadily proceed in a down- 

 warddirection. 



d. Anatomical Characters. — It is rarely that uncomplicated 

 lymphangitis results in death, the great majority of cases 

 making recoveries more or less perfect, and under many forms 

 of management and medical treatment. When a fatal result 

 is attributable to an attack of weed, death is usually the 

 immediate sequel of irritation. The structural lesions are 

 nearly always confined to the situation of the local inflamma- 

 tion, where, to the unaided eye, they are plainly marked. The 

 general swellmg of the whole limb is the most distinctive 

 feature, the greater amount of oedema existing at the superior 

 surface in the inguinal region. ^Yhen the skin is removed 

 from the limb the subcutaneous tissue and the fascia are 

 found loaded with a yellowish-coloured imperfectly organized 

 lymph, which in cases of long continuance, or where several 

 attacks have previously occurred, on being cut into disclose 

 the fact that the natural fibrous stroma or framework of the 

 connective-tissue is increased in amount or hypertrophied, that 

 it is toughened, and more distinctly fibrillated or indurated than 

 in health. The interconnective tissue existing amongst the 

 muscular and other structures is changed and infiltrated in a 

 similar manner ; to this tissue the vessels, particularly the lym- 

 phatics, seem intimately united, so much so that these latter 

 are rather difficult to demonstrate. The gland-structures in 

 the inguinal region are swollen, their intimate connective-tissue 

 hypertrophied and infiltrated with a similar fluid; while if 

 decidedly chronic the true gland-texture, in addition to in- 



