ABNORMAL ANATOMY OF THE LYMPHATIC SYSTEM. 
absorbent glands; and, thirdly, with respect to 
the nature of the contents of the system. 
Inflammation of the absorbent vessels has 
long been known to practical men. A number of 
red lines appearing through the skin, and giving 
to the touch the sensation of round and hard 
cords immediately underneath the skin, taking 
_ the direction and occupying the position of the 
superficial lymphatics, are seen to proceed from 
some point of irritation, as a poisoned wound 
or a syphilitic sore, towards the nearest set of 
absorbent glands. There are much tenderness 
and pain on the least pressure in the whole 
course of these lines, and the glands to which 
they go are more or less swollen, and the skin 
over them is of a reddish colour. These lines 
correspond to the inflamed absorbents, which, 
at first isolated, soon excite inflammation in 
the surrounding cellular tissue, and the hard 
cords above described are lost in the thickened 
and infiltrated subcutaneous tissue. When an 
Incision is made into such an inflamed surface, 
the lymphatics, according to Gendrin, are seen 
upon the margins of the incision as red fibres, 
having the irregular, knotted appearance which 
those vessels exhibit when injected with mer- 
cury and converging towards the inflamed 
tissue of a gland. 
It may be fairly presumed that the anatomi- 
cal characters of these vessels in a state of 
inflammation are the same as those of the 
inflamed thoracic duct, examples of which 
have occurred to Gendrin and Andral. The 
vessels of its coats (vasa vasorum_) are much 
injected, and the coats themselves thickened 
and rendered friable—the inner coat red, soft, 
and swollen—sometimes with lymph poured 
Out upon it, which tends to obstruct and 
obliterate the canal, giving rise to dilatation 
below the obstructed point, or with pus effused, 
which also occasions the vessels to be dilated. 
Sir A. Cooper found adhesion and ulceration 
of the valves of the thoracic duct in a body in 
which he could not succeed in injecting that 
vessel. 
In the body of a phthisical patient Andral 
found the lacteal vessels on the surface of the 
intestine, corresponding to the situation of an 
ulceration of the mucous membrane, remark- 
ably white and hard, and so dilated at intervals 
as to resemble a string of rounded nodules. 
On examination these nodules were found to 
be caused by thickening of the coats of the 
lacteal vessels. 
Irregular dilatations or varicosities of the 
absorbent vessels, but especially of the thoracic 
duct, have been very frequently observed. 
These most frequently arise from some pres- 
sure impeding the circulation of the fluid in 
them, as a tumour or aneurism pressing on 
the thoracic duct in some part of its course. 
Mr. Cruikshank delineates a thoracic duct, 
remarkable for its great size. It was found in 
a man 40 years of age, but the cause of the 
dilatation was not apparent, as no obstruction 
existed either at the entrance of the vessel into 
the veins or in any part of its course. The 
great trunks of the absorbents accompanying 
the large arteries in the extremities were en- 
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larged also, but the cutaneous absorbents were 
of their usual size. The case referred to by 
Dr. Baillie, in which the duct is said to be as 
large as the vena azygos, is probably the same. 
The morbid changes of the absorbgnt glands 
are much more familiar to us than those of the 
lymphatics themselves, as being more appreci- 
able if not of more frequent occurrence. In- 
flammatory states of these bodies are very often 
met with, either in conjunction with inflamed 
lymphatic vessels or alone. In inflammation 
the absorbent glands become enlarged, very 
vascular, and painful to the touch, and the 
surrounding cellular tissue participates in the 
inflammation, so that if several glands be 
inflamed a tumour of some size and hardness 
will be formed. The tissue of the absorbent 
glands themselves is not prone to run into sup- 
puration, but pus will often speedily form in 
the surrounding and connecting cellular tissue, 
which by-and-bye accumulates, forms an ab- 
scess, is discharged, and leaves the glands, 
with the intervening cellular tissue, dissected 
away by the suppurative and sloughing process. 
It is thus that a bubo will originate from one 
or more inflamed inguinal or axillary glands, 
and when the constitution is enfeebled and fa- 
vourable to a phagedenic action, we frequently 
find these glands exposed by the destruction of 
the skin and cellular tissue. Sometimes, how- 
ever, little collections of pus form in the glands 
themselves, and, according to Gendrin, the 
fluid in the glands differs remarkably from that 
in the cellular tissue, the latter being thick, 
opaque, viscid, and of a greenish hue, whilst 
the former is clear, transparent, and almost 
colourless. Gendrin infers from his observa- 
tions that the lymphatics which permeate the 
inflamed glands become obliterated ; but Dr. 
Bocher, a German anatomist, quoted by Andral, 
affirms that he repeatedly injected with mercury 
lymphatic ganglions presenting different forms 
of morbid alteration, and that he invariably 
found the injection pass freely through all the 
convolutions of vessels, whence he concludes 
that in diseases of these ganglions the lesion is, 
at least in the great majority of cases, confined 
to the cellular tissue that unites the convolu- 
tions of the vessels, or to the coats of the ves- 
sels, but that there is no obstruction of their 
cavity. The lymphatic glands are also liable to 
be chronically inflamed, or to be hypertrophied, 
and under both conditions put on the same 
anatomical characters, viz. redness, increased 
size, induration. In children, of both sexes, 
the glands at the angle of the jaw and those of 
the neck frequently afford examples of these 
morbid states. The bronchial and mesenteric 
glands likewise present similar enlargements. 
Atrophy of the absorbents occurs very com- 
monly in old persons. 
Various deposits are met with in the absor- 
bent glands. Of these the most frequent is 
tubercle, or a cheesy curdy matter of a yel- 
lowish hue, which bears much resemblance to 
tubercle. This matter is deposited in isolated 
spots in the glands, or else appears to be infil- 
trated throughout their substance. In phthisical 
subjects, in scrofulous patients, these deposits 
