ARTIFICIAL PRODUCTION OF TUBERCLE. 9 



visible drops ; sometimes in a finely molecular form. The change is most 

 common towards the centre of the granulations, but is also seen in cells 

 irregularly scattered through the adjacent tissue. 



There may also be sometimes seen in these masses, and in their neigh- 

 bourhood, extraordinary strings and rows of cells and nuclei. Sometimes 

 cells apparently, sometimes only nuclei, are visible. The nuclei correspond 

 with those last described. The cells, when visible, are of the type of the 

 smaller round cells ; the row or string is contained, apparently, within some 

 limitary membrane. The size of these rows is nearly twice or three times that 

 of a capillary. They have no fibrous investment like a vein ; no muscular 

 coat like an artery. They suggest to me the idea of a lymphatic tube, swollen 

 either by growth within its interior, or by cells carried into it and obstructing 

 its interior. My own conviction is, that they are lymphatics, filled with a 

 growth of cells (Plate III. fig. 6). 



When we consider the omentum, I shall have to describe to you structures 

 to which these granulations present, especially in their naked-eye characters, 

 the most striking resemblance. The granulations under the skin are, however, 

 denser ; and I have not found them situated in the sheaths of the vessels, as 

 they commonly are in the omentum. 



The next change of importance is in the lymphatic glands in the neigh- 

 bourhood of the injury — the axillary and the subscapular. They are commonly 

 enlarged to twice or three times their natural size. The changes affecting 

 them are also found in those at a considerable distance, as in the submaxillary, 

 the infraclavicular, and the substernal glands, and in those situated in the 

 course of the trachea. Their apparent number is also increased — that is to 

 say, lymphatic glands of the size of a horse-bean, or even of a kidney-bean, 

 are to be seen where none are visible naturally. On section, they are 

 indurated, semi-transparent, cartilaginous-looking, and showing very little 

 distinction between the cortical and medullary substances. Through them 

 are scattered specks, lines, or streaks of cheesy degeneration, of an opaque 

 yellow colour, which are sometimes agglomerated into areas of the size of 

 a pea (Plate I. fig. 5). These sometimes soften into a creamy, diffluent 

 matter, which presents the same granular material and molecular debris 

 which are found in the cheesy masses surrounding the wound. Occasion- 

 ally, most of the lymphatic glands throughout the body may be found 

 to have undergone similar changes. These may be seen in the lumbar, 

 sacral, and inguinal lymphatics, without any corresponding alterations being 

 found in adjacent parts sufficient to account for the diseased state of the 

 glands. 



