46 



AMYLOID INPILTEATIOX. 



in question — a view which no one ventures to dispute — receives 

 its most effectual support from a consideration of the course 

 taken by the degenerative process in individual organs. I refer 

 tlie reader to those sections of the Special Part, wliich treat of this 

 matter, limiting myself here to a description of the change as it 

 occurs in the vessels. 



The fact that the minute arteries, with their arterioles (Ueber- 

 gangsgefcisse), and the capillaries, are a favom'ite, and usually 

 the primary, seat of all infiltrations, has been already placed in 

 its true light. Amyloid infiltration stands foremost in this 



respect. 



Fig. 10. 



Malpighian tuft infiltrated Avitli amyloid matter (from the 

 kidney), ^. 



In any organ it is the efferent vessels which are first affected. 

 In these, the gradual progress of the infiltration from within 

 outvrards may readily be traced. At some points the intima 

 nlone, with its homogeneous limitary membrane, exhibits the 

 glassy intumescence ; at others, the muscular fibres are also 

 implicated, and assume a peculiar homogeneous, glistening, 

 somewhat blurred appearance ; in extreme forms of the disease, 

 such as those described by Bechnann in the thyroid body, the 

 infiltration is found to extend to the adventitia and surroundino; 

 connective tissue. 



The inevitable consequence of this degeneration is a propor- 

 tionate narrowing of the calibre of the aftected vessels. 



Their lumina are obstructed by the swelling of their walls, 

 and the obstruction may amount to absolute occlusion. Fig. 15 

 represents a Malpighian tuft of the kidney which has partially 

 undergone amyloid degeneration ; it shows how the blue injec- 

 tion (and consequently the blood during life), penetrates into 



