TYPHUS. 135 



tions maj not also occur apart from syphilis cannot be decided 

 until we know more about the minute structure of inflammatory 

 indurations in general than we do now. 



XoTE. — BiesiadecJd refers the induration to a certain stiffness and 

 dryness of the fibrous elements of the connective tissue ; earlier authors 

 sought it in the quality of the exudation {Bicord's plastic ljmph> 

 Michaelis' exudation flakes — ExudatsclwUen). 



§ 111. The syphilitic deposit may also be taken as a type of 

 the lesions caused by leprosy and glanders. In these disorders 

 specific tumours are also formed, side by side with simple inflam- 

 matory products ; the specific tumours continue for long periods 

 in the lowest stage of tissue-development, without undergoing 

 any change; they finally suppurate and burst, or else they 

 undergo fatty degeneration and are absorbed. (For details, see 

 chapter on the Morbid Anatomy of the Skin.) 



§ 112. Typhus. The typhous process is found to differ from 

 simple acute inflammation by the higher degree of development 

 to which the individual cells of the infiltration attain — a degree 

 which brings them nearer to the ''epithelial" type. The 

 acme of the typhous changes (with the details of which we shall 

 become acquainted when we investigate the morbid anatomy of 

 the mucous membranes) is known as medullary infiltration* If 

 the infiltrated matters are examined, they are found to contain 

 cells differing from simple lymph-corpuscles in containing a 

 greater proportionate amount of protoplasm. The protoplasm 

 of the lymph-corpuscle is barely equal to its nucleus in bulk ; 

 while in the cells we are now considering, it occupies at least as 

 much, on an average rather more space than the nucleus. The 

 typhous cell represents the lowest stage as it were, the first rudi- 

 ment of epithelial development ; it would seem however that this 

 augmentation of the protoplasm lacks the vigour and permanence 

 of true epithelial development, inasmuch as the typhous cells 

 maintain themselves at this acme but for a short time, and then 

 succumb rapidly to degenerative changes. 



* These observations refer clearly to enteric fever {Ileotyphus, typhus 

 ahdominalis). I have purposely retained the author's own term, not 

 wishing to define strictly -^hat he has, perhaps not unintentionally, left 

 rather vague. (Cf. § 370).— Tii. 



