41U MUCOUS MEMBRANES. 



follicular abscesses of a Fever's patch communicating* with each 

 other by fistulous passages under the mucous membrane ; the 

 latter mav be undermined in this way to a considerable dis- 

 tance. The roof ultimately dies ; it becomes detached at its edges^ 

 and the loss of substance ]'esulting from the ulceration, mani- 

 fests itself as a sharply circumscribedj round or roundish ulcer. 

 Cicatrisation usually follows without any difficulty ; yet I myself 

 have seen a perforation of the bowel just above the ileoc^ecal 

 valve. 



Follicular swelling and ulceration of the stomach, necessarily 

 presuppose the existence of follicles in the gastric mucous mem- 

 biTine. Now it is well known that in some stomachs not a sinofle 

 follicle can be discovered. As reo;ards the stomach, we mio:lit 

 perhaps be justified in speculating whether a special development 

 of follicles ad hoc might not occur, somewhat after the fashion 

 in which Ilenle assumes the '' conglobate" glands to originate. 

 The formative irritation to which the connective tissue of the 

 entire mucous membrane is subjected, becomes as it were con- 

 centrated in a series of foci, just as a cutaneous exanthem is 

 limited to a certain, though often very large, number of definite 

 centres. About the law which regulates this distribution we 

 know nothing. Characteristic of this affection, when it occurs 

 in the stomach, is the circumstance that all the follicles are in- 

 variably found in the same stage of transformation, whether as 

 grey pearly nodules, as abscesses, or as ulcers. 



§ 351. The analogous conditions of the tonsils are some- 

 what more complex. The hemispherical surface of these organs 

 presents, as we know, a certain number of pouch-like depres- 

 sions. These depressions arc lined by the pavement-epithelium 

 of the oral cavity ; little papillae, like the lingual papillsB in 

 miniature, are often found growing in the neck of the pouches. 

 Around them, embedded in the mucous parenchyma, lie the 

 lymphatic follicles. The}' are separated from the surface by a 

 thin layer of connective tissue, and are not therefore in contact 

 with it (as in the sheep, Frey). Now in catarrh of the pharynx 

 with angina tonsillaris, an increased production of epithelium 

 takes place not only on the tongue (furred tongue), but on the 

 inner surface of these depressions also. A quantity of pavement- 

 epithelium consequently accumulates in their interior ; a white, 

 greasy mass, not unlike the vernix caseosa of the foetus, forms a 



