440 MUCOUS MEMBUANES. 



§ 378. What light does the microscope throw upon tliis 

 ^^ medullary infiltration " ? Does it enable us to detect any 

 typical tissue-change, which, independently in some measm'e of 

 pre-existing structure, is able to generate " typhous " products 

 wherever connective tissue or lymphatic elements may happen to 

 exist? May we speak of a ^Hyphous" product in the same 

 sense as of a cancerous, sarcomatous, or syphilitic product? I 

 feel myself entitled to the credit of having done my best to 

 penetrate into the anatomical essence of the typhoid process, with 

 the aid of the most recent methods of investigation. The results, 

 however, have not proved equal to my expectations. Other 

 observers have described corpuscular and nuclear proliferation as 

 the only demonstrable appearances. I will venture a step farther, 

 and call attention to some points which, in the general absence 

 of " peculiarities," seem to be worthy of being put on record. 

 First then, let me refer to the enormous dilatation of the capil- 

 laries and arterioles in the parts affected with medullary infiltra- 

 tion. The double contour of their walls is represented merely 

 by a sharp line of demarcation between the parenchyma and the 

 blood ; the blood seems occasionally to have become quite stag- 

 nant, if we may judge by the appearance of the colourless cor- 

 puscles, which, just as in cases of slow coagulation, have become 

 aggregated into little clusters, occupying, without any admix- 

 ture of red ones, the whole interior of a capillary vessel for short 

 portions of its course. Notwithstanding this however, ecchymoses 

 are rare ; probabl}' because the elastic reaction of the proliferated 

 parenchyma is too powerful to allow of their production. 



As regards the morbid products themselves, I have already 

 pointed out (in § 112) that the process does not consist merely 

 of a numerical multiplication of elementary parts, as in catar- 

 rhal inflammation, but that in addition to this numerical increase, 

 which is undoubtedly very considerable, there is an increase in 

 the size of the individual elements, a tendency towards the pro- 

 duction of a specific '^typhous" cell. The individual evolution 

 appears indeed to culminate In the 2:)roduction of this *^ typhous" 

 cell, a structure which differs from the simple lymph-corpuscle, 

 by containing a larger proportionate amount of protoplasm. The 

 protoplasm of a lymph-corpuscle barely equals the contained 

 nucleus in amount; whereas in the ^Hyphens " cell, it always 

 takes up as much, on an average even more space than the 



