416 The Philippine Journal of Science 1923 



thelial cells show no obvious degenerative change; the striated 

 cuticular border is well preserved, the cytoplasm and nucleus 

 compact, staining normally. The number of goblet cells is per- 

 haps increased. Mitotic figures are frequent but not more 

 conspicuous than in a normal intestine. 



The mucosa is swollen, especially its papillary projections into 

 villi where intercellular spaces are globular in shape and much 

 exaggerated in size. There is a moderate congestion of capilla- 

 ries in villi and to a lesser extent of veins in the mucosa and 

 submucosa elsewhere. Larger lymphatics are also prominent 

 and filled with the granular precipitate of a lymph probably of 

 high protein content. No haemorrhage or cellular exudate is to 

 be seen. There is, however, a very peculiar necrosis of cells 

 within and upon the tips of villous projections of mucosa. This 

 is to be found in nearly every villus and is more prominent in 

 the ileum than in the duodenum and the jejunum. It appears 

 as a karyorrhexis of one or more nuclei of uncertain type, some- 

 times free, often within large phagocytic cells which may plug 

 capillaries at the apex of villi. This necrosis is sometimes seen 

 along the side of a villus but is found with striking uniformity 

 in the tips. An occasional polymorphonuclear or mononuclear 

 leucocyte is caught wandering through a villus, and usually 

 there are a few small mononuclear cells within the subepithelial 

 spaces. At no point is there necrosis of all cells, and capillary 

 endothelium is intact. The cells that become necrotic appear to 

 lie between capillaries and under or upon the basement mem- 

 brane of epithelium. 



The condition of jejunal mucosa is about the same as that of 

 the duodenal. In the ileum desquamation of epithelium is 

 much more prominent, especially in the lower portions. How- 

 ever, in places where the epithelial layer is still well preserved, 

 subepithelial cedema is present, elevating the cells considerably 

 above the basement membrane but to a less extent than in the 

 duodenum or the jejunum. It is to be noted also that villi de- 

 nuded of their epithelium differ in no way otherwise from those 

 over which an epithelial coat is still present. There is no more 

 congestion of capillaries, interstitial cedema or necrosis, a fact 

 which appears incompatible with the view that desquamation 

 occurred earlier than the agonal state. The apical necrosis in 

 villi is more prominent than in upper portions of the bowel, and 

 phagocytosis of dead cells is more active. Lymphoid follicles 

 in the submucosa are compact, and show neither necrosis nor 

 proliferative activity. 



