170 The Philippine Journal of Science 191s 



they are fairly numerous. Most of them measure 2 to 3 microns 

 in diameter. They usually lie singly; sometimes they lie in 

 pairs. Occasionally a medium-sized body is surrounded by a 

 zone of faintly staining protoplasm. 



The formation of bodies presumably identical may be some- 

 times seen in a polymorphonuclear leucocyte the nucleus of 

 which is breaking up into small, round, clear-cut masses ("chro- 

 molysis") . There are usually 3 to 6 of these, measuring 2 to 2.5 

 or 3 microns in diameter, though when but two are formed they 

 may be 3 to 4 microns. Once liberated by breaking down of the 

 cytoplasm, they are no longer identifiable as of leucocytic origin. 



Sections. — Too little tissue has been examined to establish a 

 typical histology. The lesion is primarily a chronic inflam- 

 matory infiltration of the chorium, with lymphoid and, more 

 prominently, plasma cell accumulation. Eosinophiles are usually 

 present and sometimes numerous. Abnormal accumulation of 

 the normal pigmented cells of the chorium is sometimes seen. 



Proliferative changes are sometimes evidenced by numerous 

 prominent blood vessels, of small lumen but thick walls of promi- 

 nent cells rich in protoplasm ; these lie in a cellular connective 

 tissue. Endothelial proliferation may diminish the lumen (figs. 



9 and 11), sometimes obliterating it entirely and producing an 

 area of endothelial cells that may suggest an early tubercle (figs. 



10 and 12). In two areas of one section there were found a 

 few giant cells with nuclei circumferentially arranged (fig. 17). 

 As a whole, this process undoubtedly tends to make the tissue 

 liable to degenerative changes. Acute inflammation, with infil- 

 tration and subsequent necrosis, apparently develops secondarily, 

 though the causative agent is not evident. It may be seen 

 developing in and about small vessels, in which thrombosis may 

 occur (fig. 13), dependent upon inflammatory injury of the vessel, 

 as in figs. 14 and 15. 



The epidermis is usually somewhat hypertrophic. In one 

 instance (fig. 7) it is peculiarly canalized by the papillae, which 

 sometimes extend very close to the surface. Pigmentation is 

 diminished where hypertrophy is evident. The epidermis is 

 not invaded, even at the edge of the ulcer. Loss of its integrity 

 seems to be dependent on nutritional disturbances caused by the 

 underlying lesion (fig. 8). 



Few organisms of any sort can be found in appropriately 

 stained sections, even in the acutely inflammatory areas, and 

 none can be found in the deeper zones. That the acute reaction 

 always results from secondary bacterial invasion seems, from 

 this and the number of bacterial colonies that appeared in the 



