{"1": {"fulltext": "", "height": "4293", "width": "2837", "jp2-path": "atlasepitomeofsp00drck_0001.jp2"}, "2": {"fulltext": "MEC\\nThe series of\\nLIBRARY OF CONGRESS.\\nChap.... .JzCopynght No\\nShelf.JlL%-5\\nUNITED STATES OF AMERICA.\\nS.\\nJl translations\\ninto English of the world-famous\\nLehmann Medicinische Handatlanten,\\nwhich for scientific accuracy, pictorial beauty, compactness, and\\ncheapness surpass any similar volumes ever published.\\nEach volume contains from 50 to 100 colored plates, besides numer-\\nous illustrations in the text. The colored plates have been executed by the\\nmost skilful German lithographers, in some cases more than twenty im-\\npressions being required to obtain the desired result. Each plate is accom-\\npanied by a full and appropriate description, and each book contains a con-\\ndensed but adequate outline of the subject to which it is devoted.\\nOne of the most valuable features of these atlases is that they offer a\\nready and satisfactory substitute for clinical observation. Such ob-\\nservation, of course, is available only to the residents in large medical centers;\\nand even then the requisite variety is seen only after long years of routine\\nhospital work. To those unable to attend important clinics these books\\nwill be absolutely indispensable, as presenting in a complete and con-\\nvenient form the most accurate reproductions of clinical work, interpreted\\nby the most competent of clinical teachers.\\nWhile appreciating the value of such colored plates, the profession has\\nheretofore been practically debarred from purchasing similar works because\\nof their extremely high price, made necessary by a limited sale and an\\nenormous expense of production. Now, however, by reason of their pro-\\njected universal translation and reproduction, affording international dis-\\ntribution, the publishers have been enabled to secure for these atlases the\\nbest artistic and professional talent, to produce them in the most-\\nelegant style, and yet to offer them at a price heretofore unapproached\\nin cheapness. The great success of the undertaking is demonstrated\\nby the fact that the volumes have already appeared in nine different\\nlanguages German, English, French, Italian, Russian, Spanish, Danish,\\nSwedish, and Hungarian.\\nThe same careful and competent editorial supervision has been\\nsecured in he English edition as in the originals. The translations have\\nbeen edited by the leading American specialists in the different sub-\\njects. The volumes are of a uniform and convenient size (5 x jjA inches),\\nand are substantially bound in cloth.\\n(For List of Books, Prices, etc* see back cover*)\\nPamphlet containing specimens of the Colored Plates\\nsent free on application*", "height": "4671", "width": "2863", "jp2-path": "atlasepitomeofsp00drck_0002.jp2"}, "3": {"fulltext": "", "height": "4688", "width": "2829", "jp2-path": "atlasepitomeofsp00drck_0003.jp2"}, "4": {"fulltext": "", "height": "4663", "width": "2839", "jp2-path": "atlasepitomeofsp00drck_0004.jp2"}, "5": {"fulltext": "", "height": "4632", "width": "2608", "jp2-path": "atlasepitomeofsp00drck_0005.jp2"}, "6": {"fulltext": "", "height": "4689", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0006.jp2"}, "7": {"fulltext": "ATLAS AND EPITOME\\nSpecial Pathologic Histology\\nDOCENT DR. HERMANN DLJRCk\\n\\\\NT IN THE PATHOLOGIC INSTITUTE; PROSECTOR TO THE MUNICIPAL\\nHOSPITAL L. I. IN MUNICH\\nAUTHORIZED TRANSLATION FROM THE GERMAN\\nEDITED BY\\nLUDVIG HEKTOEN, M.D.\\nPROFESSOR OF PATHOLOGY IN RUSH MEDICAL COLLEGE, CHICAGO\\nCIRCULATORY ORGANS; RESPIRATORY ORGANS\\nGASTRO-INTESTINAL TRACT\\nWITH 62 COLORED PLATES\\nPHILADELPHIA\\nW. B. SAUNDERS\\n925 Wai nut Stri\\n1900\\nV..", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0007.jp2"}, "8": {"fulltext": "TWO COPIES HICEIVID,\\nt itfti) of Congrot%\\ntktflet df tli\u00c2\u00ab\\nMAY S 1 1900\\nItegUter tf Copyright*\\n9-32^\\n\u00c2\u00abtCONO COPY,\\n59057\\nCopyright, 1900, by W. B. Saunders\\nPRESS OF\\nW. B, SAUNDERS, PHILADA.", "height": "4689", "width": "2961", "jp2-path": "atlasepitomeofsp00drck_0008.jp2"}, "9": {"fulltext": "EDITOR S PREFACE.\\nThe objects of this book are well set forth in the\\nauthor s preface, and it has been a pleasure to aid in plac-\\ning the work within the easy reach of the vast army of\\nmedical students in America. Two more volumes follow\\nshortly, one completing special pathologic histology, the\\nother dealing with general pathologic histology. The\\nfew notes I have added are inclosed in brackets.\\nLudvig Hektoex.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0009.jp2"}, "10": {"fulltext": "", "height": "4670", "width": "2970", "jp2-path": "atlasepitomeofsp00drck_0010.jp2"}, "11": {"fulltext": "AUTHOR S PREFACE.\\nSince Virchow showed that what we call disease\\ndepends ob disturbances of cell-life, our conception of the\\nnature of pathologic processes has conic to rest on the\\nknowledge of the changes that occur in the elementary\\nconstituents of the organism.\\nPathologic histology ahme can make it clear to us why\\nthe morbid changes in a given case necessarily a^kne\\nthe appearances presented at the postmortem table and in\\nmany instances pathologic histology is the first to reveal\\nthe reasons for the suspension or alteration of the func-\\ntions of an organ.\\nA- pathologic anatomy has become the teacher of\\nclinical medicine in general. it also has become insepa-\\nrable from the study of the microscopic tissue changes or\\npathologic histology.\\nIt i- no easy task for the beginner to select among the\\nmany changes those that are typical of a certain proc ss,\\nand t determine the causa] relations between the micro-\\nscopic and macroscopic, but. having mastered the essence\\nof a disease as shown in it- characteristic changes in the\\nelementary constituents of the body, it no longer becomes\\n7", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0011.jp2"}, "12": {"fulltext": "8\\nAUTHOR S PREFACE.\\ndifficult to understand the changes visible to the naked\\neye.\\nTo further the knowledge of the microscopic changes\\nproduced by disease is the object of the present Atlas\\nand Epitome. This statement at once makes it clear\\nthat its use will yield good results only when combined\\nwith the study of preparations under the microscope.\\nNever will he who shuns the postmortem room acquire a\\nconception of pathologic anatomy and it is no less impos-\\nsible to master pathologic histology without direct micro-\\nscopic study.\\nIf the work, whose first volume this is, proves a trusty\\nguide in this study, as an adjunct to other instruction,\\nstimulating and leading the beginner to personal and\\nexact microscopic observations, then its object will be\\nattained.\\nAll the illustrations have been drawn by C. Krapf\\nfrom my own preparations. The magnification has been\\ncalculated by means of the stage micrometer, due regard\\nbeing paid to the level of projection.\\nNaturally, I have attempted to secure the most typical\\npictures of the various processes, but in no case has it\\nbeen sought to do this by a schematic representation\\neven the combination of various areas in one or more\\npreparations has been avoided in the interests of absolute\\nexactness.\\nHermann D\u00c3\u00bcrck.", "height": "4681", "width": "2983", "jp2-path": "atlasepitomeofsp00drck_0012.jp2"}, "13": {"fulltext": "LIST OF ILLUSTRATIONS.\\nPlate 1. Fig. I.\\nFig. II.\\nPlate 2. Fig. I.\\nFig. II,\\nFig. III.\\nPlate 3. Fig. I,\\nFig. II.-\\nPlate 4. Fig. I,\\nPig. II.-\\nPJate 5. Fig. I,\\nFig. II,\\nPlate 6. Fig. I,\\nFig. [I.-\\nPlate 7. Fig.\\nFig. II.-\\nPlate 8. Fig. I.-\\n_. II,\\nPlate U. Fig. I.\\ni 11.\\nFatty Degeneration of the Heart-muscle in Acute\\nPernicious Anemia. A Fresh Teased Prepara-\\ntion. X340.\\nFrozen Section of a Papillary\\nMitral Valve. Stained with\\nFrozen Section, Stained with\\nThe Same Case\\nMuscle of the\\nSudan. X 80.\\nAdipositas Cordis.\\nSudan. X 80T\u00e2\u0080\u0094\\nBrown Atrophy of the Heart-muscle in Longi-\\ntudinal Section.\\nThe Same in Transverse Section. X 340.\\nInfarction of the Heart-muscle Undergoing Organ-\\nization. X 70.\\nEmbolic Abscess of a Papillary Muscle of the\\nMitral Valve. X?0.\\n-Acute Interstitial Myocarditis. X 300.\\nchronic Fibrous Myocarditis. X 80.\\n-A Normal, So-called Fetal. Gelatinous Nodule\\nupon the Line of Closure of the Mitral Valve\\nof t lie New-born. 70.\\n-From an Acutely Inflamed Heart-valve (Mitral)\\nin Mycotic Endocarditis. 80.\\n-Acute Verrucose, Mycotic Endocarditis of the\\nMitral Valve. 16.\\n-Verrucose Endocarditis of the Mitral Valve Under-\\ngoing organization. in.\\nAcut\u00c2\u00ab- Fibrinous Pericarditis (Cor Villosum).\\nFibrin Stain. 64.\\n-Fibrinous Pericarditis Undergoing Organization.\\n127.\\n-Subacute Tuberculous Pericarditis. 50.\\n\u00e2\u0080\u00a2Milk- Spots of the Epicardium. 65.\\n-Arteriosclerosis of a Cerebral Artery. 75.\\n-Arteriosclerosis of a Coronary Artery. X 70.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0013.jp2"}, "14": {"fulltext": "10\\nLIST OF ILLUSTRATIONS.\\nPlate 10.\\nFig.\\nFig.\\nI.\\nII.\\nFig.\\nIll\\nPlate 10a. Fig.\\nL-\\nFig.\\nPlate 10b. Fig.\\nII.-\\nL-\\nFig.\\nII.-\\nPlate 11.\\nPlate 12.\\nFig.\\nFig.\\nFig.\\nI.\\nII.\\nI.\\nFig.\\nII.\\nPlate 13.\\nFig.\\nI.\\nPlate 14.\\nFig.\\nFig.\\nII.\\nI\\nFig.\\nII.\\nPlate 15.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 16.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 17.\\nFig.\\nI\\nPlate 18.\\nPlate 19.\\nPlate 20.\\nFig.\\nFig.\\nFig.\\nFig.\\nFig.\\nFig.\\nII.\\nI.\\nII.\\nI.\\nII.\\nI.\\nFig.\\nII.\\nFig.\\nIll\\nAtheroma of the Aorta. X 20.\\nCholesterin Plates and Free Fat-globules from an\\nAtheromatous Patch of the Aorta X 130.\\nFatty Degeneration of the Cells of the Intima in\\nAtheroma of the Aorta. X 300.\\n-Atheroma (Arteriosclerosis) of the Crural Artery.\\nX55.\\n-Wall of a Small Aneurysm of the Aorta. X 20.\\n-Acute Arteritis in Tuberculous Leptomeningitis.\\nX 745.\\n\u00e2\u0080\u0094Gummatous Arteritis of the Subclavian Artery.\\nX16.\\nArteritis Obliterans. X 37.\\nArteritis Obliterans in Syphilis. X 80.\\nTuberculous Arteritis in Subacute Tuberculous\\nLeptomeningitis. X 280.\\nTubercle in the Wall of a Large Stem of the Por-\\ntal Vein. X 40.\\nAcute Purulent Phlebitis in Phlegmonous Inflam-\\nmation of the Cellular Tissue. X 40.\\nVarix from the Leg. X 26.\\nPigment Deposits within an Axillary Lymph-\\ngland in Tattooing of the Forearm. X 300.\\nMesenteric Lymph-gland in Typhoid Fever.\\nX 360.\\nAcute Lymphadenitis. A Peripheral Sinus of\\na Peribronchial Lymph-gland in Croupous\\nPneumonia. X 385.\\nIncreased Cellular Hyperplasia of a Lymph-gland\\nin Acute Pernicious Anemia. X 745.\\nHyaline Degeneration of the Eeticulum of a\\nLymph -gland. X 280.\\nChronic Indurative Lymphadenitis with Destruc-\\ntion of the Lymph-sinus and Lymph-follicle in\\nLeukemia. X 180.\\nChronic Indurative Lymphadenitis with Destruc-\\ntion as a Result of an Increase of the Recticu-\\nlum in Leukemia. X 460.\\nSubacute Tuberculosis of a Lymph-gland. X 70.\\nPassive Hyperemia of the Spleen. X 360.\\nSenile Atrophy of the Spleen. X 80.\\nAnemic Infarction of the Spleen. X 22.\\nHemorrhagic Infarction of the Spleen. X 250.\\nAcute Hyperplastic Splenic Tumor. Fresh teased\\nPreparation. X 300.\\nAcute Hyperplastic Splenic Tumor in Sepsis.\\nX 300.\\nChronic Splenic Tumor Resulting in Induration.\\nX 250.", "height": "4691", "width": "2986", "jp2-path": "atlasepitomeofsp00drck_0014.jp2"}, "15": {"fulltext": "LIST OF ILL\u00c3\u009cSTBATJOltS. 11\\nPlate 21. Fig. L Diffuse Amyloid Degeneration of the Spleen\\nBacon Spleen). 250.\\nII. Advanced Diffuse Amyloid Degeneration of the\\nSpleen. 70,\\nPlate 22. Fig, I. Amyloid Degeneration of the Splenic Follicles\\n50 Spleen 1. 2 I.\\nII Amyloid Degeneration of the Spleen (Sago\\nSpleen 260.\\nPiatt 23. Fig. I. Spleen in Amte Leukemia, x\\nFig. IL Staphylococcal Emboli of the Spleen in Pyemia.\\n7d.\\nPiatt- -34. Fig. [.\u00e2\u0080\u0094Tuberculosis of the Spleen. 92.\\nFig. II. From the Center of a Spleen-Follicle in Diph-\\ntheria, x J\\nPlate 25. Fig. I. Bone-marrow in Pernicious Anemia. From the\\nDiaphysis of the Humerus. 520.\\nII. Bone-marrow in Acute Leukemia. X 6-10.\\nI.\u00e2\u0080\u0094 Diphtheria of the Trachea. X 18.\\nII.\u00e2\u0080\u0094 Diphtheria of the Trachea. X 130.\\nI. Fleers of the Larynx in Typhoid Fever. X 35.\\nII. Pachydermia Laryngis. X 00.\\nI.\u00e2\u0080\u0094 Tuberculosis of the Larynx. X 16.\\nII. Tuberculosis of a Large Bronchus. X 54.\\nI.\u00e2\u0080\u0094 Ectasia of a Small Bronchus. X 10.\\nIL\u00e2\u0080\u0094 The Wall of an Eetatie Bronchus. 127.\\nI.\u00e2\u0080\u0094 Colloid Goiter. 56.\\nII. Parenchymatous Goiter with Hyaline Degenera-\\ntion of the Interstitial Substance. 70.\\nL\u00e2\u0080\u0094 Fetal Atelectasis of the Lung. X 70.\\nII. Compression Atelectasis of the Lung in Sero-\\nfibrinous Pleuritis. X 70.\\nL\u00e2\u0080\u0094 Anthracosis of the Lung. X 100.\\nII. Siderosisof the Lung (Red lion Lung). X 300.\\nI. Emphysema of the Lung. 40.\\n1 1. Emphysema of the Lung. 10.\\n[IL\u00e2\u0080\u0094 Emphysema of the Lung 1 Injected). X 54.\\nI. Brown Induration of the Lung. 130.\\nII. Passive Hyperemia of the Lung. 250.\\nI. Peripheral Zone of a Hemorrhagic infarction of\\nthe Lung. 1\\nII. Fit Embolism of the Lung in Fracture of a Long\\nBone 300.\\nPlate ema of the Lung. Pi:.\\nII. Marantic Splenization of the Lung. 360.\\nIII. Beginning Red Hepatization of the Lung in\\nCroupous Pneumonia. 340.\\nPlat- I. \u00e2\u0080\u0094Croupous Pneumonia ;it the Heighl of Hepatiza-\\ntion.\\nFig.\\nPlate 26.\\nFig.\\nKm.\\nFig.\\nPlate 28.\\nLiu.\\nLm.\\nPlate 29.\\nLiu.\\nPlate 30.\\nPlate 31.\\nFig.\\nFig.\\nLiu.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0015.jp2"}, "16": {"fulltext": "12\\nLIST OF ILLUSTRATIONS.\\nPlate 37.\\nFig.\\nII.-\\nPlate 38.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 39.\\nFig.\\nFig.\\nI.\\nII.\\nPlate 40.\\nFig.\\nI.\\nPlate 41.\\nPlate 42.\\nPlate 43.\\nFig.\\nFig.\\nFig.\\nFig.\\nFig.\\nFig.\\nFig.\\nII.\\nI.\\nII.\\nI.\\nII.\\nI.\\nII.\\nPlate 44.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 45.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 46.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 47. Fig. I.\u00e2\u0080\u0094\\nFie;. II.\\nPlate 48.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 49.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 50.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 51.\\nFig.\\nI.\\nFig.\\nII.\\nPlate 52.\\nFig.\\nI.\\nFig. II\\n-Croupous Pneumonia, Stage of Gray Hepatiza-\\ntion. X 360.\\nCarnification of the Lung, Following Croup-\\nous Pneumonia. X 1*70.\\n-Organization of the Exudate in Bronchopneu-\\nmonia. X 200.\\n-Beginning Catarrhal Pneumonia. X 250.\\n-Peribronchial Inflammatory Area with Beginning\\nExtension to the Surrounding Lung Tissue.\\nX80.\\n-Lobular (Purulent) Bronchopneumonia Folio w-\\ning Diphtheria. X 250.\\n-Postdiphtheric Lobular Pneumonia. X 280.\\n-Embolic Abscess of the Lung in Pyemia. X 75.\\n-Caseous Bronchitis. X 40.\\n-Miliary Tuberculosis of the Lung. X 35.\\n-Caseous Pneumonia. X 70.\\n-Miliary Tuberculous Pneumonia. X 1*70.\\n-Caseation of the Exudate of an Alveolus in Case-\\nous Pneumonia. X 360.\\n-Desquamative Pneumonia (Buhl) Surrounding a\\nTuberculous Area of the Lung. X 340.\\n-Proliferation and Desquamation of the Alve-\\nolar Epithelium in Tuberculous Pneumonia.\\nX 520.\\n-Wall of a Tuberculous Cavity of the Lung with\\nApex Cirrhosis. X 16.\\n-Slaty Induration of the Lung in Obsolete Apex\\nTuberculosis. X 55.\\n-Syphilitic White Pneumonia of the New-born.\\nX 250.\\n-Indurative Interstitial Pneumonia in Congenital\\nSyphilis. X 80.\\nAcute Fibrinous Pleuritis in Croupous Pneu-\\nmonia. X\\nBeginning Organization in Fibrinous Pleuritis.\\nX340.\\nVariola Vera of the Tongue. X 75.\\nTuberculosis of the Pharynx. X *75.\\nDiphtheria of the Pharynx. X 80.\\n\u00e2\u0080\u0094Diphtheria of the Tonsils. X 280.\\nAcute (Purulent) Embolic Parotitis. X 70.\\nThrush Vegetations in Esophagus. X 270.\\nChronic Granular Gastritis. X 30.\\nChronic Catarrh of the Stomach. X 160-\\nHemorrhagic, Necrotic Gastritis in Phosphorus\\nPoisoning. X 80.\\nHemorrhagic Erosion of the Stomach. X 57.", "height": "4691", "width": "2968", "jp2-path": "atlasepitomeofsp00drck_0016.jp2"}, "17": {"fulltext": "LIST OF ILLUSTRATIONS.\\n13\\nPlate 53. Fig. I.\u00e2\u0080\u0094\\nFig. I\\nPlato 54.\\nFig. I\\nPlate 55. Fig.\\nFig. I\\nPlate 56. Fig.\\nFig. 1\\nPlate 57. Fig,\\nFig. I\\nPlate 58. Fig.\\nFig. I\\nPlate 59. Fig.\\nFig. I\\nPlate 60. Fig.\\nFig. I\\nPound Ulcer of the Stomach with Erosion of a\\nBlood-vessel. 16.\\nBorder of a Round Ulcer of the Stomach. X 54.\\nBeginning Carcinoma of the Stomach. 5 1.\\nMarked Stenosis of the Pyloric Orifice, the Re-\\nsult o[ a Scirrhous Carcinoma of the Stomach.\\n13.\\n\u00e2\u0096\u00a0Atrophy of the Large Intestine. 85.\\nBrown Atrophy of the M oscularis of the Small In-\\ntestine in the Cachexia of Carcinoma. X 330.\\nDiphtheric Colitis in Corrosive Sublimate Poison-\\ning. 20.\\nDysentery of the Large Intestine. X 50.\\nMarked Swelling of a Lymph-follicle of the Large\\nIntestine in Typhoid Fever. 50.\\nMarked Swelling of a Lymph-follicle with Uegin-\\nning Necrosis in Typhoid Fever. X 50.\\nUlcer after Detachment of the Slough in Typhoid\\nFever. X 50.\\nIntestinal Lymphangitis. Cellular thrombus\\nin a lymph-vessel of the Submucosa of the\\nLarge Intestine in Dysentery. X 360.\\nBeginning Tuberculosis in the Vermiform Ap-\\npendix. X 80.\\nBorder of a Tuberculous Ulcer of the Intestine.\\nX80.\\nBeginning Purulent Peritonitis Twenty-four\\nhours after Ligating the Tntestine. X 6*25.\\nTuberculous peritonitis. X 72.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0017.jp2"}, "18": {"fulltext": "", "height": "4691", "width": "2973", "jp2-path": "atlasepitomeofsp00drck_0018.jp2"}, "19": {"fulltext": "CONTENTS.\\nPAGE\\nI. The Organs of Circulation 17\\nThe Heart 1?\\nDiseases of Heart-muscle 18\\nCirculatory Disturbances of the Myocardium 21\\nEndocardium 26\\nPericardium 30\\nThe Vessels\\nArteries 34\\nVeins 43\\nLymphatic Glands 4.\\nThe Spleen 53\\nInfarcts 55\\nAcute Splenic Tumor 57\\nChronic Splenic Tumor 59\\nDegeneration 61\\nThe Bone-maerow 64\\nII. The Respiratory Organs 67\\nThe Nose 67\\nThe Larynx, Trachea, and Bronchi 69\\nThe Lungs 77\\nilatory Disturbances\\nInfarction 86\\nPneumoconiosis\\nPneumonia 1)1\\nCroupous Pneumonia 95\\nBronchopneumonia 100\\nTuberculosis 104\\nSyphilis 115\\nThe Ple\u00c3\u00bcb in\\nTin. Thyroid Gland 1 1\\n15", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0019.jp2"}, "20": {"fulltext": "16 CONTENTS.\\nPAGE\\nIII. The Digestive Organs 121\\nThe Oeal Cavity, Pharynx, Esophagus 126\\nCroupous aud Diphtheric Inflammation 130\\nThe Salivary Glands 132\\nThe Stomach 133\\nGastric Ulcer 135\\nThe Intestine 138\\nInflammations 140\\nTuberculosis 147\\nThe Peritoneum 148\\nIndex 149", "height": "4691", "width": "2991", "jp2-path": "atlasepitomeofsp00drck_0020.jp2"}, "21": {"fulltext": "PATHOLOGIC HISTOLOGY.\\nI. THE ORGANS OF CIRCULATION.\\nHEART.\\nThe heart-wall consists of three layers the epieardium,\\nmyocardium, and endocardium. The epieardium (vis-\\nceral portion of the pericardium) is composed of connec-\\ntive-tissue fibers, and is covered on its outer surface by\\nHat, irregular, polygonal epithelium. [Throughout this\\nbook the word epithelium is used in the morphologic\\nsense.] Underneath the epieardium lies, normally, at\\nvarious place- a distinct layer of fat-cells. The elastic\\nfibers of the auricular epieardium are lost in the adven-\\ntitial of the larger venous trunks.\\nThe myocardium is made up of short, cylindric, trans-\\nversely striated muscle-cells. As in the voluntary mus-\\ncle-, they consist of isotropic and anisotropic transverse\\nhand-, which alternate. The protoplasm is divided into\\na peripheral, longitudinally striated, fibrillar substance\\nand a central portion the sarcoplasm. In the latter\\nlies the oval, vesicular nucleus, around which is usually\\nseen a -mall deposit of tine, granular, brownish pigment.\\nA cell-membrane the so-called sarcolemma is absent\\nin the heart-muscle of man. Many muscle-cells are\\nunited with one another through oblique and transverse\\nbranches.\\nThe endocardium is composed, like the epieardium, of\\n2 17", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0021.jp2"}, "22": {"fulltext": "18 PATHOLOGIC HISTOLOGY.\\nan avascular connective-tissue membrane, containing, espe-\\ncially in the auricles, a great number of elastic elements\\nwith a few smooth muscle-fibers. It is lined on its inner\\nsurface by a layer of polygonal, flattened epithelium. The\\nheart-valves are reduplications of the endocardium with\\nstrongly developed elastic fibers. Blood-vessels are not\\nfound normally in the valves of the full grown in the\\ncase of the auriculoventricular valves, blood-vessels reach\\nto the bases.\\nIn the fetus, however, as well as in the new-born, the\\nleaflets are richly supplied with blood-vessels up to their\\nfree borders. Along the lines of closure the connective\\ntissue is soft and myxomatous, and is composed of numer-\\nous stellate cells which anastomose with one another.\\nHere are formed the fetal, gelatinous nodules which some-\\ntimes are mistaken for endocardial inflammatory processes.\\nLater, the blood-vessels disappear, and the gelatinous\\nnodules are transformed into fibrous nodules, which are\\nnever missed at the borders of the tricuspid and mitral\\nleaflets. (Plate 5, Fig. I.)\\nDiseases of the Heart=muscle.\\nIn the course of the acute general infectious diseases\\n(sepsis, typhoid, diphtheria, scarlatina, variola, etc.) there\\noccurs quite frequently in the myocardium an albumin-\\nous degeneration, or so-called cloudy swelling, as is the\\ncase in the large parenchymatous organs. Microscopically,\\nthe fresh preparations show enlargement of the individual\\nmuscle-cells. The cement lines appear more distinctly\\nand are broader than normal, while the nuclei and the\\ntransverse striae are indistinct or entirely obscured. The\\nprotoplasm contains an enormous number of very fine\\ngranules, of a dust-like, opaque, grayish appearance. On\\nthe addition of weak solution of acetic acid this cloudi-\\nness immediately clears up, owing to the transformation", "height": "4691", "width": "2977", "jp2-path": "atlasepitomeofsp00drck_0022.jp2"}, "23": {"fulltext": "THE ORG Ays OF CIRCULATION. 19\\nof the albuminous granules into acid albumin, which be-\\ncomes dissolved in the residual acid. The striatums and\\nnuclei now become distinctly visible. In stained prepa-\\nration- thi cloudy swelling is not seen.\\nCloudy swelling is frequently a forerunner, or inter-\\nmediate staue, of a more deep-seated degenerative process\\nof the heart-muscle namely, fatty degeneration. This\\nmay occur independently of cloudy swelling. It may be\\neither circumscribed or diffuse. Usually, it is found in\\npatches in the form oi* wavy lines, parallel with the longi-\\ntudinal axis of the muscle-bundles, giving the muscle an\\nappearance similar to that of a timer s skin, the degener-\\nated area- appearing light in color. Fatty degeneration\\nmay result from local disturbance of nutrition, such as may\\nfollow narrowing or occlusion of the coronary vessels, or\\nfrom the pressure of pericardial exudate. It may occur\\nfrom acute intoxications the most important toxic agents\\nin this respect are phosphorus and arsenic less frequently,\\nchloroform, ether, and alcohol and it is found quite fre-\\nquently also in the course of the acute infections diseases,\\nthrough the action of bacterial toxins furthermore, in all\\ndiseases that lead to a diminution or destruction of the\\nblood, such as pernicious anemia and the severer forms\\nof leukemia. Microscopic examination of fresh prepa-\\nrations will show that the mu cle-eells are filled with fine,\\nround, highly retractile globules, which are arranged\\nparallel with the longitudinal fibrils, and which may\\ncompletely cover the nuclei as well as the transverse\\nStriae. On the addition of acetic acid or potassium hy-\\ndrate the granule- do not become dissolved, showing that\\nthey are fat-globules. Fn Long-standing and severe cases\\nthe individual droplets run together, forming large drops.\\nThe fat-globules are easily pressed out of the cells, after\\nwhich are seen only their shadows or outlines in the cell.\\nIn the latt T the transverse striae are completely lost the\\nlongitudinal striatums^ however, may till be present.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0023.jp2"}, "24": {"fulltext": "20 PATHOLOGIC HISTOLOGY.\\nPLATE 1.\\nFig. I.\u00e2\u0080\u0094 Fatty Degeneration of the Heart=muscle in Acute\\nPernicious Anemia. Fresh teased preparation. X 340. In the\\ncenter are seen muscle-fibers totally rilled with fat-globules the\\nfibers are partly ruptured. Transverse striations are not discernible.\\nAbove and to the left a fiber is seen, out of which the fat-globules\\nare partly extruded; here the longitudinal striation is still noticed.\\nFree, large fat drops are seen below and to the right, several slightly\\ndegenerated fibers still containing transverse striae.\\nFig. II. From the Same Case. Frozen sections of a papillary\\nmuscle of the mitral valve. Stained with sudan III. X 340. The\\nfat-droplets are stained orange-red. Here and there are seen the\\ndegenerated areas above and to the right, almost normal muscle-\\nfibers.\\nIn frozen preparations stained with sudan III the de-\\ngenerated areas are well differentiated from the normal\\nstriated muscle-fibers.\\nFatty degeneration must not be confounded with increase\\nof fat in the normal subepicardial fat-layer adipositas\\ncordis or obesitas, also known as lipomatosis cordis here\\nthe fat does not appear in globules, but as distinct fat-cells\\nand as an independent tissue. It infiltrates the heart-wall\\nin clusters, extending toward the endocardium. In severe\\ncases it appears especially over the right ventricle and\\nbelow the endocardium. The musculature becomes com-\\npressed, pushed aside, is frequently atrophied, and substi-\\ntuted by fat. The muscle-fibers may decrease to one-half\\nor two-thirds their normal size the striations, however,\\nbeing well preserved. At times, especially in corpulent\\nindividuals, it is very hard to distinguish between physio-\\nlogic and pathologic infiltration or deposition of fat.\\nUsually, the finding of atrophied muscle-bundles between\\nrows of fat-cells will differentiate these conditions.\\nA quite common, almost physiologic, condition, found\\nin advanced age, is brown atrophy of the heart-muscle.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0024.jp2"}, "25": {"fulltext": "Tab.L\\n-9.-3\\nIc I\\n1\\ni\\nv\\nIig.1.\\nH m\\nng.s.\\nLUh. Anst F. Rcic/thoUl, M\u00c3\u00bcnchen", "height": "4699", "width": "2839", "jp2-path": "atlasepitomeofsp00drck_0025.jp2"}, "26": {"fulltext": "", "height": "4687", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0026.jp2"}, "27": {"fulltext": "THE ORGANS OF CIRCULATION. 21\\nIt also occurs in young individuals suffering from exhaus-\\ntive diseases with general marasmus. The muscle-fibers\\nappear more or less diminished in size, oftentimes to a\\nconsiderable degree, and their striations are indistinct or\\nhave entirely disappeared, while the nuclei may have be-\\ncome Battened. Around the latter are found masses of\\namorphous, finely granular, yellowish-brown pigment. In\\nsevere cases the cells are completely filled with this pig-\\nment, or the pigment maybe found free between the fibers,\\nowing to the destruction o{ the cells. Tu eases not so far\\nadvanced transverse sections will not always show pigment\\nin each individual cell, for the reason that the groups of\\npigment particles, like the nuclei, are found only at certain\\nplane- fat-vacuoles are sometimes seen in the sarcoplasm\\nat the same time. The pigment gives no iron reaction,\\nand it is undoubtedly related to the pigment normally\\nfound in the heart-muscle.\\nIn severe cases of general amvloid disease there is\\nsometimes found in the myocardium amvloid degeneration\\nof the blood-vessels of the intermuscular connective tis-\\nsue. Hyaline degeneration may also be observed in the\\nintermuscular connective tissue.\\n[Among the degenerative changes of the myocardium\\nshould be mentioned segmentation, or separation of the\\nmuscle-fibers along the cement lines into the individual\\ncells that compose the fiber- and fragmentation, or the\\nbreaking of the fiber- into fragments irrespective of the\\ncement lin These changes are terminal or agonal\\n\u00c2\u00abvent- in diseases of various kinds, and are found to a\\nfcer or less degree in about two-thirds of all heart- ex-\\namined.]\\nCirculatory Disturbances of the Myocardium.\\nEmbolism, Infarction. Embolism of the coronary\\narteries of the heart occur- bin infrequently, as the result", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0027.jp2"}, "28": {"fulltext": "22 PATHOLOGIC mSTOLOGT.\\nPLATE 2.\\nFig. I. Adipositas Cordis. Frozen section. Stained with\\nhematoxylin and sudan III. X 80. 1, Transversely striated muscle-\\nfibers, pressed together, diminished in size, and continuity inter-\\nrupted 2, fat-cells in rows between the muscle-fibers.\\nFig. II.\u00e2\u0080\u0094 Brown Atrophy of the Heart= muscle in Longi=\\ntudinal Section.\\nFig. III.\u00e2\u0080\u0094 -The Same in Transverse Section. X 340. In the\\nmuscle-cells are seen masses of brownish, amorphous pigment. In\\nthe transverse section are seen round vacuoles in the sarcoplasm.\\nof detached pieces of thrombi or endocardial vegetations\\nbeing swept into those vessels. Provided sudden death\\nby obstruction of a larger stem does not occur, the results\\nare anemic infarct since the coronary arteries are, in the\\nsense of Cohnheim, end arteries in other words, do not\\nform collaterals. The whole infarcted area undergoes\\nanemic necrosis. Through coagulation of the albuminous\\nsubstances, the area presents a homogeneous, dry, firm con-\\nsistency, while the contours of the cells and transverse\\nstriae of the muscle-fibers disappear, and the nuclei do not\\nstain. Later, the musculature breaks up into a granular\\nsubstance. The infarct, like necrotic tissue in general,\\nacts upon the neighboring tissue as an inflammatory irri-\\ntant, which causes the accumulation of numerous round\\ncells, lymphocytes, and leukocytes around the periphery\\nof the infarct, forming a compact wall. At this stage\\nsoftening may take place in the infarct as the result of an\\ninfiltration of serous fluid throughout the area, the fluid\\nbeing transuded from the surrounding blood-vessels that\\nare in a state of stasis (Neelsen). This condition is desig-\\nnated as myomalacia cordis. The softened tissue can not,\\nwhen extensive, withstand the blood pressure, a local\\nbulging occurs, and an aneurysm of the heart develops.\\nIt is much more common to observe that shoots of new", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0028.jp2"}, "29": {"fulltext": "Tab.2.\\nF/fj.J.\\nK d 8\\nI\\nI a\\ni\\ni\\nEig. 3.\\nu\\nv\\nton\\n5 I\\nt\\nLU/uAnst E Reunhold, M\u00c3\u00bcnchen.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0029.jp2"}, "30": {"fulltext": "", "height": "4713", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0030.jp2"}, "31": {"fulltext": "THE ORGANS OF CIRCULATION. 23\\nblood-vessels and proliferative connective-tissue cells grow\\ninto the periphery of the infarct, which becomes gradually\\ninfiltrated with granulation tissue that is to say, the in-\\nfarct becomes organized, the necrotic muscle-tissue is sub-\\nstituted by a connective tissue at first richly cellular and\\nvascular. Plate 3, Fig. I.) Later, the blood-vessels\\ndisappear through obliteration, and the large, plasmatic,\\nepithelioid fibroblasts give way to small spindle-shaped\\ncells and long connective-tissue fibers. Minute extravasa-\\ntion- of blood lead frequently to a deposit of brownish\\npigment In this way the intarcted area is gradually\\nreplaced by a connective-tissue scar, which is outlined from\\nthe surrounding muscle-tissue by an irregular line. Myo-\\ncardial scar- may also develop in another way, which will\\nbe described later.\\nEmbolism takes the course previously described when the\\nembolus acts in a purely mechanical way. Should, how-\\never, the embolus contain micro-organisms, as in the case\\nr* pyemia or mycotic ulcerative endocarditis, then acute\\ninflammatory changes ensue, and there results an embolic\\nabscess. Plate 3, Fig. II.) Microscopically, we find in the\\ncenter of the latter staphylococcal or streptococcal masses, as\\nwell a- fragments of necrotic muscle-tissue, the nuclei and\\nstriae of which have disappeared. In the early stages the\\nil emboli arc -till -ecu inclosed within the blood-ves-\\nsels. Naturally, the walls m break down, and the\\nbacteria then lie free in the tissue. They are usually sur-\\nrounded with numerous leukocytes with lobulated and\\nrmented nuclei. The muscle-tissue at this area has\\nentirely disappeared. Around the margin of the abscess\\nthe leukocytes may be seen a- irregular shoots into the\\nintermuscular connective tissue. Sometimes the abscess\\nundergoes healing this takes place when the bacteria do\\nn t flourish, but undergo destruction. The pus-cells break\\ndown through fatty degeneration, and the contents of the\\nabscess are then entirely absorbed, while from the per-", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0031.jp2"}, "32": {"fulltext": "24 PATHOLOGIC HISTOLOGY.\\nPLATE 3.\\nFig. I. Infarction of the Heart muscle, Organizing.\\nX 70. 1, Heart-muscle still containing nuclei 2, young connective-\\ntissue cells growing into the infarcted area, and infiltrated with\\nnumerous small flakes of brownish pigment 3, new shoots of blood-\\nvessels 4, necrotic heart-muscle.\\nFig. II. Embolic Abscess in a Papillary Muscle of the\\nMitral Valve in Septicopyemia. Stained by Gram s method. 1,\\nHeart-muscle infiltrated with small round cells 2, abscess cavity\\nfilled with leukocytes 3, colonies of cocci in the center of the neigh-\\nboring abscesses 4, remains of necrotic muscle cells.\\niphery granulation tissue grows into the cavity, which\\nis finally replaced by scar tissue, as described in sim-\\nple infarction. In this way also myocardial scars are\\nformed.\\nBesides the previously described form of myocarditis\\nwhich leads to such rapid softening of larger or smaller areas\\nof muscle-tissue, there occurs another form, the real inter-\\nstitial myocarditis. The latter is not circumscribed, but\\nmore diffuse in character, and is not accompanied by direct\\nnecrosis. Apart from the processes in the endocardium\\nwhich may extend directly to the heart-muscle, this form\\nis principally observed in connection with the acute gen-\\neral infectious diseases. Through the action of bacterial\\nproducts or toxins, there is produced first nutritional dis-\\nturbances and later inflammatory changes. Primarily, we\\nfind in these forms quite frequently such degenerative\\nchanges of the muscle-fibers as cloudy swelling, areas of\\nfatty degeneration, vaeuolations, and transverse tears of\\nthe cement lines the so-called myocardite segmentaire\\nof Renaut. [Segmentation and fragmentation of the\\nheart muscle-fibers are of common occurrence. The ex-\\nistence of a distinct form of segmentary myocarditis, as\\nclaimed by Renaut, has not been established. Segmenta-", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0032.jp2"}, "33": {"fulltext": "Tab.3.\\nTT ._ r rc\\nHg.l.\\n...*2\\nEig.2.\\nLith.Anst ftechhold, M\u00c3\u00bcnchen.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0033.jp2"}, "34": {"fulltext": "", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0034.jp2"}, "35": {"fulltext": "THE ORGANS OF CIRCULATION. 25\\nturn appears as a terminal or agonal event in various dis-\\neases not necessarily involving the myocardium primarily.]\\nThe transverse striations may be absent over largo areas,\\nwhile the nuclei also -how changes. (Plate 4, Fig. I.)\\nIhre and there the nuclei an- found increased in numbers,\\nso that in a single muscle-cell several nuclei occur in rows\\nr tlu-y are found enlarged, ballooned, with a loose chro-\\nmatin network. Through disintegration of the cells part\\nof these nuclei become free. The most striking chang\\nhowever, are observed in the intermuscular connective\\ntissue. The fixed connective-ti sue cells proliferate and\\nproduce fibroblasts large spindle-shaped or round, plas-\\nmatic cells with vesicular nuclei. These accumulate es-\\npecially around the blood-vessels, forming numerous foci,\\nwhile the surrounding muscle-tissue disintegrates more\\nand more.\\nGradually, these areas are transformed into fibrous\\nsear-, which remain after the inflammatory processes have\\nsubsided. In this manner various sized -ear- are de-\\nveloped without necessarily being preceded by infarction\\nor necrosis of muscle-tissue, which, as it degenerate-, is\\nsubstituted by fibrous tissue. Myocardial scars, therefore,\\nmay develop in three ways: After infarction, after heal-\\ning of nn abscess, and a- a termination of acute interstitial\\nmyocarditis (Plate 4, Fig. II); but their genesis is not\\nyel exhausted, inasmuch as focal disappearance of muscle-\\nsubstance, accompanied with chronic proliferative changes\\nof tin- interstitial connective tissue, occur- in nil cases of\\nnarrowing of the coronary arteries in endarteritis and\\narteriosclerosi eh ionic fibrous myocarditis or arterio-\\nsclerotic myocarditis.\\nInfectious new growths, ;i- syphilis and tuberculosis,\\nare rare in the heart-muscle, but occasionally are ob-\\nserved\u00c2\u00ab They do oo1 present any special histologic pecu-\\nliarities.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0035.jp2"}, "36": {"fulltext": "26 PATHOLOGIC HISTOLOGY.\\nPLATE 4.\\nFig. I.\u00e2\u0080\u0094 Acute Interstitial Myocarditis. X 300. The trans-\\nverse strise of the muscle-fibers are obliterated in places, their nuclei\\nincreased and swollen, and partly rounded in shape.\\nBetween the muscle-fibers are seen (1) small round cells, lympho-\\ncytes and leukocytes, (2) also young connective-tissue cells (fibro-\\nblasts)\\nFig. II.\u00e2\u0080\u0094 Chronic Fibrous Myocarditis. X BO. 1, Heart mus-\\nculature 2, long connective-tissue fibers between the muscle-bundles,\\ncontaining but very few nuclei and blood-vessels.\\nEndocardium.\\nInflammation of the endocardium is usually localized\\nupon the valves of the heart, and especially upon those of\\nthe left side, because their exposed position and peculiarity\\nof function render them liable to the primary and most\\nintense action of the infectious agents. It has, therefore,\\nbecome customary to apply the term endocarditis to an in-\\nflammation of the valves of the heart, while the much rarer\\ninflammation of the mural endocardium is generally desig-\\nnated as mural endocarditis. According to the views now\\ncurrent, all forms of acute valvular endocarditis are con-\\nsidered as infectious diseases that is to say, as due to\\nthe action of micro-organisms while the slow, chronic,\\nand sclerotic forms are due to atheromatous and arterio-\\nsclerotic changes in the intima of the larger vessels that\\nspread to the valves, especially to the aortic valve and the\\naortic curtain of the mitral valve.\\nIt is customary to distinguish two varieties of acute\\nendocarditis the verrucose or rheumatic (sometimes des-\\nignated as benign) and the ulcerative or diphtheric (also\\nmalignant) form. This classification may be retained,\\nprovided gradual and quantitative, and not essential and\\nqualitative, differences are thereby understood. Quite\\nfrequently, wart-like vegetations and ulcerative changes", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0036.jp2"}, "37": {"fulltext": "Tab. 4.\\nM\\n*J1\\n-r^ c\\ne5\\n.0-\\n3\\ni 2\u00c2\u00bb c\\nr i\\nm\\nFigL\\nFig. U.\\nLi lh. Ar ist Hei chl wlil. M\u00c3\u00bcnchen", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0037.jp2"}, "38": {"fulltext": "", "height": "4678", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0038.jp2"}, "39": {"fulltext": "THE ORG ASS OF CIRCULATION. 27\\noccur at the same time they cither develop simultaneously,\\nor ulceration is established in a valve the seat of warty\\noutgrowths. Both tonus occur primarily as the result of\\nminute lesions of the endocardium, which, in turn, are due\\nto the action o\\\\ micro-organisms. The organisms either\\naccumulate directly on thi valves from the blood, or act\\non the endothelial lining by their toxins, causing minute\\nnecrosis on the basis of which other inflammatory changes\\ndevelop.\\nIn all cases of endocarditis two groups of processes\\noccur namely, inflammatory and thrombotic; at first\\ndistinct, they later cooperate in producing the so-called\\nendocardia] vegetations or efflorescences\u00c2\u00ab The inflamma-\\ntory process runs its course in the substance of the valve,\\nand the thrombi are deposited from the blood upon the\\ndiseased valve.\\nVerrucose endocarditis is characterized by the forma-\\ntion upon the valves, at their lines of closure, of either\\n.-ingle or rows of wart-like excrescence-, which later in\\ntheir course usually become organized that is to say, are\\ntransformed into connective tissue. (Plate 5, Fig. II\\nPlate 6, Fig. I.) At first there are small defects of the\\nendothelium, followed by proliferation and hyperplasia of\\nthe fixed cells of the underlying connective tissue of the\\nvalve. Prom the latter develop strings and groups of\\nspindle-shaped, polygonal, and round cells, so-called\\nfibroblasts, among which lie single small round cells.\\nOccasionally, micro-organisms accumulate upon the sur-\\nface of these cellular nodules, either singly or in small\\nmasses. At the border of the proliferating zone are seen,\\nembedded in the normal connective tissue, Bingle, large,\\nstar-shaped, richly protoplasmic cells with oval and\\nvesicular nuclei, evidently formed by mitosis from small,\\nspindle-shaped, connective-tissue cells. Before long\\nthere is deposited upon the surface of these cellular\\nnodules constituents of the blood, because of the endothe-", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0039.jp2"}, "40": {"fulltext": "28 PATHOLOGIC HISTOLOGY.\\nPLATE 5.\\nFig. L\u00e2\u0080\u0094 A Normal So called Fetal Gelatinous Nodule\\nat the Line of Closure of the Mitral Valve of the New=born.\\nX 70. The connective tissue is very cellular ground substance\\npartly myxomatous in character in it are seen (1) a number of thin-\\nwalled blood-vessels.\\nFig. II.\u00e2\u0080\u0094 A Section of an Acutely Inflamed Mitral Leaflet\\nin Mycotic Endocarditis. X 80. 1, Necrotic tissue of the leaflet\\n2, new formed blood-vessels growing into the connective tissue.\\nBetween the spindle-shaped, connective-tissue cells are seen many\\nlarge protoplasmic epithelioid cells.\\nlial defects which incite thrombotic precipitation. Usu-\\nally, a clear, finely granular mass of closely packed con-\\nglutinated blood-plates is deposited directly on the cells\\nover this layer there forms a fibrinous network or clumpy\\nmasses appear, which inclose leukocytes. Upon the sur-\\nface of this irregularly shaped vegetation a thin cluster\\nof leukocytes and bacteria in various numbers also accu-\\nmulate.\\nIn the subsequent course of verrucose endocarditis\\norganization of the thrombotic deposit, which leads to\\nhealing, takes place. From the attachment of the valves\\nblood-vessels grow between the connective-tissue lamellae\\ntoward the excrescences they send numerous shoots be-\\ntween the fibroblasts toward the thrombotic mass. (Plate\\n6, Fig. I.) These consist at first of extraordinarily fine,\\nsolid processes, which later become hollow and filled with\\nred blood-corpuscles. Gradually, the thrombotic mass\\nbecomes completely infiltrated with granulation tissue,\\nwhich is made up of fibroblasts, small round cells, and\\nblood-vessels. Later, this richly cellular and vascular\\ngranulation tissue is transformed into fibrous scar tissue,\\nin which single blood-vessels may remain present for some\\ntime. In this manner are produced nodular and diffuse\\nthickenings of the valves. Sometimes these processes of", "height": "4713", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0040.jp2"}, "41": {"fulltext": "Fig.l.\\nTab. s.\\nFig. 2.\\nLith.Anst I: Heuhliold M\u00c3\u00bcnchen", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0041.jp2"}, "42": {"fulltext": "", "height": "4684", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0042.jp2"}, "43": {"fulltext": "THE ORGANS OF CIRCULATION. 29\\nhealing lead to various changes in the form of the valves,\\nwhich produce valvular insufficiency or the new tissue\\nmay cause the valves to become adherent to each other\\nami thus produce narrowing or stenosis of the orifice.\\nSubsequently, lime salts may be deposited upon the\\nsclerosed tissue in the form of irregular and ridge-like\\nprojections.\\nUlcerative endocarditis in the early stages can not be\\ndistinguished from the verrucose, except that almost from\\nthe very first micro-organisms arc present in much greater\\nnumbers and are demonstrable in the form of dense, dark\\nballs or masses of micrococci. The further differences of\\nthe course depend upon the specific action of the microbes,\\nwhich, o\\\\\\\\ the ne hand, is essentially chemotactic, and,\\non the other, necrotic. We find the connective-tissue\\nlamella? of the valves infiltrated to a considerable extent\\nwith leukocytes, which in places are so dense that there\\nresult minute abscesses in the valvular tissue with soften-\\ning of the fibers. In the neighborhood of the masses of\\ncocci the tissue does not stain nor does it contain nuclei\\nit is necrotic. This zone is marked off from the sur-\\nrounding tissue by intense aggregations of leukocytes.\\nSuppuration and necrosis lead to more or less extensive\\ndestruction, to ulceration, and to loss of continuity in the\\ninflamed valve. The latter may become perforated, and\\nafter complete necrosis and suppurative softening whole\\nfragments may be detached and -wept into the blood-\\nstream. Hence, this malignant type of endocarditis usu-\\nally leads to a fatal end. because metastatic abscesses\\ndevelop in various organs of the body through the pro-\\nof embolism and, moreover, the individual becomes\\nprofoundly affected by the toxic action of the ever multi-\\nplyii ria.\\nThe micro-organisms observed in verrucose and ulcera-\\ntive endocarditis are the staphylococci, streptococci, diplo-\\ni pneumoniae, and, in rare cases, the gonococcL", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0043.jp2"}, "44": {"fulltext": "30 PATHOLOGIC HISTOLOGY.\\nPLATE 6.\\nFig. I.\u00e2\u0080\u0094 Acute Verrucose Mycotic Endocarditis of the\\nMitral Valve. Section through the valve and vegetation. Stained\\nby Gram s method. X 16- Bird s-eye view. 1, Connective tissue of\\nthe valve 2, a vegetation composed of conglutinated blood-cells,\\nfibrin, and, at the periphery, aggregations of staphylococcal colonies,\\n3, around which leukocytes have accumulated 4, disintegrated and\\npartly necrotic valve tissue with infiltrated leukocytes.\\nFig. II.\u00e2\u0080\u0094 Verrucose Endocarditis of the Mitral Valve, Or=\\nganizing. X40. 1, Connective tissue of the mitral valve with\\nincreased number of cells 2, endocardial efflorescence 3, blood-ves-\\nsels growing through the valve and penetrating into the excrescence\\n4, leukocytic accumulations.\\nDiseases of the Pericardium.\\nBoth layers of the pericardium are frequently the seat\\nof inflammatory processes, which are accompanied by an\\noutpouring of a fluid exudate into the pericardial cavity\\nand with a deposit of fibrin upon the opposing serous sur-\\nfaces. Most frequently, pericarditis results from exten-\\nsion of the inflammation from the pleura, the lung, the\\nmediastinum, or also from the heart or from metastases\\n(embolic) in certain infectious diseases (articular rheuma-\\ntism, septicopyemia), and from chemic irritants, as in\\nuremia. In the last case micro-organisms are not met\\nwith.\\nMicroscopically, we find in the early stages intense\\ncongestion of the pericardial blood-vessels. Sometimes\\nthe lumen of the vessel is filled with a network of fibrin\\nor with leukocytic thrombi. At the same time, there are\\nseen cloudiness and loosening of the endothelium, which,\\nlater, is rapidly destroyed, so that in advanced cases only\\nfragments of endothelial cells are found in areas, mostly\\ndetached from the underlying membrane. Upon the endo-\\nthelial lining, as well as below it, appear, at first, single", "height": "4713", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0044.jp2"}, "45": {"fulltext": "\u00e2\u0080\u00a2i\\n_ I\\n*v\\n7\\ni\\ni7//./.\\ni\\n2\\n.3\\nJ-\\nFir/.\\nl.iih.Anst F. Reicnhold. M\u00c3\u00bcnchen", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0045.jp2"}, "46": {"fulltext": "", "height": "4689", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0046.jp2"}, "47": {"fulltext": "THE ORGANS OF CIRCULATION. 3 1\\nthreads of fibrin later, more as an interwoven network\\nforming a thick layer in which are inclosed varying num-\\nbers of leukocytes. The deposition of fibrin, which is the\\nresult of the exudation of plasmatic finid from the dilated\\nvessels followed by coagulation, may attain a consider-\\nable degree, forming a thick, reticular membrane or long,\\nhairy-like projections upon the surface (cor villosum).\\n(Plate 7. Figs. I and II. Compare also Plate 60, Fig.\\nI. In the underlying connective-tissue layer of the peri-\\ncardium various cellular processes also run their course.\\nThe connective-tissue cells produce, through mitosis,\\nshort spindle-shaped or polygonal cell-elements with\\nlaige vesicular nuclei (epithelioid cells, fibroblasts), while\\nthe endothelial cells of the lymph and blood-vessels also\\nundergo proliferation. Between these appear a great\\nnumber of lymphocyte- and Leukocytes.\\nLater, the blood-vessels give off sprouts, which, at first\\n.-\u00c2\u00ab\u00c2\u00bblid. become lmllow and pass into the loosened and cellu-\\nlar layer of connective tissue and out toward the fibrin,\\nwhich is gradually infiltrated with new cells and eventu-\\nally completely substituted by granulation tissue. And\\nnow the new vessels gradually disappear, the cells diminish,\\nand the granulation tissue changes into connective tissue\\nwhich is at first rieh in spindle-shaped cells, but later be-\\ncomes more and more fibrillated at the expense of the cells.\\nIn thi- way the fibrinous deposit is gradually changed\\ninto cicatricial tissue, which produce- either flat, glisten-\\nopaque thickenings in the epicardium (so-called ten-\\ndinous spots, u soldier-spots or more or less extensive\\nadhesions of the pericardial layers up to a complete\\nfibrous obliteration of the pericardial cavity.\\nIn tuberculous pericarditis the processes described of\\nexudation, proliferation, and organization run their\\ncourse in the same manner but, in addition, there appear\\nin the granulation tissue, under the fibrinous layer, typical\\ntubercles, generally composed of radially arranged epi-", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0047.jp2"}, "48": {"fulltext": "32 PATHOLOGIC HISTOLOGY.\\nPLATE 7.\\nFig. I.\u00e2\u0080\u0094 Acute Fibrinous Pericarditis (Cor Villosum).\\nFibrin stain. X 64. 1, Myocardium 2, subepicardial fat-tissue 3,\\nthickened and richly cellular epicardium 4, fibrin deposit, in the\\nmeshes of which leukocytes are seen 5, blood-vessels growing toward\\nthe fibrin and filled with leukocytes.\\nFig. II.\u00e2\u0080\u0094 Fibrinous Pericarditis, Organizing. X127. 1,\\nPericardial connective tissue 2, young, connective-tissue layer with\\nnumerous, thin-walled blood-vessels, epithelioid (fibroblasts) and round\\ncells 3, fibrin layer (stained red with eosin); 4, the fibrin penetrated\\nby new blood-vessels and fibroblasts.\\nthelioid cells, giant cells, and round cells, the center early\\nbecoming the seat of caseous necrosis.\\nThe confluence of nodules and caseous areas leads to\\nthe formation of extensive necrotic layers, which are sur-\\nrounded by granulation tissue or fibrous tissue. New\\ntubercles spring up in the young connective tissue exter-\\nnally, undergo the same degeneration, and become covered\\nby a new layer of fibrin and of granulation tissue in this\\nway thick masses are formed, which consist of, at times,\\nnumerous alternating layers of granulation tissue and\\ncaseous and necrotic material. Usually, this process goes\\non in the same way in both the pericardial layers, which\\nbecome firmly adherent and thus obliterate t^pericardial\\ncavity.\\nPLATE 8.\\nFig. I.\u00e2\u0080\u0094 Subacute Tuberculous Pericarditis. X50. 1, Heart-\\nmuscle 2, subepicardial fat-tissue greatly infiltrated with small\\nround cells 3, thickened pericardium 4, tubercle with cheesy center\\nand epithelioid cells arranged in a radiating manner 5, giant cells\\n6, fibrin deposit.\\nFig. II.\u00e2\u0080\u0094 Sclerotic or Milk Spots of the Epicardium. X 65.\\n1, Transverse section of the heart-muscle 2, normal epicardial con-\\nnective tissue 3, layer of greatly thickened sclerotic connective-tissue\\nfibers.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0048.jp2"}, "49": {"fulltext": "3\\nC\u00c2\u00b0.v.r.\\n7J/\u00c3\u0084./.\\nFig. n.\\nLilh. An.st A Hcirhhold Munrhcn", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0049.jp2"}, "50": {"fulltext": "", "height": "4716", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0050.jp2"}, "51": {"fulltext": "Tab. 8-\\n4\\nR*4fc\\nUpi.\\n5.\\nLUfuAnst F! Reichhold, M\u00c3\u00bcnchen,", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0051.jp2"}, "52": {"fulltext": "", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0052.jp2"}, "53": {"fulltext": "THE ORGANS OF CIRCULATION. 33\\nVESSELS.\\nThe arteries present a wall in which throe layers are\\nrecognizable: the internal, middle, and external coats.\\nIn all arteries the internal coat, or intima, is covered with\\nHat. polygonal or four-sided, epithelial cells. The other\\nlayers are composed of fibrous, elastic, and muscular\\ntissues, which reach varying thicknesses and are variously\\ndisposed according as the caliber of arteries varies. Three\\ngeneral groups may be distinguished In the smallest,\\ndied precapillary, arteries the epithelial lining is\\nsituated upon a thin, elastic membrane, outside of which\\nlies the media, which is composed of a single layer of\\ncircularly arranged smooth muscle-fibers. The external\\ne \u00c2\u00bbat i- formed of a few longitudinally disposed, eonnective-\\ntissue, and elastic fibers.\\nIn the middle-sized arteries there occurs, outside the\\nepithelium, a layer of connective tissue made up of fine\\nfibers, scattered among which lie flat, triangular, or stellate\\ncells. This reinforced intima is bordered externally by\\nthe inner elastic layer, or fenestrated membrane, which is\\nperforated by numerous round openings. The media con-\\nsists of several layer- of circular, muscular fibers, between\\nwhich are distributed line elastic fibers in varying num-\\nbers. Externally, also, the media is bordered by a\\nthick\u00c2\u00ab-]* elastic membrane, the external elastic. The\\nadventitia consists of partly circular, partly longitudinal,\\nconnective-tissue fibers, between which ran occasional\\nelastic fibers. In some arteries isolated bundles of longi-\\ntudinally arranged muscular fibers are found in the ad-\\nventitia. Furthermore, the adventitia supports the minute\\nvasa vasorum.\\nIn the large arteries (aorta, pulmonary, carotid, sub-\\nclavian) all the three layers receive additional reinforce-\\nments. In the intima several layers of connective-tissue\\nfibers, with polygonal, flat cell-, and also circular elastic", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0053.jp2"}, "54": {"fulltext": "34 PATHOLOGIC HISTOLOGY.\\nfibers occur outside the epithelial lining. The internal\\nelastic coat consists generally of several layers. In the\\nmiddle coat the elastic elements are especially well devel-\\noped, and consist of thick, fenestrated, elastic plates\\nthat are connected with one another by bands of fibers.\\nIn the interspaces lie the muscular fibers, which here also\\nhave a circular arrangement. The elastic membrane is\\nnot so sharply demarcated as in the arteries of medium\\ncaliber. The adventitia shows the same structure as in\\nthese, but does not contain any muscular bundles. The\\ntwo inner layers of the walls of arteries consequently\\nnever contain vessels when normal whenever such a\\ncondition exists, it is pathologic.\\nThe veins differ from the arteries especially in the\\nmarked reduction that takes place in the middle coat.\\nExternal to the epithelial lining there are, in the largest\\nand medium-sized veins, some fibrillated connective-tissue\\nand also, occasionally, longitudinal, muscular bundles.\\nThe internal elastic coat is distinctly marked, and consists\\noften of several layers. The middle coat contains usually\\nonly a few circular, muscular bundles, but more elastic\\nand connective-tissue elements, which often cross one\\nanother obliquely in some veins e. g. y the meningeal\\nand osseous veins the media may be entirely absent.\\nThe external tunic contains also much connective tissue,\\nas well as many longitudinal bundles of smooth muscle-\\nfibers, which in some veins form a continuous muscular\\ncoat. The valves in veins are formed by a duplicature\\nof the intima.\\nThe walls of capillaries consist only of a single layer of\\nflat, many sided, epithelial cells.\\nArteries.\\nAtheroma and Arteriosclerosis.\u00e2\u0080\u0094 Atheroma is a dis-\\nease of the vessel wall produced by a combination of pro-\\ncesses, in part inflammatory, in part degenerative. It", "height": "4691", "width": "2854", "jp2-path": "atlasepitomeofsp00drck_0054.jp2"}, "55": {"fulltext": "THE ORGANS OF CIRCULATION. 35\\nnearly always begins in the intima, and leads to diffuse or\\ncircumscribed, often quite marked, thickening of this\\ncoat eventually, the outer tunics also become involved.\\nAccording to the vascular tunic affected, the process may\\nbe called endarteritis, mesarteritis, or periarteritis.\\nBy the word atheroma, or atheromatosis, special stress\\nis laid upon the retrogressive changes. It should, there-\\nfore, be reserved for those cases in which softening gives\\nrise to curdy material while arteriosclerosis is the more\\nappropriate designation for the remaining forms. [Inas-\\nmuch as there is no distinction of fundamental import\\nbetween atheroma and arteriosclerosis, and as arterio-\\nsclerosis in it- broadest significance includes atheroma,\\nthere is no good reason why the term atheroma should not\\nbe discarded in the interests of simplicity and clear-\\nWhen the process involves a medium-sized or smaller\\nvessel of about the caliber of the basilar artery, the ex-\\namination of transverse sections of the diseased vessel will\\nshow, under low magnification, that the lumen is narrow and\\ndistorted; it no longer has the normal circular form, and\\ni- not central, but eccentric; at one point, or several, the\\nwall appears thinner; at others, considerably thicker, due\\nt nodular or oftener to semilunar protuberances, which\\niroach upon the lumen. Closer examination will show\\nthat the section i- surrounded by an intact adventitia of\\nuniform thickness, and also that the media i- continuous\\nand of uniform width. Contrariwise, the intima presents\\nmarked changes, inasmuch a- the halfmoon-shaped bulg-\\nare found to be due to a large increase in it- vol-\\nume at th\u00c2\u00ab-\u00c2\u00bb points. The internal elastic layer and the\\nepithelium are retained only over the thin or normal por-\\ntions of the wall. Where the intima begins to be thick-\\n1. it is seen that a layer of new tissue arises in the sub-\\nepithelial \u00c2\u00bbnn -ctiv tissue between the elastic membrane\\nand ill\u00c2\u00bb- epithelial lining. The two points of die crescent", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0055.jp2"}, "56": {"fulltext": "36 PATHOLOGIC HISTOLOGY.\\nPLATE 9.\\nFig. I. Arteriosclerosis of a Cerebral Artery (Sylvian\\nArtery) Transverse Section. X 75. The lumen is eccentric in\\noutline, as a result of irregular thickening of the wall 1, Adventitia\\n2, media 3, the internal elastic coat at 4 the elastic layer becomes\\nlost 5, slightly thickened side of the intima 6, newly formed, richly\\ncellular connective tissue from the inner layer of the intima 7, outer\\nlayer of the same, noncellular, containing several slit-like and rounded\\nspaces filled with fat.\\nFig. II.\u00e2\u0080\u0094 Arteriosclerosis of a Coronary Artery of the\\nHeart; Transverse Section. Weigert s elastic fiber stain. X?0.\\n1, Adventitia 2, media 3, internal elastic coat, at 4 becoming fibril-\\nlar and sending shoots into the newly formed connective tissue (5).\\nstart here. (Compare Fig. I, Plate 9.) The new forma-\\ntion consists principally of connective tissue. The elastic\\nlayer may be traced for a distance into the new tissue,\\nwhere it is soon lost often the ends become distinctly\\nsplit up into fibrils. The inner layers of the thickened\\narea are relatively cellular, and contain numerous, short,\\ndense, spindle-shaped, and also some round, nuclei. The\\nexternal layers are less cellular and densely fibrillated, at\\ntimes almost homogeneous in places there are small,\\nround, and oval openings, which in the fresh state contain\\nfat in the latter stages this part of the tissue generally\\nundergoes retrogressive changes. The fibers coalesce to\\nform uniformly glistening, thick beams, and assume a\\nhyaline appearance, not unlike the ground substance of\\ncartilage small areas may become necrotic and break up\\ninto a granular detritus in which are free fat, crystals of\\nfatty acids, and, quite generally, Cholesterin tablets. Cal-\\ncification frequently takes place small, round, and irregu-\\nlar calcareous granules are deposited, or there arise larger\\ncalcareous scales or concentrically lamellated, roundish\\nmasses, which may so press upon the muscular coat as to\\ncause it to atrophy in places.", "height": "4713", "width": "2865", "jp2-path": "atlasepitomeofsp00drck_0056.jp2"}, "57": {"fulltext": "Tab.\\nMg.l.\\nEiff.2.\\nLtth. Ans/ Heichhohi M\u00c3\u00bcnchen", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0057.jp2"}, "58": {"fulltext": "", "height": "4691", "width": "2826", "jp2-path": "atlasepitomeofsp00drck_0058.jp2"}, "59": {"fulltext": "THE ORGANS OF CIRCULATION. 37\\nRapture of degenerated areas into the lumen rarely\\noccurs in the smaller arteries. The processes of connec-\\ntive-tissue growth and of calcification may gradually\\nspread so as to encircle the entire lumen, and then the wall\\nof the artery becomes changed, over a greater or less ex-\\ntent, into a rigid calcareous cylinder.\\nIn the larger arteries the process differs, in so far as here\\nthe degeneration in the intima frequently appears in the\\nground, while the other walls presenl changes of an\\notially inflammatory nature. Here, also, proliferation\\nand thickening of the normally well-developed tissue of\\nthe intima constitute the primary changes; circumscribed\\nfibrous areas are formed, which may extend into the media\\nand project into the lumen as nodular elevations. Over\\nsuch districts the epithelium is losi early the elastic ele-\\nment- are separated and split up; frequently they disin-\\ntegrate throughout large area-, forming small, irregular\\npieces and in the midst of the fibrous areas single frag-\\nment- may he demonstrable by means of special staining\\nmethod-. The part of the fibrous tissue adjacent to the\\nlumen frequently presents a yellowish appearance. In\\nsuch place- thin, continuous lamellae can he peeled oil\\nwhich, it examined when fresh, distinctly -how fatty de-\\nration of the large, Hat cells they contain. Elongated,\\ntriangular, and stellate groups of closely aggregated, line,\\nglistening fat-drops are -ecu, a- well as large connective-\\ntissue cells, which become especially distinct on accounl\\nof the fat in their interior. Plate 10, Fig. III.)\\nLreas of necrosis are common in the fibrous and cica-\\ntricial tissue; at firs! oval, or round, inclosed on all Bides\\nby connective tissue, they may in time break through\\ninto the lumen ami thus produce sinuous ulcers with\\nundermined edges, the floor being covered with a curdy\\nmaterial composed of detritus and crystals of fatty acid-,\\nand frequently large accumulations of Cholesterin tablets\\nalso found Plat.- 10, Fig. II.;", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0059.jp2"}, "60": {"fulltext": "38 PATHOLOGIC HISTOLOGY.\\nPLATE 10.\\nFig. I. Atheroma of the Aorta (Arteriosclerosis). X20.\\n1, Intima, greatly thickened through sclerotic, slightly cellular, con-\\nnective tissue 2, media, also thickened with patches of new connec-\\ntive tissue (at 3) 3, shoots of new blood-vessels, surrounded by small,\\nround cells, growing from the adventitia toward the intima.\\nFig. II.\u00e2\u0080\u0094 Cholesterin Plates and Free Fat=droplets from an\\nAtheromatous Patch of Wall of Aorta. X 130. A fresh preparation.\\nFig. III.\u00e2\u0080\u0094 Fatty Degeneration of the Cells of the Intima in\\nArtheroma of the Aorta. X 300. Fresh preparation, which was\\nobtained by stripping a fine lamella from the thickened and yellow\\nintima of the aorta.\\nThe star-shaped cells normally present in the intimal connective\\ntissue are clearly shown, since they are filled with a large number of\\nvariously sized fat-droplets.\\nThe frequent occurrence of very extensive calcification\\nin such cases is well known. The calcareous deposits\\nmay be situated at various levels they occur either in\\nthe innermost layers of the connective tissue, while the\\nnecrosis progresses underneath or they may reach down\\ninto the media in the form of broad and thick plates and\\nscales with irregular projections toward the lumen.\\nThe external layers of the arterial wall may also\\nshow abnormal conditions. Cellular accumulations in\\nthe adventitia pass in between the muscular bundles and\\nelastic plates of the media. These generally correspond\\nto the newly formed vessels, originating from the vasa\\nvasorum, and running in various directions, sometimes\\nreaching into the intima. In their course are seen large,\\npolygonal, and spindle-shaped cells, as well as lympho-\\ncytes. The elastic elements of the media may be sepa-\\nrated by the cell accumulations, and their continuity\\ninterrupted. Often evidences of degeneration are noticed.\\nIn the adventitia groups of leukocytes resembling lymph-\\nfollicles may occur.", "height": "4691", "width": "2857", "jp2-path": "atlasepitomeofsp00drck_0060.jp2"}, "61": {"fulltext": "Tab. to.\\nM\\nTig.1.\\n2\\nFiq j\\nq*\\ni\\nFig.3.\\nI.iJh. Anst F. ReicMwld, M\u00c3\u00bcnchen", "height": "4633", "width": "2839", "jp2-path": "atlasepitomeofsp00drck_0061.jp2"}, "62": {"fulltext": "", "height": "4713", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0062.jp2"}, "63": {"fulltext": "THE ORGANS OF CIRCULATION. 39\\nArteritis. Inflammations occur in the walls of all\\narteries that lie in tissue the seat of inflammatory pro-\\ncesses involvement of the arterial walls is especially\\nmarked in tuberculous and syphilitic granulation tissue,\\nhut the arterial changes do not, of necessity, present\\nspecific characteristics. The acute stages of these pro-\\ncesses :uc seen especially well in tuberculous leptomenin-\\ngitis. In the beginning the adventitia is richly infiltrated\\nwith leukocytes, which form broad, deeply stained, cellu-\\nlar circle- about the innermost arterial walls. Gradually,\\nwandering cells pass into the muscular layers of the\\nmedia. Under high magnification the cells are seen\\nplainly making their way between the circularly arranged\\nmuscular cells the wandering cells assume long-drawn-\\nout form- the nucleus, at first shaped like a pear, be-\\ncomes long and filamentous, so that narrow passages are\\ntraversed frequently, the emh of the nucleus are swollen\\nwhile the connecting central piece is creeping through a\\ntight place. The cells also seem to pass through the pre-\\nformed -pace- in the internal elastic coat, and accumu-\\nlate in small heaps under the epithelium, which is raised\\nup fr\u00c2\u00ab\u00c2\u00bbm its normal substratum later, the epithelium is\\nbroken through in place-, and leukocytes reach the lumen\\nof the vessel, where they aggregate in the form of small,\\nparietal, cellular masses.\\nIn thi- process exactly the reverse occurs of the leuko-\\ncytic emigration as is seen in Cohnheim s well-known ex-\\nperiment. (Se General Part, Inflammation.) Here it\\nconcerns immigration. In the further course the internal\\nelastic layer becomes more and more separated from the\\nendothelium, which i- lifted up: usually, this condition\\ni- not uniformly present at the entire periphery of the\\narterial lumen, n side of which generally shows the\\nnormal relations of the elastica and the epithelium.\\nCommonly, the continuity of the elastic coal becomes\\ndestroyed at the point of the greatest accumulation of", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0063.jp2"}, "64": {"fulltext": "40 PATHOLOGIC HISTOLOGY.\\nPLATE 10 a.\\nFig. I.\u00e2\u0080\u0094 Arteriosclerosis of the Crural Artery. X 55. Stain-\\ning of the elastic fibers according to Weigert 1, Adventitia 2, com-\\npressed and atrophied media 3, greatly thickened intima at 4 scle-\\nrotic, fibrous tissue, noncellular at 5 scales of lime salts containing\\nspaces filled with a fatty detritus.\\nFig. II. Wall of a Small Aneurysm of the Aorta. X 20.\\nWeigert s elastic fiber stain. The intima is somewhat diffusely thick-\\nened, and surrounds the lumen of the aneurysm completely (1) the\\nmedia (with numerous elastic fibers) is greatly atrophied and nearly\\ntorn (2) 3, thickened adventitia, infiltrated with spindle-shaped and\\nround-cell accumulations.\\nleukocytes, among which are now found other cells, such\\nas large, spindle-shaped cells with much protoplasm and\\na vesicular nucleus these cells are plainly fibroblasts\\nand descendants of the normal, subepithelial connective\\ntissue.\\n[In tuberculous leptomeningitis and probably also in\\ntuberculous processes elsewhere, there quite constantly\\noccurs a subepithelial proliferation of connective-tissue\\nPLATE 10 b.\\nFig. I.\u00e2\u0080\u0094 Acute Arteritis in Tuberculous Leptomeningitis.\\n(From the wall of a small meningeal artery.) X 745. 1, Adven-\\ntitia 2, media 3, el astica interna 4, detached epithelium 5, in the\\nmuscularis, emigrating leukocytes, showing various stages of deformity;\\n6, leukocytes which have passed through the internal elastic coat and\\nreached the epithelium.\\nFig. II.\u00e2\u0080\u0094 Gummatous Arteritis of the Subclavian Artery.\\nX 16. Weigert s elastic fiber stain. The lumen is almost occluded\\nas the result of the proliferation of the intima, the elastic fibers of\\nwhich are greatly increased. In the media numerous gummata with\\ncheesy centers (1) and giant cells (2) reaching to the intima. Vasa\\nvasorum of the adventitia infiltrated with small, round cells.", "height": "4717", "width": "2858", "jp2-path": "atlasepitomeofsp00drck_0064.jp2"}, "65": {"fulltext": "Tab. 10\\n\u00c2\u00ab3\\nLa\u00c2\u00aba\u00c2\u00abB^\\n7 //y/. i\\nFig 2.\\nLUfuAnSt R Reichhold Manchen.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0065.jp2"}, "66": {"fulltext": "", "height": "4687", "width": "2821", "jp2-path": "atlasepitomeofsp00drck_0066.jp2"}, "67": {"fulltext": "Tab./ 0,6.\\n2\\ni\\ns\u00c2\u00ab\\nm\\nf| 1*. ^t\\n1 f\\n4\\nifci.\\nF,u 8.\\nLith.An.sl F! Reichhold, Munch en.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0067.jp2"}, "68": {"fulltext": "", "height": "4690", "width": "2846", "jp2-path": "atlasepitomeofsp00drck_0068.jp2"}, "69": {"fulltext": "THE OBGANS OF CIRCULATION. 41\\ncells, resulting in the formation of a layer of epithelioid\\ncells among which giant cells are sometimes found this\\nform of tuberculous endoarteritis is not due to extension\\nfrom without.]\\nSimilar changes are observed in tuberculous areas in the\\nlungs, especially in the vessels which pass like hands\\nthrough the caverns. In such the increase in the thick-\\nness of the walls leads to great narrowing and even\\nclosure of the lumen, whereby the entrance into the blood\\nof the infectious agent is prevented. Later, the small,\\nround cells and leukocytes disappear, and a fibrillated con-\\nnective tissue forms in the former vascular channel.\\nI icasionally, in the midst of this connective tissue a new\\nelastic membrane appears, thinner than the original elas-\\ntic membrane whose general course it imitates it forms\\nthe inner hounds of the new, greatly narrowed, lumen.\\nBut the process is not necessarily at a standstill as yet.\\nInside of the new elastic layer connective tissue may\\nagain form, which then lead- to complete obliteration of\\nthe lumen and occludes the vessels permanently (endarter-\\nitis obliterans). Obliterating endarteritis of this kind\\nmust not be confounded with the process of organization\\nwhich occurs in occluding thrombi and which also event-\\nually may \u00c2\u00ab\u00c2\u00bbMiniate the lumen by new fibrous ti- ue.\\nThis process is described in the General Part in connec-\\ntion with the consideration f Thrombosis.\\nIn addition to this indifferent form of arteritis, which,\\nit is true, is observed principally in tuberculous and syph-\\nilitic granulation tissue, there arc also true, specific forms,\\nin which syphilitic or tuberculous nodules arise in the\\nrial walls. In gummous arteritis the adventitia es-\\npecially is the seal of the nodules thai more rarely\\ndevelop in the media or reach to the intima, which be-\\ncomes thick ii account of newly formed fibrous and elastic\\ntissue. At first, the areas are rounded aggregations of\\nlymphocytes and epithelioid cells soon a caseous necrosis", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0069.jp2"}, "70": {"fulltext": "42 PATHOLOGIC HISTOLOGY.\\nPLATE 11.\\nFig. I.\u00e2\u0080\u0094 Arteritis Obliterans (Orcein Stain). X 37. 1, Ad-\\nveutitia 2, media 3, internal elastic coat, which at some places is\\nflbrillated 4, newly formed connective tissue, nearly filling the lumen;\\nat 5 it contains several blood-vessels 6, part of lumen limited by a\\nfine, new-formed elastica.\\nFig. II.\u00e2\u0080\u0094 Arteritis Obliterans (Sylvian Artery) in Syphilis.\\nX 80. 1, Adventitia 2, muscularis 3, normally preserved old\\nelastica interna 4, proliferated connective tissue 5, newly formed\\ntunica elastica, imitating the course of the old G, newly proliferated\\nconnective tissue growing into the lumen, which it has fully occluded.\\noccurs in the center, while at the periphery there is a ten-\\ndency to fibrous encapsulation. Occasionally, a single\\ncross-section of large vessels may show in the wall a series\\nof such nodules. (Compare Fig. I, Plate 10 b.)\\nTubercle usually extends to the walls of vessels from\\nthe neighborhood. The thin walls of veins are not rarely\\ninfiltrated by tuberculous foci, from the rupture of which\\ninto the lumen the circulating blood may become con-\\ntaminated with infectious material, leading to a multiple\\nembolic tuberculosis in the corresponding capillary terri-\\ntory. In case of invasion through a pulmonary vein\\nthe general circulation becomes involved in case of\\na vein elsewhere, a miliary distribution in the lungs would\\nfollow, and in an artery in its capillaries.\\nAneurysm. Only those aneurysms are of histologic\\nvalue in which the arterial walls remain intact. In the\\ndissecting aneurysms there occurs a simple rupture of the\\nintima, and also of the media, through the base of a\\ndefect of arteriosclerotic or other nature. The entering\\nblood stretches the adventitia and forces it outward.\\nIn the true aneurysm the intima is retained and clothes\\nthe inner surface of the aneurysm throughout its whole\\nextent. The usual changes of the intima are those of\\narteriosclerosis the elastic fibers are replaced over exten-", "height": "4715", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0070.jp2"}, "71": {"fulltext": "Tab.\\n...J\\nlig.L\\n,1\\nvF^ v t\u00c3\u0084- ^v ^o\\n?^v\\nLU/uAnst Reichhold M\u00c3\u00bcnchen", "height": "4641", "width": "2798", "jp2-path": "atlasepitomeofsp00drck_0071.jp2"}, "72": {"fulltext": "", "height": "4659", "width": "2860", "jp2-path": "atlasepitomeofsp00drck_0072.jp2"}, "73": {"fulltext": "TUE OkGANS OF CIRCULATION. 43\\nsive areas by a sclerotic fibrous tissue; often the intima\\nshows recent vascular foci of infiltration, and its thickness\\nis increased. The media presents constant and character-\\nistic changes, which must be regarded as essential and of\\nfundamental import in the development of the aneurysm.\\nIt- muscular and elastic layers arc greatly reduced in\\nthickness, amounting to complete absence at the point of\\nitest dilatation. This is especially well shown in\\naneurysms of the aorta, where the media consists mostly\\nlastic fibers, which are now seen to end abruptly in the\\nmargin of the dilatation, or to become greatly attenuated.\\nquently, there are seen interruptions in the contin-\\nuity of the muscular and elastic fibers, the fragments hav-\\ning been pushed aside irregularly so that they have lost their\\nfinally circular arrangement. At the bottom of large\\naneurysms the media isoften wholly absent, the intima be-\\ning in direct contact with the adventitia frequently, granu-\\nlar blood pigment is found in such places. The adventitia\\nalso is nearly always altered, especially in the way of\\nssive thickness, on account of increase in the connec-\\ntive-tissue fibers there are also areas of cell infiltration,\\nr marked about the vasa vasorum, which commonly\\nshow more or less narrowing and often complete endarter-\\nitis obliterans.\\nAmyloid degeneration of arteries is considered in the\\ni in connect ion with A uivloidosis.\\nVeins.\\nmmations of the walls of veins are either due to\\nnsion from the neighborhood, as in erysipelas of the skin\\nand in phlegmons, and successively attack the adventitia,\\nmedia, and intima (periphlebitis, mesophlebitis, endophleb-\\niti V^irchow), or they arise from infectious thrombi.\\nthat is, from within. in which case the intima is first\\ninvolved. The second form is designated as thrombo-", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0073.jp2"}, "74": {"fulltext": "44 PATHOLOGIC HISTOLOGY.\\nPLATE 12.\\nFig. I. Tuberculous Arteritis from a Subacute Tubercu=\\nlous Meningitis. X 280. 1, Lumen eccentric in outline and greatly\\nnarrowed 2, internal elastic coat, which is torn at 3 3, between it\\nand the endothelial lining a number of cells have proliferated, con-\\nsisting of leukocytes, lyrnphocy tes, and epithelioid cells the muscu-\\nlar coat is present only to a slight extent above and to the left 4,\\nlarge sized tubercle with caseous center at 5.\\nFig. IL\u00e2\u0080\u0094 Tubercle in the Wall of a Larger Branch of the\\nPortal Vein. Rupture iuto the lumen subacute disseminated tuber-\\nculosis of the liver. X 40. 1, 1, Liver tissue 2, centrally caseated\\ntubercle 3, lumen of branch of the portal vein at 4 the vessel\\nwall is ruptured on account of the richly cellular infiltrations of the\\nperiphery of the tubercle, Avhich is projecting into the lumen of the\\nvein.\\nphlebitis, and is more fully considered under Thrombosis,\\nas are also the processes in the walls of the veins asso-\\nciated with the organization of thrombi.\\nPure phlebitic processes run a course similar to acute\\narteritis. The vasa vasorum of the adventitia are con-\\ngested, leukocytes migrate into the inner layer of the vein\\nw r alls and reach the lumen, into which they occasionally\\npenetrate and induce a secondary thrombosis, so that here\\nalso a thrombophlebitis is established. In phlegmonous\\nprocesses a formal suppuration of the venous walls may\\noccur. In addition to the pus-cells there are found, how-\\never, also large polygonal and spindle-shaped cells with\\nvesicular nuclei derivatives of the connective-tissue cells\\nnormally present in the wall. The muscular coat is\\npressed asunder, its fibers are disarranged, and often the\\nmuscle nuclei can not be found throughout large areas.\\nSevere purulent forms of phlebitis are caused mostly by\\nstreptococci, and lead, in the majority of cases, to multiple,\\npurulent metastases and death, under the clinical picture\\nof pyemia. Chronic inflammations of the wralls of veins", "height": "4714", "width": "2989", "jp2-path": "atlasepitomeofsp00drck_0074.jp2"}, "75": {"fulltext": "Fifj.L\\nJ\\nFig. u.\\nLUfu Anst Heiciiholil Simulien", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0075.jp2"}, "76": {"fulltext": "", "height": "4681", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0076.jp2"}, "77": {"fulltext": "THE ORGANS OF CIRCULATION. 45\\ncause a diminution (\u00c2\u00bb1* their elasticity, followed by dilata-\\ntion of the lumen, which assumes a markedly irregular\\nform (varix, phlebectasia). In old varices the intima\\nconsists mostly of a coarse connective tissue of varying\\nthickness in different places, often producing nodular pro-\\njections into the lumen. The muscular elements of the\\nmedia are generally wholly destroyed, while the elastic\\nfibers usually do not suffer in such marked degree. The\\nadventitia is usually much thickened, and passes without\\nany distinct boundary into the surrounding connective\\ntissue, which, especially in the case of subcutaneous\\nvarices, generally shows a diffuse hyperplasia.\\nOccasionally, calcification of the walls of veins occurs\\nlarge, calcareous masses of this kind are called phlebo-\\nliths, especially those which result from infiltration of\\nthrombi.\\nThe extension to the venous wall of tuberculous and\\nsyphilitic area- in the adjacent tissue has been referred to.\\nLYMPHATIC GLANDS.\\nThe lymphatic glands are organs in which lymphocytes\\ndevelop, intercalated in the system of lymphatic vessels.\\nThey consist of a framework of connective tissue in which\\nlymphatic cells are accumulated into regular groups. The\\nglands, which are more or less reniform, are surrounded\\nby a capsule of several layers of connective-tissue fibrill\u00c2\u00ab,\\namong which lie a few smooth muscle-fibers. The inner\\nsurface of the capsule sends off connective-tissue septa, or\\ntrabecule, which converge toward the hilus, and are con-\\nnected with an extremely fine reticular tissue, which is\\ntehed across the spaces between the septa. At the\\nintersection of the fine fibrillae lie fiat cells with small,\\nround^ dense nuclei. The reticulum contains accumula-\\ntions of lymphoid cells arranged in the form of rounded\\nnodules situated at the periphery of the convexity of the", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0077.jp2"}, "78": {"fulltext": "46 PATHOLOGIC HISTOLOGY.\\nPLATE 13.\\nFig. I. Acute Suppurative Phlebitis in Phlegmonous In=\\nflammation of the Cellular Tissues of the Skin. X 40. The\\nlumen of the vein has become narrowed to a slit-like opening (1). in\\nwhich are seen cloudy coccal masses the wall is hardly recognizable,\\ndue to the great infiltration of leukocytes the vessels of the adventitia\\nare greatly dilated and filled with blood (2) some of their shoots have\\nproliferated toward the lumen (3) at 4, remains of tunica media.\\nFig. IL\u00e2\u0080\u0094 Varix from the Leg. X 26. Elastic stain. 1, Epi-\\ndermis 2, cutis 3, sweat-glands the adventitia of the dilated vein\\nwith the numerous elastic fibers can not be separated from the sur-\\nrounding connective tissue the media has disappeared 4, thickened\\nintima the lumen is more or less affected as the result of the great\\nirregularity and tortuosity of the vessel.\\nglands. These are called secondary nodules or follicles\\nthey lie between the trabecule, and present a dense and\\ndark outer zone of concentric layers, and a lighter center\\nthe germinal center in which the lymphocytes are\\nproduced and in which numerous mitoses are normally\\nfound. The zone in which the follicles lie is called the\\ncortex of the lymph-glands. The follicles send off into the\\ncentral parts cord-like, lymphocytic accumulations, which\\nanastomose freely. These form the medullary substance\\nor follicular cords. Between the follicles themselves, be-\\ntween the follicles and the capsule and the trabecule, and\\nbetween the follicular cords run cleft-like spaces traversed\\nby reticulum. These spaces are called lymph-sinuses\\nthey are in direct communication with the lymph-vessels,\\nwhich enter the convexity of the glands as vasa afferentia,\\nand emerge at the hilus as vasa efferentia. The sinuses\\nthat lie between the capsule and the cortex are called mar-\\nginal, those near the hilus and in continuity with the\\nefferent vessels are called terminal sinuses. All sinuses\\nare lined with flat, polygonal, epithelial cells, as are also\\nthe fibers of the reticulum which pass through the sinuses.", "height": "4714", "width": "2869", "jp2-path": "atlasepitomeofsp00drck_0078.jp2"}, "79": {"fulltext": "Tab. 13.\\nv \\\\Kvr i\\n\u00e2\u0096\u00a05 flfci.\\ni\\nj\\nL\u00c3\u00bcfuAnst Reichhold, M\u00c3\u00bcnchen", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0079.jp2"}, "80": {"fulltext": "", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0080.jp2"}, "81": {"fulltext": "THE ORGANS OF CIRCULATION. 47\\nThe lymph flows through the sinuses and receives cells\\nfrom the germinal renter-. The larger blood-vessels run,\\nfor the most part, within the trabecular\\nBy virtue of their peculiar structure and et* their\\nsituation as way-stations in the lymph-stream, the lymph-\\nglands are capable of retaining chemic substances and\\nterm\u00c2\u00ab elements of all kinds which reach them from\\nthe periphery. I [ence, they nearly always are involved by\\ninflammatory processes which run their course in the terri-\\ntory drained by their respective radicle-. Not niy irri-\\ntating substances, hut also substances of indifferent nature\\nare brought to and deposited in the lymph-gland a-, for\\ninstance, blood from hemorrhagic extravasations accom-\\npanied with rupture or opening of the lymph-channel-.\\nThe red corpuscles reach the glands, either tree or in-\\nclosed in cells, and are here changed to pigment masses.\\nGranular and flaky blood pigment may later be carried\\nto the sinuses by lymphocytes.\\nThe peribronchial and other intrathoracic glands are\\nextensively involved in the various forms ^l pneumoconi-\\nosis; and after tattooing, exogenous pigments of various\\nkind- may reach the regional lymph-glands.\\nThe distribution of corpuscular elements in the lymph-\\nglands follows a certain regularity, depending on the phy-\\nsical peculiarities. The line particles are carried by the\\nlymph-stream through the vasa efferentia into the lymph-\\nsinuses, and are deposited in the perifollicular lymph-\\nspaces, either free or inclosed in large, round cells\u00c2\u00ab The\\ncircumstance that in the early stages the granules usually\\nfound free, hut later intracellular, indicates that they\\ntaken up by the cells after they have reached the\\nlymph-glands. From the perifollicular lymph-spaces the\\n3 pass into the follicles and the follicular cords.\\nIn the earlier periods they are found only at the periphery\\nthe follicles, the germinal centers remaining free at\\nfirst the granules are found mostly in .-mall, round cell-;", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0081.jp2"}, "82": {"fulltext": "48 PATHOLOGIC HISTOLOGY.\\nPLATE 14.\\nFig. I. Deposition of Pigment in an Axillary Lymph=gland\\nas a Result of Tattooing on the Forearm. X 300. The lymph-\\nsinuses and peripheral portions of the follicle are filled with large,\\ndark masses of pigment which is partly intracellular.\\nFig. IL\u00e2\u0080\u0094 Mesenteric Lymph gland in Typhoid Fever.\\nX 360. 1, Small artery with partly detached epithelium in the\\nadjacent lymph-sinus are numerous large, round cells, some containing\\ntwo nuclei. Their protoplasmic bodies are infiltrated with fat-droplets\\n[digestive vacuoles (2); furthermore, lymphocytes (3), red blood-\\ncorpuscles, and a granular detritus 4, clumps of typhoid bacilli.\\nlater, also in spindle- and star-shaped cells, which un-\\ndoubtedly belong to the reticulum, as well as in the flat\\ncells, which cover the trabeculse. The nuclei of the cells\\nare sometimes recognizable among the granules, but often\\nthe granules cover them, in which case the occurrence of\\nmasses with regular outlines indicates the intracellular situ-\\nation of the foreign particles. Up to this stage it con-\\ncerns a simple deposition of particles in the glands later,\\nthe follicles and follicular cords may atrophy at the same\\ntime as the connective tissue undergoes hyperplasia, and\\nthus obliterate the lymph-spaces. The capsule becomes\\nmaterially thicker than when it is normal from its inner\\nsurface arise the broadened trabecule, which pass as mas-\\nsive connective-tissue bands into the gland, and at the\\nsame time the reticulum is increased by the proliferation\\nof spindle-shaped and stellate cells, while the lymphoid\\ncells disappear the reticular tissue becomes more and\\nmore fibrous, and eventually it presents a wavy, fibril-\\nlated structure. In time the connective-tissue bands\\nwhich are formed in this way change into broad, glis-\\ntening, anuclear, hyaline beams, similar to those seen in\\nother chronic inflammatory conditions of the lymph-\\nglands.\\nOccasionally, the particles in an overladen lymph-gland", "height": "4716", "width": "2857", "jp2-path": "atlasepitomeofsp00drck_0082.jp2"}, "83": {"fulltext": "Tab. 14.\\n**i\\nV _\\ni\\nMti\\nc^\\n9\\nIj\\n\u00e2\u0080\u00a2a e v\\nv\\ni\\n2\\n2\\nH\\ni\\ni//.sv ERtuhhoUL M\u00c3\u00bcnchen", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0083.jp2"}, "84": {"fulltext": "", "height": "4717", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0084.jp2"}, "85": {"fulltext": "THE ORGANS OF CIRCULATION. 49\\nare transferred to the blood this is especially due to ero-\\nsion of the walls of adjacent blood-vessels by the indur-\\nated and enlarged glands.\\nPathologic pigments originating in the skin and else-\\nwhere may be carried to the lymph-glands, and, under\\ncertain circumstances, the normal cutaneous pigment may\\nlikewise be taken to the glands as, for instance, in syph-\\nilitic leukoderma.\\nWhen phlogistic substances, especially bacteria, are\\nbrought to the lymph-glands from the territory drained\\nby these, then secondary inflammatory foci are produced.\\nThe course of these processes varies, depending on the\\nkind and specific mode of action of the micro-organisms\\nin question. Thus, in suppurative inflammations in the\\nperipheral parts, in erysipelas, and in pneumonic pro-\\nhe corresponding regional lymph-glands severally\\npresent inflammations of the suppurative type. The cap-\\nBule is loosened and richly cellular, and its lymph-vessels\\nare distended with leukocytes; the trabecule may also be\\ninfiltrated with cells the vessels are congested and it is\\nespecially noticeable that the lymph-sinuses are widened\\nat the expense of the follicles and follicular cords. The\\nsinuses also contain masses of leukocytes with fragmented\\nnuclei, as well as red corpuscles in varying numbers, and\\na finely granular, molecular mass, which consists of de-\\ntritus imported from the periphery. The cells of the\\nr ticulum and also the epithelial cells of the glands always\\nundergo marked proliferation in processes of this kind.\\nhen the pyogenic microbes are present in great num-\\nbers, purulent disintegration and abscess formation may\\ntake place in the glands, in which cases the follicles and\\nthe medullary parts become infiltrated with leukocytes\\nwhich crowd out the lymphocyte-. In croupous and\\ndiphtheric inflammations of the mucous membranes the\\nonal lymph-glands are also the seal of exudative pro-\\n!i the sinuses and at the peripheries of the follicles", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0085.jp2"}, "86": {"fulltext": "50 PATHOLOGIC HISTOLOGY.\\nPLATE 15.\\nFig. I.\u00e2\u0080\u0094 Acute Lymphadenitis. Peripheral sinus of a peri-\\nbronchial lymph-gland in croupous pneumonia. X 386. 1, Capsule\\nof the lymph-gland, the fibers loosened and spread apart 2, marginal\\nsinus, containing 3, lymphocytes, 4, leukocytes, 5, enlarged and pro-\\nliferating epithelium, 6, shadows of red blood-corpuscles, 7, granular\\ndetritus.\\nFig. II.\u00e2\u0080\u0094 Large Cellular Hyperplasia of a Lymph=gland in\\nAcute Pernicious Anemia. X 745. The lymph-sinuses are filled\\nwith large, elongated, fusiform, and round cells, which are looked\\nupon as springing from the reticular epithelium. Amoug them are\\nsingle (1) lymphocytes.\\nfibrin is deposited the blood-vessels of the glands may\\nbe occluded by fibrinous plugs.\\nCharacteristic changes occur in the mesenteric and retro-\\nperitoneal lymph-glands in typhoidal disease of the intes-\\ntines Typhoid bacilli are found in large, close, aggre-\\ngated heaps in the greatly swollen and softened glands\\n(medullary infiltration) the blood-vessels are greatly\\ndilated and filled with red and white corpuscles the\\nlymph-sinuses are many times wider than normally, the\\nfollicles correspondingly small and compressed, and at\\ntimes almost unrecognizable in the sinuses are found\\nnumerous, large, protoplasmic cells that often are some-\\nwhat flattened by mutual pressure their nuclei are deeply\\nstained and granular, resembling those of the lympho-\\ncytes frequently a cell contains two or three or more\\nnuclei in the protoplasm are numerous fat-vacuoles. [As\\nshown by Mallory, these cells have marked phagocytic\\nproperties, and the vacuoles may be digestive vacuoles.\\nThe large cells are often seen to contain red blood-corpus-\\ncles, lymphocytes, etc.] These cells appear to originate\\nnot from the fixed cells, but from the lymphocytes whose\\ncytoplasm has greatly enlarged under the influence of the\\ninfection. [Undoubtedly the epithelium of the blood- and", "height": "4714", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0086.jp2"}, "87": {"fulltext": "Tab. to.\\n*5 *V \u00c2\u00ab\u00c2\u00bb\u00c2\u00aen*4\\ni\\nR\\nf\\nt\\nFig.\\nB\\nI.ilh AtlSt R\u00c3\u00a4Chkold, Munt lim", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0087.jp2"}, "88": {"fulltext": "", "height": "4689", "width": "2854", "jp2-path": "atlasepitomeofsp00drck_0088.jp2"}, "89": {"fulltext": "THE ORGANS or CIRCULATION. 1\\nlymph-vessels also may give rise to these cells.] In\\nthe lat; k tensive but circumscribed ureas o\\\\\\nnecrosis develop in the accumulations of these cells at\\nfirst the nuclei stain less deeply, followed by their gradual\\nbut complete fading away the cell-body crumbles into a\\ngranular mass in which the typhoid bacilli remain demon-\\nstrable lor a Ion-- time. [Capillary thrombosis is a\\nprominent cause of the necrosis, j\\nIn acute inflammations of lymph-glands there some-\\ntimes occur- a hyperplasia of large cells. The sinuses\\n\u00c2\u00bbme widened and filled with large, polygonal, spindle-\\nshaped, epithelioid cells with one or more vesicular nuclei.\\nThese cells originate principally from the epithelial cells\\nof the glands, and also in part from the branching, fixed\\nof the reticulum.\\nThe majority of the forms of inflammation mentioned\\nmay pa\u00e2\u0080\u0094 into a chronic stage interstitial inflammation\\nof lymph-glands is at times primaiyand chronic from the\\nstart. In these cases there is connective-tissue hyper-\\nplasia of the reticulum at the expense of the lymphatic\\npassages, the follicles, and the medullary substance. In\\nplace of the extraordinarily fine and fibrillated network\\nthick, anastomosing, fibrous bands are formed, the spaces\\nbetween which become -mailer and -mallei* until they are\\nwholly obliterated. The epithelioid cells change to small,\\nspindle-shaped cells with long fibrillar prolongations.\\nThe folli sist the connective-tissue increase the longest,\\nbut finally they also become so small and so deficient in\\ncells that they are hard to locate in the dense fibrous tissue.\\nHyaline degeneration of the thickened reticulum, which\\nfrequently tak pi. rise to glassy, anuclear scales,\\nsuch as are also seen in the dust diseases of lymph-glands.\\nTuberculosis of lymph-gland an exceedingly common\\nnearly always in the follicles, where the\\ncha tic nodules develop from the accumulation of\\nepithelioid and giant cells formed by the descendants of", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0089.jp2"}, "90": {"fulltext": "52 PATHOLOGIC HISTOLOGY.\\nPLATE 16.\\nFig. I.\u00e2\u0080\u0094 Hyaline Degeneration of the Reticulum of a Lymph\u00c2\u00bb\\ngland in Tuberculosis. X 280. Among the lymphocytes are seen\\nsingle reticular fibers, which are greatly thickened and transformed\\ninto shining, homogeneous, nonnucleated bars (1).\\nFig. II.\u00e2\u0080\u0094 Chronic Indurative Lymphadenitis with Destruc=\\ntion of the Lymph=sinuses and Follicles in Leukemia. X 180.\\n1, Thickened capsule 2, Lymphaclenoid tissue compressed as a result\\nof the new growth of wavy bundles of short fibers of connective tissue.\\nconnective-tissue elements of the reticulum. At the\\nperiphery there is a massing of leukocytes (Baumgarten).\\nThe center of the nodules undergoes caseation, and the\\nconfluence of several caseous areas may give rise to casea-\\ntion involving whole glands or gland packets scrof-\\nula/ because so often observed in swine (skropha). In\\nthe vicinity of the nodules proliferation of the sinus epi-\\nthelium occurs and dilatation of the spaces occasionally,\\ncaseation takes place in such districts of proliferation\\nwithout there having first formed distinct nodules or tuber-\\ncles. The caseous necrosis may extend to the capsule,\\nwhence it may extend to the neighborhood, and lead, per-\\nchance, to perforation of adjacent hollow organs, such as\\nthe trachea, bronchi, and vessels.\\nPLATE 17.\\nFig. I.\u00e2\u0080\u0094 Chronic Indurative Lymphadenitis with Destruc=\\ntion as a Result of Increase of the Reticulum in Leukemia.\\nX 460. (A part of the preceding section.) The lymphocytes (1) as\\nwell as the epithelium are greatly diminished on account of the enor-\\nmously thickened reticulum.\\nFig. II.\u00e2\u0080\u0094 Subacute Tuberculosis of a Lymph=gland. X~0.\\n1, Thickened capsule 2, caseous centers of the tubercles. At the\\nperiphery of the gland the tubercles are still discrete, and between\\nthem lies lymphadenoid tissue. In the center of the gland the\\nnodules have formed larger confluent areas. Numerous giant cells.", "height": "4714", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0090.jp2"}, "91": {"fulltext": "Tab. 16.\\nFuji.\\nV\\nh\\n1\\nJ\\nLi\u00c3\u009cuAnst F, Reichhold, M\u00c3\u00bcnchen.", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0091.jp2"}, "92": {"fulltext": "", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0092.jp2"}, "93": {"fulltext": "e f\\n3\\n.if\\na\\nTab.P-\\nZ\\nM\\ne\\nI\\ni\\ne a v\\n9 w\\nSO -^A\\n-v*\\n1\\nI.ith.An.st HvichhaUl M\u00c3\u00bcnchen", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0093.jp2"}, "94": {"fulltext": "", "height": "4671", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0094.jp2"}, "95": {"fulltext": "THE una ASs OF CIRCULATION. 53\\nTHE SPLEEN.\\nThe hi-, structure of the Spleen presents certain\\nsimilarities to that of the lymph-glands. The capsule,\\ncoalesced with the external peritoneal covering, is com-\\n3ed of rigid, connective-tissue fibers, among which are\\nscattered muscular and elastic elements. In the spleen,\\nalso, the trabecule give rise to an exceedingly delicate,\\ne-like, reticular, connective tissue, which is stretched\\nacross the intertrabecular -pare-, and constitutes the\\nframework of the splenic parenchyma. The trabecule\\nand the reticulum are clothed with large, flat, and peculiar\\nb-shaped epithelial cells. The splenic artery enters\\nthe organ at the hilus, and divide- into branches whose\\nadventitial -heath- at regular intervals are surrounded\\nby oval, nodular accumulations of lymphocytes, called\\nsplenic follicles or Malpighian bodies. The splenic\\nfollicles are built up exactly according to the plan of the\\nlymphatic follicle, like which they also contain germ-\\ninal centers in which lymphocytes are continuously pro-\\nduced.\\nThe arteries rapidly break np into arterial capillaries,\\nwhich, contrary to those of other organs, do aol go over\\ninto capillaries but end in the so-called intermed-\\niate lacunae, which are wide, vascular spaces, hounded by\\nperforated, sieve-like walls, which coalesce to form vein-.\\nThe remaining space in the spleen is occupied by the\\ndied pulp. This i- a place of origin as well as de-\\nstruction o\\\\ red blood-corpuscles. In addition to normal\\nerythrocytes the pnlp contain- also nucleated or em-\\nbryonal red corpuscles, lymphocytes, and other cells in-\\nred blood-discs, ami the various f trans-\\nformation of the blood coloring-matter, and aU a varying\\nMiliar blood-pigmenl a- well a- lyniph-\\neukocytes, and the epithelial cells situated upon\\nthe stroma\u00c2\u00ab", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0095.jp2"}, "96": {"fulltext": "54 PATHOLOGIC HISTOLOGY.\\nPLATE 18.\\nFig. I.\u00e2\u0080\u0094 Passive Hyperemia of the Spleen. X 360. Pulp-\\nspaces overfilled with red blood-corpuscles (1) the capillaries also\\ngreatly dilated (2), their walls traceable for a short distance only.\\nFig. II \u00e2\u0080\u0094Senile Atrophy of the Spleen. X 80. The splenic\\npulp is infiltrated with numerous brownish masses of blood-pigment\\nand occasional lines of spindle-shaped cells. The trabeculae are con-\\nsiderably thinned.\\nVariations in the blood contents of the spleen are ex-\\nceedingly common and, up to a certain degree, physiologic.\\nPermanent delay of the outflow of the blood from the\\nspleen on account of obstruction in the portal circulation\\ngives rise to passive congestion of the spleen.\\nThe peculiar structure of the intermediate lacunae of\\nthe spleen and their close relation to the spaces in the pulp\\nmake it evident that in all congestions of the splenic ves-\\nsels cellular elements from the blood pass out into the\\npulp tissue. In acute passive congestion not only are the\\ncapillaries dilated and filled with red corpuscles, but the\\nred cells pass into the pulp and press its cells apart, so\\nthat they appear to have undergone diminution the\\ntrabecule are also pressed together, and the outer layers\\nof the follicles infiltrated with red cells. Generally, it is\\nextremely difficult, if not impossible, to recognize the walls\\nof the smaller blood-vessels. Microscopically, a spleen\\nin this condition is enlarged and of soft consistency, the\\ncut surface of the pulp is deep red and swollen, so that\\nthe follicles and trabecule are covered over. In passive\\nhyperemia of longer duration reactive changes occur on\\npart of the walls of the vessels and of the stromal frame-\\nwork. The trabecule and the adventitia of the arterial\\nvessels are thickened, and the Avails of the smaller vessels\\nalso become more distinct frequently, the endothelial\\ncells are swollen, rounded, or nearly cubic, and project", "height": "4723", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0096.jp2"}, "97": {"fulltext": "Tab. 18.\\n-a...\\ne\\nS 3 .0\u00c2\u00ab\\nv5 f Jtf\\nLUfuAnst KpicI\u00c3\u00bckiIiI M\u00c3\u00bcnchen", "height": "4625", "width": "2897", "jp2-path": "atlasepitomeofsp00drck_0097.jp2"}, "98": {"fulltext": "", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0098.jp2"}, "99": {"fulltext": "THE ORGANS or CIRCULATION. 55\\ninto the lumen. The reticulum appears increased on ac-\\ncount of the procure of fibrillated tissue. There occurs\\nconstantly a deposition of blood-pigment in the form of\\nbrownish-red, scaly heaps between the connective-tissue\\nfibers, and the large, rounded pulp-cells also contain pig-\\nment granules.\\nPigmentation occurs, further, in old age and also in the\\ncourse of severe cachectic diseases, especially carcinoma,\\nwhen the spleen is usually atrophied. The reticulum is\\nincreased and thickened, and connective-tissue elements\\npredominate. In the adventitial -heath of the vessels\\nand in the pulp abundant, brownish, and granular pig-\\nment occurs in large and small masses, at first intracellu-\\nlar later, almost entirely free. In chronic malaria there\\nis marked pigmentation of the spleen due to the extensive\\ndisintegration of the red blood-corpuscles and the trans-\\nformation of the hemoglobin into a black pigment, some-\\ntime- called melanin. In this condition the spleen is\\noften thickly beset with black masses, at the same time\\nshowing the usual changes due to chronic inflammation.\\nExogenous pigments also occur in the spleen a genu-\\nine anthracosis is-observed, especially in coal-miners, due\\neither to the slow entrance into the blood of pigment-\\nladen cells or to the rupture of enlarged, anthracotic\\nlymph-glands into the lumen of a vein.\\nInfarcts.\\n[nfarcts in the spleen are frequent, and result from the\\nembolic occlusion of arterial branches by fragments of\\nthrombi, endocardial excrescence s, etc. The splenic arteries\\nend-arteries in iohnheim s sense that is, do Dot anas-\\ntomose with each other and consequently the white or\\nanemic infarct is the most frequent Retrograde currents\\nin the veins and extravasations from the capillaries may,\\nhowever, had to a fairly uniform and early infiltration", "height": "4625", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0099.jp2"}, "100": {"fulltext": "56 PATHOLOGIC HISTOLOGY.\\nPLATE 19.\\nFig. L\u00e2\u0080\u0094 Anemic Infarction of the Spleen. X22. 1, Capsule\\nof the spleen 2, completely necrotic and anuclear center of the wedge-\\nshaped infarct 3, dark peripheral zone, which, under the high power,\\nshows numerous small nuclear fragments the infarct has receded\\nsomewhat from the surrounding tissue, and is being encapsulated by\\nfibrous tissue (4).\\nFig. II.\u00e2\u0080\u0094 Hemorrhagic Infarct of the Spleen. 1, Normal\\nzone 2, the infarcted area the spleen-tissue is here necrotic, and the\\nnuclei do not take the stain. The area is filled throughout with red\\nblood-corpuscles 3, transverse sections of blood-vessels their walls\\nare necrotic.\\nwith red blood-corpuscles of the infarct, which then be-\\ncomes red or hemorrhagic. In the subsequent stages the\\nanemic infarcts nearly always present a hemorrhagic\\nborder, due to hemorrhages into the vicinity.\\nSplenic infarcts constantly have a wedge-shaped or\\npyramidal form, the base corresponding to the capsule and\\nthe apex pointing toward the hilus. A fresh anemic in-\\nfarct is a yellowish-white area that projects above the\\nlevel of the healthy tissue, than which it is of greater\\nconsistency. Microscopically, the necrosis, as shown by\\nthe absence of nuclear stain, is sharply defined from the\\nhealthy tissue. The follicles are still recognizable in the\\ninfarct, being somewhat darker in color, without, however,\\npresenting any nuclear structure. These appearances are\\nsoon changed. On account of the loss of fluids the\\nanemic and necrotic area shrinks and appears more or less\\ncollapsed simultaneously, numerous leukocytes accumu-\\nlate about the necrotic area, into which they gradually\\nwander in stained preparations the leukocytic accumula-\\ntion appears as a dark ring. In the mean time prolifera-\\ntion of the preexisting connective tissue about the infarct\\ngives rise to a capsule, which surrounds the dead tissue on\\nall sides and cuts into it. The connective-tissue fibers are", "height": "4721", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0100.jp2"}, "101": {"fulltext": "Tab. 19.\\nr iff.\\n%MM if:-\\nFig. 11.\\ni.iih An.si I Heicliliolti M\u00c3\u00bcnchen", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0101.jp2"}, "102": {"fulltext": "", "height": "4668", "width": "2858", "jp2-path": "atlasepitomeofsp00drck_0102.jp2"}, "103": {"fulltext": "THE OBQANS OF CIRCULATION. 57\\nat first short, mixed with large, spindle-shaped, and\\nrounded cells, and they run parallel with the margins of\\nthe necrotic zone; tor a long time they inclose in their\\nmeshes long rows of lymphocytes; frequently, pigment\\nis present as a resull of the hemorrhage about the mar-\\ngin of the infarct While the connective-tissue capsule\\nincreases in thickness, becoming more and more fibrous,\\nthe inclosed necrotic area dwindles and shrinks and con-\\nnective-tissue processes pass into its substance. Ulti-\\nmately, there remains a hard, contracted sear, in the center\\nof which there may be found a caseocalcareous or calca-\\nreous remnant of the infarct.\\nMultiple embolic scars are frequently observed. In\\nthe case of the hemorrhagic infarct it is to be noted, in\\naddition, that the red corpuscles on disintegration give\\nrise to pigment masses, remains of which are long to be\\nseen in the scar.\\nMicro-organisms, when present in the blood in large\\nnumbers, as may be the case in malignant endocarditis,\\nare filtered especially out by the spleen, whose vessels are\\nn \u00c2\u00bbt rarely closed up by heap- or emboli of microbes. The\\neffects of such emboli are mechanical and inflammatory\\nthe arterial closure produces an anemic necrosis, while the\\nbacteria rapidly swarm through the arterial wall and in-\\nduce ;i circumscribed, purulent inflammation, which may\\niid in an embolic abscess. Occasionally, purulent foci\\nreach tin- capsule of the spleen and the peritoneum, and\\nacute purulent peritonitis may develop in consequence of\\nthe rupture ol an abscess into the peritoneal cavity.\\nAcute Splenic Tumor.\\nBy virtue of it- peculiarly constructed, wide blood-\\nspaces, the spleen constitutes a sponge-like filter, and\\nin consequence it becomes extensively involved in all\\ninflammatory processes in which microbes, or their pro-", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0103.jp2"}, "104": {"fulltext": "58 PATHOLOGIC HISTOLOGT.\\nPLATE 20.\\nFig. I.\u00e2\u0080\u0094 Acute Hyperplastic Splenic Tumor. A teased, fresh\\npreparation. X 300. There are many crescent- and sickle-shaped\\ncells (epithelial), some containing two nuclei (1); also lymphocytes\\n(2), leukocytes (3), and red blood- corpuscles (4).\\nFig. II.\u00e2\u0080\u0094 Acute Hyperplastic Splenic Tumor in Sepsis (ln=\\nfectious Splenic Tumor). Embedded section. X 300. The same\\nelements are seen as in the previous section. The epithelium appears\\nnow as long, spindle-shaped cells (1), or shorter when cut obliquely (2).\\nFig. III.\u00e2\u0080\u0094 Chronic Splenic Tumor Ending in Induration\\nfrom Leukemic Spleen in Chronic Leukemia. X 250. Reticu-\\nlum greatly thickened poorly cellular, fibrillar connective tissue is\\ntaking the place of the richly cellular pulp. In the connective tissue\\nthe remains of the pulp, epithelial cells, lymphocytes, and red blood-\\ncorpuscles are present. At 1 there is a deposit of amorphous masses\\nof blood -pigment.\\nducts, enter the circulating blood, just as the lymphatic\\nglands constitute a filtering apparatus for the lymph-\\nstream. The enlargement of the spleen under such cir-\\ncumstances depends on an increased amount of blood in\\nthe capillaries, especially the venous, the exit of red\\nblood-discs into the spaces of the pulp, the swelling and\\nincrease of the cells of the pulp, and on an importation of\\nnew cells (acute hyperplastic splenic tumor or swelling).\\nGeneral septic processes are usually accompanied with a\\nmarked increase in the volume of the spleen. A fresh\\nsmear preparation of the soft, swollen pulp of a splenic\\ntumor of this kind will be found to contain numerous red\\ncorpuscles large, round, granular, mononuclear cells,\\nwhich often contain whole erythrocytes or fragments of\\nsuch also leukocytes with peculiar and horseshoe-shaped\\nnuclei and especially noteworthy are numerous large,\\nsickle- and crescent-shaped cells drawn out into two fine\\nprocesses. Corresponding to the site of the nucleus\\nthe protoplasmic body is swollen, and often such cells", "height": "4723", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0104.jp2"}, "105": {"fulltext": "Tab. 20.\\n1\\n1\\nr5 f J 1\\nvr\\ni\\n\u00e2\u0080\u00a2\u00e2\u0080\u00a2TT\u00c2\u00bb i*\\n\\\\.*f \u00c2\u00ab-.V v^- r\\nV\u00c2\u00ab\\n/.i/h.Anst F.R\u00c3\u00bcd\u00c3\u00bcwld M\u00c3\u00bcndii", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0105.jp2"}, "106": {"fulltext": "", "height": "4691", "width": "2853", "jp2-path": "atlasepitomeofsp00drck_0106.jp2"}, "107": {"fulltext": "THE ORGANS OF CIRCULATION. 59\\ncontain two nuclei. These last-mentioned cells evi-\\ndently correspond to the fiat cells which normally\\nclothe the -picnic framework probably the epithelium\\nof the capillaries also partake in the formation. At all\\nevents, the fixed cells are greatly increased in sections\\ntheir arched form is, of course, only exceptionally visible\\nisionally, they arc -ecu in short rows, but generally\\nthey are cut across at all possible levels. At times the\\ncell- and nuclei in the splenic pulp undergo disintegration,\\nand large mononuclear lymphatic oells( phagocytes [are seen,\\nladen with fat-droplets and granular, cellular detritus\\noften large area- appear necrotic and tail to take the\\n-tain. Frequently, micro-organisms can be demonstrated\\nin microscopic sections of the spleen, and, as in lymphatic\\nglands, typhoid bacilli are found in characteristic heap-.\\n(Plate 14, Fig. II.)\\nAccumulations of pyogenic bacteria may cause circum-\\nscribed suppurations or -picnic abscesses. In many in-\\nfection- diseases, as diphtheria, scarlet fever, and measles,\\nthe follicles undergo characteristic changes, when they\\nappear much enlarged, stellate, and frequently coalesced.\\nMicroscopically, the follicles are found to contain numer-\\nous, large, polygonal cells, provided with processes,\\nvesicular, and at times misshapen, nuclei, a- well a- fat-\\nvacuoles. Many of these cells are crowded with -mall,\\ndeeply stained, nuclear fragments, which also occur free\\nin the spaces between the cell-. Such appearances evi-\\ndently represent degenerative processes with nuclear dis-\\nintegration.\\nChronic Splenic Tumor.\\nTin-,. nie infectious diseases, especially malaria and\\nsyphilis, and occasionally aU tuberculosis, may produce\\nforms t* splenic swelling that differ markedly from thai\\njust described. In this case indurative changes pre-\\ndominate. The reticulum becomes thickened and i-", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0107.jp2"}, "108": {"fulltext": "60 PATHOLOGIC HISTOLOGY.\\nPLATE 21.\\nFig. I.\u00e2\u0080\u0094 Diffuse Amyloid Degeneration of the Spleen (Bacon\\nSpleen). X 250. The process has as yet not advanced very far. The\\nwalls of all the blood-vessels are uniformly thickened, and the capil-\\nlary and pulp-spaces narrowed. 1, Transverse section of a small\\nartery with a greatly thickened and amyloid wall at the periphery\\nare still seen a few muscle nuclei 2, oblique section of a similar\\nvessel 3, longitudinal section of a small artery 4, capillaries.\\nFig. II. Advanced Diffuse Amyloid Degeneration of the\\nSpleen (Bacon Spleen). Spontaneous amyloidosis in a woman, age\\neighty. X 70. Almost complete destruction of the pulp. The amy-\\nloid bands (1) are not confined to the blood-vessels, but the reticulum\\nis also uniformly affected. The pulp-cells are largely destroyed. The\\nremaining cells are the epithelium of the capillaries and a small num-\\nber of lymphocytes. At 2 there are remains of an atrophied Malpig-\\nhian corpuscle.\\nchanged into a densely fibrillated tissue, which is distin-\\nguished with difficulty from the trabecule. The lym-\\nphatic cells are crowded out, and the capillary spaces are\\nnarrowed and contain but few blood-corpuscles. The\\nfollicles are small and widely separated, containing but few\\nlymphocytes. Brownish blood-pigment is found quite con-\\nstantly between the connective-tissue fibers. A spleen like\\nthis is naturally hard, firm, pale in color, and dry often\\nthe pigment gives the tissue a distinctly brownish tinge.\\nPLATE 22.\\nFig. I.\u00e2\u0080\u0094 Amyloid Degeneration of the Spleen (Sago Spleen).\\nX24. 1, An amyloid follicle, in which are seen only a few nuclei\\nthe blood-vessels, in transverse section, have also undergone amyloid\\ndegeneration 2, compressed pulp-spaces 3, trabecule.\\nFig. II. Amyloid Degeneration of the Spleen (Sago\\nSpleen). X260. 1, Follicle that has undergone amyloid degenera-\\ntion, only few islands of cells remaining 2, transverse sections of\\nblood-vessels with broad, glistening (amyloid) walls 3, normal pulp.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0108.jp2"}, "109": {"fulltext": "Tab. 21.\\n_tV\\nc ft M\\nff \u00c2\u00bbSV\\n:Vi\\nuC-.?Ml\\n3 r 3 c\\nl\\nFig\\nl.iIh.\u00c3\u0084n.st HpicIiIwUI Mi uulun", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0109.jp2"}, "110": {"fulltext": "", "height": "4688", "width": "2859", "jp2-path": "atlasepitomeofsp00drck_0110.jp2"}, "111": {"fulltext": "Tab. 22.\\nFiff.j.\\nVi* 1,\\ni\\nReichhold M\u00c3\u00bcnchen,.", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0111.jp2"}, "112": {"fulltext": "", "height": "4655", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0112.jp2"}, "113": {"fulltext": "THE ORG ASS OF CIRCULATION. 1)1\\nDefeneration.\\nAmyloid degeneration of the spleen is frequent; usu-\\nally, it occurs in connection with amyloidosis of other\\norgans, such as the kidney, liver, and intestine rarely,\\nthe change is confined to the spleen. As elsewhere, the\\nchange begins in the walls of the smaller arteries later,\\nthe capillary walls arc involved, and then the other struc-\\ntures. It is [uite peculiar that in the spleen amyloid\\ndegeneration occurs in two macroscopically differenl forms,\\naccording to the localization of the process. The degen-\\neration is either diffuse, when it lead- to a uniform in-\\ncrease in the size and the consistence of the spleen, which\\nha- a characteristic, lardaceous, and glistening appearance,\\nor it is confined to the Malpighian bodies, which are\\nalv enlarged, glistening, and prominent, appearing on\\nthe cut surface as swollen grains of sago (sago spleen).\\nIn the former instance the early stages -how characteristic\\nchanges: the arterial wall- are greatly thickened and ap-\\npear as homogeneous, glistening rings surrounded by the\\ncell- of the adventitia. Oblique section- of such vessels\\nappear a- -olid piece- of amyloid substance. The capil-\\nlaries are unusually plain and sharply outlined, forming\\nuniformly colored hand-, or ribbons, when stained with\\ndiffusely staining anilin dye.-. In the early stages the\\nepithelium i- -till present, but tin- is soon h\u00c2\u00bbt here and\\nthere. The Bpaces of the pulp become -mailer, and the\\nnumber of cells i- reduced soon the degeneration spreads\\nt\u00c2\u00ab the reticulum, whose fibers become broader and finally\\ncoalesce in places the reticular -pace- become lined with\\nflat and spindle-shaped cells, and the amount of blood\\npresent i- reduced tin- follicles also become smaller, hut\\nremnants persist into the latest stages.\\n8 _ spleen i- different in this case the degeneration\\nbegins in the arteries, which bore their way through the\\nfollicles the so-called arterise penicillate) j their wall", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0113.jp2"}, "114": {"fulltext": "62 PATHOLOGIC HISTOLOGY.\\nPLATE 23.\\nFig. I.\u00e2\u0080\u0094 Spleen in Acute Leukemia. X 300. The pulp is\\nloaded with mononuclear, small round cells (lymphocytes), and larger\\ncells (myelocytes). 1, Capillary epithelium.\\nFig. II. Staphylococcal Embolism of the Spleen in Pyemia.\\nX 70. Two follicles are seen in the field with their arteries in trans-\\nverse section, filled with colonies or clumps of cocci (stained by Gram s\\nmethod) (1); between the follicles is the pulp (4); at 2 a clear zone is\\nseen surrounding blood-vessels in transverse section. The follicular\\ntissue consists largely of lymphocytes. The thickened, darker, outer\\nzone is due to the presence of large numbers of leukocytes (pus-cells)\\nearly stages of the embolic abscess.\\nbecomes broadened, and the media is changed into a broad,\\nglistening band. The degeneration next extends to the\\nadjacent structures, being at first limited to the follicles,\\nthe lymphoid cells of which rapidly disappear, their place\\nbeing taken by a homogeneous material, which evidently\\narises from the follicular reticulum. Viewed under\\nhigher magnification, the follicles show coalescing cords,\\nwhich still inclose small groups of lymphoid cells, while\\nthe degenerated vascular walls remain clearly defined.\\nGradually, the follicles become larger and larger, and\\ncrowd out the intervening pulp and capillaries, but in\\npure forms of sago spleen the generally homogeneous and\\nglistening appearance of the pulp is not produced. Occa-\\nsionally, however, the two forms are combined, the amy-\\nloid change taking place in the follicles as well as in the\\npulp.\\nThe histologic changes in the spleen in leukemia and\\npseudoleukemia are quite characteristic. These two dis-\\neases differ in this respect, that in acute leukemia the pro-\\nportion between the red and white blood-corpuscles changes\\ngreatly in favor of the leukocytes, while in pseudoleuke-\\nmia there is no such marked increase of the leukocytes,\\nthe swelling of the lymphatic organs being, however,", "height": "4717", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0114.jp2"}, "115": {"fulltext": "Tab.23.\\nB*\\nFig. L\\nm\\nFig ii.\\nJ.iifi. Anst Reid\u00c3\u00bcwld, M\u00c3\u00bcnchen", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0115.jp2"}, "116": {"fulltext": "", "height": "4640", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0116.jp2"}, "117": {"fulltext": "THE ORGANS OF CIRCULATION. do\\nsimilar to that in leukemia. In both diseases the Volume\\nof the spleen increases to many times above 1 the normal.\\nAcute and chronic changes are recognizable. In the first\\nthe space- in the pulp and the capillaries are widened and\\ntilled with mononuclear cells, while the red corpuscles tall\\ninto the background and the epithelial cells are only occa-\\nsionally visible. The Malpighian bodiesare greatly hyper-\\nplastic, and their limit- from the surrounding tissue indis-\\ntinct. At time- the follicles only are enlarged, being\\nreadily distinguishable from the darker pulp as grayish-\\nwhite nodules. In the pure, -picnic form of leukemia\\nthe -mall, mononuclear lymphocytes principally predomi-\\nnate. In addition may occur large colorless cells with\\noval or round nuclei and a granular, eosinophilic proto-\\nplasm such cells are found especially in the so-called\\nmyelogenic leukemia.\\nLater, the lymphatic hyperplasia of the spleen dis-\\nappear- frequently, larger areas undergo a uniform necro-\\nsis, such as is seen in infarcts. There develops a thick-\\nened stroma, the reticulum becomes fibrillated, as in the\\nchronic infectious swellings of the spleen, and brownish\\nblood-pigment accumulates about the follicles finally, the\\nspaces in the pulp become obliterated on account of the\\nincreasing amount of connective-tissue formation only\\nthe narrowed capillaries persist. The consistency of the\\nspleen i- greatly increased, being often almost wooden.\\nTubercles in the spleen are frequently encountered in\\neral miliary tuberculosis. The nodules occur thickly\\nin the pulp underneath the capsule, the follicle- generally\\nremaining intact. Larger, conglomerate tubercles in the\\nspleen are observed frequently in children, a- well as in\\nmany animals, especially swine, guinea-pigs, and monkeys.\\nI ll histologic structure of the tubercles is the same as that\\nf other organs.", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0117.jp2"}, "118": {"fulltext": "64 PATHOLOGIC HISTOLOGY,\\nPLATE 24.\\nFig. I.\u00e2\u0080\u0094 Tuberculosis of the Spleen. X 92. Two tubercles\\nare seen situated beneath the capsule 1, Thickened fibrous capsule\\n2, trabecular 3, caseated centers of the tubercles 4, giant cells.\\nFig. IL\u00e2\u0080\u0094 Central Portion of a Spleen -follicle in Diphtheria.\\nX 745. There are seen numerous, large, polygonal cells with vesic-\\nular, swollen nuclei (1), some are filled with small, dark, nuclear\\nfragments (2), also free chromatin granules (3).\\nTHE BONE=MARROW.\\nIn the adult the bone-marrow is the principal seat\\nof production of red corpuscles. The shafts and the dis-\\ntal epiphyses of the long bones contain the yellow, fatty\\nmarrow all other bones, the red marrow. The red\\nmarrow consists of an extremely fine reticulum, in which\\nthe cellular elements and the vessels are suspended.\\nHere are found, first of all, the so-called myelocytes, or\\nmarrow-cells, which are ameboid cells of the type of lym-\\nphocytes, but with larger, though less chromatic, nuclei\\nlymphocytes, such as are found in the blood large proto-\\nplasmic cells with regularly fragmented, lobulated nuclei,\\nor many nuclei, the giant cells of the marrow, or mye-\\nPLATE 25.\\nFig. I.\u00e2\u0080\u0094 Bone=marrow from the Diaphysis of the Humerus\\nin Pernicious Anemia. X 520. The normal fat of the marrow has\\nalmost disappeared. At 1 only a few fat-cells or fat-vacuoles are seen;\\nthe number of cells in the marrow is greatly increased 2, white mar-\\nrow-cells, myelocytes 3, the same with several nuclei 4, nucleated,\\nred blood-corpuscles 5, cells containing red blood-corpuscles 6,\\neosinophilic cells between the cells a fine fibrillar reticulum.\\nFig. IL\u00e2\u0080\u0094 Bone=marrow in Acute Leukemia from the Di=\\naphysis of the Femur. X 640. The fat of the marrow has disap-\\npeared here also. 1, Erythrocytes 2, myelocytes, greatly increased\\nin number 3, lymphocytes between the cells is the reticulum.", "height": "4714", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0118.jp2"}, "119": {"fulltext": "Tab. 24.\\n\u00e2\u0096\u00a0t\\nF,g.l.\\n*_ \u00c2\u00abU\\n\u00e2\u0080\u00a2fe\\n,v\\nO.\\nc\\n\u00c2\u00ab\u00c2\u00abP CID\\nv-i.\\n\u00e2\u0080\u00a2\u00e2\u0080\u00a2/v\\n2\\n.i//.s7 Reichhold, M\u00c3\u00bcnchen.", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0119.jp2"}, "120": {"fulltext": "", "height": "4665", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0120.jp2"}, "121": {"fulltext": "Tab. 17.\\n6 4\\n\u00e2\u0080\u00a2\u00c2\u00ab\u00e2\u0080\u00a24\\ni.\\ni\\nP* ,C\\nV 7- Jpg* (B\\n1 Vifj. II.\\n/.tili Inst Reichhold,, M\u00c3\u00bcnchen\\nW", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0121.jp2"}, "122": {"fulltext": "", "height": "4609", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0122.jp2"}, "123": {"fulltext": "THE ORGANS OF CIBC\u00c3\u009cLATIOK 65\\nloplaxes nucleated red blood-cells, the forerunners of\\nthe erythrocytes rounded cells, whose protoplasm con-\\ntains hemoglobin, the nuclei being small and dense\\neosinophile cells and ml blood-corpuscles.\\nThe venous capillaries of the hone-marrow are wide,\\nand have sieve-like openings in the walls, like the splenic\\nlacume.\\nThe yellow marrow consists only of connective tissue\\nand fat; it develops by fatty changes in the red marrow\\nin postfetal life.\\nThe so-called gelatinous marrow is found in emaciated\\nand cachectic individual-, and is the result of fat atrophy\\nin the yellow marrow.\\nFocal necrosis of the bone-marrow occur- in certain in-\\nfectious diseases, especially in variola, typhus, and typhoid\\nfever.\\nThe bone-marrow presents quite a characteristic ap-\\npearance in those diseases that produce changes in the\\nserum and the cells of the blood, such as pernicious\\nanemia and leukemia. In pernicious anemia the yellow\\nmarrow of the long hone- changes to red marrow, which\\ncontain- all the element- normally found in this -ort of\\nmarrow, such a- marrow-cells, giant cell-, eosinophilous\\ncells, and nucleated red corpuscles, flic last, as well as\\nnonnucleated, red corpuscles, may assume a remarkably\\nlarg nacroerythrocytes, Ehrlich) some may contain\\ntwo or more -mall, dense nuclei. In addition, there are\\nusually found numerous cells containing blood-corpuscles\\nthese cells are presumably marrow-cells, idled with red\\nblood-corpuscles, which have undergone disintegration and\\nhave been taken up by the phagocytic cells. The fat-tissue\\ni- usually reduced to a minimum.\\nIn leukemia yellow marrow i- also commonly changed\\ngrayish-red or red in the mosl advanced stages it\\nbecomes ud puriform, a- in the myelogenic form of\\nleukemia, in which tin- change in the marrow i- regarded\\n5", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0123.jp2"}, "124": {"fulltext": "66 PATHOLOGIC HISTOLOGY.\\nas a primary condition. The reticulum contains marrow-\\ncells in large numbers that is, large, round cells with a\\nnarrow, protoplasmic ring and large, lightly stained,\\nround or oval nuclei, from which the smaller and dark\\nnuclei of the lymphocytes are sharply differentiated. In\\nthis form the blood is also loaded with myelocytes. The\\nfat-tissue may be crowded out completely.\\nThe infectious processes in the bone-marrow, as sup-\\npurative and tuberculous osteomyelitis, are considered in\\nconnection with diseases of the bones.", "height": "4681", "width": "2963", "jp2-path": "atlasepitomeofsp00drck_0124.jp2"}, "125": {"fulltext": "II. RESPIRATORY ORGANS.\\nTHE NOSE.\\nThe mucous membrane of the nose is lined with a\\nsingle layer of ciliated epithelium, exec])! in that part of\\nits cavity known as the auricle, which is covered by\\nstratified, flat epithelium. Under the epithelial covering\\nis a stratum proprium, richly infiltrated with leukocytes.\\nThe epithelium of the olfactory region carries the special\\nolfactory cells. peculiarly transformed ganglion cells,\\nwhich communicate with the olfactory lobes by means of\\nnerve-fibers that originate at the base of the cells. The\\nstratum proprium also contains alveolar glands. The\\nloose submucous tissue supports a well-developed plexus\\nof vein-.\\nOne of the most frequent pathologic processes in the\\nnasal mucous membrane is the so-called nasal catarrh, or\\ncoryza. Histologically, this is characterized by great hy-\\nperemia, edema, and increased secretion of the glands, so\\nthat many of their cells are converted into goblet cells.\\nlet cells also appear among the ciliated surface cells.\\nThe Leukocytes of the stratum proprium are increased\\nthey penetrate the epithelium and become mixed with the\\ntion, which, in proportion to the Dumber of cells,\\nassumes a more or less well-marked purulent character.\\nI squamated epithelial cells also become mixed with the\\netion, which, furthermore, contains bacteria among\\nwhich diplococci and Friedender pneumobac\u00c3\u00bclus pre-\\ndominate staphylococci are also met with.\\n67", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0125.jp2"}, "126": {"fulltext": "68 PATHOLOGIC HISTOLOGY.\\nShould the catarrh become chronic under the influence\\nof long-continued, injurious agencies, then the mucous\\nmembrane becomes thicker than normal on account of the\\nextensive development of the veins and of the increase of\\ntissue in the stratum proprium. The stroma of the mu-\\ncous membrane is infiltrated with young connective tissue\\nand round cells, and the glands are enlarged and greatly\\nconvoluted. In the latter stages it is common to find an\\natrophy of the whole mucous membrane. The glands\\nshrink and disappear the vessels show a marked thick-\\nening of their walls with narrowing of the lumen, which\\nmay become wholly closed. The mucous membrane\\nbecomes dry, the epithelium falls oif or is much atrophied,\\nthe cells in the stratum proprium and the submucosa\\ndisappear, and a thin layer of stiff connective tissue\\ndevelops. Such atrophic changes are generally found in\\nconnection with processes that are designated as ozena\\nulcers in the altered mucous membrane are also occasion-\\nally found.\\nChronic catarrh of the nasal mucous membrane is\\nnot infrequently associated with the development of cir-\\ncumscribed and, later, pedunculated swellings or polypi,\\nthe structure of which resembles that of the mucosa the\\nstroma is fibrous connective tissue, which is more or less\\nswollen by virtue of an accumulation of edematous fluid in\\nits meshes at times this may give it a typical myxomatous\\nappearance, especially when the fluid contains mucinous\\nsubstances the nuclei become spindle-shaped, and when\\nthe cell-body can be demonstrated, it is found to present\\nnumerous radiating processes. In addition, the spaces of the\\ntissue contain numerous round cells, of the type of lymph-\\nocytes, which are found especially numerous in the vicin-\\nity of the vessels, and also some polymorphonuclear leuko-\\ncytes. The glands of the normal mucous membrane are\\nfound also in the polypoid outgrowth not infrequently, the\\nglands show an extraordinary development, and when their", "height": "4717", "width": "2984", "jp2-path": "atlasepitomeofsp00drck_0126.jp2"}, "127": {"fulltext": "\u00c3\u009cESPIXATOSY OBGANS. 69\\nducts are closed or narrowed, cystic dilatations result, which\\nmay become so large and so numerous that they constitute\\nthe principal mass of the polyp (cystic polyp). The sur-\\nface of these new formations are covered with cylindric\\nepithelium at least, in their earlier stages; later, the\\nepithelium may become much reduced or even wholly de-\\nstroyed. On the whole, these polyps are best regarded\\nas fibromata, which, when edematous, approach the type\\nof myxomata. The word polyp does not convey any idea\\nof the histologic structure of the growth; it refers only\\nto the ur form e., a pedunculated growth, no matter\\nwhether it is a fibroma, -arc\u00c2\u00bb una, or epithelioma.\\nInfectious processes, such as tuberculosis, syphilis, and\\nglanders, are met with in the nasal mucous membrane.\\nThe tuberculous and syphilitic lesions differ in no way\\nfrom the same processes as they occur in other mucous\\nmembranes; and the nodules of glanders, which may de-\\nvelop upon the nasal lining of man and animals, are also\\ncomposed of epithelioid cells derived from the fixed cells\\nand lymphocyte- and leukocytes. Central necrosis\\noccur- early, and may lead to perforation of the free sur-\\nface and the formation of sinuous ulcer-.\\nDiphtheria of the nose, which is not so infrequent, pre-\\nsents n histologic peculiarities, and further reference is\\nmade t what i- -aid concerning diphtheria of the larynx,\\ntrachea, and the pharynx.\\nLARYNX, TRACHEA, AND BRONCHI.\\nThe larynx, trachea, and bronchi are covered by a mu-\\ncous membrane lined with ciliated cells. Each epithelial\\ncell passes through the entire thickness of the epithelial\\nering, hut on account of mutual pressure the form may\\nh\u00c2\u00ab varying, Buch a- conic and spindle-shaped. The\\nnuclei are situated at the broadest part of the cell, and,", "height": "4691", "width": "2847", "jp2-path": "atlasepitomeofsp00drck_0127.jp2"}, "128": {"fulltext": "70 PATHOLOGIC HISTOLOGY.\\nPLATE 26.\\nFig. I.\u00e2\u0080\u0094 Diphtheria of the Trachea. (Bird s-eye view.) X 18.\\n1, Cartilage of the trachea 2, mucous glands 3, infiltrated sub-\\nmucosa 4, false membrane on the mucous surface, composed of fibrin\\nand necrotic elements.\\nFig. II.\u00e2\u0080\u0094 Diphtheria of the Trachea. X 130. Weigert s fibrin\\nstain. 1, Infiltrated tissue of the tunica propria 2, fibrin layer, cov-\\nering the largely necrotic mucous membrane 3, remains of epithe-\\nlium 4, peripheral layer of the diphtheric pseudomembrane, consist-\\ning of nuclear fragments and leukocytes 5, nonnucleated necrotic\\nmasses.\\nconsequently, they occur at varying levels, so that at first\\nglance the impression is given of several layers of cells.\\nThe thread-like, basal processes of the cells end in a\\ndense, homogeneous basement membrane. Normally,\\nthere are found in the epithelium a large number of gob-\\nlet cells whose protoplasm is the seat of mucoid change.\\nIn the larynx, however, the most exposed parts, the parts\\nsubjected to the most movement, are supplied with a more\\nsubstantial and more protective covering namely, strati-\\nfied, squamous epithelium situated upon the basal layer\\nof cylindric cells is the stratum Malpighii with its char-\\nacteristic prickle cells. The parts thus covered are the\\nfree margins of the epiglottis, a part of its upper and\\nlower surfaces, the region between the arytenoid cartilages,\\nand the vocal cords. Under the basement membrane\\nlies a stratum proprium composed of fibrillated connec-\\ntive tissue, elastic elements, and blood-vessels scattered\\nthroughout are numerous lymphocytes. In some points\\nof the larynx and trachea the accumulation of lympho-\\ncytes becomes more dense, a true lymphadenoid tissue\\nbeing formed and at times complete lymph-follicles\\nresult (posterior surface of epiglottis). The stratum\\nproprium of the true vocal cords is, for the most part,\\ncomposed of stiff, parallel, elastic fibers. The glands", "height": "4714", "width": "2973", "jp2-path": "atlasepitomeofsp00drck_0128.jp2"}, "129": {"fulltext": "Tab.26.\\nFiff.I.\\nFig. u.\\nI, i lh. Anal E Reuhhold, Manchen", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0129.jp2"}, "130": {"fulltext": "", "height": "4665", "width": "2985", "jp2-path": "atlasepitomeofsp00drck_0130.jp2"}, "131": {"fulltext": "RESPIRATORY ORGANS. 71\\nin the submucosa and in the deeper layers of the stratum\\nproprium belong to the compound, alveolar, mucous glancte.\\nThe cells, which produce mucus, are cubic or goblet- or\\nballoon-shaped. The gland ducts are lined with cylin-\\ndric epithelium, which may be provided with cilia for a\\ndistance into the duct. There are do aland- at all in the\\ntrue cords. The submucosa of the larynx is separated\\nfrom the cartilage by muscular tissue in the trachea and\\nlarger bronchi a -mall amount of tat and of connective\\ntissue separates the submucosa from the internal perichon-\\ndrium. The cartilage is hyaline except in the epiglottis,\\nthe cartilages of Santorini and of Wrisberg, which are\\ncomposed f elastic r reticular cartilage. The external\\nsurface of all the cartilages is covered by fibrous, ex-\\nternal perichondrium.\\nAs in the nose, simple catarrh is the most frequent form\\nof inflammation in the larynx. In the acute form there\\nare diffuse swelling and redness of the mucous membrane.\\nThe vessels are distended, and frequently small hemor-\\nrhages are observed. The stratum proprium of the\\nmucosa, a- well a- the submucosa, are more or les\\ncrowded with leukocytes, which infiltrate the epithelium\\nalso and appear in the secretion. Small losses of substance\\nfrequently appear in the epithelial lining, due mucous\\n-land- are -wollen and in a condition of hypersecretion;\\nnumerous goblet cells appear among the cylindric cells of\\nthe lining.\\nIn the course of the infection- diseases, especially\\ntyphoid fever, numerous bacteria, principally staphylococci\\nand streptococci, lodge upon the loosened epithelium,\\nwhich they probably also penetrate. The collection of\\nleukocytes in the mucous membrane increases greatly\\nthe superficial parts of the infiltrated area may become\\nnecrotic, and on being cast off ulcers form whose wall- and\\nfloors are formed by the pus-cells. In the vicinity the\\nepithel\u00c3\u00bci appear without nuclei and are often occupied by", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0131.jp2"}, "132": {"fulltext": "72 PATHOLOGIC HISTOLOGY.\\nPLATE 27.\\nFig. I. Ulcer of the Larynx in Typhoid Fever. X35. 1,\\nThe epithelium still present around the border of the ulcer (stratified\\nsquamous epithelium, vocal cord) 2, epithelium falling off toward\\nfloor of the ulcer, over which it is completely necrotic 3, bacterial\\nmasses 4, tunica propria of the mucosa infiltrated with leukocytes\\n5, sections of blood-vessels; 6, mucous glands; 7, transverse section\\nof striated muscle-fibers.\\nFig. IL\u00e2\u0080\u0094 Pachydermia Laryngis. X 60. 1, Cylindric epithe-\\nlium 2, area of transition into (3) stratified squamous epithelium\\n4, papillary body 5, dilated blood-vessels of tunica propria 6,\\nmucous glands.\\nheaps of cocci. Similar ulcerations occur in the larynx in\\nvariola.\\nIn chronic catarrh the entire mucous membrane is\\nthicker than normal, due to infiltration of round cells,\\nwhich occur chiefly in small masses, and to the increase of\\nthe fixed connective-tissue elements of the stratum pro-\\nprium. The mucous glands are enlarged, frequently their\\nducts are plugged by secretions, when the overlying epi-\\nthelium is liable to be pushed forward a little so that the\\nsurface of the mucous membrane appears granular (granu-\\nlar laryngitis).\\nIn chronic catarrh of the larynx the epithelial covering\\nis the seat of the most important changes. Where strati-\\nfied squamous epithelium is present (margins of epiglottis,\\ninterarytenoid region, margins of vocal cords), the layers\\nbecome increased in number, and in the superficial ones\\nhornification is likely to occur. Squamous epithelium may\\nalso appear in places normally covered by cylindric cells\\nbut which have fallen off; such islands of flat cells may\\ncoalesce to form larger areas, which may be recognized\\nmacroscopically as whitish, usually definitely circum-\\nscribed thickenings of the mucous membrane, known as\\npachydermia laryngis (Virchow). Underneath the epi-", "height": "4691", "width": "2959", "jp2-path": "atlasepitomeofsp00drck_0132.jp2"}, "133": {"fulltext": "Fuf.l.\\nTab. 27.\\n6 F\u00c3\u00bcf.2-\\nLitli.Anst Reichhold, M\u00c3\u00bcnchen.", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0133.jp2"}, "134": {"fulltext": "", "height": "4669", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0134.jp2"}, "135": {"fulltext": "BESPIBATOXY ORGANS.\\n73\\nthelium a papillary body may form, the vascular papilhe\\nat times growing in length so that warty excrescences!\\nirregular thickenings, and branching polypoid outgrowths\\narc produced. A large part of the so-called laryngeal\\npolypi owe their development to such chronic catarrhal\\nconditions.\\nIn children croupous and diphtheric inflammations of\\nthe upper air-passages arc frequent. The characteristic\\nfeature of such processes is the formation of fibrinous\\nmembranes associated with necrosis oi the mucosa. AVhen\\nthe membrane is easily removable and only the superficial\\nlayers of the mucosa undergo necrosis, the term croup is\\nusually applied but when the fibrinous membrane extends\\ninto the tissue of the mucosa because the necrosis involves\\nthe deeper layer- of the mucous membrane, then the con-\\ndition is anatomically a true diphtheric inflammation, no\\nmatter whether caused by L\u00c3\u00b6ffler s bacillus or by strepto-\\ncocci, or by chemic agents.\\nIn both cases the fibrinous membrane presents a retic-\\nular structure. Between the fibrinous threads lie leu-\\nkocytes and desquamated, more or less necrotic, cells.\\nIn croup this layer of fibrin simply covers the mucous\\nmembrane, which retains its normal structure though\\nusually thickly infiltrated with leukocyte- the superfi-\\ncial epithelium i- the only part that undergoes necrosis,\\nbut after the separation of the false membrane perfect\\nregeneration of the epithelium usually takes place. In\\ndiphtheria, on the other hand, the precipitation of fibrin\\nrids into the deeper layers of the stratum proprium,\\nwhich thereby lose their distinctness and become ne-\\ncrotic. Between the layers of fibrin are seen the ami-\\nclear scales of the dead epithelium. The gland ducts are\\nusually covered by membrane, so thai the secretion ac-\\ncumulates in the glands, which may also fall victims to\\nnecrosis. At the border of necrotic tissue is found a\\nwall of leukocytes of considerable thickness, which cir-", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0135.jp2"}, "136": {"fulltext": "74 PATHOLOGIC HISTOLOGY.\\nPLATE 28.\\nFig. I.\u00e2\u0080\u0094 Tuberculosis of the Larynx. X 16. The epithelium\\nis completely destroyed and is absent at many places. The free sur-\\nface is formed by the floor of the tuberculous ulcer, which resulted\\nfrom the growth of tubercles in the submucosa, and the tunica propria\\nof the mucosa, and upward extension, the tubercles coalescing and\\nbreaking through the epithelial lining. At times the caseous centers\\nof the tubercles, and at times their richly cellular peripheries, are seen\\non the free border of the ulcer. 1, Deep-seated tubercle in submu-\\ncosa 2, remains of mucous glands j 3, cartilage.\\nFig. II. Tuberculosis of a Large=sized Bronchus. X54.\\nEpithelium entirely disappeared. 1, Cartilage 2, mucous glands, the\\ninterstitial tissue of which is greatly iniiltrated 3, tubercle, with\\nbeginning caseation of the center and numerous giant cells 4, greatly\\ndistended blood-vessels, reaching to the surface of the ulcer.\\ncumscribes the area doomed to mortification. The sepa-\\nration of the dead tissue, iniiltrated with fibrin, leaves a\\ndeep defect, the diphtheric ulcer, which in healing\\noften gives rise to extensive cicatricial deformation of the\\nmucous membrane usually, the mucous glands are per-\\nmanently lost in such areas.\\nTuberculosis of the larynx is frequently associated with\\npulmonary tuberculosis, to which it is usually secondary\\na primary laryngeal tuberculosis is much more rare. The\\nmacroscopic appearances and the histologic characteristics\\nvary greatly. In the early stages are found small, sub-\\nepithelial, more rarely submucous, nodules, which are\\ncomposed of round and epithelioid cells, and frequently lift\\nup the epithelium. With increasing growth the central\\nnecrosis, which is quite constant, also increases, several\\nneighboring areas may coalesce, or solitary nodules increase\\nand break through the superficial epithelium and dis-\\ncharge the caseous and necrotic material in the center\\nthus arise sinuous ulcerations with overhanging margins.\\nSimultaneously, the caseating infiltrations may extend", "height": "4691", "width": "2973", "jp2-path": "atlasepitomeofsp00drck_0136.jp2"}, "137": {"fulltext": "Tab. 28.\\nvz\\ntf\u00c3\u009ci M\\ni\\na\\n41\\ni^./.\\n_\\nLUfuAnst Reichhold, Manchen,", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0137.jp2"}, "138": {"fulltext": "", "height": "4637", "width": "2984", "jp2-path": "atlasepitomeofsp00drck_0138.jp2"}, "139": {"fulltext": "KESPIEATO\u00c3\u009fY ORGANS. 75\\ndownward and involve the perichondrium, which is de-\\nstroyed, bo that the cartilage is laid bare (tuberculous\\nperichondritis), and eventually larger and smaller ne-\\ncrotic pieces may be exfoliated.\\nIn addition to this common form of ulcerative tuber-\\nculosis of the larynx other varieties also occur that\\noftenest arc recognized as tuberculosis only by the micro-\\nscopic examination in these varieties distinct nodules\\nand ulcer- may not be formed, but large, often extensive,\\npolypoid excrescences, composed of a diffuse, tuberculous,\\ngranulation tissue with epithelioid and giant cells. Dis-\\nintegration and ulceration frequently appear late in this\\nso-called polypoid, laryngeal tuberculosis.\\nLike tuberculosis, syphilis of the larynx may cause\\ngranulomatous areas, which disintegrate and form ulcers\\ngummatous laryngitis; extensive necrosis of the laryn-\\ngeal wall may result, and especially of the epiglottis,\\nloading to sequestration of large portions. Healing and\\ncicatrization of syphilitic defects frequently lead to exten-\\nsive connective-tissue formations, followed by contractions\\nand narrowing of the larynx and trachea.\\nLeprosy and glanders produce laryngeal nodules and\\nulcers, whose true nature is recognized by microscopic\\nexamination and the demonstration of the specific mi-\\ncrobes.\\nTRACHEA, BRONCHI.\\nThe diseases of the trachea and larger bronchi are\\nhistologically similar to those of the larynx. The dis-\\nof the smaller and smallest bronchi are to bo studied\\nin connection with the surrounding lung tissue.\\nAcute trachea] and bronchial catarrh manifest them-\\nselves by desquamation of the epithelial cell-, enlargement\\nthe mucous glands, marked vascular injection, and more\\nor less leukocytic infiltration of the epithelium and strar", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0139.jp2"}, "140": {"fulltext": "76 PATHOLOGIC HISTOLOGY.\\nPLATE 29.\\nFig. I.\u00e2\u0080\u0094 Ectasia of a Small Bronchus. X10. 1, Irregularly\\ndilated lumen the epithelium, the whole of the mucosa, and a large\\npart of the submucosa have disappeared at 2 a small portion of car-\\ntilage is still present the wall is greatly infiltrated with round cells,\\nand penetrated throughout with numerous blood-vessels filled with\\nblood (3). Externally, a dense, fibrillar, connective tissue is seen in-\\nfiltrated with dust.\\nFig. IL\u00e2\u0080\u0094 Bronchiectatic Wall. X 127. (Part of the foregoing\\nsection.) 1, Lumen 2, cartilage; lacunae in cartilage, dilated and\\nfilled with leukocytes 4, dilated blood-vessels, filled with blood.\\ntum proprium. When the catarrh becomes chronic, then\\nthe swelling of the mucous membrane may persist but in\\nthe later stages the opposite may occur namely, atrophy.\\nThe desquamated epithelium is not replaced, the stratum\\nproprium and the submucosa become thin, deficient in cells,\\nstiff, and fibrous the glands shrink and in part disap-\\npear. Macroscopically, the mucous membrane is pale,\\nthin, adherent to the cartilages, and traversed by occa-\\nsional prominent bands. Frequently, the chronic inflam-\\nmation is not confined to the bronchial mucosa but spreads\\nto the subjacent structures. The submucous and muscu-\\nlar vessels, and the vessels in the connective tissue outside\\nthe cartilages are dilated and filled and surrounded by\\nleukocytes and lymphocytes. The elastic and muscular\\nelements are pressed apart the leukocytes may penetrate\\nthrough the perichondrium into the cartilage, the ground\\nsubstance of which becomes eroded and absorbed. Finally,\\nthe cartilaginous spaces are opened and filled with pus-\\ncells and the cartilage cells are destroyed (peribronchitis).\\n(Plate 29, Figs. I and II.) By these processes and\\nthrough the edema that accompanies the inflammatory\\nhyperemia, the whole wall becomes softened and may\\ngive way. If there occurs a hindrance to the outflow of\\nthe secretion, or if there is present a strong, positive", "height": "4719", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0140.jp2"}, "141": {"fulltext": "Ift I\\nFig.1.\\nTab. 2!).\\n..-4\\nFig. S.\\nl.ilh.An.sl Houlilwlil M\u00c3\u00bcnchen", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0141.jp2"}, "142": {"fulltext": "", "height": "4617", "width": "2973", "jp2-path": "atlasepitomeofsp00drck_0142.jp2"}, "143": {"fulltext": "RESPIRATORY (Uta Ays. 77\\npressure in the bronchial lumen, as in the case of severe\\ncoughing, larger or smaller areas of permanent dilatation\\nmay result bronchiectasis).\\nOftentimes the mucous membrane of such dilatations is\\nwin \u00c2\u00bb11 v destroyed, and the lumen is bounded by a greatly\\ninfiltrated, richly vascular, connective tissue, the vessels of\\nwhich are thin walled and dilated the continuity of the\\nmuscle layer is lost, and of the cartilage also, so that\\nthere i- found only cartilaginous rudiment- or islands.\\nIn the later stages the connective tissue becomes acellular\\nand avascular, and, finally, the irregularly dilated lumen\\nis surrounded by cicatricial connective tissue.\\nLUNGS.\\nA- they become smaller and smaller, the branching,\\narborescent bronchioles lose altogether the cartilage and\\nthe mucous glands in their walls the cylindric, ciliated\\nepithelium diminishes in length, becomes polyhedral and\\ngranular, while below the epithelium lies a thin stratum\\nproprium and a circular layer of smooth muscle-fibers,\\nand internally a layer of Loose vascular connective tissue\\nwith numerous elastic fibers.\\nIn this manner arc formed the respiratory or terminal\\nbronchioles. Each continues a- a short, tubular struc-\\nture, the alveolar passage or duet, which in returfi ter-\\nmini tes as a funnel-shaped expansion the terminal vesi-\\nr infundibulum.\\nTic- wall of the terminal vesicle becomes pouched out\\ngularly into saccular dilatations, generally half-\\nular in shape, and designated a- the alveoli or lung\\nThese alveoli communicate freely with the in-\\nfundibulum. and also with one another through minute\\nii their walls the so-called stigmata of Cohn.\\nwalls of the alveoli and the terminal vesicles, in addi-", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0143.jp2"}, "144": {"fulltext": "78 PATHOLOGIC HISTOLOGY.\\nPLATE 30.\\nFig. I.\u00e2\u0080\u0094 Colloid Goiter. The glandular acini are dilated (1) and\\nfilled with an increased amount of homogeneous, colloid material\\n(stained light red in color). The epithelium (2) is somewhat flattened\\nin places. The connective-tissue septa are thickened.\\nFig. IL\u00e2\u0080\u0094 Parenchymatous Goiter with Hyaline Degenera-\\ntion of the Interstitial Substance. X 70. 1, Dilated acini partly\\nfilled with colloid material 2, epithelium of the same 3, hyaline\\nconnective tissue, the nuclei of which have disappeared.\\ntion to the small polyhedral cells, are also lined with\\nlarger, flat cells, which are extremely thin, clear, and\\npolygonal, and partly nonnucleated. They directly cover\\nthe capillaries, which surround the alveoli in the form of\\na network. When the lung is fully expanded, there are\\npresent small openings or stomas between the cells, through\\nwhich communications between the alveoli and the finer\\nlymph-channels are established. It is believed that it is\\nthrough these stomas that corpuscular elements are carried\\nby inspiration into the lymph-stream. The layer of\\nsmooth muscle is present in the wall of the infundibula\\nin the form of remnants from the end bronchioles, but\\nmuscle-cells are not found in the alveolar walls. The\\nframework of the alveolar walls consists of a thin net of\\nelastic fibers that continue directly from the end bronchi-\\noles, and of a delicate, fibrillar, connective tissue with\\nstar-shaped cells.\\nA respiratory bronchiole with its infundibula and\\nalveoli is surrounded by a layer of connective tissue that\\nis continuous at the proximal end with the adventitia of\\nthe larger bronchial stem, while at the distal end it be-\\ncomes lost in the connective tissue of the pulmonary\\npleura. In this way sharply outlined areas result, pyram-\\nidal in shape, the bases lying under the pleura, while the\\napices point toward the hilus of the lung. These areas\\nare known as lobules, and are especially well marked in", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0144.jp2"}, "145": {"fulltext": "Tab. 30-\\nTig.l.\\nS.", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0145.jp2"}, "146": {"fulltext": "", "height": "4577", "width": "3003", "jp2-path": "atlasepitomeofsp00drck_0146.jp2"}, "147": {"fulltext": "RESPIRATORY ORGANS. 79\\nthe lungs of children and in highly pigmented lunge.\\nThe capillaries of the pulmonary artery, surrounding the\\nalveoli, anastomose more or less freely with the capillaries\\nof the bronchia] artery.\\nNormally, the alveoli contain air since the very firsl\\ninspiration after birth under pathologic conditions, how-\\never, the air may be pressed out either through sinking\\ntogether of the alveolar walls, which come in contact with\\neach other, or by other substances thai completely fill the\\nlumen of the alveoli. The firsl condition is designated\\nas atelectasis. Its prototype is present physiologically\\nduring fetal life. In the fetus no air enters the alveoli\\nthey are not expanded, but lie close together; at this\\ntime the alveolar epithelium has nuclei, and the flat,\\nthin, nonnucleated platelet- area- yet absent. (Plate 31,\\nFig. I.) Microscopically, the organ shows a compact\\nappearance. The few spaces present correspond to the\\nlumen- of the bronchi and bronchioles, while the infun-\\ndibula are hardly to be made out.\\nUnder various pathologic conditions part of the whole\\norgan may present the same appearance a- during fetal\\nlife. This is frequently the case when a part or the whole\\nof a lobe is pressed upon, a- by tumors, exudates, transu-\\ndates, by the enlargement of neighboring organs, etc.\\nThe lower sharp borders of the lower lobe- frequently\\nbecome compressed and airless a- the result of a high\\nposition of the diaphragm. Such conditions are desig-\\nnated a- compression atelectasis, in contradistinction to\\nrption oi- collapse atelectasis, which i- also frequent\\nand due to the occlusion of a larger bronchial stem by\\nforeign bodies, mucus, etc., when the air present in the\\naffected district is gradually absorbed. In consequence,\\nthe alveoli collapse because no longer exposed to the\\npressure of the air, and the alveolar lumen- become\\npbliterated.\\nWhen sections of this kind are stained to bring out", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0147.jp2"}, "148": {"fulltext": "80 PATHOLOGIC HISTOLOGY.\\nPLATE 31.\\nFig. I.\u00e2\u0080\u0094 Fetal Atelectasis of Lung. X 70. The alveolar walls\\nare very close together, the alveoli not expanded. The tissue, there-\\nfore, appears more cellular than normal, aerated, lung tissue. 1, Bron-\\nchioles 2, infundibula 3, pleura.\\nFig. II.\u00e2\u0080\u0094 Compression Atelectasis of the Lung in Sero=\\nfibrinous Pleuritis. X 70. The elastic fibers stained. The alveo-\\nlar walls with their elastic fibers are approximated and compressed,\\nespecially at the peripheral portions. 1, Thickened pleura as a result\\nof inflammation.\\nthe elastic elements, the elastic fibers of the alveolar walls\\nand the walls themselves will be found wrinkled or\\ncrumpled and in close contact with each other. (Plate 31,\\nFig. II.) In compression atelectasis the capillaries, in\\ncontrast to fetal atelectasis, are mostly empty and hardly\\nvisible while in resorption atelectasis they usually con-\\ntain the same amount of blood, if not more, than the\\nsurrounding vessels. If the cause in either compres-\\nsion or resorption atelectasis is removed in a certain\\nlength of time, it is possible for the affected lung area to\\nreturn to its normal state. The air-cells become inflated,\\nand their walls are smoothed out. If, however, the con-\\ndition of atelectasis is present for a longer time, then\\nadhesions take place between the folded alveolar septa.\\nFirst, the alveolar epithelium degenerates, and then the\\nfixed, connective-tissue cells proliferate, and finally lead\\nto the formation of a cicatricial area which remains per-\\nmanently airless. When the atelectatic area is located at\\nthe periphery of the lung, the pleural or subpleural con-\\nnective tissue takes an active part in the proliferation and\\nformation of the new tissue. The capillaries are fre-\\nquently in a state of hyperemia and stasis they may rup-\\nture and lead to extravasations into the thickened tissue,\\nwith subsequent deposit of pigments.\\nResorption atelectasis, when resulting from bronchitis", "height": "4691", "width": "2971", "jp2-path": "atlasepitomeofsp00drck_0148.jp2"}, "149": {"fulltext": "Tab. 31.\\n...3\\nHfe S\\nW% ;eyim a\\ni V/./.\\nt\\nFig II.\\nJ ith AftSt ReiChhold, M\u00c3\u00bcnchen", "height": "4716", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0149.jp2"}, "150": {"fulltext": "", "height": "4593", "width": "2986", "jp2-path": "atlasepitomeofsp00drck_0150.jp2"}, "151": {"fulltext": "RESPIRATORY ORGANS. 81\\n(especially in children), is usually a forerunner of inflam-\\nmatory processes that extend from the bronchial wall\\ndown into the airless lung tissue. (See Peribronchitis and\\nLobular Pneumonia.)\\nThe reverse condition of atelectasis is emphysema of\\nthe lune. By this term we understand an increase of\\nthe air contained within the lungs. Sometimes it occurs\\nacutely after severe coughing orforcible inspiration, which\\nds to rupture of the air-passages or space-, and extra-\\nvasation of the air into the interlobular septa as well as\\nunder the pleura. This condition is designated as inter-\\nstitial or intervesicular or subpleural emphysema, and\\nshows no changes f any particular interest from a histo-\\nlogic point of view.\\nImportant histologic changes are found, however, in\\nthe substantial er vesicular form of emphysema. This\\nconsists in the distention of the air-cells or spaces, and a\\nsimultaneous disappearance of their walls or septa so that\\nan apparent increase in the volume of the whole organ is\\nproduced. Vesicular emphysema must be distinguished\\nfrom atrophy of the lung, which always occurs more or less\\nin old age and is distinguished histologically from emphy-\\nsema only with difficulty. The alveoli, first of all, are\\nflattened nt. the edge-like partitions which project into the\\ninfundibular spaces become shorter, while the infundibula\\n;i- a result become larger. Constant and increased intra-\\nvesicular pressure causes the alveolar septa to become\\nxtended, stretched, and thinned out. Naturally, thi-\\nn-ion first shows it-elf at those areas where the walls\\ncontain minute openings. The stigmas of Cohn are ren-\\ndered dehiscent, and in the thicker sections they can he\\nrecognized on the surface of the alveolar wall- as round\\noi oval holes. It the extension continues, the alveoli\\nbecome confluent with the infundibular spaces in larger\\nas the increased rarefaction of the lung and the dis-\\nappearance of tin- elastic fibers and blood-vessels produce\\n8", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0151.jp2"}, "152": {"fulltext": "82\\nPATHOLOGIC HISTOLOGY.\\nPLATE 32.\\nFig. I.\u00e2\u0080\u0094 Anthracosis of the Lung. X 100. The lung tissue\\nis very much indurated as the result of newly formed connective tissue\\nin which are embedded star-shaped masses of fine, granular, blackish\\npigment of inhaled coal particles.\\nFig. IL\u00e2\u0080\u0094 Siderosis of Lung (Red Iron Lung). X330. The\\nlung tissue is loaded with numerous masses of iron-dust, which\\nare found mostly within the cells in the thickened alveolar walls,\\nthe nuclei being covered by the pigment. Between the pigment\\ncells the connective tissue is fibrillar and contains but few nuclei.\\nAlveoli partly compressed. Atypical, proliferated epithelium in the\\nalveoli.\\nlarge, bladder-like, thin-walled spaces, varying in size,\\naccording to circumstances, from that of a pea to that of\\na large walnut, and even larger (bullous emphysema).\\n(Plate 33, Figs. I, II, and III.)\\nThe normal elastic fibers, always slightly tortuous or\\nbent, become stretched, give way gradually, and are\\nfinally torn in half. The same changes take place in\\nthe capillaries in the intervesicular and infundibular\\nwalls. Their lumen becomes narrower and narrower\\nPLATE 33.\\nFig. I.\u00e2\u0080\u0094 Emphysema of the\\nalveolar spaces, extraordinarily thin\\nand torn at many places so that the\\none another. 1, Interlobular septum\\n3, dilated and confluent alveoli.\\nFig. IL\u00e2\u0080\u0094 Emphysema of the\\nseen, whose interalveolar septa are\\nand about to be torn through in the\\nLung. X40. Greatly dilated\\nalveolar septa, deficient in cells\\nseveral alveoli communicate with\\n2, contiguous but normal alveoli\\nLung. X 340. Two alveoli are\\nextremely thin, deficient in cells,\\ncenter.\\nFig. III. Emphysema of the Lung. X 54. From an injected\\npreparation.", "height": "4691", "width": "2979", "jp2-path": "atlasepitomeofsp00drck_0152.jp2"}, "153": {"fulltext": "Tab. 32.\\nMs\\n^Mf:\\n^5v*:\\nJHG y*\\nFn,.L\\nim\\nV38\\nLUfuAnst Reichhold, M\u00c3\u00bcnchen.", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0153.jp2"}, "154": {"fulltext": "", "height": "4641", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0154.jp2"}, "155": {"fulltext": "Tab. .33-\\nMg.l.\\nV\\n\u00c2\u00bb9\\n/\u00e2\u0080\u00a2v; 7 ,y.\\n///fl. /Jz/.v/ A Reichhold, M\u00c3\u00bcnchen.", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0155.jp2"}, "156": {"fulltext": "", "height": "4649", "width": "2980", "jp2-path": "atlasepitomeofsp00drck_0156.jp2"}, "157": {"fulltext": "RESPIRATORY ORGANS. 83\\nfrom the constant stretching, until finally the walls\\nfor some distance lie in such close contact that a solid\\nfiber results eventually this i torn, and the stump may\\n-till he found projecting into the dilated space. Rudi-\\nments of degenerated or obliterated vessels are especially\\nwell shown in injected preparations. In severe forms\\nof emphysema there i- also noticed a similar oblitera-\\ntion of the -mailer arteries and veins with eventual dis-\\nappearance f the walls. Naturally, the alveolar epithe-\\nlium also becomes destroyed through fatty degeneration.\\nUsually the emphysematous portion- are less pigmented\\nthan the normal lung tissue. This is due, first, to the\\nfact that the pigment masses lie further apart on account\\nof the widening of the tissues, which macroscopically\\ngives it a lighter appearance, and, secondly, to the resorp-\\ntion of the original pigment inclosed within the alveolar\\nand vascular epithelium, which, on breaking down, sets\\nfree the pigment.\\nCirculatory Disturbances.\\nIn long-continued obstruction to the outflow of blood\\nfrom the hmg- to the left auricle, especially from insuffi-\\nciency and stenosis of the mitral valves, there result- a\\npassive hyperemia of the lungs. Later, the organ in-\\ncreases in consistency, due to hyperplasia of the connec-\\ntive tissue. With the deposition of blood pigments the\\ntissue acquires a brownish discoloration, and the condition\\ni- th -n designated a- brown or cyanotic induration.\\nA- a resull of the damming back of blood in the vein-,\\ntin- capillaries in the alveolar walls are greatly distended\\nthey become twisted and tortuous, and projeci irregularly\\ninto the alveolar lumen. In this manner the alveolar\\nspaces become contracted and the respiratory surface\\ndiminished. (Plate34, Figs. I and II.) With the increase\\nof intracapillary pressure more or less diapedesis of red", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0157.jp2"}, "158": {"fulltext": "84 PATHOLOGIC HISTOLOGY.\\nPLATE 34.\\nFig. I.\u00e2\u0080\u0094 Brown Induration of the Lung. X 130. Thickened\\nalveolar septa, due to newly formed connective tissue arranged around\\nthe blood-vessels. Large, round cells containing amorphous granular\\nblood pigment partly in the septa and partly within the alveoli (so-\\ncalled Herzfehlerzellen\\nFig. IL\u00e2\u0080\u0094 Passive Hyperemia of the Lung. X 250. 1, Ectatic\\nand distended blood-vessels, filled with blood 2, engorged and tor-\\ntuous capillaries 3, lumen of alveolus 4, increased interlobular con-\\nnective tissue 5, cells, containing blood pigment, within the alveolar\\nlumen 6, free, amorphous blood pigment.\\n(also white) blood-corpuscles takes place and, occasionally;,\\nrupture of the capillaries. The extravasated blood is\\nfound in the alveoli as well as in the tissues of the alveolar\\nsepta, and the same changes occur as in extravasated\\nblood in general. Later, the red blood-corpuscles are\\ntaken up by the desquamated alveolar epithelium, as well\\nas by wandering cells (lymphocytes and leukocytes), and\\nalso by young connective-tissue cells that proliferate from\\nthe alveolar walls as a result of the irritation of the\\nhemorrhage. The alveolar lumen and the alveolar septa\\nare then found to contain cells loaded with masses of\\nyellowish or brownish pigment. The pigment-containing\\ncells are expectorated and appear in the sputum as the\\ncells of heart-disease Herzfehlerzellen\\nThe deposit of pigment and subsequent proliferative\\nchanges in the alveolar walls lead to thickening of the\\nwalls and increased consistency. The elasticity of the\\ntissue is lessened while the respiratory surface becomes\\nencroached upon on account of the continued compression\\nof the alveoli. Sometimes areas of alveoli are completely\\nfilled with pigment-containing cells, so that there results\\na condition of catarrhal inflammation. In addition to\\nblood pigment the cells may also contain coal pigment,", "height": "4691", "width": "2989", "jp2-path": "atlasepitomeofsp00drck_0158.jp2"}, "159": {"fulltext": "Tub. 34.\\nr\\nf..\\nXU\\n.TS\\ny\\n*c\\n/O- V\\nV.. M\\nFu,l\\nv\\nft J\\nl.ith. Ansl Re\u00c3\u00bcMiold, M\u00c3\u00bcnchen*.", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0159.jp2"}, "160": {"fulltext": "", "height": "4657", "width": "2979", "jp2-path": "atlasepitomeofsp00drck_0160.jp2"}, "161": {"fulltext": "RESPIRATORY ORGANS, 85\\nwhich is easily distinguished, however, on account of its\\nblack color. When the cells break down, the pigment is set\\nfree and is then deposited in the thiekened alveolar septa,\\nthe peribronchial and perivascular connective tissue, and\\nlymph-spaces as amorphous, hematoidin granules arranged\\nin n\u00c2\u00bb\\\\\\\\-. Hematoidin crystals are rare in the lung.\\nIn severe chronic passive hyperemia there often occurs\\ncomplete stasis in many of the capillaries. The blood-\\ncorpuscles are then changed into pigment within the ves-\\nsels, and in such instances we find the lumen of the\\ncapillaries and the smaller arteries dilated and completely\\nfilled with pigment, some of which is inclosed within cells.\\nIn obstructed vessels of this kind the circulation entirely\\nceas\\nThis form of passive hyperemia must not be mistaken\\nfor another that develops in the posterior portions\u00c2\u00bb of the\\nlower lohe- in cases of heart failure and asthenia namely,\\nhypostatic congestion. Here we also have dilatation\\nof the vessels with passing out of the red blood-corpuscles\\ninto the alveolar tissue. If, in addition, inflammatory\\nchange- occur, the process is designated marantic spleni-\\nzation. Likewise, edema of the lung is the result of a\\npassive hyperemia that, however, often occurs first during\\nthe death agony. (Plate 36, Fig. I.) It may either\\ndevelop acutely or in a more chronic way; oftentimes\\nit accompanies inflammation of the surrounding lung\\narea, or it i- a forerunner of inflammation, being then\\nknown a- inflammatory edema. In edema the alveoli are\\nfilled with a richly albuminous fluid and cell- (alveolar\\nepithelium and round cells). For microscopic examination\\nit i- besl to preserve the fluid by throwing -mall piece- of\\nedematous lung tissue into boiling water for one or two\\nminutes. This causes the fluid to become coagulated, and\\nit is found in the alveoli as an opaque, grayish, crumbling,\\noi thread-like mass.\\nI hi- procedure i- advisable when it is necessary to", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0161.jp2"}, "162": {"fulltext": "86 PATHOLOGIC HISTOLOGY.\\nPLATE 35.\\nFig. I.\u00e2\u0080\u0094 Marginal Zone of Hemorrhagic Infarct of Lung.\\nX 40. 1, Lung tissue in which the alveoli are normal 2, compressed\\nand airless lung tissue 3, infarcted lung tissue infiltrated throughout\\nwith red blood-corpuscles the nuclei are poorly stained, and necrosis\\nhas occurred in places.\\nFig. II. Fat Embolism of the Lung, Resulting from Frac=\\nture of a Long Bone. X 100. Fresh preparation. There is seen\\nan infundibulum with several alveoli, in the wall of which are present\\nglobular, sausage-shaped, and branched, shining, yel low bodies, partly\\ninclosed within the capillaries and partly free as a result of the teasing.\\ndifferentiate between edematous fluid in the lung and\\naspirated water as a result of death by drowning.\\nOftentimes the alveolar walls and interlobular septa also\\nbecome saturated with the edematous fluid. The inter-\\nstitial tissue is then found swollen and expanded, and the\\nsame coagulated mass is seen in the spaces. In inflamma-\\ntory edema the fluid is often mixed with numerous cells,\\nespecially leukocytes.\\nInfarction.\\nIt has been pointed out that the lung tissue is richly\\nsupplied with blood-vessels therefore, in case of occlusion\\nof an arterial branch the conditions are favorable for the\\nestablishment of collateral circulation. For, as a matter\\nof fact, we frequently find on the postmortem table larger\\nor smaller arterial branches of the lung occluded with\\nthrombi without leading to any consecutive tissue changes.\\nThis being the case, then the cause of infarction of the\\nlung must be sought for in other injuries of the vessel\\nwall, and this is found in chronic passive congestion. For\\nthat reason infarction occurs most frequently in lungs that\\nare the seat of passive hyperemia. (Plate 35, Fig. I.)\\nIf in such a lung one of the arterial branches is occluded", "height": "4691", "width": "2963", "jp2-path": "atlasepitomeofsp00drck_0162.jp2"}, "163": {"fulltext": "\u00c2\u00bbJ\\nFig.1.\\nTab.35.\\nl.ith. A/i.st F Reichhold, M\u00c3\u00bcnchen.", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0163.jp2"}, "164": {"fulltext": "", "height": "4681", "width": "2961", "jp2-path": "atlasepitomeofsp00drck_0164.jp2"}, "165": {"fulltext": "RESPIRATORY ORGANS. 87\\nby an embolus, the area of tissue beyond the vessel be-\\ncomes anemia Blood now flows from the surrounding\\ncapillaries into the empty vessels, but the walls have lost\\ntheir integrity the blood-corpuscles pass out, as through\\na sieve, into the lumen of the alveoli, infundibula, and\\noftentimes into the smaller bronchi, infiltrating in a diffuse\\nmanner these structures. All forms of infarction of the\\nlung are, without exception, hemorrhagic. Anemic infarc-\\ntion does not occur, on account of the peculiar arrange-\\nment of the blood-vessels.\\nAt this stage the infarcted lung tissue is found more or\\nless necrotic, manifested by the absence of the nuclei j\\nwhile the tissue itself is infiltrated with closely packed red\\nblood-corpuscles. Frequently, the capillaries are occluded\\nwith fibrinous or hyaline thrombi, which can be removed\\nas fine bands or strings. Occasionally, fine fibrin threads\\narc demonstrable between the extravasated red blood-\\ncorpuscles. The infarcted area is usually sharply out-\\nlined from the surrounding tissue.\\nAfter the infarct lias existed for some time it may be-\\ncome absorbed. The necrotic lung tissue breaks down\\nthrough fatty degeneration, while the blood is transformed\\ninto pigment, which is taken up by wandering cells. The\\ninfarct may also become organized that is to say, it i\\nreplaced by granulation tissue that is derived from the\\nsurrounding connective tissue, especially the peribronchial\\nand finally transformed into a fibrous scar. (See\\norganization, in reneral Part.\\nA lbnn of embolism peculiar to the lung is fat em-\\nbolism. It occurs after extensive crushing and bruising\\nof the Bubcutaneous fat-tissue and the fatty marrow of\\nbones, as a result of traumatism or fractures. (Plate 35,\\nFig. II. The f;it droplets are absorbed by the open veins\\nand transported to the right side of the heart and then to\\nthe lungs. It may also occur, though rarely, in cases of\\nspontaneous lipemia, ;i- a result of diabetes. The inter-", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0165.jp2"}, "166": {"fulltext": "88 PATHOLOGIC HISTOLOGY.\\nalveolar capillaries and, occasionally, the smaller arteries\\nare found plugged with yellowish, transparent fat droplets\\nor fat-globules. These are partly seen singly or in the form\\nof branched or sausage-shaped masses. The fat can be\\nfixed in loco with osmic acid or it can be stained with\\nsudan III in frozen sections after hardening in formalin.\\nThe sections must not be too thin.\\nOccasionally, we have pulmonary emboli that are cel-\\nlular in their nature. Thus, in cases of malignant tumors\\nthe metastases in the lung can oftentimes be traced to\\nsmall emboli of tumor cells. (See Metastasis, General\\nPart.)\\nTrue parenchyma cell emboli also occur in the lung.\\nThus, for instance, after traumatic injury of the liver as\\nwell as in the course of the acute infectious diseases and\\nintoxications, liver cells may be carried to the lungs as\\nemboli. Placental cells, especially in eclampsia, and giant\\ncells from the bone-marrow after injury to, or operations\\non, bones, may also be carried to the lungs as emboli.\\nPneumoconiosis.\\nDust is constantly carried into the respiratory organs\\nwith the inhaled air some of the dust is caught in the\\nupper respiratory tract by the ciliated cylindric epithelium\\nand again discharged, while the rest reaches the alveoli of\\nthe lungs. Even in the trachea and bronchi the inhaled\\ndust particles are found partly inclosed by cells in the\\nlung tissue the dust is also found either free or intracellular.\\nThese cells, which are known as dust cells, are partly\\nsmall and round, with a darkly granular, richly chromatic,\\nand sometimes lobulated nucleus, while others are larger,\\nflat, and have clear vesicular nuclei. The former are\\nlymphoid elements that have wandered out from the blood-\\nstream, while the latter are desquamated, alveolar, epithe-\\nlial cells. In the bronchi the cylindric epithelial cells", "height": "4691", "width": "2964", "jp2-path": "atlasepitomeofsp00drck_0166.jp2"}, "167": {"fulltext": "RESPIRATORY ORGANS. 89\\nand tile so-called goblet cells are transformed into dust\\ncells. Occasionally, the still adherent epithelium is Pound\\nfilled with dust particles. Sometimes a number of such\\nepithelial cells are detached from the underlying basement\\nmembrane while joined, and appear as small, membranous\\nflakes. In cases of excessive inhalation of dust larger\\narea- are found, in which the alveoli are completely filled\\nwith dust cells.\\nThe larger part of the free and intracellular dust is\\nagain discharged through the bronchi the rest, however, is\\nretained within the lung and deposited at certain fixed\\ndepot-. Hen- it may accumulate in stich quantities as\\nto give the tissue a distinct, oftentimes intense, discolo-\\nration. The free particles and the dust cells find their\\nway between the epithelial cell- of the alveolar walls,\\nthrough line stomas in the lymph-spaces of the connective\\ntissue, and from thence into the narrow lymphatic vessels\\nin which the dust, especially coal dust, is closely packed in\\nrow- and fill- up the lumen. The free granules are swept\\nalong by the lymph-stream, while the dust cells, besides a\\npassive, also play an active, part and penetrate into the\\nlymph-stream by their own ameboid movements. Both\\nlymphoid and epithelial cell- have this power.\\nUsually, the dust i- found accumulated largely in the\\ninter- and peri-infundibular a- well as peribronchial and\\nperivascular connective tissue in the latter it accumulates\\nin the adventitial lymph-spaces of the -mall, pulmonary,\\nlymphatic nodules. Here the dust may he arrested for\\n-\u00c2\u00ab\u00c2\u00bbin.- tiiii.- later, it may break through tin- filter, whence\\nit i- transported to the pleura, the pleural, peribronchial,\\nand mediastinal lymph-glands. Not rarely the dust\\ncrowds into the wall- of the blood-vessels a- far a- to the\\ninternal elastic coat.\\nInhaled dost, when present in large quantities, has\\nth.- power, by virtue of it- chemic or physical nature, to\\nstimulate or irritate the lung tissue to an inflammatory", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0167.jp2"}, "168": {"fulltext": "90 PATHOLOGIC HISTOLOGY.\\nreaction. The protoplasm and the nuclei of the dust cells\\nbreak down with the formation of fatty granules, while\\nthe surrounding alveolar wall is infiltrated with numerous\\nround cells and eventually replaced by fibrous tissue.\\nThe alveolar wall finally becomes very much thickened,\\nand there results a small connective-tissue nodule, which\\ncontains more or less free pigment granules. Later, the\\nnodule may undergo hyaline degeneration so much so\\nthat it becomes hard to trace its genesis. It is difficult\\nto draw a sharp line between these processes and certain\\nforms of true inflammation of the lungs, which are classed\\nas circumscribed indurative bronchopneumonia (endoperi-\\nvasculitis nodosa of Arnold).\\nIn long-continued inhalations of dust in large amount\\nsuch nodular masses may fuse and give rise to extensive\\nindurations.\\nThe pigment masses deposited in the peri-infundibular,\\nperibronchial, and perivascular tissue may excite the latter\\nto similar connective-tissue proliferation, which leads\\nto further enlargement of the indurated areas (peri- and\\nendolymphangitis fibrosa or peribronchitis and perivascu-\\nlitis nodosa). In the same way similar nodules may\\narise in the pleura, as in the case of the so-called miliary\\nfibromas of the pleura observed in stone-cutters.\\nThe extent and intensity of the histologic processes\\ndescribed depend upon the kind of dust, as well as on\\nthe amount of dust, inhaled. Fine amorphous soot\\nthat is, amorphous coal dust is found in the lungs of\\nnearly every individual of adult age. This condition is\\ndesignated as simple anthracosis. Since soot-particles\\nhave no sharp edges, indurations are but seldom ob-\\nserved. In exceptional cases, when the deposit is exten-\\nsive, nodular or larger indurations occur in the lungs.\\n(Plate 32, Fig. I.) The dust of bituminous coal acts\\nmore intensely, since the fine, sharp-edged, chip-like\\nparticles give rise to considerable irritation and inflam-", "height": "4691", "width": "2982", "jp2-path": "atlasepitomeofsp00drck_0168.jp2"}, "169": {"fulltext": "RESPIBATOBY OEGAXs. 91\\nnation in the lung tissue. (Plato 32, Fig. II.) This is\\neven more 90 in case of inhalation of stone dust (cha\u00c3\u009f\u00c3\u00b6O-\\nsis pulmonis) and metal dust (siderosis pulmonis). In\\nthese cases it may load to circumscribed necrosis of lung\\ntissue, and finally to cavity formation.\\nDu-t thai on account of its chemic or physical nature\\nacts injuriously upon the lung tissue produces thereby an\\nincreased susceptibility to infection. The predisposition\\nto tuberculosis excited by metal and stone dust is gener-\\nally known and feared.\\nPneumonia.\\nBy the term pneumonia we understand the filling up of\\nthe air-cells with inflammatory exudate, as a result of\\nwhich area- of lung tissue become airless. When the in-\\nflammatory irritant acts directly upon the inner surface of\\nthe lung, larger portions of lung tissue (one or more lobes)\\nmay become simultaneously involved. In that ease the\\ninflammatory exudate, which is derived from the alveoli\\nthemselves, develops suddenly, and the condition is known\\nas genuine or lobar pneumonia.\\nMore frequently, inflammation of the lung results from\\nextension of a primary affection in the larger or smaller\\nbronchi. It may either spread by continuity that is to\\nsay, along the inner surface of the bronchi, bronchioles,\\ninfundibula, and then to the alveoli or by contiguity\\nthat is, perpendicular to the long axis of the bronchus,\\nspreading transversely outward to the surrounding hing\\ntissue. The inflammation spreads from the epithelial sur-\\nface to the stratum proprium, and then outward into the\\nperibronchial connective tissue. In this manner develops\\nan area of peribronchitis.\\nIn both instances the pneumonic process that results is\\nd signated as bronchopneumonia. 1 1 manner of spread-\\ning is lobular in character thai is to say, the inflamma-", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0169.jp2"}, "170": {"fulltext": "02 PATHOLOGIC HISTOLOGY.\\ntion does not usually extend beyond the limit of a lobule\\nand its accompanying bronchiole.\\nFurthermore, areas of pneumonic infiltrations may be\\nthe result of emboli lodged in the blood-vessels of the\\nlung and containing substances acting as inflammatory\\nirritants. Around the embolic thrombus there usually de-\\nvelops a purulent inflammation (embolic or metastatic\\npneumonia). Its mode of spreading is not dependent\\nupon the course of the bronchi, but is wholly an irregular\\none the so-called insular form.\\nFinally, inflammation of the lung may be secondary to\\nprimary inflammatory affections of the pleura the in-\\nflammatory processes extending usually along the course\\nof the interlobular connective tissue toward the centrally\\nlocated alveolar areas the so-called pleurogenic pneu-\\nmonia.\\nAll the different special forms of inflammation known\\n(see General Pathologic Anatomy) may run their course\\nin the lung and exudation, cellulation, and emigration\\nshare in different degrees in building up the pneumonic\\ninfiltrate. Under certain conditions we find the alveoli\\nfilled only with a richly albuminous fluid in which are\\npresent but a few cells (inflammatory edema or serous\\npneumonia). The exudate may be fixed in situ by boiling\\nportions of the lung tissue. Frequently, this condition is\\nonly an early stage of other inflammatory changes. This\\nis due to the fact that the bacteria that we believe cause\\nthe cellular or fibrinous form of pneumonia are often found\\nin the inflammatory, edematous fluid in very large num-\\nbers. The serous exudate may become cloudy and partly\\ncrowded out by the admixture of cells or through the pre-\\ncipitation of fibrin. Occasionally, there are present a con-\\nsiderable number of red blood-corpuscles, so that the exu-\\ndate is distinctly hemorrhagic in character (hemorrhagic\\npneumonia). If the process occurs suddenly and exten-\\nsively, it usually leads to fatal results, and it may then be", "height": "4691", "width": "2974", "jp2-path": "atlasepitomeofsp00drck_0170.jp2"}, "171": {"fulltext": "RESPIRATORY ORGANS 93\\ngnized upon the postmortem table only. I sually, in-\\nflammatory edema occurs in parts of the lung surrounding\\ninflammatory areas (collateral edema), and may appear in\\nthe same or neighboring lol\\nMost frequently, the exudate filling the alveoli is cellu-\\nlar in nature from the very beginning two types of cells\\nare recognized first, large, flat, epithelial cells from the\\nalveolar lining, and, second, leukocytes. It the alveolar\\nepithelium prevails and if desquamation is combined with\\nactive proliferation, the process is designated as catarrhal\\npneumonia. On the other hand, if the leukocytes are\\nmore numerous or present exclusively, the term purulent\\npneumonia is employed.\\nThe leukocytes (pus-cells) not only till the lumen of\\nthe alveoli, but oftentimes infiltrate throughout the alveo-\\nlar septa, infundibular walls, and occasionally the inter-\\nlobular connective tissue. If the leukocyte- accumulate\\nin large numbers, it may lead to larger areas of necrosis.\\nTlii- is frequently the case in the hematogenous, embolic\\npneumonia.\\nIn nearly all cases there is present in the inflammatory\\nexudate a varying amount of thread-like fibrin, the dis-\\ntribution of which will be referred to later.\\nIn special forms of pneumonia, especially the genuine\\npneumonia, which is distinguished by the fact that large\\nis, usually a whole lobe, become simultaneously\\ninflammatory exudate which rapidly fills the\\nalveoli soon coagulates, so that there appears in cadi\\nalveolus a plug of fibrin mixed with but few cells. This\\nform is, therefore, known as croupous or fibrinous pneu-\\nmonia in the strict sense.\\nA.8 the termination- of pneumonia differ clinically from\\none another, so, in like manner, the histologic picture is a\\nvariable one. The most frequent termination namely,\\nresolution of the inflammatory consolidation and resorp-\\ntion of the exudate is manifested by a progressive fatty", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0171.jp2"}, "172": {"fulltext": "94 PATHOLOGIC HISTOLOGY.\\nPLATE 36.\\nFig. I.\u00e2\u0080\u0094 Edema of the Lung. X127. Section through a por-\\ntion of boiled lung. In the somewhat dilated alveoli is seen a grayish,\\nopaque, homogeneous mass (the coagulated edematous fluid) in which\\nare intermingled single, desquamated, alveolar, epithelial cells and\\nleukocytes.\\nFig. IL\u00e2\u0080\u0094 Marantic Splenization of the Lung. X 360. 1,\\nElastic fibers, sharply outlining an alveolus in the latter (2) coagu-\\nlated edematous fluid 3, desquamated alveolar epithelium 4, leuko-\\ncytes 5, red blood- corpuscles.\\nFig. III.\u00e2\u0080\u0094 Beginning Red Hepatization of Lung in Croupous\\nPneumonia. X 340. Weigert s fibrin stain. Alveolar walls appar-\\nently broadened, owing to the great distention with blood of the capil-\\nlaries, which are tortuous and project into the lumen of the alveoli.\\nIn the alveoli are seen red blood-corpuscles, a few desquamated alveo-\\nlar epithelial cells, and fine, thread-like bunches of fibrin.\\ndegeneration and breaking down of the cells and the\\nfibrin, and gradual emulsification of the fibrinous plugs.\\nOccasionally, the pneumonic area may become purulent,\\ndue to the presence of a large number of emigrated leu-\\nkocytes and the melting down of the lung tissue this\\nleads to the formation of an abscess cavity filled with pus.\\nThe cause of this result is to be found in the kind and\\nnumber of micro-organisms present in the exudate. Fre-\\nquently, partial or total purulent softening may occur in\\nfibrinous pneumonia as a result of the penetration within\\nthe exudate of pus-producing microbes.\\nIf putrefactive bacteria gain entrance into an inflam-\\nmatory area in the lung, for instance, by aspiration of\\nfluid substances from the mouth, the exudate may then\\nundergo putrid decomposition the surrounding lung\\ntissue as well as the part primarily affected may undergo\\nnecrosis and putrefaction, large gangrenous shreds being\\nthrown off (termination in gangrene of the lung).\\nFinally, the various forms of pneumonic exudates^ in-", "height": "4691", "width": "3014", "jp2-path": "atlasepitomeofsp00drck_0172.jp2"}, "173": {"fulltext": "u\\nFig. 1\\nTab. 36.\\nJ\\ns\\nFig S", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0173.jp2"}, "174": {"fulltext": "", "height": "4617", "width": "3004", "jp2-path": "atlasepitomeofsp00drck_0174.jp2"}, "175": {"fulltext": "RESPIRATORY ORGANS.\\nstead of becoming resolved, undergo organization, the end\\nof which is the filling up and the compression of the lung\\ntissue by fibrillar connective tissue as a result, larger\\nportions of the lung become converted into a resisting,\\ntough mass. This condition is designated as carnification,\\nbecause the lung tissue, as a result of this process, has a\\nflesh-like consistence.\\nCroupous Pneumonia.\\nCroupous pneumonia is, in a certain manner, the para-\\ndigm of a typical inflammation of the lung, and therefore\\ni- here considered first The inflammation starts in the\\nlung tissue proper that is t say, the alveoli and affects\\nusually large ana-, mostly a whole lobe, occasionally\\nral at the same time, and in rare instances even both\\nlungs. It is characterized by the coagulation of the exu-\\ndate within the alveoli.\\nFrom the microscopic appearances croupous pneumonia\\nis usually divided into four stages, which, however, are not\\nsharply separable from one another, hut microscopically\\nthey clearly show recognizable differences.\\nL Tin Stage qf Congestion. The affected lung area is\\nhighly injected, the capillaries of the alveolar walls are\\nfilled to their full extent with blood and partly bulge in a\\ntortuous manner into the alveolar lumen.-. The latterare\\nfilled with a fluid substance composed largely of albumin,\\nwhich, after boiling small pieces or hardening in the ordi-\\nnary fixing solutions, appears a- a homogeneous, coagulated\\nmass that stains readily with the acid aniline dyes. Even\\n;it this stage line thread- of fibrin are found, usually as star-\\ndiaped bunches, radiating from particular point- upon the\\nalveolar surface coagulative centers/ H\u00c3\u00a4user). Among\\nthe fibrin are intermingled a few large, vesicular, alveolar,\\nepithelial cells, m- well a- a variable number of leukocytes\\nand red blood-corpuscles. Plat.;;!;, Fig, III.)", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0175.jp2"}, "176": {"fulltext": "96 PATHOLOGIC HISTOLOGY.\\nPLATE 37.\\nFig. I.\u00e2\u0080\u0094 Croupous Pneumonia at the Height of Hepatiza=\\ntion. X 88. Weigert s fibrin stain. The infundibula and alveoli\\nare filled with a thick network of fibrin (stained blue) owing to the\\nhardening agent, it has retracted from the walls. In several of the\\nalveoli the exudate has altogether or partly dropped out.\\nFig. II.\u00e2\u0080\u0094 Croupous Pneumonia, Stage of Gray Hepatization.\\nX 360. Weigert s fibrin stain. The fibrin network is beginning to\\nbreak up (1) at 2 exudate passing through Cohn s interalveolar\\nspaces 3, leukocytes 4, alveolar epithelium mixed with exudate.\\nThe Stage of Red Hepatization. The hyperemia still\\ncontinues, but the separation of fibrin has increased in pro-\\nportion, so that the affected lung area has more of a liver-\\nlike consistence.\\nThe fibrin threads fill the alveoli in the form of plugs or\\nskeins that are more compact at their periphery, while the\\ncentral parts are looser in structure, inclosing Avithin the\\nmeshes some leukocytes and swollen or broken down alve-\\nolar epithelium. The cells and fibrin are not necessarily\\nuniformly distributed there is usually a sort of a lobular\\narrangement, the cells being found most numerous within\\nthe bronchioles and the central alveoli, while the peripheral\\nalveoli contain principally a fibrinous exudate (Bezzola).\\nAt many points fibrinous bands are found to pass over from\\none alveolus to another through their walls, and form inter-\\nalveolar bridges. Occasionally, the bridges consist of single\\nfibrinous threads, oftentimes of whole bundles, with their\\nbroad bases toward the skeins in which they become lost. 1\\nAt times we see fibrinous deposits within the capillaries\\nof the alveolar walls, in the larger arterial and venous\\nbranches, as well as within the lymph-vessels of the inter-\\nlobular connective tissue. (Plate 37, Figs. I and II.)\\n1 Formerly, it was believed that the spaces were the result of the pneu-\\nmonia, but the investigations of Hansemann have shown that they are\\nnormally present in the lung (Cohn s stigmas).", "height": "4691", "width": "2990", "jp2-path": "atlasepitomeofsp00drck_0176.jp2"}, "177": {"fulltext": "Tab. 37.\\nFig.l.\\n4\\nw\\n.*v* v\\nf i\\nAr,\\nl.ith.Anst ReicMwld, M\u00c3\u00bcnchen", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0177.jp2"}, "178": {"fulltext": "", "height": "4689", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0178.jp2"}, "179": {"fulltext": "RESPIRATORY ORGANS.\\n97\\n3. Gradually, the condition passes over into the third\\nstage \u00c3\u009cu stagi of gray hepatization. The cut surface is\\ngranular, due to the projecting fibrinous plugs it is grayish\\nin color, explained by two factors namely (1) the deple-\\ntion of the alveolar capillaries, caused by the increased pres-\\nsure of tli\u00c2\u00ab ever-increasing fibrinous exudate, and (2) to the\\nretrograde metamorphosis of the exudate itself. At this\\n-tau* Hi\u00c2\u00bb nt surface, when -craped, will yield an opaque,\\npuriform, viscid, juicy substance. The latter, when freshly\\nmined, is found t he composed of fatty plugs, partly of\\nshining, fibrinous masses, and of cells which have under-\\ngone marked fatty changes. Stained sections will show\\nthe exudate t he partly broken down into fine, molecular\\ngranules, or changed into thick clumps that give the fibrin\\nreaction hut do not .-how the single threads of which they\\nare formed.\\n4. The exudate, which gradually softens and becomes\\nsimilar to an emulsion of milk, is expectorated and ab-\\nsorbed, and finally the stage of gray hepatization passes\\ninto the fourth stage the stage of resolution or lysis.\\nThis stage is recognized histologically by the complete\\ndisintegration of the fibrinous network and of the cells,\\nand by the gradual emptying of the alveolar spaces.\\nThe lung tissue, a- a rule, is wholly restored.\\nThe specific micro-organisms which are looked upon as\\nthe causative i i t i of croupous pneumonia are, in the\\nfirs! place, the diplococcus pneumoniae of Fr\u00c3\u00a4nkel and\\nWeichselbaum (micrococcus lanceolatus), less frequently,\\npneumobacillus of Friedl\u00c3\u00a4nder (bacillus mucosus cap-\\nsulata\u00c2\u00bb), and sometimes the pyogenic staphylococci and\\nstreptococci. A- a rule, the bacteria are demonstrable\\nmicroscopically in large numbers in the early stages of\\nthe inflammation. They are seen sometime- in thick\\nclumps, especially in the central lobules, which contain\\nmany cells and hut little fibrin. [It is exceedingly prob-\\nable thai the micrococcus lanceolatus or the diplococcus", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0179.jp2"}, "180": {"fulltext": "98 PATHOLOGIC HISTOLOGY.\\nPLATE 38.\\nFig. I.\u00e2\u0080\u0094** Carnification of the Lung, Following Croupous\\nPneumonia. X 170. Stained with orcein. There is passing into\\nthe alveoli, which are sharply outlined by the staining of the elastic\\nfibers (1), a dense, fibrillar, and somewhat richly cellular, connective\\ntissue in the form of loops or garland-like bundles (2) at areas is\\nstill recognized the swollen, partly desquamated epithelium (3).\\nFig. IL\u00e2\u0080\u0094 Organization of the Exudate in Bronchopneu=\\nmonia. A proliferating connective-tissue shoot within a small bron-\\nchus. X 200. 1, Epithelium of bronchus 2, plug of connective\\ntissue.\\npneumonia is the essential cause of croupous pneumonia,\\nthe other bacteria met with being due to a secondary,\\nmixed infection.]\\nThe regular typical course of croupous pneumonia\\ndepends evidently on the vitality of the micro-organisms\\nin question with the death of the latter disintegration of\\nthe exudate soon follows.\\nOccasionally, resolution does not take place the fibrin\\nmay disappear, but in its place the leukocytes increase.\\nThe latter fill the lumens of the alveoli, break through\\ntheir walls, and infiltrate the lobular septa of connective\\ntissue. In this way, as a result of either a continued in-\\ncrease or growth of the pneumococci (Zenker) or through\\nsubsequent infection with pus organisms, pneumonia is\\nsucceeded by either focal or more extensive suppuration\\nand destruction of lung tissue. Not infrequently, espe-\\ncially in cachectic individuals, in children, and in the\\naged, putrefactive bacteria may gain entrance through the\\nbronchial tract into pneumonic areas, or areas previously\\nthe seat of purulent infiltration, and set up a putrefactive\\ndestruction of the lung gangrene and sequestration.\\nIn croupous pneumonia the stage of resolution is some-\\ntimes retarded the fibrin remains present for an unus-\\nually long time, and finally becomes replaced by the in-", "height": "4691", "width": "2966", "jp2-path": "atlasepitomeofsp00drck_0180.jp2"}, "181": {"fulltext": "Tab. 3S-\\nfl^Li.\\nk\\nEig,\\nRpirhhvUl Manchen", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0181.jp2"}, "182": {"fulltext": "", "height": "4691", "width": "2973", "jp2-path": "atlasepitomeofsp00drck_0182.jp2"}, "183": {"fulltext": "RESPIBATOBY OBGANS. 99\\ngrowth into the alveoli of fibrous tissue. The latter\\neventually converts portions of lung tissue into a resisting,\\nflesh-like mass carnification, or chronic fibrous pneu-\\nmonia.\\nIn sections of this kind (chiefly when stained especially\\nfor elastic fibers) there will be seen shoot- of spindle-\\nshaped, connective-tissue cells (fibroblasts) breaking\\nthrough the alveolar walls and passing in a wreath-like\\nmanner from alveolus to alveolus, filling up and distending\\nthe Lumens. The connective tissue is moderately cellular,\\ncially in the central portions of the shoots, in which\\narc seen richly protoplasmic, epithelioid cells, as well as\\ndark, small, round cells. An increase in the thickness of\\nthe alveolar walls does not usually take place. The\\nrather -canty vascular connective tissue does not, there-\\nfore, originate from the alveolar walls, but rather from the\\n-canty connective tissue surrounding the end bronchioles.\\nSometimes the shoots also penetrate into the finer bron-\\nchiole-. The unresolved fibrin seems to play the role of\\nbridges, which the connective tissue follows in passing\\nthrough Cohn s paces, which become dilated. Polypoid\\nconnective-tissue plugs are -ecu penetrating into smaller\\nbronchioles, and finally occluding them. Detached alveo-\\nlar epithelium may -till be found within the alveoli\\n.-nid near the connective-tissue shoots. Occasionally,\\nthese -li .t- become lined with extensive row- of cuboid\\nepithelium.\\nQuite frequently, there i- Been a proliferation of the\\nremaining epithelium of the alveoli not altogether idled\\nwith the connective-tissue plugs. These new cells do not\\nremain flat and low. bin become higher, cuboid, oftentimes\\ncylindric in shape, bo thai adenoma-like structures resull\\niedlander s atypical proliferation of the alveolar epi-\\nthelimn). This atypical proliferation occurs in all those\\nprocesses in which the lung tissue becomes indurated, in-\\ncluding tuberculosis and syphilis, and depend- undoubt-", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0183.jp2"}, "184": {"fulltext": "10\u00c3\u0096 PATHOLOGIC HISTOLOGY.\\nedly on the removal of the pressure of the air on the walls\\nof the partially occluded alveoli.\\nNaturally, such fibrous, carnified portions of the\\nlung are rendered useless for respiratory purposes. In\\nsuch areas are sometimes found glistening, concentrically\\nlamellated, globular bodies, the so-called corpora amy-\\nloidea. (See General Part.)\\nBronchopneumonia.\\nAll the remaining forms of pneumonia (with the excep-\\ntion of the tuberculous) are macroscopically distinguished,\\nin the early stages, by the appearance of circumscribed\\nareas of inflammation, usually affecting single lobules.\\nThrough confluence of many lobules it may lead to larger\\nareas of infiltration sometimes a whole lobe may in this\\nmanner become solidified. When this occurs, it is known\\nas pseudolobular extension. All these forms of\\npneumonia are most commonly the result of extension\\nfrom a primary infection of the smaller bronchioles. A\\nsimple catarrhal inflammation of a bronchiole may spread\\nto the surrounding lung tissue, which the bronchiole\\nsupplies. Usually, the bronchial stem becomes occluded\\nby the accumulation of cells and increased mucous secre-\\ntion, as a result of which the alveolar area that it supplies\\ncollapses and becomes atelectatic. Later, these collapsed\\nalveoli become distended, not with air, but with cellular\\nelements, especially with alveolar epithelium. The latter\\nfind their way into the lumen partly through desquamation\\nand, on the other hand, as a result of active proliferation.\\nSome of the cells are still flat and polygonal in shape,\\nwhile others have become swollen, vesicular, or globular,\\nand may easily be distinguished from other cellular\\nelements by their vesicular nuclei. Around tuberculous\\nareas in the lung similar forms of pneumonia may develop\\n(desquamative pneumonia of Buhl, see Tuberculosis).", "height": "4722", "width": "2993", "jp2-path": "atlasepitomeofsp00drck_0184.jp2"}, "185": {"fulltext": "RESPIRATORY ORGANS. 101\\nIn the later stages those cells become mixed with a\\nvariable number of leukocytes as well as red blood-\\ncorpuscles which have passed out from the alveolar cap-\\nillaries. Fibrin is not found in the purely catarrhal\\nforms of bronchopneumonia if present, it is only met\\nwith in limited amount. Macroscopically, the cut surface\\nof such inflammatory areas is always smooth. Resolution\\ntakes place through fatty degeneration of the cells that\\ntill tin- alveoli.\\nA form o{ consolidation that resembles catarrhal pneu-\\nmonia very much in structure is the so-called marantic\\nsplenization of the lung. It is usually found in con-\\nnection with long-standing, hypostatic congestion, especially\\nwhen edema is also present. (Plate 36, Fig. II.)\\nComplicated in structure as well as in genesis is the\\n-\u00c2\u00ab\u00c2\u00bb-called lobular pneumonia that occurs secondarily to\\nvarious other diseases, and especially in children after the\\nacute infections, such as diphtheria, measles, scarlatina,\\nsmallpox, whooping-cough, influenza, etc. These forms of\\npneumonia are also of bronchiogenic development, but the\\ninflammation, instead of extending along the long axis of\\nthe bronchial tube into the corresponding lobule, spreads\\ninto the bronchial walls and the surrounding peribron-\\nchial tissue, whence it passes over into the neighboring\\ngroups of alveoli. Since the latter do not belong to the\\nlobule supplied by the affected bronchus, the typical\\nlobular arrangement of the consolidation is. disturbed, and\\nthere are produced variously ize rounded, elongated or\\ncircular, infiltrated areas, which surround a bronchus and\\nare noi confined to the lobular limit or border. Trans-\\nverse sections through a bronchus and it- surrounding\\nlung tissue will show, even macroscopically, the central\\nyellow-stained portion namely, the bronchus filled\\nwith the purulent exudate, and its infiltrated wall, while\\nthe periphery of the nodule i- deeper in color.\\nMicroscopically, the bronchus is tilled with pus-cells", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0185.jp2"}, "186": {"fulltext": "102\\nPATHOLOGIC HISTOLOGY.\\nPLATE 39.\\nFig. I.\u00e2\u0080\u0094 Beginning Catarrhal Pneumonia. X 250. In the\\nalveoli is seen a purely cellular exudate the latter consists of large,\\nswollen, polygonal or round, alveolar, epithelial cells (1) and a few\\nleukocytes.\\nFig. II. A Peribronchial Inflammatory Area with Begin=\\nning Extension into the Surrounding Lung Tissue. X 80.\\n1, Lumen of small bronchus filled with pus-cells and cocci (diplo-\\ncoccus pneumoniae and streptococcus) 2, epithelium of bronchus infil-\\ntrated with leukocytes 3, muscularis, also infiltrated with leuko-\\ncytes 4, peribronchial tissue greatly infiltrated with leukocytes the\\nblood-vessels are greatly dilated 5, the infiltration extends to the\\nwalls as well as to the lumen of the adjacent alveoli.\\nas well as detached cylindric epithelium, sometimes in\\nrows, and also numerous micro-organisms. The connective\\ntissue and muscular layers are densely infiltrated with\\nleukocytes sometimes the muscle-fibers are so pressed\\napart by the pus-cells that they are hardly recog-\\nnizable. The blood-vessels of the bronchial wall are\\ngreatly distended with red blood- corpuscles, oftentimes\\noccluded with fibrin and leukocytic thrombi. The sur-\\nrounding alveoli are not sharply outlined, as their walls\\nare also infiltrated with polymorphonuclear leukocytes\\nfilling the lumen. The composition of the exudate is a\\nvariable one, especially as regards the amount of fibrin\\npresent, and its manner of distribution is often irregular.\\n(Plate 39, Fig. II.)\\nThere are cases of bronchopneumonia in which the\\nexudate is purely cellular, in other instances fibrin pre-\\ndominates at the peripheral alveoli of the lobule, while in\\nthe central ones the cellular elements of the exudate pre-\\ndominate. Sometimes areas are found in which single\\nfields can not be distinguished from a typical croupous\\npneumonia. The fibrinous plugs are quite numerous,\\nwhile interalveolar fibrin threads and bundles are also", "height": "4713", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0186.jp2"}, "187": {"fulltext": "Tab. 39.\\nM\\no\\nO\\nr\\nO\\nJ\\n9\\nv\u00c3\u00b6O\\n3\\ne\\nv\u00c2\u00bb CT O 4 oo f\u00c2\u00bb.\\n9\\n1\\nLitfuAnst Hpichhold. Mund ich.", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0187.jp2"}, "188": {"fulltext": "", "height": "4687", "width": "2961", "jp2-path": "atlasepitomeofsp00drck_0188.jp2"}, "189": {"fulltext": "JRESPIKATOBY OKGAXS. 103\\npresent, and oftentimes the fibrinous exudate Extends into\\nthe bronchi themselves, from which it may also start.\\nThe variability of the exudate does not depend so much\\nupon the kind of micro-organism present as upon their\\nnumber. The micro-organisms that arc found are the\\ndiplococcus pneumoniae (Fr\u00c3\u00a4nkel-Weichselbaum), the\\nstreptococcus pyogenes, the pyogenic staphylococci, the\\npneumobacillus t Friedlander, the diphtheria bacillus,\\nthe influenza bacillus, and the tubercle bacillus which\\ni- found in the bronchopneumonia around tuberculous\\nareas.\\nGenerally speaking, it may be -aid that the amount of\\nfibrin found i- in inverse proportion to the number of\\nbacteria present in other words, the greater the number\\nt bacteria, the -mailer i the amount of fibrin. The\\nwhole process really depends upon the chemotactic action\\nof bacteria on the leukocytes. (See General Part, In-\\nflammation.)\\nUnder peculiar circumstances there are formed in the\\nexudate of the alveoli a larger or smaller number of giant\\neel!-, especially in cases of postdiphtheric pneumonia and\\nin cases following measles. They are seen in the alveoli\\na- massive, polynuclear, occasionally extraordinarily large-\\nsized, polygonal, or irregularly pointed cells that inclose\\nwithin their cytoplasm a number of white blood-corpus-\\ncles, nuclear and cellular fragments, and clumps of fibrin.\\n(Plate 10, Fig. II.) These cells are formed by the con-\\nglutination of a number of detached, alveolar, epithelial\\ncells, a- well ;i- by the multiplication of the nucleus\\nin the cell without subsequent division of the cell-body.\\nasionally, they are found in fibrous indurated lungs,\\nresulting from the atypically proliferated epithelium.\\nThe embolic and pleurogenous forms of pneumonia have\\nbeen mentioned. The embolic forms are often accom-\\npanied with the formation of infarction tin- occurs\\nwhen bacteria alone do not reach the lung, but are car-", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0189.jp2"}, "190": {"fulltext": "104 PATHOLOGIC HISTOLOGY.\\nPLATE 40.\\nFig. I.\u00e2\u0080\u0094 Purulent (Lobular) Pneumonia Following Diph=\\ntheria. X 250. I, Bronchus filled with pus-corpuscles and loosened\\nepithelium, the latter in form of rows. The wall of the bronchus is\\ninfiltrated with leukocytes (pus-cells). Alveolar septa contain greatly\\ninjected blood-vessels. The alveoli are filled with a purely cellular\\nexudate, composed largely of leukocytes and partly of desquamated\\nepithelium.\\nFig. IL\u00e2\u0080\u0094 Postdiphtheric Lobular Pneumonia. X 280.\\nWeigert s fibrin stain. The exudate in the alveoli is partly cellular\\nand partly fibrinous (2) capillaries of the alveolar walls are greatly in-\\njected the cellular material in the alveoli consists largely of leuko-\\ncytes, less so of alveolar, epithelial, and giant cells (1). The giant\\ncells are the result of the melting together of a number of the alveolar\\nepithelial cells their protoplasmic bodies are filled with various kinds\\nof detritus, nuclear fragments, and particles of fibrin, etc.\\nried there by an embolus in which they are inclosed. The\\nmost frequent points of origin are infectious thrombi in\\nveins in various parts of the body for instance, the uter-\\nine veins in puerperal septicopyemia more rarely, endo-\\ncarditic vegetations in the right side of the heart. First,\\nthere is formed a hemorrhagic infarct in the affected area\\nthat soon becomes infiltrated with leukocytes as a result of\\nthe peculiar action of the micro-organisms, and more or less\\npurulent softening of the surrounding tissue (embolic ab-\\nscess) soon takes place. The picture of an insular pneu-\\nmonia in this instance is of brief duration, as the process\\nof softening of larger areas is soon accomplished. Some-\\ntimes the clump-like masses of cocci are visible with the\\nlow power.\\nTuberculosis.\\nThe histologic appearance of pulmonary tuberculosis is\\nextremely varying and polymorphous. Formerly, before\\nthe discovery of the tubercle germ led to the establishment", "height": "4713", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0190.jp2"}, "191": {"fulltext": "Tab. 40.\\nv-.;v;;.v/ ..v^;v\\\\\\ntt\\nAnst HeirhhoUt. M\u00c3\u00bcnchen.", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0191.jp2"}, "192": {"fulltext": "", "height": "4681", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0192.jp2"}, "193": {"fulltext": "RESPIRATORY organs. 105\\nof their etiologic unity, these processes were looked upon\\nas a -eric- of distinct diseases (phthisis, caseous pneumonia,\\ncirrhosis, etc.\\nThe localization, distribution, and course of the tuber-\\nculous disease of the lungs are so manifold that it becomes\\nwell nigh impossible to consider these processes from a\\ncommon histologic standpoint. All the forms of inflam-\\nmation and their several terminations, which were referred\\nto previously, may run their course side by side with the\\nspecific tuberculous processes no organ in the body un-\\ndergoes so many alterations from tuberculosis as the Lung.\\nThe tuberculous virus may reach and spread throughout\\nthe lung along three distinct routes the circulating blood,\\nby inhalation through the bronchi, and by way of the\\nlymph-vessels. In the first case we speak of a hemato-\\ngenous or embolic tuberculosis, or of an acute miliary\\ntuberculosis, because in this case the tuberculous eruptions\\nat the time of death generally reach the size of millet\\nseeds. This form of tuberculosis most frequently develops\\nas the result of a tuberculous focus in some part of the\\nbody e. g. a tuberculous lymphatic gland rupturing into\\na vein, the infectious material being carried by the blood\\nto the right heart and thence into the lungs. A somewhat\\nsimilar event occur- after the rupture of a tuberculous\\nfocus into a larger lymphatic vessel, followed by a trans-\\nport of tuberculous material into the circulating blood.\\nCircumscribed miliary tuberculosis of parts of the lung\\ntissue may result from the breaking into an arterial\\nbranch of a preexisting tuberculous focus in the lung\\nitself.\\nIn all these cases there circulate in the blood tubercle\\nbacilli that, if arn-ted in the capillaries, produce multi-\\nple, miliary, embolic, tuberculous foci, the beginning of\\nwhich takes place in the capillary wall- and their imme-\\ndiate surround in\\nA- elsewhere, tubercle bacilli in the lung- cause first", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0193.jp2"}, "194": {"fulltext": "106 PATHOLOGIC HISTOLOGY.\\na proliferation of the fixed tissue cells. The capillary\\nendothelium, the connective-tissue cells of the alveolar\\nsepta, the alveolar epithelium in the neighborhood of\\nthe bacilli begin to proliferate, and there are produced the\\nso-called epithelioid cells that form the basis for the pul-\\nmonary tubercle. At this stage a purely cellular nodule\\nis found, usually surrounded by the elastic fibers of the\\nalveolar walls, and projecting into the adjacent alveolar or\\ninfundibular lumen. Under the influence of this nodule\\nthe alveolar epithelium begins to desquamate at the same\\ntime that inflammatory exudation also occurs, so that a\\nvarying amount of fibrin is deposited in the affected\\nalveoli and around the cellular nodules. Histologically,\\nthe pulmonary tubercles of hematogenous origin differ\\nin no way from miliary tuberculopneumonic foci that\\ndevelop in lymphogenic or bronchiogenic tuberculosis of\\nthe lung. Several adjacent tubercles may coalesce with\\none another, thus giving origin to large conglomerations\\nof tubercles, which for some time remain microscopically\\ndistinct.\\nIn acute general miliary tuberculosis the nodules do\\nnot, as a rule, reach beyond the stages just described.\\nOccasionally, such nodules are found in the lumen of an\\ninfundibulum or an alveolus their localization is readily\\nseen in preparations in which the elastic fibers are stained\\nby special methods. It is then seen that, according to\\nage, the cellular or more or less caseous centers are en-\\ncircled by the elastic fibers of the walls of these spaces.\\nThe epithelioid cells may form giant cells in varying\\nnumbers. Frequently, giant cells are seen with numer-\\nous protoplasmic pseudopods extending out and becoming\\nlost in the reticulum of the tubercle. (See General Part,\\nTuberculosis.) With increasing growth there develops in\\nthe center of the cellular complexus a caseous necrosis\\nwhich steadily advances.\\nThe forms of tuberculosis that begin in and spread", "height": "4691", "width": "2981", "jp2-path": "atlasepitomeofsp00drck_0194.jp2"}, "195": {"fulltext": "HESPIEATORY OEGAXS. 107\\nalong the bronchial tree or the lymphatic vessels, while\\npresenting the same histologic changes in their inception,\\ndiffer markedly in their further course.\\nBy far the most frequent mode of tuberculous infection\\nof the lung and of the body as a whole is by way of the\\ninspiration. Through the respiratory passages the bacilli\\nnach the -mall bronchial branches where they become\\narrested and produce in the walls the earliest changes, or\\nthey reach the inthndibnla or alveoli, where the specific\\nchanges then develop. In the first case processes de-\\nvelop similar to those seen in the evolution of broncho-\\npneumonia. Bronchitis, peribronchitis, and bronchopneu-\\nmonia develop successively, the inflammation extending\\nthrough the bronchial wall into the surrounding tissue\\nhistologically, these changes are modified only in so far as\\nthe specific effects on the tissues of the tubercle bacillus\\ncome into play. There is formation of nodules and then\\nthe caseous necrosis, which, as a rule, befalls tuberculous\\ntissue at a certain stage.\\nIt may be assumed that the bacilli are arrested in a plug\\nof mucus in a small bronchus, and next come in contact\\nwith the epithelial cells of the Avails the toxic action of\\nthe bacilli at once induces a proliferation of the cells and\\nleukocytic emigration, and a bronchial tubercle is formed.\\nThe nodules enlarge the smaller the bronchus, the sooner\\nthe nodules coalesce; caseation occurs, and the caseous\\nera aoon run together and form a partial or complete\\nous ring around the bronchial lumen. At this point\\nthe neighborhood of the bronchus is extensively involved\\nthe nodules spread to the external layer- of the bronchial\\nwall, which are destroyed and included in the caseous\\nriii-. Gaseous material either partially or wholly fills the\\nlumen, and, in consequence, the corresponding alveolar\\narea -ink- together in atelectasis. Furthermore, the peri-\\nbronchial connective tissue and the alveoli adjacent there-\\nto present consecutive changes: the alveolar wall- are", "height": "4650", "width": "3005", "jp2-path": "atlasepitomeofsp00drck_0195.jp2"}, "196": {"fulltext": "108 PATHOLOGIC HISTOLOGY.\\nPLATE 41.\\nFig. I.\u00e2\u0080\u0094 Embolic Abscess of Lung in Pyemia. X 75. (In-\\nsular, embolic, purulent pneumonia.) Around the blue stained coccal\\nmasses lie a great number of leukocytes in the alveolar lumens and\\nsepta. The lung tissue is in part undergoing purulent softening.\\nFig. IL\u00e2\u0080\u0094 Caseous Bronchitis. X 40. Transverse section\\nthrough a small bronchus and surrounding lung tissue. The wall of\\nthe bronchus is completely broken down, caseated (1), its lumen\\npartly rilled with the cheesy material (2). The tuberculous process\\nextends in a circular manner outward to the surrounding lung tissue\\nthe alveoli of the latter are infiltrated and filled with numerous con-\\nfluent tubercles (3).\\ninfiltrated with numerous round cells and appear thick-\\nened in the alveolar lumen a lively desquamation of the\\nepithelium occurs, and the cells are mixed with red and\\nwhite blood-corpuscles at certain points large accumula-\\ntions of leukocytes appear, which obscure the outlines of\\nthe alveolar walls. Fibrin, in greater or less quantity,\\nmay also be precipitated in the surrounding alveoli in\\nbrief, at a short distance from the caseated bronchus there\\nexists a typical bronchopneumonic focus, which at first\\npresents nothing to betray its tuberculous origin gradu-\\nally, the picture changes, however tubercle bacilli enter\\nthis zone also, either directly by virtue of their own pro-\\nliferation, or, more frequently by far, they are imported by\\nwandering cells. And now there appear in the walls of\\nthe alveoli new nodules, which grow eccentrically wdrile\\ncentral necrosis takes place or, when bacilli are present\\nin large numbers, the cellular exudate already present in\\nthe alveoli undergoes caseation to a larger extent, so that\\nnow a focus of caseous pneumonia results.\\nFurther inflammatory changes of a consecutive nature\\nalso develop in the lobule of the occluded bronchus. The\\natelectasis is succeeded by a lively proliferation and des-", "height": "4685", "width": "2993", "jp2-path": "atlasepitomeofsp00drck_0196.jp2"}, "197": {"fulltext": "Tab At.\\n\u00e2\u0080\u00a2I\\nFig. I\\nU.\\nLuh.An.st r Reichhold, Muuuhui*", "height": "4634", "width": "2830", "jp2-path": "atlasepitomeofsp00drck_0197.jp2"}, "198": {"fulltext": "", "height": "4645", "width": "3010", "jp2-path": "atlasepitomeofsp00drck_0198.jp2"}, "199": {"fulltext": "6\\nRESPIRATORY ORGANS. 109\\nquamation of the alveolar epithelium, which tills the\\nalveolar spaces often some fibrin is also precipitated, and\\nthis gives the tissue a certain compactness and a peculiar\\ngelatinous consistence. In the absence in the closed\\nalveoli of all interalveolar pressure on part of the air-\\ncurrenl the proliferating epithelium frequently assumes\\nthe cubic and atypical forms referred to, which bear such\\nmblance to glandular epithelium. The connective\\ntissue of the interlobular septa, or the peribronchial tissue,\\nif not alnady tuberculous, may inaugurate the same pro-\\nf organization that are seen in the common pneu-\\nmonia, and that lead t fibrous induration and obliteration\\n\u00c2\u00bbf the pulmonary area involved. Frequently, however,\\nthe collapsed and gelatinous Inno; tissue becomes infected\\nwith tubercle bacilli, either from the surrounding tuber-\\nculous bronchopneumonia or from the tuberculous plug in\\nthe bronchial lumen, and in this case it undergoes a rapid\\ncaseous necrosis (caseous pneumonia). When fibrin is\\npresent in larger quantities in the alveoli, then it may\\nas also the elastic tissue in the alveolar walls resist the\\nnecrotic action of the bacilli longer than the cells in the\\nalveoli. The bodies of the cells run together, and the in-\\ndividual colls are no longer distinguishable, but disintegrate\\ninto a finely granular, opaque mass peculiar distortions\\noccur in the nuclei which undergo fragmentation, the result-\\nin- (\u00c2\u00bbarticle- often retaining for a long time their affinity\\nfor stains. Gradually, this process extend- to the cells of\\nthe alveolar walla and destroys the epithelium, the cap-\\nillaries, and the connective-tissue liber- and cells. At\\ntlii- tin- necrotic lung tissue may till contain\\ndense, easily stainable plugs of fibrin even the inter-\\nalveolar connecting bands may he retained. Eventually,\\nthe fibrin also disintegrates, leaving only the elastic\\nfibers, which, :i- a rule, break up into segments arranged\\nin rows before disappearing. Finally, there result larger\\n3 composed of an unstainable and almost structureless", "height": "4634", "width": "2830", "jp2-path": "atlasepitomeofsp00drck_0199.jp2"}, "200": {"fulltext": "110 PATHOLOGIC HISTOLOGY.\\nPLATE 42.\\nFig. I.\u00e2\u0080\u0094 Miliary Tuberculosis of the Lung. X 35. The\\ntubercles are caseated in the center (2), and are surrounded by air-\\ncontaining,- alveolar tissue (1) at parts the tubercles are so close to\\neach other that larger nodules are formed giant cell (3).\\nFig. IL\u00e2\u0080\u0094 Caseous Pneumonia. Weigert s fibrin stain and elas-\\ntic-fiber stain. X 70. The tissue has undergone complete necrosis\\nnuclei can not be recognized either in the alveolar walls or in their\\nlumens in the latter are seen an opaque, granular (cheesy) detritus\\nwith some chromatin fragments 3, well-preserved fibrin is seen in the\\nperipheral parts, and a few alveoli are filled with closely packed fibrin,\\nas is seen in croupous pneumonia the elastic fibers in the alveolar\\nwalls (1) and blood-vessels (2) are still well preserved.\\nmaterial, the caseous material, which is rather dry and\\nwholly bloodless, hence the well-known yellowish-white\\ncolor. The blood-vessels in areas of caseous pneumonia\\nare usually stopped up by fibrinous and leukocytic thrombi\\na dense network of fibrin adhering to the intim a.\\nTuberculous bronchopneumonia, and caseous, circum-\\nscribed pneumonic foci are commonly succeeded by a\\nfurther spread of the tuberculous process through the\\nlymphatic system. The lymph-vessels run parallel with\\nthe bronchi and with the vessels, being situated in the\\nperibronchial and perivascular connective tissue their\\nroots and radicles are, therefore, inclosed in the tubercu-\\nlous granulation tissue in the forms of pulmonary tuber-\\nculosis now described, and bacilli naturally find their\\nway into the lymph-current, by which they are then\\ncarried further. In this way multiple tubercles form in\\nthe lymph-vessels themselves, which, on account of the\\nresulting swellings, may appear as strings of beads, as\\nthey run around the bronchi. This may be properly\\ndesignated as peribronchial tuberculous lymphangitis.\\nIn this case the tubercles originate from the lymphatic\\nepithelium. The concentric enlargements extend, on the", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0200.jp2"}, "201": {"fulltext": "3--\\ni\u00c3\u00bcf.1.\\nFf//. 2.\\nTab. 42.\\n2\\nAnst F. Reichhold M\u00c3\u00bcnchen.", "height": "4634", "width": "2954", "jp2-path": "atlasepitomeofsp00drck_0201.jp2"}, "202": {"fulltext": "", "height": "4659", "width": "2980", "jp2-path": "atlasepitomeofsp00drck_0202.jp2"}, "203": {"fulltext": "RESPIRATORY ORGANS. Ill\\none hand, toward the bronchi on the other hand, toward\\nthe Burronnding alveolar tissue. When several lymph-\\nvessels in the circumference of a bronchus become tuber-\\nculous, thm caseous rings may form around the bronchi,\\ndue to the circular confluence of spreading tubercles which\\nmay attack the bronchial wall secondarily, and eventually\\nml to the lumen. It sometimes happen- that in\\nfavorable sections of a pulmonary lobe the yellowish,\\nnodular cords can be followed with the naked eye clear\\nto the hilus, where they end in the peribronchial lymph-\\nid-. In the latter stages of the disease, when the\\nconfluent aodules have destroyed the bronchus and invaded\\nthe surrounding tissue, the exact genesis of the disease can\\nno longer be followed.\\nWhen the tubercle bacilli enter the alveolar tissue\\ndirectly through the bronchi, which is often the case in the\\napices of the lungs, then there develops a minute pneu-\\nmonic infiltration in case the bacilli remain or they may\\nhe taken up bywandering cells and carried into the lymph-\\nvessels of the interstitial tissue, become arrested here, and\\ninduce the formation of nodules. In the first case there\\ni- produced a miliary, tuberculous pneumonia in the\\niid, a pulmonary tubercle. But the histologic differ-\\nences a- to position and mode of further spreading are\\nearly obliterated, because the interstitial tubercle very\\ncaus pneumonie changes, while the primary foci\\nin the alveoli, in their turn, soon induce interstitial\\nchanges. In the beginning the alveolar foci consist prin-\\ncipally of proliferated, alveolar epithelium and wandering\\ncells, while the interstitial foci are built up by connective-\\ntissue cells and vascular epithelium. Prom the resulting\\nepithelioid cells giant cells are formed with pseudopodial\\npro* (tending into the reticulum of the tubercle j\\nthe protoplasm of the giant cells frequently \u00c2\u00bbnt ;ii n-\\ntubercle bacilli a- well as disintegration product- of such.\\nIn genera] the giant cells are the more numerous the", "height": "4634", "width": "2830", "jp2-path": "atlasepitomeofsp00drck_0203.jp2"}, "204": {"fulltext": "112 PATHOLOGIC HISTOLOGY.\\nPLATE 43.\\nFig. I.\u00e2\u0080\u0094 Miliary Tuberculous Pneumonia. X 170. Wei-\\ngert s fibrin stain and elastic-fiber stain. Several alveoli adjoining\\neach other are filled with a cellular and fibrinous exudate. The cells\\nconsist largely of desquamated epithelium some of their nuclei have\\nnot taken the stain (beginning caseation). The attached alveolar epi-\\nthelium is undergoing proliferation.\\nFig. II. \u00e2\u0080\u0094Caseation of the Exudate in an Alveolus in a Case\\nof Caseous Pneumonia. X 360. Elastin staining. The alveolus\\nis filled up with a grayish, fine, granular mass, containi\u00c3\u00bcg a larger num-\\nber of nuclei which are undergoing degeneration. The cell-bodies are\\nno longer visible.\\nslower the process of nodule formation in the rapidly\\nspreading, diffusely pneumonic, and extensively caseated\\nforms giant cells are often absent. As elsewhere, the\\ncenter of the nodules, after a time, becomes caseous, and\\nlarger caseous areas result from the confluence of groups\\nof nodules.\\nThe further fate of such isolated tuberculous foci may\\nvary much. The form of healing through connective-\\ntissue encapsulation is relatively common. In this case\\nthe exudation does not progress further into the adjacent\\nalveolar groups, but from the margins of the nodules\\nPLATE 44.\\nFig. I.\u00e2\u0080\u0094 Desquamative Pneumonia (Buhl) Around a Tuber=\\nculous Area of the Lung. X 340. 1, Atypically proliferated,\\ncuboid, and cylindric, alveolar epithelium 2, desquamated, vesicu-\\nlated, swollen, alveolar, epithelial cells 3, epithelial cells loaded with\\nanthracotic pigment.\\nFig. II. Proliferation and Desquamation of the Alveolar\\nEpithelium in Tuberculous Pneumonia. X 520. 1, Fibrin plug\\nin an alveolus 2, interalveolar fibrin bridge (Cohn s stigma) 3, pro-\\nliferated alveolar epithelium partly detached from the underlying\\nmembrane 4, elastic fibers of the alveolar wall.", "height": "4715", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0204.jp2"}, "205": {"fulltext": "7 ab. 43.\\n\u00e2\u0096\u00a0f\\nT\\\\\\n\u00e2\u0080\u00a2V\\n(5\\ntr 1\\nFig. S.\\nLUfuAnst ERekhhoUt, M\u00c3\u00bcnchen.", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0205.jp2"}, "206": {"fulltext": "", "height": "4687", "width": "2982", "jp2-path": "atlasepitomeofsp00drck_0206.jp2"}, "207": {"fulltext": "Tab A4.\\n*J\\nr*\\nr a\\nV\\n6\\n6\\n8\\n*e\\nW\\n6\u00c2\u00bb O ft\\nc\\nVSo\\nl^i.\\ns.\\n4/id E Reichhold, Munr .wn.", "height": "4643", "width": "2806", "jp2-path": "atlasepitomeofsp00drck_0207.jp2"}, "208": {"fulltext": "", "height": "4687", "width": "2971", "jp2-path": "atlasepitomeofsp00drck_0208.jp2"}, "209": {"fulltext": "RESPIB\u00c3\u0084TOJRY OEGAXS. 113\\nsprings a cellular connective tissue which gradually\\nbecomes more and more fibrous and less cellular at the\\nsame time as it surrounds and encroaches upon the case-\\non- zone the epithelioid cells, which often are arranged\\nin a radiating manner around the caseous center, and also\\nthe more peripheral round cells, disappear, and in their\\nplace connective-tissue hands appear derived from the in-\\nterstitial tissue, especially the peribronchial. The advanc-\\ning connective tissue frequently takes up the giant cells,\\nwhich may remain inclosed with the new tissue. The\\ncaseous material dries up more and more, and shrinks, and\\ncalcareous salts are frequently deposited here; the caseous\\nfocus, at first soft and gritty, later becomes converted into\\na dry and brittle calcareous mass. The connective-tissue\\nformation i- not always limited to encapsulation of a pre-\\nexisting focus, but may assume a more progressive charac-\\nter and give rise to a cirrhotic induration of the surround-\\ning tissue fibroplastic sprouts, similar to those observed\\nin the organization after lobar pneumonia, grow into the\\nalveoli, fill up the lumens, and eventually change the tis-\\nsue into a hard, cicatricial mass. Such scars are favorite\\nplaces for the deposition of coal pigment, which is scattered\\nabout in stellate and spindle-shaped groups between the\\nlibrilhe a- well as in the persisting cells (slaty induration).\\nThe alveoli immediately adjacent are often the seat of a\\nvicarious emphysema. (Plate 45, Fig. II.) The epithe-\\nlium of the alveoli that are not obliterated often assumes\\na cubic form, giving rise to gland-like spaces and tubules.\\n(Plate H. Fig, I.) [f living tubercle bacilli are not pres-\\nent in the caseous or calcareous focus, then the tuberculosis\\ni^ to I\u00c2\u00bb.- regarded a- healed.\\nBui the course is not always so favorable as this; fre-\\nquently, indeed, does the opposite happen namely, soft-\\neningand \u00c2\u00bblnti \u00c2\u00bbn of the foci. Two conditions are to be\\nconsidered in connection with this process namely, the\\nmechanical and the infectious.\\n8", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0209.jp2"}, "210": {"fulltext": "114 PATHOLOGIC HISTOLOGY.\\nPLATE 45.\\nFig. I. Wall of a Tuberculous Cavity in the Lung with\\nCirrhosis of the Apex. X 16. 1, Cavity 2, shreddy, caseous\\nmasses 3, closely fibrillar fibrous tissue with authracotic pigment 4,\\ncompressed alveoli with proliferating epithelium.\\nFig. II.\u00e2\u0080\u0094 Slaty Induration of the Lung in Obsolete Fibrous\\nTuberculosis (Cirrhosis). X 55. 1, Emphysematous lung tissue\\n2, an indurated area of lung, composed of a close, fibrillar, and slightly\\ncellular, connective tissue (scar), infiltrated with masses of black pig-\\nment.\\nIf the tuberculous focus either starts from a bronchus or\\na bronchiole or reaches them in the course of its extension,\\nthen the bronchial wall becomes involved in the necrotic\\nprocess no longer able to withstand the inspiratory pres-\\nsure, the wall dilates, and in the necrotic district there\\nresults a cavity which is in connection with the bronchus\\nthe so-called bronchiectatic cavity. Such cavities may\\narise in the smaller bronchi and, by amalgamation, form\\nlarger, irregular caverns.\\nThe majority of the cavities, how r ever, are the result of\\nmixed infections with pneumococci, streptococci, etc., which\\nreach the tuberculous pneumonic areas with the air. This\\nmixed infection leads to a softening of the caseous material\\nand a progressive suppuration at the periphery of the focus\\nsooner or later the focus empties itself through a bron-\\nchus. The innermost layer of the walls of a cavity like\\nthis consists of necrotic tissue containing innumerable\\ntubercle bacilli the adjacent layers are infiltrated very\\ndensely with leukocytes following the evacuation there\\nensues an active and productive inflammation, the result\\nof which is the production of a connective-tissue sac\\naround the cavity this sac has a structure similar to the\\nslaty induration around caseous foci coal pigment may\\nbe deposited in fibrous lamellae, and the epithelium of the\\nadjacent alveoli may assume a cuboid form.", "height": "4684", "width": "2967", "jp2-path": "atlasepitomeofsp00drck_0210.jp2"}, "211": {"fulltext": "Sgl.\\nTab. 4-5.\\n4\\n4\\nv\\nwv.\\nEig.2.\\nLUhmAnst HpichhoUL, M\u00c3\u00bcnchen.", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0211.jp2"}, "212": {"fulltext": "", "height": "4672", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0212.jp2"}, "213": {"fulltext": "RESPIRATORY ORGANS. 1 1\\nAs the cavities enlarge, a few persisting bands or ridges\\nof tissue are usually found to pass across the spaces.\\nOn examination, these are found to consist largely of\\nblood-vessels with greatly thickened walls, the lumens\\nbeing wholly or partly closed by endarteritic or endophle-\\nlutie changes, (See Circulatory Organ-, p. 3 J.)\\nSyphilis.\\nTlicr\u00c2\u00ab- is no doubt but that syphilis of the lungs\\noccurs in the adult, but its histologic changes are little\\nkn \u00c2\u00bbwn. It is probably frequently confounded with the\\nchronic indurative forms of tuberculosis, both macroscopi-\\ncally and microscopically. The tubercle bacilli are\\nabsent, of course. In the new-born, however, and the\\nprematurely still-born the pulmonary lesions of congeni-\\ntal hies present characteristic appearances. Two chief\\nforms are distinguished the pneumonic form, which in-\\nvolve- whole lobes and often the entire lung, and the\\ncircumscribed, nodular form.\\nThe diffuse form is characterized by a general increase\\nof the interstitial connective tissue, interlobular as well as\\nperibronchial the alveolar septa are also thickened; this\\nLb due to the presence of numerous, spindle-shaped and\\npolygonal, fibroblastic cells. The alveolar spaces become\\ncontracted they usually contain a rather richly cellular\\nexudate composed of Borne leukocytes and numerous, dv\\nquamated, epithelial cells, which have a pronounced ten-\\ndency to fatty changes. The blood-vessels present thick-\\nd walls; in the adventitia arc connective tissue\\nproliferation and follicular heaps of rounds cells, and in\\nthe intima is hyperplasia of the subepithelial connective\\ntissue, so thai the lumen becomes greatly narrowed and\\neven wholly closed. Tin- render- the organ anemic.\\nThis combined with the fatty changes in the alveolar epi-\\nthelium gives the involved district a yellowish-white", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0213.jp2"}, "214": {"fulltext": "116 PATHOLOGIC HISTOLOGY.\\nPLATE 46.\\nFig. I. Syphilitic White Pneumonia of the New=born.\\nX 250. The alveolar walls are considerably thickened with a richly\\ncellular, connective tissue (1). In the alveolar lumen numerous large,\\ndesquamated, epithelial cells (2) and several leukocytes are seen.\\nFig. IL\u00e2\u0080\u0094 Indurative Interstitial Pneumonia in Hereditary\\nSyphilis. X 250. The connective-tissue septa of the alveoli are\\nconsiderably broadened (1). The alveolar lumens are small and\\ntubular in appearance (2), with atypically proliferated, cuboid epi-\\nthelium.\\nappearance and a firm consistence, and hence the term\\nwhite pneumonia.\\nIn many cases the lungs of syphilitic fetuses contain\\nlarger or smaller, light-colored, dry nodules, which are\\nusually not sharply circumscribed. Examined micro-\\nscopically, it is seen that the changes evidently date from\\nan early embryonal period. The principal part of these\\nnodules consists of a dry connective tissue with long fi-\\nbrillse and spindle-shaped nuclei. This tissue is arranged\\nin dense bands, and incloses gland-like and branching\\ncenters lined with a cubic, cylindric, or quite regular epi-\\nthelium. These spaces correspond to the alveoli whose\\ndevelopment was arrested by the growth of connective\\ntissue in an early period when the alveolar lining in\\ngeneral is cubic in character. The centers of these nod-\\nules are often caseous that is, the nuclei are not stained\\nwhile the coarser structure is quite distinct, as is often the\\ncase in the caseation of syphilitic lesions. In the lung\\ntissue about the nodules the alveolar septa are usually\\nthickened for a considerable extent, and frequently a\\nwhite pneumonia is also present.", "height": "4683", "width": "2967", "jp2-path": "atlasepitomeofsp00drck_0214.jp2"}, "215": {"fulltext": "TabA6.\\n/a fiT J,\\nJ.\\ni- /n\\nLtlh. Ans/ Hciclihnlil Mnnrhcn", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0215.jp2"}, "216": {"fulltext": "", "height": "4688", "width": "2853", "jp2-path": "atlasepitomeofsp00drck_0216.jp2"}, "217": {"fulltext": "IBATOBT ORGANS. 117\\nPLEURA.\\nThe pulmonary and costal (including the diaphragmatic)\\npleura consists of a layer of parallel connective-tissue\\nrs with l ui few nuclei and interspersed with numerous\\nrs, 1 free surface is covered with flat, polyg-\\nonal epithelium\u00c2\u00ab The pleura is involved in all pul-\\nmonary inflammations that reach the pleural surface of\\nthe lung. The character of the exudate varies from a\\nfine, macroscopically barely visible layer of fibrin to\\nvoluminous, fibrinous precipitates or purulent collections.\\nIn fibrinous pleuritis the epithelium is losl early through\\n1 fatty changes where it is still retained it\\nshows loosening and Granular disintegration; rarely docs\\nit appear to proliferate. The fibrin, which is derivedfrom\\nthe exudation and coagulation of plasmatic fluid, may\\nappear first upon or under the epithelial cells. The con-\\nnective tissue shows much vascular congestion, the blood-\\nsels often containing leukocytes or thrombi of filamen-\\ns fibrin the lymph-vessels are widened and often con-\\ntain fibrin in addition to desquamated cells. Between\\nthe connective-tissue fibers lie leukocyte-, which usually\\ni infiltrate the fibrinous deposit the cells of the oon-\\nle proliferate freely and a granulation tissue\\nI of fibroblasts, leukocytes, and new\\nwhich push toward and eventually replace\\nthe fibrin, [stands of fibrin may be found inclosed in the\\ntissue; such fibrinous masses often undergo\\nhyaline and form glistening, homogeneous flakes\\nwhich do I- i the fibrin stain. rradually, the gran-\\nulation tissue changes into a densely fibrillated, fibrous\\ndiminish, it- vessels becoming obliterated.\\nigations by Ziegler, hyaline\\nccur in mature connective tissue, prob-\\nably due to an infiltration of the connective tissue with\\nIbuminoufl body that has coagulated in hyaline form.", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0217.jp2"}, "218": {"fulltext": "118 PATHOLOGIC HISTOLOGY.\\nPLATE 47.\\nFig. I.\u00e2\u0080\u0094 Acute Fibrinous Pleuritis in Croupous Pneumonia.\\nX 66. Weigert s fibrin stain. 1, Deposit of fibrin inclosing leuko.\\ncytes 2, lung tissue infiltrated with pneumonic exudate 3, thick-\\nened pleura infiltrated with young connective-tissue cells and shoots\\nof thin walled blood-vessels, in the lumen of which are seen leuko-\\ncytes and fibrin (2).\\nFig. II.\u00e2\u0080\u0094 Beginning Organization in Fibrinous Pleuritis.\\nA part of the preceding figure X 340. 1, Layer of fibrin (the pleura\\nis to be thought as near 2) 3, young blood-vessels growing toward\\nthe fibrinous layer 4, as a result of fibrinous accumulation, one of\\nthe vessels has become thrombosed 5, large epithelioid cells with\\nvesicular nuclei 6, spindle-shaped, young, connective-tissue cells 7,\\nlymphocytes 8, leukocytes.\\nIn this way arise the connective-tissue band s, wide-spread\\nfibrous adhesions, and extensive scars in which lime-salts are\\nlater deposited.\\nThe tuberculous pleuritis is distinguished from the sim-\\nple by the presence of tubercles and caseating nodules in\\nthe granulation tissue. Otherwise, the same processes of\\nexudation, proliferation, and organization occur.\\nTHYROID GLAND.\\nThe thyroid gland is a compound tubular gland whose\\nduct, the thyroglossal, which at one time opens at the\\nforamen cecum on the back of the tongue, becomes oblit-\\nerated in early embryonal life. The tubules are blind at\\nboth ends, and dense strands of fibrous tissue separate them\\ninto lobules. Clothed with a cubic and cylindric epithelium,\\nwhich is arranged upon a basement membrane, the tubules\\nat all stages contain a homogeneous, so-called colloid mass\\nwhich also fills the lymph-vessels. The stroma is richly\\nvascular.", "height": "4686", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0218.jp2"}, "219": {"fulltext": "Tab A).\\nWi\\nTig- 1. 3 2\\n1 fa\\nj\\ni\\ni\\nJ.if/i Inst Heult hold Mmirhcn", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0219.jp2"}, "220": {"fulltext": "", "height": "4537", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0220.jp2"}, "221": {"fulltext": "BESPlRATORY ORGANS. 119\\nThe commonest change of the thyroid is an increase in\\nvolume, called goiter or struma, which may depend on\\nvarious histologic processes. From embryonal remnants\\nof epithelial cells, which arc not arranged as tubules,\\nthere may develop solid columns and loops the ends (A\\nwhich are expanded, bul in which the amount of colloid\\nusually is slight. This is generally called adenoma of\\nthe thyroid, or parenchymatous goiter. At other times\\nthe preexisting tubules increase both in length and breadth\\nat the same time as the amount of colloid greatly increases.\\nThis is known as colloid goiter.\\nThe colloid material is secreted by the cells, which may\\nalso change directly into colloid material in that case\\nthere appear in the cells small, glistening drops of colloid\\nsubstance which gradually coalesce to form larger masses,\\ncrowding the nucleus and obscuring the cell outline.\\nWhen such changes occur over a considerable part of an\\nacinus, the colloid material lies in direct contact with the\\nconnective tissue. Desquamated epithelial cells, or frag-\\nments of such, are often found in the colloid material.\\nIt the epithelial cells do not degenerate, the constantly\\nincreasing ma\u00e2\u0080\u0094 of colloid flattens the cell- more and\\nmore. The colloid contents of the lymph- vessels are also\\noften much increased. The great dilatation of adjacent\\nfollicles may lead to their confluence with lymph-vessels,\\nwhereby larger cystic spaces filled with colloid material\\nare produc d (cystic goiter). Hemorrhages may render the\\ncontents rusty red or brownish in color, and mixed with\\nblood pigment (hemorrhagic goiter). The surrounding\\nstroma often proliferates, sometimes in the form of papil-\\nlary ingrowths into the follicular spaces, the epithelium\\nof which i- lifted up and carried inward.\\nAmong the frequent degenerative changes in the fibrous\\ntissue of :i goiter may be mentioned hyaline changes,\\nwhich are among the more common. Broad, glistening,\\nhom a is bands without nuclei are then formed between", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0221.jp2"}, "222": {"fulltext": "120 PATHOLOGIC HISTOLOGY.\\nthe gland spaces the hyaline changes frequently occur in\\nan extensive degree in the walls of the blood-vessels,\\nwhose lumen often appears greatly narrowed.\\nCalcareous salts are frequently deposited in goiters, so\\nthat very hard and extensive calcification results (calcareous\\ngoiter). Goiter is also accompanied with telangiectatic\\ndilatations of the blood-vessels, leading to formal cavern-\\nous spaces (vascular goiter).\\nCarcinoma is the most frequent tumor in the thyroid\\ngland sarcoma is more rare, and osteosarcoma sometimes\\noccurs.", "height": "4667", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0222.jp2"}, "223": {"fulltext": "III. THE DIGESTIVE ORGANS.\\nThe oral cavity is lined by a mucous membrane com-\\nposed of a squamous, stratified epithelium and tunica pro-\\npria. The latter rises up into papillae of varying heights,\\n-nine being very high. The basal layer of the epithelium\\nis eylindrie, then comes the stratum Malpighii with its\\nprickle cells, which become flatter and flatter toward the\\nsurface. The tunica propria, which is composed of con-\\nnective tissue, elastic fibers, and fine vessels, contains\\nlymphocytes, scattered either diffusely or accumulated in\\nfollicular masses. Below, the tunica propria merges gradu-\\nally into the submucous coat, which contains the glands.\\nThe glands are compound, tubulo-acinous, mucous glands\\nthe duet-, lined principally with flat cells, empty upon the\\nsurface of the mucous membrane: not infrequently, small\\naccessory glands empty into the main ducts. In several\\nplaces occur striped muscles under the oral mucosa.\\nThe bulk of the tongue consists of striated muscles, the\\nbundles of which interlace in various directions. A median\\nseptum divides the muscular mass into a right and a left\\nhalt*. The musculature is surrounded by a submucous coat,\\nwhich contains numerous mucous and serous glands, some of\\nwhich extend into the muscles. The papillae, formed by the\\ntunica propria, are more or less complicated. In man four\\ngeneral types are distinguished (1) The filiform papillae,\\nwhich arc eylindrie elevations with numerous dichotomous\\nbranches a the free end; (2) the fungiform papillae, situ-\\nated ii ;i broad base and covered by numerous secondary\\npapillae; (3) the circumvallate papillae, especially large", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0223.jp2"}, "224": {"fulltext": "122 PATHOLOGIC HISTOLOGY.\\nand separated from the surrounding mucosa by a circular\\nfurrow (4) the papillae foliate, which are parallel folds at\\nthe lateral margins of the tongue. All papillae are cov-\\nered with stratified squamous epithelium. The summits of\\nthe filiform papillae are not infrequently hornified. In the\\nepithelium covering the sides of the circumvallate papillae\\nlie the end-organs of the nerves of taste the taste-buds\\nelongated epithelial cells, forming oval bodies in which the\\nnerves end. At the base of the tongue the tunica propria\\nand even the epithelium are infiltrated with numerous\\nlymphocytes, which at various points are gathered into\\ndenser nodules, the lymph- follicles of the tongue.\\nAll the salivary glands in the oral mucous membrane\\nand the vicinity of the mouth are built upon the tubulo-\\nacinous plan that is, clustered about the ends of branch-\\ning ducts as small round saccules, the whole somewhat\\nresembling a bunch of grapes. According to the secre-\\ntion produced, there are distinguished (1) Pure mucous\\nglands, without demilunes, occurring at the root of the\\ntongue, on the hard palate, and at the anterior margin of\\nthe soft palate. (2) Mixed mucous glands, with demi-\\nlunes, occurring in the lips, the cheeks, in the tip of the\\ntongue (Nuhn s glands) here belong also the lingual\\nglands. (3) Mixed serous glands the submaxillary\\nglands. (4) Pure serous glands, occurring in the tongue\\nin the vicinity of the circumvallate papillae and the pa-\\npillae foliate also the parotid glands.\\nThe demilunes, or marginal cells, are flat cells in close\\ncontact with the basement membrane of the glands these\\ncells produce a secretion that differs from that of the mu-\\ncous cells proper.\\nThe faucial tonsils consist of from ten to twenty\\nlymph-nodes. The adenoid tissue contains numerous\\nfollicles with germinal centers. The surface of the tonsils\\nis marked by depressions, lined with epithelium the\\nso-called crypts numerous lymphocytes are always found", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0224.jp2"}, "225": {"fulltext": "THE DIGESTIVE ORGANS. 123\\nmigrating through the epithelium, and constitute a fertile\\nsource of the salivary corpuscles. The tunica propria of\\nthe pharynx is also infiltrated with leukocytes which\\nmigrate through the epithelium.\\nIn the esophagus three coats arc present The mucosa,\\ncovered by stratified squamous epithelium, and containing\\nin the tunica propria a longitudinal muscularis mucosae;\\nthe submucosa and the internal circular and the external,\\nlongitudinal, muscular layers. In the upper fourth the\\nmuscular tissue is exclusively striated in the lower fourth\\nit is exclusively unstriated and in the middle two-fourths\\nthe two are mixed. Outside of the muscular coat are\\nconnective-tissue bundles, interspersed with elastic fibers,\\namong which run vessels and nerves. The submucosa\\ncontains mucous glands in the upper and lower ends of\\nthe esophagus are glands which correspond in structure to\\nthe fundus glands of the stomach. Leukocytes commonly\\ninn* It rate the neighborhood of the glands.\\nThroughout the entire intestinal tract, from the stomach\\nto the rectum, the walls comprise three layers The serous\\ncoat, the muscular, and the mucous. Between the mucous\\nand the muscular lies the submucous.\\nThe serous coat, or the visceral layer of the peritoneum,\\nconsists of interlacing bundles of connective-tissue and\\nnumerous elastic networks, which externally in places arc\\ncondensed to v\\\\n a distinct limiting membrane. The\\nfive surface is covered by a single layer of Hat, polygonal,\\nepithelial cells. In various places the subserous connec-\\ntive tissue contains a varying amount of fat-cells. The\\nparietal peritoneum ;ii some points contains smooth muscle-\\nfibers.\\nThe muscular ooa of the stomach has three layers\\nnamely, external longitudinal fibers, a central circular\\nlayer, and an oblique inner layer which in the fundus pre-\\nsents ;i complicated arrangement. Throughout the large\\nand small intestines the muscularis presents bul an inner", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0225.jp2"}, "226": {"fulltext": "124 PATHOLOGIC HISTOLOGY.\\ncircular and an external longitudinal coat. Normally, the\\nspindle-shaped muscle-cells in the adult contain some pig-\\nment granules about the nucleus. Between the two mus-\\ncular layers occurs Auerbachs nerve-plexus.\\nThe submucous coat consists of fibrillated connective\\ntissue with numerous elastic elements it contains spindle-\\nshaped, stellate, and other cells, and also small masses of\\nfat-cells. Internally, this layer passes on into the stratum\\nproprium of the mucous coat, in which there are no elastic\\nelements, but it contains a varying number of lymphoid\\ncells and thus acquires the characteristics of the so-called\\ncytogenic connective tissue (adenoid tissue).\\nThe muscularis muscosse, which occurs throughout the\\nAvhole gastro-intestinal tract, may be regarded as the\\nboundary between the submucous coat and the tunica pro-\\npria of the mucous layer. The muscularis mucosae con-\\nsists, as a general rule, of a single layer of longitudinal,\\nsmooth muscle-bundles, which at certain places (the villi)\\nsend prolongations into the mucous membrane proper.\\nThe epithelium from the cardiac end of the stomach to\\nthe anus is a single layer of cylindric cells. In the sub-\\nmucous coat lies a second nerve-plexus with ganglion cells,\\nthe so-called Meissners plexus. The transition between\\nthe flat epithelium of the esophagus and the cylindric epi-\\nthelium of the stomach is sudden and sharp.\\nThe epithelium of the stomach covers its interior com-\\npletely it continues into the mouths of the glands and\\nproduces mucus, in consequence of w T hich there are found\\na varying number of goblet cells. There is no cuticular\\nformation.\\nThree forms are recognized among the tubular glands\\n(1) The cardiac glands, occupying a small zone at the\\ntransition of the esophagus into the stomach. They are\\ncompound, tubular glands, which empty into pit-like de-\\npressions lined by typical gastric epithelium. (2) The\\ngastric glands proper, which are found in the fundus and", "height": "4691", "width": "2962", "jp2-path": "atlasepitomeofsp00drck_0226.jp2"}, "227": {"fulltext": "THE DIGESTIVE ORGANS. 125\\nthe body of the stomach. They rest upon the museularis\\nmucosae, and are simple tubular glands, often branched.\\nThey contain two distinct kinds of cells the chief or\\ncentral cells which, small and prismatic, line the principal\\npart of the tubule and secrete pepsin and the parietal or\\naeid cells, which occur at irregular intervals along the\\nmembrana propria and outside of the chief cells. The\\nparietal cells appear to secrete the acids of the gastric\\njuice, (3) The pyloric glands, occurring in the pyloric\\npart of the stomach, and distinguished from the preceding\\nby numerous turns and divisions of the tubules and by\\nentire absence of the parietal cells. In addition, the\\nmucous membrane of the stomach contains closed follicles\\nsimilar in structure t that of the solitary follicles of the\\nintestine.\\nThe mucous membrane of the intestine presents nu-\\nmerous elevations., the intestinal villi, which consist\\nof a prolongation of the tunica propria, smooth muscle-\\nfiber-, a capillary network with small meshes, and also, as\\na rule, one, or rarely several, central chyle vessels. In\\nthe duodenum the villi are broad and leaf-like. Two\\nkind- of epithelium cover the villi the epithelial cells\\nproper, of cylindric form and provided with a distinct\\nCUticular border on their free surface, the nucleus lying in\\nthe inferior half of the cells; between these occur the\\niid kind of cells, the goblet cells.\\nThe glands of the small intestine are formed by the sim-\\nple tubular depressions, or Lieberk\u00c3\u00bchn s crypts, between\\nthe villi, and they are lined with cylindric cells and goblet\\ncells. Between the epithelial cells of the villi and of the\\ncrypts migratory leukocytes are found in varying numbers.\\nIn the duodenum there occur also branched tubular\\nglands of Brunner, which pierce the museularis mucosae,\\n:md are lined with darkly granular, cylindric cell-.\\nThe large intestine is devoid of villi the crypts of\\nLieberk\u00c3\u00bchn are larger and contain numerous goblet cell.-.", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0227.jp2"}, "228": {"fulltext": "126 PATHOLOGIC HISTOLOGY.\\nThe surface epithelium presents a cuticular or basal\\nborder.\\nIn the mucous membrane of both large and small intes-\\ntines are numerous lymph-nodules, occurring either singly\\n(solitary follicles) or in flattened groups (agminated\\nfollicles or Peyer s patches). They lie partly in the\\nmucous membrane itself, partly in the submucous tissue\\nthey reach, on the one hand, to the surface epithelium\\non the other, to the muscular coat. They possess\\na delicate connective-tissue capsule and a delicate reticulum,\\nin the spaces of which lie the lymphocytes. The interior\\npresents a distinct germinal center.\\nIn the large intestine are found only solitary follicles\\nthat here are embedded a little deeper in the mucosa, the\\nepithelium forming small crypt-like depressions upon their\\nsurface.\\nORAL CAVITY, PHARYNX, ESOPHAGUS.\\nIn the mouth and pharynx occur simple catarrhal pro-\\ncesses that histologically resemble those of the upper\\nair-passages, except in so far as the stratified squamous\\nepithelium naturally is more resistant than the cylindric.\\nThe vessels of the stratum proprium and of the submu-\\ncosa are strongly injected. The wandering cells, present\\nnormally, are now increased, lymphocytes and numerous\\nleukocytes are present, and in the act of passing out be-\\ntween the epithelial cells, in whose interior they also fre-\\nquently are found.\\nThe mucous glands are enlarged here and there a duct\\nis dilated and cystic, filled with mucus. The epithelium\\nshows a granular cloudiness of its protoplasm, especially\\nin the upper layers, and there is an increased desquama-\\ntion on the tongue the loosened cells dry up and form\\nbrownish masses, which contain numerous bacteria and\\nthread fungi the adenoid tissue is often considerably", "height": "4691", "width": "2960", "jp2-path": "atlasepitomeofsp00drck_0228.jp2"}, "229": {"fulltext": "THE DIGESTIVE ORGANS, 127\\nincreased, especially in the pharynx in chronic catarrhal\\nconditions, leading to follicular nodules, which give the\\nmucous membrane a granular appearance (granular phar-\\nyngitis).\\nThe papillae of the tongue, especially the secondary\\npapillae of the filiform variety, are often covered by the\\nthread- ()f a fungus (Leptothrix bnccalis, Robin), which\\nmust not he con founded with the hair-like prolongations\\nof the apices of the filiform papillae, produced by increased\\ngrowth of the epithelium in marked eases the tongue\\nappear- a- if covered witli hairs, from nine to thirteen\\nmillimeters long and pointing backward (lingua hirsuta\\nor villosa frequently, the hornified epithelium assumes\\na black color (black, hairy tongue).\\nInfant- that are poorly nourished, marantic individuals\\nin general, and especially diabetics, frequently present\\nwhitish-yellow, circumscribed deposits upon the lining of\\nthe mouth, pharynx, esophagus, and in children even of\\nthe stomach these deposits are easily removable and at\\nfirst glance they are not unlike diphtheric membranes.\\nMicroscopically, they are found to consist almost wholly\\nof a branching network of the mycelium of the thrush\\nfungus, or oidium or saecharomyces albicans. The\\nthread- are septate, and the hyphae carry oval conidia or\\nspores. Between the threads lie masse- of desquamated,\\npartly necrotic, epithelium. In sections it i -ecu that the\\nmycelium passes deeply into the softened epithelium,\\nwhich is infiltrated with leukocytes. On the surface of\\nthe mass lie masses of spores and bacteria of various kinds.\\nTin- loosened epithelial cells frequently show poorly\\nstained nuclei, r no nuclei. Occasionally, the mycelium\\npenetrates the entire thickness of the epithelium and\\nreaches down into the stratum proprium.\\nTuberculosis of the mucous membrane of the mouth\\nand t the pharynx, ;i- well a- of the esophagus^ is rela-\\ntively tare; histologically, it is devoid of peculiarities", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0229.jp2"}, "230": {"fulltext": "128 PATHOLOGIC HISTOLOGY.\\nPLATE 48.\\nFig. I.\u00e2\u0080\u0094 Variola Vera of the Tongue. X 75. 1, The whole\\nthickness of the epithelial lining is broken down and necrotic sub-\\nmucosa penetrated with greatly injected blood-vessels 2, the sub-\\nmucous glands are necrotic, with cyst-like dilatation of the acini\\n3, musculature.\\nFig. IL\u00e2\u0080\u0094 Tuberculosis of the Pharynx. X 75. 1, Epithe-\\nlium in places very thin and at the point of rupture in stratum\\nproprium numerous confluent tubercles with beginning necrosis and\\nmany giant cells (2) 3, mucous glands.\\nthe nodules develop in the stratum proprium of the\\nmucosa, and consist of epithelioid and giant cells and\\nperipherally arranged round cells. The center early be-\\ncomes caseous, and as the process invades the epithelium\\nthis becomes thinner and thinner and infiltrated with\\nround cells, until, finally, rupture takes place caseous\\nmaterial is then discharged, and a tuberculous ulcer with\\nsinuous outlines is formed the development of new\\ntubercles followed by caseation leads to increase in ex-\\ntent and depth of the ulcer, whose surroundings are\\nusually widely infiltrated with round cells.\\nPLATE 49.\\nFig. I. Diphtheria of the Pharynx. X 80. The exudation\\nof fibrin (1) between the necrotic epithelial cells is far advanced the\\nnecrosis has not yet reached the superficial surface. In the submucosa\\n(2) the blood-vessels are dilated, some filled with fibrinous thrombi\\n(3).\\nFig. II\u00e2\u0080\u0094 Diphtheria of the Tonsil. X 280. 1, Fibrinous de\\nposit, inclosing in its meshes nuclei which are disintegrating 2, zone\\nof- the former epithelial layer epithelial cells largely disintegrated\\n3, nuclei of disintegrated epithelial cells 4, lymphocytes of tonsillar\\nfollicle.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0230.jp2"}, "231": {"fulltext": "Tab.43.\\nFigl.\\nr*-.\\n,J\\nFig.2.\\nI.ith. An.st Heichlwltl Afiuirfirn.", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0231.jp2"}, "232": {"fulltext": "", "height": "4691", "width": "2986", "jp2-path": "atlasepitomeofsp00drck_0232.jp2"}, "233": {"fulltext": "TabAv.\\n3\\nIig.l.\\n9\\n1\\nLitfuAnst Reichhold. Mum hen", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0233.jp2"}, "234": {"fulltext": "", "height": "4686", "width": "2832", "jp2-path": "atlasepitomeofsp00drck_0234.jp2"}, "235": {"fulltext": "THE DIGESTIVE ORGANS 1*29\\nNoma i- the name given to an inflammation beginning\\nin the mucous membrane of the lips or the mouth, especi-\\nally in children after severe infectious diseases. At first\\nthe mucous and submucous coats become edematous and\\ninfiltrated with blood, followed by leukocytic accumulation\\nand an extensive and rapid gangrene, which spreads in ex-\\ntent and depth, involving all the adjacent soft tissues, such\\nglands, muscles, fat, and external skin. Previous to\\ntheir total disappearance the nuclei break up into frag-\\nment- and deeply staining, minute particles. The blood-\\nvessels generally are thrombotic.\\nIn smallpox the mouth, pharynx, and also the esopha-\\ngus are often the seal eruptions quite similar histo-\\nlogically to the cutaneous pustules of variola. The epi-\\nthelium becomes the seat of vesicular spaces filled with\\nserous fluid, and formed by the pressing asunder of\\nthe cells that may remain connected by protoplasmic\\nhand- and bridges, so that the cavity of the vesicle is sub-\\ndivided into many compartments. The accumulation of\\nemigrating leukocytes ultimately renders the contents\\nwholly purulent. Through rupture of the summit of the\\npustule a flattened ulcer is formed usually, this occurs\\nearlier in the eruption- upon mucous surfaces than on the\\nexterna] -kin, whose horny layer i more resistant. The\\nfloor of the ulcer is formed by necrotic epithelium and\\nbacterial masses, especially staphylococci and streptococci.\\nThe stratum proprium and the submucosa are much con-\\nd and infiltrated with leukocyte-. Flic mucous elands\\nof the submucosa may present similar pustular efflores-\\ncences with necrosis of the glandular epithelium and also\\ncystic dilatations of some acini, which become filled with\\nmasses of mucus owing to occlusion of some of the secretory\\nducts. The infiltration usually extends to the underlying\\ntissues.", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0235.jp2"}, "236": {"fulltext": "130 PATHOLOGIC HISTOLOGY.\\nCroupous and Diphtheric Inflammation.\\nCroupous and diphtheric processes occur frequently,\\nespecially in children, upon the soft palate, the tonsils, in\\nthe pharynx, and more rarely in the mouth itself. Ana-\\ntomically, the terms croupous and diphtheric signify an\\ninflammation in which are combined necrosis of the\\nmucous membrane and fibrinous exudation, so that a\\nmembrane pseudomembrane is formed. If the\\nnecrosis involves only the superficial layers of the mucosa,\\nmerely the epithelial layer or perhaps only the outer\\nlayers of this, the affection is called croup while diph-\\ntheria, in the anatomic sense, is characterized by a deeper\\nnecrosis, which extends into the stratum proprium. Prac-\\ntically, the two forms are hard to differentiate from each\\nother transitional stages occur from superficial fibrinous\\ndeposits with but a slight necrosis, to a severe mortification\\nwith the formation of fibrinous material in the deepest lay-\\ners of the mucous membrane. The necrosis and precipitation\\nof fibrin go hand in hand, and stand in direct causal rela-\\ntion with each other because the death of the tissue cells sets\\nfree fibrin ferment which induces coagulation in the plas-\\nmatic fluid exuded from the dilated vessels. This process\\ncan be observed histologically in various stages of the\\ndisease. In the beginning the vessels of the stratum\\nproprium are greatly dilated and filled to distention with\\nblood mixed among the red blood-corpuscles are\\nnumerous leukocytes which are also found free in the con-\\nnective tissue and the epithelial layer. In some vessels\\nocclusion by fibrinous filaments can be recognized. The\\nepithelium is swollen, the protoplasm of the cells in the rete\\nMalpighii is granular, and the intercellular cement lines\\nappear broad. And now the first threads of fibrin can be\\nobserved as broad, glistening bands between the cells the\\nbands or layers unite to form a network the meshes of\\nwhich become narrower and narrower while the inclosed", "height": "4676", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0236.jp2"}, "237": {"fulltext": "THE DIGESTIVE ORGANS. 131\\nepithelial cells undergo a progressive solution. Gradually,\\nthe nuclear chromatin becomes condensed (pyknosis), fol-\\nlowed by disintegration into minute fragments eventually,\\nthe fragments disappear wholly, and the destruction of\\nthe epithelium is now complete. In the mean time other\\nnuclei appear in the fibrin, due to the migration of\\nnumerous leukocytes and nuclear fragmentation occasion-\\nally, lymphocytes are also visible. Usually, the exudation\\nrises above the epithelium. The plasmatic fluid emerges\\nupon its surface and runs over it for a distance before\\nfiliation takes place on this account the margins of\\nthe pseudomembrane are usually easily separated from the\\nunderlying tissue. Sometimes the emigration of leuko-\\ncyte- into the membrane is very marked, so that it be-\\ncome- softened and assumes a purulent appearance. A\\ndense, leukocytic wall forms at the margins of the zone of\\ncoagulation necrosis; finally, the new membrane separates\\neither in the form of large shreds or as smaller, softer\\npieces, due to fatty changes, so that a more or less deep\\nLoss of substance results the diphtheric ulcer. Healing\\nresults from proliferation of the epithelium in the vicinity,\\nand new cells gradually cover the defect.\\nThe disease just described is caused in the pharyngeal\\ncavity and in the respiratory mucous membranes princi-\\npally by L\u00c3\u00b6ffler^ bacillus of diphtheria; in the latter\\nstages other micro-organisms, especially streptococci, are\\nalso found present^ often in dense layers. At times these\\nonly are active a-, for instance, in scarlatinal diphtheria.\\nBui chemic agents, especially corroding substances such as\\nammonia, can also produce the anatomic picture of a\\ncroupous-diphtheric inflammation. This form of inflam-\\nmation i- consequently not of itself absolutely distinctive\\nof a definite infection,", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0237.jp2"}, "238": {"fulltext": "132 PATHOLOGIC HISTOLOGY.\\nPLATE 50.\\nFig. I.\u00e2\u0080\u0094 Acute Suppurative Embolic Parotitis. X 70. (In\\nappendicitis.) The interstitial tissue of the lobules is purulently in-\\nfiltrated, the acini themselves are largely destroyed and also greatly\\ninfiltrated with leukocytes (2) a few are still present (1). At several\\nareas accumulations of pyogenic cocci (3) are seen.\\nFig. II.\u00e2\u0080\u0094 Thrush Vegetations in Esophagus. X 270. Stained\\nby Gram s method. The upper epithelial layers are loosened in their\\nconnections, separated and infiltrated with the mycelium of the thrush\\nfungus (oidium or saccharomyces albicans) the threads are septate.\\nIn the lower layers of the epithelium (right) numerous leukocytes are\\npresent.\\nSALIVARY GLANDS.\\nThe salivary glands, especially the parotid, are not\\nrarely the seat of inflammation. In addition to the epi-\\ndemic form of acute parotitis or mumps, the parotid\\ngland is frequently involved in suppurative processes,\\nprincipally in the acute infectious diseases typhoid fever,\\ndysentery, cholera, scarlet fever, diphtheria, sepsis, pyemia.\\nThe pyogenic microbes in most cases probably enter the\\nducts of the gland (Stenson s duct) from the oral cavity.\\nThere results an acute sialodochitis with occlusion of the\\nsalivary passages by pus-cells, desquamated epithelial cells,\\nand bacterial masses. The overflow of secretion is hin-\\ndered and the entrance of bacteria into the substance of\\nthe gland favored. The interstitial tissue, and later the\\nacini, become densely infiltrated with leukocytes the epi-\\nthelial cells may be covered over by leukocytes numer-\\nous cloud-like masses of cocci are seen. Finally, multiple\\nabscesses are formed, which coalesce, and thus establish\\nsuppuration throughout the whole gland. Frequently,\\nthe purulent process extends to the periglandular tissue.\\nThe diseases of the esophagus do not demand any sepa-\\nrate consideration from the histologic standpoint, resem-\\nbling those of the mouth and the pharynx.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0238.jp2"}, "239": {"fulltext": "Tab. JO.\\nJfc*\\nI//.S/. Reichhold, M\u00c3\u00bcnchen", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0239.jp2"}, "240": {"fulltext": "", "height": "4649", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0240.jp2"}, "241": {"fulltext": "THE DIGESTIVE ORGANS. 133\\nCorrosion of the esophagus by caustic alkalies and by\\nacid- presents the appearance of a more or less deep-seated\\nnecrosis, with a fibrinous exudation between the necrotic\\nepithelial cells and even in the deeper layers of the\\nmucosa. Ammonia and carbolic acid especially produce\\ntypical lesions.\\nIn cardiac insufficiency and in cirrhosis of the liver the\\nsubmucous veins o{ the esophagus frequently become\\nvaricose, and this may result in rupture and hemorrhage\\na- well a- in the formation of genuine varicose ulcers.\\nSTOMACH.\\nCirculatory disturbances of the stomach are observed in\\ncardiac insufficiency and in obstruction of the portal circu-\\nlation, a- in cirrhosis of the liver. The veins of the mu-\\ncosa become dilated and small hemorrhages frequently\\noccur yellow or brownish blood-pigment is often found\\nin the stratum proprium, and the tissue of the submncosa\\nmay be edematous.\\nAcute catarrhal gastritis does not present any histologic\\npeculiarities. In chronic gastric catarrh, as seen so com-\\nmonly in drunkards, noteworthy changes occur in the\\nmucous membrane, affecting the glands as well as the\\nstratum proprium. Usually, the surface epithelium ap-\\npears increased a- compared with the glandular epithelium\\nproper; frequently, it contains remarkably tall cylindrie\\ncells and also numerous goblet cells. In the glands the\\nparietal cells especially appear atrophic often they disap-\\npear wholly. The chief cells occasionally present numer-\\nous karyokinetic figures and other evidences of prolifera-\\ntion. They also form numerous goblet cells, which are\\nfound from tic mouth to the fundus of the glands, giving\\ntin- mucosa a certain resemblance to that of the rectum.\\nr I he specific glandular elements disappear more and more,\\nand in the stratum proprium proliferative processes on", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0241.jp2"}, "242": {"fulltext": "PATHOLOGIC HISTOLOGY.\\nPLATE 51.\\nFig. I. \u00e2\u0080\u0094Chronic Granular Gastritis. X 30. 1, Mucosa; 2,\\nproliferated and greatly convoluted gastric glands 3, stratum pro-\\nprium, thickened, infiltrated with round cells, and provided with pa-\\npillary elevations below, the muscularis mucosae and the submucosa\\n4, tunica muscularis 5, serosa with subserous fat-layer.\\nFig. II.\u00e2\u0080\u0094 Chronic Catarrh of the Stomach. X 160. The\\ncells of the stratum proprium much increased in number. Interstices\\nbetween the glands broadened. In the glandular cells are numerous\\nmitotic figures many are changing into goblet cells (1).\\npart of the connective tissue are very prominent. The\\ncells are increased in number, and there is also leukocytic\\ninfiltration, so that the glands and their ducts are crowded\\napart and forced above the level of the surrounding mu-\\ncosa as small papilla, which form especially in the course\\nof the large submucous vessels (granular gastritis). The\\nresulting irregularity and granular condition of the mucous\\nmembrane and the increased consistence are readily recog-\\nnized macroscopically, and, when marked, frequently\\nreferred to as the so-called etat mamelonne. Occasionally,\\nthe increasing proliferation of the connective-tissue ele-\\nPLATE 52.\\nFig. I.\u00e2\u0080\u0094 Hemorrhagic, Necrotic Gastritis in Sulphuric Acid\\nPoisoning (from Dog). X80. The upper layers of the mucosa\\nform a necrotic scab, infiltrated with numerous red blood-corpuscles\\nthe glands are not visible (1); 2, areas still containing glands; in\\nstratum proprium many round cells 3, muscularis mucosae 4, sub-\\nmucosa.\\nFig. II.\u00e2\u0080\u0094 Hemorrhagic Erosion of the Stomach. X 57. The\\nsuperficial layers of the mucosa are destroyed. 1, Remains, of glands\\n2, deposit composed of conglutinated red blood-corpuscles and portions\\nof necrotic mucosa 3, the stratum proprium is exposed 4, muscu-\\nlaris mucosae 5, submucosa 6, circular muscular layer.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0242.jp2"}, "243": {"fulltext": "Tab. sr.\\nOCgf\u00c3\u00b6\\n\u00e2\u0080\u009e-0\\nFig.1.\\nFig.2.\\n/.////.Ans/ F. Reichhold, M\u00c3\u00bcnchen,.", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0243.jp2"}, "244": {"fulltext": "", "height": "4676", "width": "2841", "jp2-path": "atlasepitomeofsp00drck_0244.jp2"}, "245": {"fulltext": "Tab. 52.\\nj^.j.\\nJ\\nLOA. Aast. F ReuchJtwUl, Mu/i/Jwn", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0245.jp2"}, "246": {"fulltext": "", "height": "4667", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0246.jp2"}, "247": {"fulltext": "THE DIGESTIVE ORGANS. 135\\nments and the elongation and cystic dilatation of the glands\\nbecome bo marked at certain places that pedunculated\\npolypoid excrescences arise (polypoid gastritis). Such\\npolypoid outgrowths may acquire very considerable dimen-\\nsions j in rare cases masses are formed as large as goose\\n2jgs 3 consisting of the proliferated elements of the normal\\nmucous membrane. The submucous connective tissue also\\ntake- part in these polypoid formations, so that the mus-\\ncularis mucosae at their base may he broken through. The\\nlymph-follicles frequently undergo considerable hyperplasia\\nin these chronic inflammatory condition-.\\nDiphtheric eschars appear on the gastric mucous mem-\\nbrane after the action of acids or alkalies sulphuric acid\\nproduces a linn, brownish or greenish, pseudomembranous\\nlayer, consisting of the necrotic mucous membrane into\\nwhich fibrin has been precipitated, usually freely mixed\\nwith red blood-corpuscles.\\nPhlegmonous gastritis is the term applied to purulent\\ninflammation of the wall of the stomach. It concerns a\\nfocal r diffuse, purulent infiltration, especially of the sub-\\nmucosa. The muscularis mucosae and the stratum pro-\\nprium arc densely infiltrated with leukocytes, which also\\ngather between the glandular epithelium, which may be\\nwholly covered over. In this way multiple abscesses are\\nformed in the mucous membrane, which, on rupturing,\\nLiivr rise t ulcer- at other times large shreds of the\\nmucosa are exfoliated in continuity on account of the sub-\\nmucous suppuration.\\nGastric Ulcer.\\nDefects varying -i/o and depth appear upon the\\nmucous membrane of the stomach. Such defects are\\nproduced, in the first place, by the digestive action of\\nthe gastric juice after injuries of various kind- to the\\ninner layer of the wall. Small, circumscribed hemor-", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0247.jp2"}, "248": {"fulltext": "136 PATHOLOGIC HISTOLOGY.\\nPLATE 53.\\nFig. I.\u00e2\u0080\u0094 Round Ulcer of the Stomach with Erosion of a\\nBlood=vessel. X16- 1 Ulcerated margin, with surrounding\\nmucosa, muscularis mucosae, and submncosa the ulcer extends to the\\ninner muscle layer its rloor (2) is covered with necrotic material 3,\\neroded arterial blood-vessel with thrombotic lumen.\\nFig. II.\u00e2\u0080\u0094 Margin of a Round Ulcer of the Stomach. X 64.\\n1, Mucosa 2, muscularis mucosae 3, submucosa 4, muscularis\\n6, infiltrated floor of the ulcer in the outer layers of the muscular coat.\\nrhages, as occur in gastric catarrh and passive congestion,\\nare, perhaps, the most frequent first cause for the su-\\nperficial defects, usually called hemorrhagic erosions.\\nThese are frequently multiple, and at times the mucous\\nmembrane is thereby given a sieve-like appearance they\\ngenerally involve the mucous coat only, reaching rarely\\nthrough the muscularis mucosae the surface epithelium is\\ndestroyed, while the lower part of the glands may be\\npresent, especially in the slanting margins the tissue im-\\nmediately adjacent is usually necrotic and infiltrated with\\ndisintegrated red blood-corpuscles and brownish blood-\\npigment below this zone there is proliferation of cells\\nand leukocytic accumulations.\\nSuperficial defects like these commonly heal the tunica\\npropria is repaired by scar tissue, and new epithelium\\ncovers the surface.\\nShould the peptic action last for a longer time, the\\ndefect becomes deeper and wider and there is formed the\\nround ulcer of the stomach. This ulcer extends through\\nthe entire thickness of the mucosa, the muscularis mucosae,\\nand the submucosa frequently, part or all of the mus-\\nculature is also eaten away, and even the serous coat may\\nbe perforated.\\nGenerally, the margins of the ulcer appear terraced or\\nstep-like, because the loss of substance in the mucosa is", "height": "4680", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0248.jp2"}, "249": {"fulltext": "Fig.l.\\nTab. S3-\\nWmr 2\\nBfi W2\u00c2\u00a3,\\n^^S\u00c3\u00a4ft?\\n/v\\nZ^/l. ,4^ /T Jteichhofd M\u00c3\u00bcnchen", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0249.jp2"}, "250": {"fulltext": "", "height": "4683", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0250.jp2"}, "251": {"fulltext": "THE DIGESTIVE OEGAXS. 137\\nlarger than in the inner layers of the muscular coat, and\\ntin- again larger than in the outer layers. AVith low powers,\\nsection- of the nicer show that the margins rapidly slope\\nto the hot torn, that the mucosa is frequently contracted in\\na somewhat funnel-shaped manner,, that the immediate\\nvicinity of the delect is necrotic while the more distant\\nparts are infiltrated with round cells. The bottom of the\\nnicer also presents a thin, necrotic, anuclear layer. Blood-\\nvessels arc often eroded and fatal hemorrhage may occur.\\nMicroscopically, the vessel walls are then found cut\\nthrough just as sharply as the single layers in the margins\\nof the ulcer. Usually, the lumen of the vessels is partly\\nor wholly closed by thrombi. It is highly probable that\\na part of the round ulcers of the stomach originate upon\\nthe basis f a hemorrhagic infarction of the gastric wall\\nwith consecutive digestion of the mortified area.\\nSimple atrophy of the mucous membrane of the stomach\\nwith disappearance of the glands occurs in chronic gastric\\ncatarrh, in carcinoma of the stomach, also in the marantic,\\nand especially in atrophic infants.\\nAmyloid degeneration occasionally occurs simultaneously\\nwith amyloidosis of the intestinal mucous membrane.\\nFatty changes of the epithelial and connective-tissue\\nelements are observed, especially in acute phosphorous,\\nand also in arsenous, poisoning.\\nTuberculosis and syphilis of the wall of the stomach\\nare of rare occurrence; the specific granulomatous pro-\\na is form in the stratum proprium and in the submu-\\noosa.\\nTumors. The adenomas of the mucous membrane\\nfrequently originate from the polypi previously mentioned.\\nOf the connective-tissue tumors, fibroma, myoma, lipoma,\\nand sarcoma are observed. All forms of carcinoma occur\\nin the stomach, from the hard, fibrous scirrhous to soft,\\nalmost confluent colloid.\\nOpportunity is occasionally given for the study of", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0251.jp2"}, "252": {"fulltext": "138 PATHOLOGIC HISTOLOGY.\\nthe beginning of the development of carcinoma in the\\nmucous membrane of the stomach. It is then seen that\\nmany layered or solid epithelial masses, starting from the\\nlower parts of the glands, perforate the stratum proprium\\nand the muscularis mucosae, and infiltrate the submucosa\\nin nest-like groupings. The carcinoma in this case grows\\ninto the w T all of the stomach without first destroying the\\noverlying mucous membrane. At times larger portions\\nof the wall of the stomach are diffusely infiltrated with\\ncarcinomatous masses, and thus rendered greatly thickened\\nand stiff, while the mucosa does not show any loss of sub-\\nstance.\\nThe hard or scirrhous forms of carcinoma are quite\\nprone to cause much narrowing of the lumen, especially\\nof the pylorus. Microscopically, the walls are composed\\nof broad fibrous masses in w T hich are narrow slit-shaped\\nalveoli, filled with a sparse, low epithelium, also present\\nin the muscular coat, which is then usually hypertrophied.\\nINTESTINE.\\nPassive congestion of the intestines with marked injec-\\ntion of the vessels and edema of the walls occurs in car-\\ndiac insufficiency and in obstruction to the portal circula-\\ntion when of longer duration, it is usually associated\\nwith the manifestations of a chronic gastric catarrh.\\nHemorrhagic infarction and necrosis of larger segments\\nof the intestine occur only after complete occlusion of the\\nsuperior mesenteric artery. The occlusion of small arte-\\nries is generally without effect, because of the numerous\\nanastomoses.\\nAtrophy of the intestinal wall is found in prolonged\\ninanition, especially in atrophic infants. The lumen is\\nthen usually widened by the presence of gas, the walls\\nare thin as paper, transparent, and exceedingly pale.", "height": "4688", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0252.jp2"}, "253": {"fulltext": "THE DIGESTIVE ORGANS. 139\\nMicroscopically, all layers appear uniformly thinned. The\\nsurface epithelium is lost, as a rule, the glands are short,\\nthe lymph-follicles have generally disappeared, and both\\nmuscle-layers are greatly attenuated. On account of the\\ndiminution of the muscle-cells, the lymph-vessels appear\\nmore distinct. (Plate 55, Fig. I.)\\nA peculiar form of atrophy, associated with pigmenta-\\ntion of the musculature, is observed in old age, in marantic\\nand cachectic persons, in alcoholics, and also in cases of a\\nsimultaneous pigmentation of other organs, such as the\\nlymph-glands, spleen, kidneys, and liver the so-called\\nhemochromatosis of Recklinghausen, a disease which appar-\\nently depends on an increased destruction of the red\\n1 1( \u00c2\u00bbod-c \u00c2\u00bbrpuseles. 1 Examined fresh, the muscle-cells are\\nfound somewhat enlarged and partly, or in severe cases\\nwholly, filled with numerous, minute pigment-granules,\\nwhich do not always give the iron reaction. Often the nuclei\\nare covered by the pigment particles. The longitudinal mus-\\ncular layer is commonly more pigmented than the circular.\\nOccasionally, pigment is found in the muscularis mucosae\\nand the submucosa. The process has a marked similarity\\nto the brown atrophy of striped muscle as seen in the\\nheart. (Plate 55, Fig. II.)\\nAmyloid degeneration of the intestinal mucosa is occa-\\nsionally observed in amyloidosis of other organs (kidney,\\nspleen, liver). A- elsewhere, the degeneration of the in-\\ntestinal mucosa also begins in the .-mailer arteries and\\npreferably in the branches within the villi glistening\\nmasses, giving the well-known specific reactions, are de-\\nposited in their walls. The further increase causes a nar-\\nrowing of the vessels, the mucous membrane becomes\\nanemic and acquires a peculiar stiffness the epithelium is\\nlost, and many villi appear as if broken across; in some\\nFor a full discussion of hemochromatosis Opie, The Journal\\ntperimenta] Medicine, 1--!\u00c2\u00bb. iv. 279, and Transactions t the\\nAssociation of Ajnerican Physicians/ \\\\iv, 253.", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0253.jp2"}, "254": {"fulltext": "140 PATHOLOGIC HISTOLOGY.\\nPLATE 54.\\nFig. I.\u00e2\u0080\u0094 Beginning Carcinoma of the Stomach. X 54. At\\nleft, free surface of mucosa. 1, Proliferated glands with several layers\\nof epithelial cells 2, muscularis mucosae, at one point ruptured by\\nglandular proliferation 3, submucosa 4, in the submucosa are seen\\nthe alveoli of the carcinoma.\\nFig. II.\u00e2\u0080\u0094 Marked Stenosis of the Pylorus as a Result of a\\nScirrhous Carcinoma. X 13. The lumen is extraordinarily nar-\\nrowed the mucosa is wholly destroyed. 1, Connective-tissue bauds\\nwith small, slit like, cancer alveoli greatly hypertrophied muscularis.\\ncases the villi are represented by short, broad, anuclear\\nprojections. The vessels in the muscular coat are also\\nliable to amyloid change, but the process does not extend\\nto the muscle itself, which may, however, undergo a\\nsecondary atrophy.\\nInflammations.\\nIn acute catarrhal enteritis the intestinal mucous mem-\\nbrane is swollen, hyperemic, and edematous. The epithe-\\nlium contains an increased number of goblet cells, and\\noften extensive mucous degeneration is observed, not\\nonly in the surface epithelium, but also in the glandular\\nthe mucus accumulates as large, viscid, flocculent, grayish\\nPLATE 55.\\nFig. I. Atrophy of the Large Intestine Chronic Tuber=\\nculosis in a Child. X 85. Mucous membrane very thin, with short\\nglands (1) and somewhat increased stratum proprium (2); 2, muscu-\\nlaris mucosae 3, submucosa 4, muscularis 5, serosa.\\nFig. II. Brown Atrophy of the Muscularis of the Small\\nIntestine in Cachexia Due to Cancer. X 330. Almost all muscle-\\ncells filled with fine, granular, brownish pigment the nuclei are covered\\nby the latter.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0254.jp2"}, "255": {"fulltext": "Tab. J 2\\nV rv.VT\\n\u00e2\u0080\u00a2%^VCr*W.\u00c2\u00b0 o v c .*v *i;, i .-\u00e2\u0096\u00a0\u00e2\u0080\u009e4\\njy?. l\\ni c o 6 a te s\\na-v.v# r\\nff\\nZi/A. 4/w\u00c2\u00a3 Reichhold, M\u00c3\u00bcnchen", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0255.jp2"}, "256": {"fulltext": "", "height": "4676", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0256.jp2"}, "257": {"fulltext": "Tab. SS.\\nSSV X ^;\\\\f^ ..2\\nc^\\nr\\nf\\ns\\n^S C-v~ x\\n-f\\nv*-^-\u00e2\u0080\u0094 .^__;\\nC- 3\\nj X\\n-o-V\\nZ***r\\nv ^r~\u00c2\u00b0~\\nJtoi.\\nV/\\nZ^/t. \u00c3\u0084nst. t: Rpicl\u00c3\u00bcwld, M\u00c3\u00bcnchen", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0257.jp2"}, "258": {"fulltext": "", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0258.jp2"}, "259": {"fulltext": "THE DIGESTIVE ORGANS. 141\\nmasses. The lymphatic apparatus is also involved the\\nfollicles are swollen and often project above the level of\\nthe mucosa as small nodules as large as a grain of wheat\\n(follicular enteritis). The germinal centers are enlarged\\non account of an increased formation of lymphocytes\\nfrequently the centers become necrotic, and, on rupture\\ninto the lumen, small, follicular ulcers are produced,\\nwhich usually heal promptly by proliferation of the ret-\\niculum, leaving, however, a small depression easily recog-\\nnized by the presence of blackish pigment.\\nIn chronic catarrh, which frequently develops as a con-\\nsequence of long-continued passive hyperemia, the changes\\ndescribed are supplemented by an increase in the stratum\\nproprium and the submucosa, owing to round-cell infiltra-\\ntion and proliferation of the fixed cells. The continua-\\ntion of this process may lead to partial destruction of the\\nintestinal glands, the mucous membrane becomes irregu-\\nlarly uneven, and polypoid protuberances may be formed\\nby the connective-tissue proliferation (polypoid enteritis).\\nThe frequent, minute hemorrhages may lead to an exten-\\nsive punctiform, blackish pigmentation.\\nGenuine croupous enteritis L formation of a fibrin-\\nous layer upon the surface of the necrotic intestinal\\nepithelium is a very rare disease on the other hand,\\nvarious etiologic agents may produce the anatomic picture\\nof diphtheria deep necrosis of the mucosa with precipi-\\ntation of a varying amount of fibrin. Toxic agents are\\nthe most common in mercurial poisoning the action of\\nthe corrosive chlorid eliminated by the mucous membrane\\nof the colon produces a diphtheric colitis and uremic\\ncolitis is a diphtheria caused by an elimination of deriva-\\ntives from urea diphtheric inflammation is also the\\nresult of pressure-necrosis of the mucous membrane,\\ncaused by inspissated fecal masses or hard foreign bodies\\nin severe septic and pyemic processes diphtheric inflam-\\nmation of the large intestine arises by metastasis finally,", "height": "4667", "width": "2947", "jp2-path": "atlasepitomeofsp00drck_0259.jp2"}, "260": {"fulltext": "142 PATHOLOGIC HISTOLOGY.\\nPLATE 56.\\nFig. I.\u00e2\u0080\u0094 Diphtheric Colitis in Corrosive Sublimate Poison-\\ning. X 20. 1, Necrotic mucous membrane, covered by eschar 2,\\nleukocytic wall at margin of slough 3, greatly injected submucosa\\n4, muscularis.\\nFig. II.\u00e2\u0080\u0094 Dysentery of Large Intestine. X 50. The super-\\nficial layers of the mucosa are necrotic. In the deeper layers between\\nthe glands many leukocytes have accumulated (1) 2, fibrinous\\nthrombus in a small artery 3, muscularis mucosae ruptured in many\\nplaces by leukocytic accumulations 4, submucosa with greatly\\ndilated blood-vessels.\\nsome forms of the so-called dysentery are anatomically\\ndiphtheria of the colon. In sublimate poisoning the\\ndiphtheric changes may be very extensive the entire\\nmucous membrane may be converted into a solid, hard\\neschar, composed of an opaque, grayish layer, which\\nmicroscopically is found to be without nuclei and infil-\\ntrated with hemorrhages and small chromatin fragments\\nLieberk\u00c3\u00bchn s glands may be recognized in the form of\\nshadowy and indistinct outlines. Externally, the zone of\\nnecrosis is bounded by a thick layer of polynuclear leuko-\\ncytes, the subjacent submucosa is highly congested, hem-\\norrhagic, and infiltrated with round cells similar, but\\nnot so well-marked, changes may be present in the mus-\\ncular coat. By means of the fibrin stain the necrotic\\neschar and also the submucous tissue are shown to contain\\na fine, fibrinous network many of the vessels are also\\noften the seat of fibrin formation. (Plate 56, Figs. I\\nand II.)\\nDysentery, in the strict sense, is characterized by a\\npurulent infiltration of the mucous and submucous coats.\\nThe glands are compressed and separated from each other\\nby the accumulation of cells, and pus may form in the\\nglandular lumen, Simultaneously, fibrin is deposited in", "height": "4682", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0260.jp2"}, "261": {"fulltext": "..\\\\Vjip.\\n\u00e2\u0080\u00a2\u00e2\u0080\u00a2\u00e2\u0080\u00a2\u00e2\u0096\u00a0-\u00e2\u0080\u00a2v. 4-v\\nFig.l.\\nTab. 56.\\n)3\\nmsi i\\n[v 3\\nv^ V V: -V-\\nZdft. Reichhold, M\u00c3\u00bcnchen.", "height": "4708", "width": "2996", "jp2-path": "atlasepitomeofsp00drck_0261.jp2"}, "262": {"fulltext": "", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0262.jp2"}, "263": {"fulltext": "THE DIGESTIVE OEGAXS. 143\\nthe superficial layers of the epithelium, which undergoes\\nnecrosis. The process may spread toward the submucosa\\nand lead to an extensive and deep coagulation necrosis of\\nthe mucous membrane. In the beginning the necrotic\\nareas may be separated from each other, but later they\\ncoalesce to form thick, stiff, brownish or greenish crusts\\nand membranes. The increasing accumulation of the\\nleukocytes gradually separates the crusts and ulcers, at\\nthe base of which appears the hypercmic and infiltrated\\nsubmucosa, which may continue to suppurate for a long\\ntime. The lymphatic follicles are also much swollen,\\nand a central necrosis may produce crater-shaped losses of\\nsubstance. [In amebic dysentery the ulcers have over-\\nhanging margins.]\\nIn these processes, as well as in the typhoid intestinal\\nlesions, the lymph-vessels are involved in a characteristic\\nmanner. They appear as remarkably distinct, richly\\ncellular cords at the boundary of the submucosa and\\nbetween the muscular layers. Their lumen is filled with\\nlarge, polygonal, and flat cells, desquamated epithelial\\ncells, which often appear necrotic or filled with fat-\\nvacuoles in addition, are seen leukocytes and deeply\\nstained bacterial masses. (Plate 58, Fig. II.)\\nOn account of its rapid course cholera does not produce\\nextensive or noteworthy histologic changes in the intes-\\ntines. In the ea-es that die in the stage of asphyxia\\nthere are found small hemorrhages, extensive desquama-\\ntion of the surface epithelium, necrosis of the summits of\\nthe villi occasionally, the necrosis may extend to the\\nbase of the villi; the submucosa usually contains numer-\\nous mast-cells.\\nThe changes in the intestines in typhoid lever are more\\ncharacteristic and more severe. Die specific microbes\\nlocalize in the lymphatic apparatus of the mucous mem-\\nbrane, and it i- here that the most marked changes occur.\\n[These changes correspond in a general way with those", "height": "4708", "width": "2996", "jp2-path": "atlasepitomeofsp00drck_0263.jp2"}, "264": {"fulltext": "144 PATHOLOGIC HISTOLOGY.\\nPLATE 57.\\nFig. I.\u00e2\u0080\u0094 Typhoid Fever. Medullary Swelling of Follicle of\\nLarge Intestine. X 50. The follicle is greatly enlarged, and\\nshades into the surrounding infiltration at its upper part the mucous\\nmembrane is almost displaced. 1, Remains of the glands of Lieber-\\nk\u00c3\u00bchn 2, infiltrated submucosa 3, remains of follicle.\\nFig. IL\u00e2\u0080\u0094 Typhoid Fever. Medullary Swelling with Begin=\\nning Necrosis of a Follicle. X 50. In the center of the follicle\\nnecrosis has taken place a small amount of fibrin is here found (3) in\\nthe submucosa (4) greatly inj ected blood-vessels and numerous, large,\\nround cells (deeply stained with eosin) 1, mucosa infiltrated with\\nleukocytes 2, muscularis mucosae 5, muscularis.\\nthat occur in the mesenteric lymph-glands and in the\\nspleen, and which have been referred to. In the first\\nstage, corresponding to the first two weeks of the disease,\\nthe solitary follicles and Peyer s patches, especially those\\nnear the ileocecal valve, become considerably enlarged,\\nof soft consistence, rising above the surrounding mucosa\\n(so-called medullary infiltration).\\nMicroscopically, the swelling of the follicles is found to\\ndepend upon a marked multiplication and enlargement of\\nthe cells in the germinal centers and their vicinity. In\\nplace of the lymphocytes appear numerous, large, roundish\\ncells, with a large amount of acidophilous protoplasm,\\nthe nuclei being mostly vesicular, although some may be\\nricher in chromatin and often a number are present in one\\ncell. The appearance resembles very much those pre-\\nsented by mesenteric glands that are the seat of typhoid\\nswelling. (Plate 14, Fig. II.) This similarity is in-\\ncreased by the appearance of fat-vacuoles in the plasmatic\\ncells, [phagocytic cells that often contain red corpuscles,\\netc.] in the intestinal follicles.\\nIn the beginning masses of typhoid bacilli are found\\njust as in the lymph-glands (Plate 14 Fig. II) later, the", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0264.jp2"}, "265": {"fulltext": "7hl). S7.\\n4 Fig l\\nFig j\\nl.ith Ansf Reichhold, M\u00c3\u00bcnchen", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0265.jp2"}, "266": {"fulltext": "", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0266.jp2"}, "267": {"fulltext": "THE DIGESTIVE ORGANS. 145\\nbacilli disappear, while other micro-organisms may invade\\nthe tissue secondarily. Mast-cells appear in the vicinity\\noi the swollen follicles almost without exception these\\ncells are large, round cells filled with small, roundish\\ngranules, which stain deeply with alkaline, aniline dyes.\\nThe limits of the follicles become obscured on account of\\nthe leukocytic infiltration of the adjacent mucosa and sub-\\nmucosa.\\n[Mast-cells are cells whose protoplasm is filled with\\nbasophile granules that stain red (metachromatically) with\\npolychrome methylene-blue. 1 Ma-ma cells are cells of\\noval, cubic, or rhombic form, whose protoplasm retains a\\nblue color when stained with methylene-blue, while the\\nnucleus, generally eccentric in its situation, stains more\\nlightly and presents a few blue, chromatic masses. It is\\nregarded as derived from preexisting or emigrated lympho-\\ncytes, and occurs in various cell accumulations of inflam-\\nmatory nature.]\\nThe mucous membrane covering the follicles is raised\\nso that the crypts at the side of the swelling acquire\\nan oblique position very soon retrogressive changes\\nmake their appearance in these parts of the mucosa. The\\nsuperficial epithelium, and also, in part, that lining the\\ncrypts, becomes in erotic the villi also undergo necrosis\\nfibrin is deposited in the necrotic layer, so that at a\\ncertain definite stage there is a diphtheric inflammation\\nover the follicles. The surrounding blood-vessels are\\ngreatly congested. Occasionally, the medullary infiltra-\\ntion of the follicle- subsides, and a simple resolution\\nensues without extensive and general necrosis 5 theswollen\\nand enlarged cell- undergo fatty changes, and the fat-drops\\nare absorbed. Plate 07. Figs. I and IT.) Usually, how-\\never, the end of the second or the beginning of the third\\nweek witnesses the appearance of an at firsl limited and\\nsuperficial necrosis that gradually involves the whole fol-\\nlicle. A delicate, fibrinous network appears between the\\n10", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0267.jp2"}, "268": {"fulltext": "146 PATHOLOGIC HISTOLOGY.\\nPLATE 58.\\nFig. I.\u00e2\u0080\u0094 Typhoid Fever. Ulcer after Detachment of Slough.\\nX 50. The margins of the defect end abruptly in the floor of the\\nulcer, which reaches into the submucosa, are seen a few necrotic por-\\ntions of tissue with extensive infiltration of leukocytes. 1, Mucosa 2,\\nmuscularis mucosae 3, submucosa with overfilled blood-vessels 4,\\nmuscularis.\\nFig. IL\u00e2\u0080\u0094 Intestinal Lymphangitis. Cellular Thrombus\\nin a Lymph=vessel of the Submucosa of the Large Intestine\\nin Dysentery. X 360. 1, In the lymph-vessel are seen large\\npolygonal, partly necrotic cells, some with two nuclei among these\\nare several leukocytes.\\ndisintegrating cells eventually, the necrotic follicle and\\nthe necrotic mucous membrane are changed into a struc-\\ntureless mass, often stained greenish by the bile, and sur-\\nrounded by a dense leukocytic wall. This is the typhoid\\nslough.\\nToward the end of the third or the beginning of the\\nfourth week this slough becomes loosened from the sur-\\nroundings and thrown off the typhoid ulcer has formed.\\n(Plate 58, Fig. I.) The margins of the ulcer are usually\\nabrupt the depth varies, depending on the extent of the\\nnecrosis and the size of the follicles involved it always ex-\\ntends at least to the submucosa, and not rarely the necrosis\\nmay involve the muscular coat, so that at times there is ex-\\nposed the serous membrane, which may become perforated.\\nThe floor of the ulcer is at first brownish or blackish from\\nthe extravasated blood, but soon it becomes clean, so that\\nthe tissue exposed is readily recognizable. Later, the\\ntissue forming the floor of the ulcer produces granulation\\ntissue from newly formed connective-tissue cells and em-\\nbryonic vessels, until the defect is filled up. The surface\\nepithelium may be regenerated from that at the margin\\neven the villi are partly reproduced, but the glands do not\\nseem to be reproduced.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0268.jp2"}, "269": {"fulltext": "Tab. 58.\\nI\\n2\\nIig.l.\\nS\\nL\\nAte\\n\u00c2\u00abp\\n^r\\ns\\ni\u00c2\u00a3\\n\u00c3\u00b6g\\nggp2)\\nFiff.2.\\nLtth. Aast E RetchhoUl, Manchen.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0269.jp2"}, "270": {"fulltext": "", "height": "4684", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0270.jp2"}, "271": {"fulltext": "THE DIGESTIVE ORGANS. 147\\nThese regenerative processes do not generally appear\\nbefore the fifth to the sixth week of the disease.\\nAs in diphtheric enteritis and in dysentery, so also in\\ntyphoid, the lymph-vessels of the intestinal wall become\\ninvolved through extensive desquamation and new forma-\\ntion of their epithelium.\\nTuberculosis.\\nPrimarily, tuberculosis of the intestines also tends to\\nbecome localized in the lymphatic apparatus of the mu-\\ncous membrane. As the leukocytes accumulate, large\\npolygonal cells, with vesicular, clear nuclei, the so-called\\nepithelioid cells, appear among them and often form\\ngiant cells. The epithelioid cells are undoubtedly deriv-\\natives of connective-tissue cells, and the cells lining lymph-\\nvessels.\\nWhile different cells accumulate about the small nodules\\nand densely infiltrate the mucous membrane, the center of\\nthe mass undergoes coagulation necrosis the nuclei disin-\\ntegrate into fine fragments and finally disappear wholly.\\nThe caseous area spreads and involves the surrounding\\ntissue, so that the mucous membrane is broken through\\nand the caseous center empties itself into the lumen of the\\nintestine the follicular, tuberculous ulcer which is thus\\nformed corresponds to the caseous area, and has over-\\nhanging, irregularly thickened, -wollen margins. The\\ndefect increases rapidly because new tubercles form in the\\nMoor and undergo caseation the process frequently\\nspreads in a circular direction that is, perpendicularly\\nto the long axis of the intestine. In advanced instances\\nall the layer- of the intestinal wall the submucous, mus-\\ncular, and serou become infiltrated with nodules that\\nmay undergo necrosis, until eventually perforation takes\\nplace. Plate 59, Figs. I and 1 1. 1\\nSyphilitic granulomas occur in the intestinal walls in\\ncongenital syphilis of the new-horn a.- well as in adults", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0271.jp2"}, "272": {"fulltext": "148 PATHOLOGIC HISTOLOGY.\\nPLATE 59.\\nFig. I.\u00e2\u0080\u0094 Beginning Tuberculosis in the Vermiform Ap=\\npendix. X 80. Mucosa about normal, but with infiltrated stratum\\nproprium. 1, Moderately sharply circumscribed, cellular nodule in\\nthe submucosa with beginning central necrosis.\\nFig. IL\u00e2\u0080\u0094 From the Margin of a Tuberculous Ulcer of the\\nIntestine. X 80. The greater part of the mucosa is destroyed by\\nexfoliation of the caseous tissue. 3, The overhanging margin of the\\ntuberculous ulcer; 2, floor of ulcer at (1) is a newly formed nodule.\\nAll the blood-vessels are greatly distended with blood.\\nin the later stages of acquired lues. The nodules differ\\nfrom tuberculosis on account of their tendency to fibrous\\nencapsulation and the constant presence of syphilitic en-\\ndarteritis in their vicinity. The confluence of adjacent\\nnodules may occasionally produce larger sclerotic patches\\nin the mucosa and submucosa.\\nPERITONEUM.\\nThe inflammations (including tuberculosis) of the peri-\\ntoneum resemble, histologically, the same processes in the\\npleura. In order to avoid repetitions, it is sufficient to\\nrefer the reader to page 117.\\nPLATE 60.\\nFig. I.\u00e2\u0080\u0094 Beginning Suppurative Peritonitis, Twenty=four\\nHours after Ligating the Intestine (from Guinea=pig). X 625.\\n1, Peritoneal connective tissue in longitudinal and transverse section\\n2, epithelium 3, exudate, consisting of a moderate amount of fibrin\\n(several of the threads are also deposited between the epithelial cells\\nand the connective tissue of the serosa), numerous leukocytes, and red\\nblood-corpuscles. Scattered about are nuclei of detached epithelium\\nand various bacteria.\\nFig. IL\u00e2\u0080\u0094 Tuberculous Peritonitis. X 72. 1, Epithelium; 2,\\ninfiltrated connective tissue of the serosa 3, subserous fat-layer 4,\\ntubercle with giant-cells 5, villus-like elevations.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0272.jp2"}, "273": {"fulltext": "/.-\u00e2\u0080\u00a2\u00c2\u00abJ** Sr.- jf \u00c3\u00a4*.;:v\\nj^j.\\n\u00e2\u0096\u00a0i.V.* v V-v* 1\\n7\u00c2\u00ab\u00c3\u0084. j\u00c2\u00bb.\\nZi/A. AnstE Reichhold, M\u00c3\u00bcnchen", "height": "4650", "width": "2971", "jp2-path": "atlasepitomeofsp00drck_0273.jp2"}, "274": {"fulltext": "", "height": "4681", "width": "2840", "jp2-path": "atlasepitomeofsp00drck_0274.jp2"}, "275": {"fulltext": "Tab, 60.\\nr\\ng\u00c2\u00bb\\n\u00e2\u0082\u00ac5*\\nW\\nP\\n*e\\nA^\\n3 V ft ^.v\\n\u00c2\u00abJT- A\\n2ty.i.\\nin :T -VC-*\\nv\\n*I7* J v\\nJ\\nFig. 2.\\nLith. Aast. F. Reichhold, M\u00c3\u00bcnchen.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0275.jp2"}, "276": {"fulltext": "", "height": "4684", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0276.jp2"}, "277": {"fulltext": "INDEX,\\nA.\\nAbscess, embolic, 23 PL 3\\nof lang, PI. 41\\nof spleen, 57\\npurulent, of lymphatic glands,\\n49\\nsplenic, 59\\nAcute inflammation of lymph-\\ngland, 51\\nAdenoma of stomach, 137\\nAdipositas cardis, 20 PI. 2\\nAlbuminous degeneration of\\nheart-muscle, 18\\nAmebic dysentery, 143\\nAmyloid degeneration of intes-\\ntine, 139\\nof spleen, 61 PL 21, 22\\nof stomach, 137\\nAmyloidosis of spleen, 61 PL\\n2 1 22\\nAnemia, pernicious, bone-mar-\\nrow in, 65 PL 25\\nAneurysm. 12\\nof aorta. PL 10 a\\nAnthraeosis of lung, 90 PL 32\\nof spleen, 55\\nAorta, aneurysm of, PL 10a\\nArteries, fatty degeneration of,\\n37; PI. 10\\nstructure of, 33\\nArteriosclerosis. 35 PL 9, 10\\nArteriosclerotic myocarditis, 25\\nArteritis, 39\\ngummatous. 11 PL 10 b\\nin tuberculous leptomeningitis,\\n29, 10 PL 10 1)\\nobliterans, PL 11\\ntuberculous, PL 12\\n149\\nArtery, atheroma of, 34, 35 PL\\n10\\ncalcification of, 37\\ninflammation of, 39\\nAtelectasis, 79\\ncollapse, 79\\ncompression, 79, 80 PL 31\\nfetal, 79 PL 31\\nresorption, 80\\nAtheroma of artery, 34, 35 PL\\n10\\nAtheromatosis, 35\\nAtheromatous patch, Cholesterin\\nplates from, 37 PL 10\\nAtrophy of heart-muscle, brown,\\n20, 21 PL 2\\nof intestine, 138 PL 55\\nbrown, 139 PL 55\\nof mucous membrane of stom-\\nach, 137\\nof spleen, senile, PL 18\\nBacon spleen, 61 PL 21\\nBlack tongue, hairy, 127\\nBlood-vessels, structure of, 33\\nBone-marrow, gelatinous, 65\\nin acute leukemia, 65 PL 25\\nin pernicious anemia, 05 PL\\n25\\nnecrosis of, 65\\nstructure of, 64\\nBronchi, diseases of, 75\\nstructure of, 69, 71\\nBronchia] catarrh, 75\\nBronchiectasis, 76 PL 29", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0277.jp2"}, "278": {"fulltext": "150\\nINDEX.\\nBronchiectatic cavity, 114 PI.\\n45\\nBronchitis, caseous, 207 PL 41\\nBronchopneumonia, 91, 100\\ncircumscribed indurative, 90\\norganization of exudate in, PI.\\n38\\nBronchus, ectasia of, PI. 76\\ntuberculosis of, PI. 28\\nBrown atrophy of heart-muscle,\\n20, 21 PI. 2\\ninduration of lung, 83 PI. 34\\nBullous emphysema of lung, 82\\nC.\\nCalcareous goiter, 120\\nCalcification of artery, 37\\nof veins, 45\\nCapillaries, structure of, 34\\nCarcinoma of stomach, 137 PI.\\n54\\nof thyroid gland, 120\\nCardiac glands, 124\\nCarnification of lung, 95, 99 PL\\n38\\nCaseation of lymph-glands, 52\\nCaseous bronchitis, 107 PL 41\\nnecrosis in gummatous arteritis,\\n41 PL 10 b\\nof pericardium, 32\\npneumonia, 108, 109 PL 42\\nCatarrh, bronchial, 75\\nnasal, 67\\nchronic, 68\\nof larynx, 71\\nchronic, 72\\nof oral cavity, 126\\nof pharynx, 126\\nCatarrhal enteritis, acute, 140\\nchronic, 141\\ngastritis, acute, 133\\nchronic, 133 PL 51\\npneumonia, 93 PL 39\\nChalkosis pulmonis, 91\\nCholera, effect on intestine, 143\\nCholesterin plates from athero-\\nmatous patch, 37 PL 10\\nCirculatory disturbances in the\\nlungs, 83\\nof myocardium, 21\\nof stomach, 133\\nCircum vallate papillae, 121\\nCirrhotic induration of lung, 113\\nPL 45\\nCloudy swelling in heart-muscle,\\n18\\nCoagulative centers in croupous\\npneumonia, 95\\nCohnheim s experiment, 39\\nCohn s stigmas, 77, 96\\nColitis, diphtheric, 141 PL 56\\nuremic, 141\\nCollapse atelectasis, 79\\nCollateral edema of lung, 93\\nColloid goiter, 119\\nColon, diphtheria of, 142\\nCompression atelectasis, 79\\nCongestion, passive, of intestine,\\n138\\nof spleen, 54\\nstage of, in croupous pneumo-\\nnia, 95\\nCoronary arteries, embolism of,\\n21\\nCorpora amyloidea, 100\\nCorrosion of esophagus, 133\\nCor villosum, 31 PL 7\\nCoryza, 67\\nCroup, 73, 130\\nCroupous enteritis, 141\\nlaryngitis, 73\\npneumonia, 93, 95\\nCyanotic induration of lung, 83\\nPL 34\\nCystic goiter, 119\\npolyp of nose, 69\\nD.\\nDegeneration, albuminous, of\\nheart-muscle, 18\\namyloid, of intestine, 139\\nof spleen, 61 PL 21,22\\nof stomach, 137\\nfatty, of arteries, 37 PL 10\\nof heart, 19 PL 1", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0278.jp2"}, "279": {"fulltext": "IXDEX.\\n151\\nDegeneration, hyaline, of lymph-\\nglands, 51 PL 16\\nof spleen, 61\\nDemilune cells, 1*22\\nDesquamative pneumonia, 100\\nPI. 44\\nDiphtheria, 130\\nLoffler s bacillus in, 131\\nof colon, 142\\nof nose, 69\\nof pharynx, 130 PI. 49\\nof tonsil, 130: PI. 49\\nof trachea, PI. 26\\nspleen-follicle in, PI. 24\\nDiphtheric colitis, 141 PI. 56\\nendocarditis. 26, 29\\neschars, 135\\nlaryngitis. 73\\nulcer, 74, 131\\nDiplococcus pneumoniae, 97\\nDust in lungs. 88, 89, 90\\nDust-cells in lungs, 88\\nDysentery. 142 PI. 56\\namebic. 143\\nE.\\nEctasia of bronchus, PI. 76\\nEdema of lung, 85 PI. 36\\ncollateral, 93\\ninflammatory. 92\\nEmbolic abscess, 23 PL 3\\nof lung, PL 41\\nof spleen, 57\\nparotitis, acute suppurative,\\n132 PL 50\\npneumonia, 92, 93, 103\\nscars of spleen, 57\\ntuberculosis. 105\\nEmbolism of coronary arteries, 21\\nof lung, fiat, 87 PL 35\\nof spleen, staphylococcal, PL\\n23\\nEmphysema of lung, 81 PL 33\\nbullous. 82; PL 33\\ninterstitial subpleural, 81\\nintervesicular, 81\\nEndarteritis. 35\\nobliterans. 41\\ntuberculous, 39, 40\\nEndocarditis, 26\\ndiphtheric, 26, 29\\nmycotic, 27 PL c\\nrheumatic, 26, 27\\nulcerative, 26, 29\\nverrucose, 26, 27\\nmycotic, 28 PL 6\\norganized, 28 PL 6\\nEndocardium, inflammation of,\\n26\\nstructure of, 18\\nEndolymphangitis fibrosa, 90\\nEndoperivasculitis nodosa, 90\\nEndophlebitis, 43\\nEnteritis, 140\\nacute catarrhal. 140\\nchronic catarrhal, 141\\ncroupous, 141\\nfollicular, 141\\npolypoid, 141\\nEpicardium, milk spots of, PL 8\\nsclerotic spots of, PL 8\\nstructure of, 17\\nErosion, hemorrhagic, of stomach,\\nPL 52\\nEschars, diphtheric, 135\\nEsophagus, corrosion of, 133\\ndiseases of, 126, 132\\nin smallpox, 129\\nstructure of, 123\\ntuberculosis of, 127\\ntuberculous ulcer of, 128\\nvaricose veins of, 133\\nF.\\nFat-embolism of lung, 87 PL 35\\nFatty degeneration of arteries, 37\\nPL 10\\nof heart, 19 PL 1\\nFaucial tonsils, 122\\nFetal gelatinous nodule, 18 PL 5\\nFibrinous pericarditis, acute, 31\\nPL 7\\npleuritis, 117 PL 47\\npneumonia, 93\\nFibroma of stomach, 137\\nFibrous myocarditis, chronic, 25;\\nPL 4", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0279.jp2"}, "280": {"fulltext": "152\\nINDEX.\\nFiliform papillae, 121\\nFollicles of lymphatic glands, 46\\nsplenic, 53\\nFollicular enteritis, 141\\nFragmentation of myocardium,\\n21, 24\\nFungiform papillae, 121\\nGastric glands, 124\\nulcer, 135\\nGastritis, acute catarrhal, 133\\nchronic catarrhal, 133 PI. 51\\ngranular, 134 PL 51\\nhemorrhagic, PI. 52\\nnecrotic, PL 52\\nphlegmonous, 135\\npolypoid, 135\\nGelatinous bone-marrow, 65\\nGlanders of larynx, 75\\nof nose, 69\\nGlands, lymphatic, structure of,\\n45\\nGoiter, 119\\ncalcareous, 120\\ncolloid, 119\\ncystic, 119\\nhemorrhagic, 119\\nparenchymatous, 119\\nvascular, 120\\nGranular gastritis, 134 PL 51\\nlaryngitis, 72\\npharyngitis, 127\\nGray hepatization, 96, 97\\nGummatous arteritis, 41 PL 10 b\\nlaryngitis, 75\\nH.\\nHeart, fatty degeneration, 19\\nHeart-muscle, albuminous degen-\\neration of, 18\\nbrown atrophy of, 20, 21 PL\\n2\\ncloudy swelling in, 18\\ndiseases of, 18\\ninfarction of, organized, 23\\nPL 5\\nHematogenous pneumonia, 93\\ntuberculosis, 105\\nHematoidin crystals in lung, 85\\nHemochromatosis, 139\\nHemorrhagic gastritis, PL 52\\ngoiter, 119\\ninfarction of intestine, 138\\npneumonia, 92\\nHepatization, gray, 97 PL 37\\nin croupous pneumonia, 96\\nred, 95, 96 PL 36\\nHerzfehlerzellen, 84\\nHyaline degeneration of lymph-\\nglands, 51; PI. 16\\nHyperemia of lung, passive, 83,\\n85 PL 34\\nof spleen, passive, 54 PL 18\\nHyperplasia, cellular, of lymph-\\ngland, PL 15\\nHypostatic congestion of lung, 85\\nI.\\nIndurative lymphadenitis, PL 16\\nInfarction of heart-muscle, or-\\nganized, 23 PL 3\\nof intestine, hemorrhagic, 138\\nof lung, 86 PL 35\\nof spleen, anemic, 56 PL 19\\nInfarcts in spleen, 55\\nhemorrhagic, 56 PL 19\\nInfiltration, medullary, in lymph-\\natic glands, 50\\nInflammation, interstitial, of\\nlymph-glands, 51\\nof artery, 39\\nof endocardium, 26\\nof intestine, 140\\nof larynx, 71\\nof lung, 91\\nof lymph-glands, 47\\nacute, 51\\nsuppurative, 49\\nof pericardium, 30\\nof perineum, 148\\nof stomach, 133\\nof veins, 43\\nInflammatory edema of lung, 85", "height": "4690", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0280.jp2"}, "281": {"fulltext": "IXDEX.\\n153\\nInterstitial inflammation of\\nlymph-glands, 51\\nmyocarditis, 24 PL 4\\nIntestinal lymphangitis, 143\\nPI. d8\\nvilli, 125\\nIntestine, amyloid degeneration\\nof, 139\\natrophy of, 138 PL 55\\nbrown. 139 PL \u00c3\u00b6d\\ndiphtheric inflammation of, 141\\ndiseases of. 138\\neffect of cholera on, 143\\neffect of typhoid fever on, 143\\nfollicular nicer of. 141\\nhemorrhagic infarction of, 138\\ninflammation of, 140\\nlarge, structure of, 125, 126\\npassive congestion of, 138\\nsmall, structure of, 125. 126\\nsyphilitic granuloma of, 147\\ntuberculosis of. 147\\ntuberculous ulcer of, 147\\nL.\\nLarge intestine, structure of, 125,\\n126\\nLaryngeal ulcer, 71 PI. 27\\nLaryngitis, 71\\ncroupous, 73\\ndiphtheric. 73\\ngranular. 72\\ngummatous. 75\\nLarynx, catarrh of, 71\\nchronic, 72\\nglanders of. 75\\ninflammation of, 71\\nleprosy of, 75\\nstructure of, 69, 70, 71\\nsyphilis of, 75\\ntuberculosis of, 74 PL 28\\nulcerations of, 74, 75\\nLeprosy of larynx, 75\\nLeptomeningitis, tuberculous, in\\narteritis, 39, 40 PL 10 b\\nLeptothrix buccal is. 127\\nLeukemia, acute, bone-marrow\\nin, 65 PL 25\\nLeukemia, myelogenic, 63\\nspleen in, 62 PL 23\\nLingua hirsuta, 127\\nLipoma of stomach, 137\\nLipomatosis cordis, 20 PL 2\\nLobar pneumonia, 91\\nLobular pneumonia, 101 PL 40\\npostdiphtheric, 103 PL 40\\nL\u00c3\u00b6ffler s bacillus, 131\\nLung, anthracosis of, 90 PL 32\\natelectasis of, 79\\nof fetal, 79; PL 31\\nbrown induration of, 83 PL\\n34\\nbullous emphysema of, 82 PL\\n33\\ncarnification of, 95, 99 PL 38\\nchalicosis of, 91\\ncirrhotic induration of, 113\\nPL 45\\ncollateral edema of, 93\\ncyanotic induration of, 83 PL\\n34\\nedema of, 85 PL 36\\nembolic abscess of, PL 41\\nemphysema of, 81 PL 33\\ninterstitial, 81\\nintervesicular, 81\\nfat embolism of, 87 PL 35\\nhypostatic congestion of, 85\\ninfarction of, 86 PL 35\\ninflammation of, 91\\ninflammatory edema of, 85, 92\\nmarantic splenization of, 101\\nPL 36\\nnodular syphilis of, 115, 116\\npassive hyperemia of, 83, 85\\nPL 34\\nred iron, PL 32\\nsiderosisof, 91 PL 32\\nslaty induration of, 113 PL 45\\nsyphilis of, 115\\ntuberculosis of, 104\\nLungs, circulatory disturbances\\nin, 83\\ndust in, 88, 89, 90\\nembolism of, cellular, 88\\nhematoidin crystals in, 85\\nstructure of, 77", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0281.jp2"}, "282": {"fulltext": "154\\nINDEX.\\nLymphadenitis, 47 PI. 15\\nindurative, PI. 16, 17\\nLymphangitis, intestinal, 143\\nPI. 58\\nperibronchial tuberculous, 110\\nLymph-glands, acute inflamma-\\ntion of, 51\\ncaseation of, 52\\ncellular hyperplasia of, PI. 15\\ndeposition of pigment in, due to\\ntattooing, 48 PI. 14\\nfollicles of, 46\\nhyaline degeneration of, 51\\nPI. 16\\ninflammation of, 47\\ninterstitial inflammation of, 51\\nin typhoidal diseases, 50 PI.\\n14, Fig. 2\\nmedullary infiltration in, 50\\nnecrosis of, 51\\npurulent abscess of, 49\\nsecondary nodules of, 46\\nstructure of, 45\\nsuppurative inflammation of,\\n49\\ntuberculosis of, 51 PI. 17\\nLymph-sinuses, 46\\nLymph -vessels, 46\\nLysis, stage, of, in croupous pneu-\\nmonia, 97\\nM.\\nMacroerythrocytes, 65\\nMalpighian bodies, 53\\nMarantic splenization, 85 PI. 36\\nof lung, 101 PI. 36\\nMarginal lymph-sinuses, 46\\nMast-cells, 145\\nMedullary infiltration in lymph-\\natic glands, 50\\nMesarteritis, 35\\nMesophlebitis, 43\\nMetastatic pneumonia, 92\\nMicrococcus lanceolatus, 97\\nMiliary tuberculosis, acute, 105,\\n106 PI. 42\\ntuberculous pneumonia, 111\\nPI. 43\\nMilk spots of epicardium, PI. 8\\nMouth, croupous inflammation of,\\n130\\ndiphtheric inflammation of, 130\\nin smallpox, 129\\nMucous glands, mixed, 122\\npure, 122\\nMumps, 132\\nMuscularis mucosae, 124\\nMycotic endocarditis, 27 PL 5\\nverrucose, 28 PI. 6\\nMyelogenic leukemia, 63\\nMyeloplaxes, 65\\nMyocardial scars, 23, 25 PI. 4\\nMyocardite segmentaire, 24\\nMyocarditis, arteriosclerotic, 25\\nfibrous, chronic, 25 PI. 4\\ninterstitial, 24 PI. 4\\nMyocardium (see also Heart-mus-\\ncle), circulatory disturbances\\nof, 21\\nfragmentation of, 21, 24\\nsegmentation of, 21, 24\\nstructure of, 17\\nMyoma of stomach, 137\\nMyomalacia cordis, 22\\nN.\\nNasal catarrh, 67\\nchronic, 68\\npolypi, 68\\nNecrosis, caseous, in gummatous\\narteritis, 41 PI. 10 b\\nof pericardium, 32\\nof bone-marrow, 65\\nof lymphatic glands, 51\\nNecrotic gastritis, PL 52\\nNodular syphilis of lung, 115, 116\\nNodule, fetal gelatinous, 18 PL 5\\nNodules, secondary, of lymphatic\\nglands, 46\\nNoma, 129\\nNose, diphtheria of, 69\\nglanders of, 69\\nstructure of, 67\\nsyphilis of, 69\\ntuberculosis of, 69\\nNuhn s glands, 122", "height": "4686", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0282.jp2"}, "283": {"fulltext": "INDEX.\\n155\\no.\\nObesitas cordis, 20 PI. 2\\nOidium albicans, 127\\nOral cavity, 121\\ncatarrh of, 126\\ndiseases of, 126\\ntuberculosis of, 127\\ntuberculous ulcer of, 128\\nOrgans of circulation, 17\\nOsteosarcoma of thyroid gland,\\n120\\nOzena, 63\\nP.\\nPachydermia laryngis, 72 PL\\n27\\nPapillae foliatae, 122\\nParenchyma, splenic, 53\\nParenchymatous goiter, 49\\nParotid glands, 122\\nParotitis, 132\\nembolic, acute suppurative,\\n132 PL 50\\nPeriarteritis, 35\\nPeribronchial tuberculous lymph-\\nangitis, 110\\nPeribronchitis, 76\\nnodosa, 90\\nPericarditis, 30\\nfibrinous, acute, 31 PL 7\\ntuberculous, 31\\nsubacute, 31 PL 8\\nPericardium, caseous necrosis of,\\n32\\ndiseases of. 30\\ninflammation of. 30\\nPerichondritis, tuberculous, 75\\nPerilymphangitis fibrosa, 90\\nPeriphlebitis, 43\\nPeritoneum, inflammation of, 148\\nPeritonitis, 148\\nsuppurative, PL 60\\ntuberculous, 148 PL 60\\nPerivasculitis nodosa, 90\\nPharyngitis, granular. 127\\nPharynx, catarrh of, 126\\ncroupous inflammation of, 130\\ndiphtheria of. 130 PL 49\\ndiseases of, 126\\nin smallpox, 129\\nPharynx, tuberculosis of, 127,\\n123 PL 48\\nPhlebectasia, 45\\nPhlebitis, 43, 44\\nsuppurative, PL 13\\nthrombo-, 43\\nPhlegmonous gastritis, 135\\nPigmentation in spleen, 55\\nPlasma cells, 145\\nPleura, structure of, 117\\nPleuritis, fibrinous, 117 PL 47\\ntuberculous, 118\\nPleurogenic pneumonia, 92\\nPleurogenous pneumonia, 103\\nPneumobacillus of Friedl\u00c3\u00a4nder,\\n97\\nPneumoconiosis, 88\\nPneumonia, 91\\ncaseous, 108, 109 PL 42\\ncatarrhal, 93 PL 39\\ncroupous, 93, 95\\ndesquamative, 100 PL 44\\nembolic, 92, 93, 103\\nhematogenous, 93\\nhemorrhagic, 92\\nlobar, 91\\nlobular, 101; PL 40\\npostdiphtheric, 103 PL 40\\nmetastatic, 92\\nmiliary tuberculous, 111 PL\\n43\\npleurogenic, 92\\npleurogenous, 103\\npseudolobular, 100\\npurulent, 93 PL 40\\nserous, 92\\nsyphilitic, 115; PL 46\\nwhite, 115; PL 46\\nPolyp, cystic, of nose, 69\\nPolypi, nasal, 68\\nPolypoid enteritis, 141\\ngastritis, 135\\nPseudolobular pneumonia, 100\\nPseudomembrane, 130\\nPulmonary tubercle, 111\\nPulp of spleen, 53\\nPurulent abscess of lymphatic\\nglands, 49\\npneumonia, 93 PL 40", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0283.jp2"}, "284": {"fulltext": "156\\nINDEX.\\nPyknosis, 131\\nPyloric glands, 125\\nRed hepatization, 96\\nRed iron lung, PL 32\\nResolution, stage of, in croupous\\npneumonia, 97\\nResorption atelectasis, 79\\nRespiratory organs, 67\\nRheumatic endocarditis, 26, 27\\nRound ulcer of stomach, 136\\nSaccharomyces albicans, 127\\nSago spleen, 61; PI. 22\\nSalivary glands, 122\\ndiseases of, 132\\nSarcoma of stomach, 137\\nof thyroid gland, 120\\nSclerotic spots of epicardium, PL\\n8\\nScrofula, 52\\nSecondary nodules of lymphatic\\nglands, 46\\nSegmentation of myocardium, 21,\\n24\\nSerous glands, mixed, 122\\npure, 122\\npneumonia, 92\\nSialodochitis, acute, 132\\nSiclerosis of lung, 91 PL 32\\nSinuous ulcers of arteries, 37\\nSlaty induration of lungs, 112\\nPL 45\\nSmall intestine, structure of, 125,\\n126\\nSmallpox, esophagus in, 129\\nmouth in, 129\\npharynx in, 129\\nSoldier-spots, 31\\nSpleen, amyloid degeneration of,\\n61 Plate 21, 22\\namyloidosis of, 61 PL 21, 22\\nanemic infarction of, 56 PL\\n19\\nanthracosis of, 55\\nSpleen, bacon, 61 PL 21\\nembolic scars of, 57\\nhemorrhagic infarct of, 26 PL\\n19\\ninfarcts in, 55\\nin leukemia, 62 PL 23\\nin pseudoleukemia, 62\\npassive congestion of, 54\\nhyperemia of, 54 PL 18\\npigmentation in, 55\\nsago, 61; PL 22\\nsenile atrophy of, PL 18\\nstaphylococcal embolism of, PL\\n23\\nstructure of, 53\\ntubercle of, 63\\ntuberculosis of, PL 24\\nSpleen-follicle in diphtheria, PL\\n24\\nSplenic abscess, 59\\nfollicles, 53\\nparenchyma, 53\\npulp, 53\\ntumor, acute, 57\\nhyperplastic, 58 PL 20\\nchronic, 59 PL 20\\ninfectious, PL 20\\nSplenization, marantic, 85 PL\\n36\\nof lung, 101 PL 36\\nSpots, tendinous, 31\\nStigmata of Cohn, 77, 96\\nStomach, adenoma of, 137\\namyloid degeneration of, 137\\natrophy of mucous membrane\\nof, 137\\ncarcinoma of, 137 PL 54\\ncirculatory disturbances of, 133\\ndiseases of, 133\\nfibroma of, 137\\nhemorrhagic erosion of, PL 52\\ninflammation of, 133\\nlipoma of, 137\\nmyoma of, 137\\nround ulcer of, 136 PL 53\\nsarcoma of, 137\\nstructure of, 123\\nsyphilis of, 137\\ntuberculosis of, 137", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0284.jp2"}, "285": {"fulltext": "IXDEX.\\n157\\nStomach, tumors of, 137\\nStruma. 119\\nSubmaxillary glands, 1*2*2\\nSuppurative inflammation of\\nlymphatic glands, 49\\nphlebitis. PL 13\\nSwelling, cloudy, iu heart-muscle,\\n18\\nSyphilis of larynx, 75\\nof lung, 115\\nof nose, 69\\nof stomach, 137\\nSyphilitic granuloma of intestine,\\n147\\npneumonia, 115 PL 46\\nT.\\nTattooing, deposition of pigment\\nin lymphatic glands as result\\nof, 47 PL 14\\nTendinous spots, 31\\nTerminal lymph-sinuses, 46\\nThroinbo-phlebitis, 43\\nThrush. 127 PL 50\\nThyroid gland, carcinoma of, 120\\nosteosarcoma of. 120\\nsarcoma of. 120\\nstructure of, 118\\nstruma of, 119\\nTongue, black, hairy, 127\\nstructure of. 121\\nvariola vera of, PL 48\\nTonsil, croupous inflammation of,\\n130\\ndiphtheria of, 130 PL 49\\ndiphtheric inflammation of,\\n130: PL 49\\nTonsils, faucial. 122\\nTrachea, diphtheria of. PI. 26\\ndiseases of. 76\\nstructure of, 09. 70, 71\\nTrachea] catarrh, 75\\nTubercle in vein-wall. PI. 12\\nof spleen,\\npulmonary, 111\\nTuberculosis, embolic. 105\\nhematogenous, 105\\nin vermiform appendix, PL 59\\nTuberculosis, miliary, acute, 105,\\n106 PL 42\\nof bronchus. PI. 28\\nof esophagus, 127\\nof intestine, 147\\nof larynx, 74 PL 28\\nof lung, 104\\nol lymph-gland, PL 17\\nof lymph-glands, 51\\nof nose, 69\\nof oral cavity, 127\\nof pharynx, 127; PL 48\\nof spleen, PL 24\\nof stomach, 137\\nTuberculous arteritis, PL 12\\nendoarteritis, 39, 40\\nleptomeningitis, arteritis in, 39,\\n40; PL 10 b\\npericarditis, 31: PL 8\\nperichondritis. 75\\nperitonitis, 148 PL 60\\npleuritis, 118\\nTumor, splenic, acute, 57\\nhyperplastic, 58 PL 20\\nchronic, 59 PL 20\\ninfectious, PL 20\\nTumors of stomach, 137\\nTyphoid fever. PL 57\\neffect on intestine, 143\\nTyphoidal disease, lymphatic\\nglands in, 50 PL 14, Fig. 2\\nU.\\nL^lcer, diphtheric, 74. 131\\nfollicular, of intestine, 141\\ngastric, 135\\nlaryngeal, 71; PL 27\\nround, of stomach, 136 PL\\nsinuous, of arteries, 37\\ntuberculous, of esophagus, 128\\nof intestine, 147\\nof oral cavity, 128\\nof pharynx, 12ft\\nUlcerations of larynx, 74. 75\\nUlcerative endocarditis, 26, 29\\nUremic colitis, 141", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0285.jp2"}, "286": {"fulltext": "158\\nINDEX.\\nV.\\nVaricose veins of esophagus, 133\\nVariola vera of tongue, Pi. 48\\nVarix, 45 PI. 13\\nVascular goiter, 120\\nVeins, calcification of, 45\\ninflammation of, 43\\nstructure of, 34\\nVein-wall, tubercle in, PI. 12\\nVerrucose endocarditis, 26, 27\\nmycotic, 28 PI. 6\\norganized, 28 PL 6\\nVilli, intestinal, 125\\nW.\\nWhite pneumonia, 115 PI. 46", "height": "4726", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0286.jp2"}, "287": {"fulltext": "", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0287.jp2"}, "288": {"fulltext": "", "height": "4717", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0288.jp2"}, "289": {"fulltext": "Medical and Surgical Works\\nPU3L1SHED By\\nW. B. SAUNDERS, 925 Walnut Street, Philadelphia, Pa.\\nAbbott on Transmissible Diseases iS\\nAmerican Pocket Medical Dictionary 35\\n\u00c2\u00bbAmerican Text-Book of Applied Thera-\\npeutics 8\\n\u00e2\u0099\u00a6American Text-Book of Dis. of Children 13\\n\u00e2\u0080\u00a2An American Text-Book of Diseases ot the\\nRye. Ear, Nose, and Throat 15\\n\u00e2\u0080\u00a2An American Text-Book of Genito-Uri-\\nnary and Skin Diseases 14\\n\u00e2\u0080\u00a2American Text-Book of Gynecology 12\\nAmerican Text-Book of Legal Medicine 44\\n\u00c2\u00bbAmerican Text-Book of Obstetrics 9\\nAmerican Text-Book of Pathology 44\\nAmerican Text-Book of Physiology 7\\nAmerican Text-Book of Practice 10\\n\u00e2\u0099\u00a6American Text-Book of Surgery 11\\nAnders Theory and Practice of Medicine 21\\nAshton s Obstetrics 43\\nAtlas of Skin Diseases 2S\\nBall s Bacteriology 43\\nBastin s Laboratory Exercises in Botany 36\\nBeck s Surgical Asepsis 41\\nBoisliniere s Obstetric Accidents 39\\nBrockway s Physics 43\\nBurr s Nervous Diseases 41\\nButler s Materia Medica and Therapeutics 24\\nCerna s Notes on the Newer Remedies 32\\nChapin s Compendium of Insanity 35\\nChapman s Medical Jurisprudence 41\\nChurch and Peterson s Nervous and Men-\\ntal Diseases 17\\nClarkson s Histology 33\\nCohen and Eshner s Diagnosis 43\\nCorwin s Diagnosis of the Thorax 37\\nCragin s Gynaecology 43\\nCrookshank s Text-Book of Bacteriology 27\\nDaCosta s Manual of Surgery 23\\nDe Schweinitz s Diseases of the Eye 29\\nDorland s Pocket Medical Dictionary 35\\nDorland s Obstetrics 41\\nFrothingham s Bacteriological Guide .30\\nGarrigues Diseases of Warnen 34\\nGleason s Diseases of the Ear 43\\n\u00e2\u0099\u00a6Gould and Pyle s Curiosities of Medicine 17\\nGrafstrom s Massage 28\\nGriffith s Care of the Baby 38\\nGriffith s Infant s Weight Chart 39\\nGross s Autobiography 26\\nHampton s Nursing 39\\nHare s Physiology 43\\nHart s Diet in Sickness and in Health 36\\nHaynes Manual of Anatomy 41\\nHeisler s Embryology 19\\nHirst s Obstetrics 20\\nHyde s Syphilis and Venereal Diseases 41\\nInternational Text-Book of Surgery 6\\nJackson s Diseases of the Eye 19\\nJackson and Gleason s Diseases of the Eye,\\nNose, and Throat 43\\nKeating s Pronouncing Dictionary 26\\nKeating s Life Insurance 39\\nKeen s Operation Blanks 36\\nKeen s Surgery of Typhoid Fever 22 t\\nPAGE\\nKyle s Diseases of Nose and Throat 18\\nLaine s Temperature Charts 32\\nLevy Klemperer s Clinical Bacteriology44\\nLock wood s Practice of Medicine 41\\nLong s Syllabus of Gynecology 34\\nMacdonald s Surgical Diagnosis and Treat-\\nment 22\\nMcFarland s Pathogenic Bacteria 30\\nMallory and Wright s Pathological Tech-\\nnique 22\\nMartin s Surgery 43\\nMartin s Minor Surgery, Bandaging, and\\nVenereal Diseases 43\\nMeigs Feeding in Early Infancy 30\\nMoore s Orthopedic Surgery 23\\nMorris Materia Medica and Therapeutics 43\\nMorris Practice of Medicine 43\\nMorten s Nurses Dictionary 38\\nNancrede s Anatomy and Dissection 31\\nNancrede s Anatomy 43\\nNancrede s Principles of Surgery 19\\nNorris Syllabus of Obstetrical Lectures 37\\nPenrose s Diseases of Women 24\\nPowell s Diseases of Children 43\\nPryor s Pelvic Inflammations 33\\nPye s Bandaging and Surgical Dressing 23\\nRaymond s Physiology 41\\nSaundby s Renal and Urinary Diseases 25\\n*Saunders American Year-Book of Medi-\\ncine and Surgery 16\\nSaunders Medical Hand-Atlases 3, 4, 5\\nSaunders Pocket Medical Formulary 35\\nSaunders New Series of Manuals 40, 41\\nSaunders Series of Question Compends 42, 43\\nSayre s Practice of Pharmacy 43\\nSemple s Pathology and Morbid Anatomy 43\\nSemple s Legal Medicine and Toxicology. 43\\nSenn s Genito-Urinary Tuberculosis 24\\nSenn s Tumors 25\\nSenn s Syllabus of Lectures on Surgery 37\\nShaw s Nervous Diseases and Insanity 43\\nStarr s Diet-Lists for Children 38\\nStelwagon s Diseases of the Skin 43\\nStengel s Pathology 20\\nStevens Materia Medica and Therapeutics 32\\nStevens Practice of Medicine 31\\nStewart s Manual of Physiology 37\\nStewart and Lawrance s Medical Elec-\\ntricity 43\\nStoney s Materia Medica for Nurses 31\\nStoney s Practical Points in Nursing 27\\nSutton and Giles Diseases of Women 29, 41\\nThomas s Diet-List and Sick-Room 38\\nThornton s Dose-Book and Manual of Pre-\\nscription-Writing 41\\n/ah and Nisbet s Diseases of the\\nStomach 21\\nVecki s Sexual Impotence 33\\nVierordt and Stuart s Medical Diagnosis 28\\nWarren s Surgical Pathology 25\\nWatson s Handbook for Nurses 26\\nWolff s Chemistry 43\\n-ruination of Urine 43", "height": "4691", "width": "2954", "jp2-path": "atlasepitomeofsp00drck_0289.jp2"}, "290": {"fulltext": "GENERAL INFORMATION.\\nOne Price. One price absolutely without deviation. No discounts allowed,\\nregardless of the number of books purchased at one time. Prices\\non all works have been fixed extremely low, with the view to\\nselling them strictly net and for cash.\\nOrders. An order accompanied by remittance will receive prompt\\nattention, books being sent to any address in the United States, by\\nmail or express, all charges prepaid. We prefer to send books by\\nexpress when possible.\\nCash or Credit. To physicians of approved credit who furnish satisfactory\\nreferences our books will be sent free of C. O. D. One volume\\nor two on thirty days time if credit is desired; larger purchases\\non monthly payment plan. See offer below.\\nHow to Send There are four ways by which money can be sent at our risk,\\nMoney by namely a post-office money order, an express money order, a\\nMail. bank-check (draft), and in a registered letter. Money sent in any\\nother way is at the sender s risk. Silver should not be sent through\\nthe mail.\\nShipments. All books, being packed in patent metal-edged boxes, neces-\\nsarily reach our patrons by mail or express in excellent condi-\\ntion.\\nSubscription\\nBooks.\\nMiscellaneous\\nBooks.\\nLatest\\nEditions.\\nBindings.\\nBooks in this catalogue marked with a star are for sale by\\nsubscription only, and may be secured by ordering them through\\nany of our authorized travelling salesmen, or direct from the\\nPhiladelphia office: they are not for sale by booksellers. All\\nother books in our catalogue can be procured of any bookseller\\nat the advertised price, or directly from us.\\nWe carry in stock only our own publications, but can supply\\nthe publications of other houses (except subscription books) on\\nreceipt of publisher s price.\\nIn every instance the latest revised edition is sent.\\nIn ordering, be careful to state the style of binding desired-\\nCloth, Sheep, or Half Morocco.\\nSpecial Offer. To physicians of approved credit who furnish satisfactory\\nMonthly references books will be sent express prepaid terms, $5.00 cash\\nPayment upon delivery of books, and monthly payments of $5 00 thereafter\\nPlan, until full amount is paid. Any of the publications of W. B. Saunders\\n(100 titles to select from) may be had in this way at catalogue price,\\nincluding the American Text-Book Series, the Medical Hand-\\nAtlases, etc. All payments to be made by mail or otherwise, free\\nof all expense to us.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0290.jp2"}, "291": {"fulltext": "SAU NDERS\\nMEDICAL HAND-ATLASES.\\nThe series of books included under this title consists of authorized translations\\ninto English of the world-famous Lehmann Medicinische Handatlanten,\\nwhich for scientific accuracy, pictorial beauty, compactness, and cheap-\\nness surpass any similar volumes ever published. Each volume contains from\\n50 to 100 colored plates, executed by the most skilful German lithographers,\\nbesides numerous illustrations in the text. There is a full and appropriate de-\\nscription, and each book contains a condensed but adequate outline of the\\nsubject to which it is devoted.\\nIn planning this series arrangements were made with representative pub-\\nlishers in the chief medical centers of the world for the publication of transla-\\ntions of the atlases into nine different languages, the lithographic plates for all\\nbeing made in Germany, where work of this kind has been brought to the greatest\\nperfection. The enormous expense of making the plates being shared by the\\nvarious publishers, the cost to each one was reduced to practically one-tenth.\\nThus by reason of their universal translation and reproduction, affording in-\\nternational distribution, the publishers have been enabled to secure for these\\natlases the best artistic and professional talent, to produce them in the most\\nelegant style, and yet to offer them at a price heretofore unapproached\\nin cheapness. The great success of the undertaking is demonstrated by the\\nfact that the volumes have already appeared in thirteen different languages\\nGerman, English, French, Italian, Russian, Spanish, Japanese, Dutch, Danish,\\nSwedish, Roumanian, Bohemian, and Hungarian.\\nIn view of the unprecedented success of these works, Mr. Saunders has con-\\ntracted with the publisher of the original German edition for one hundred\\nthousand copies of the atlases. In consideration of this enormous under-\\ntaking, the publisher has been enabled to prepare and furnish special additional\\ncolored plates, making the series even handsomer and more complete than\\nwas originally intended.\\nAs an indication of the great practical value of the atlases and of the im-\\nmense favor with which they have been received, it should be noted that the\\nMedical Department of the U. S. Army has adopted the Atlas of Opera-\\ntive Surgery, as its standard, and has ordered the book in large quantities for\\ndistribution to the various regiments and army posts.\\nThe same careful and competent editorial supervision has been secured in\\nthe English edition as in the originals. The translations have been edited by\\nthe leading American specialists in the different subjects.\\n(For List of Volumes in this Series, see next two pages.)\\n3", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0291.jp2"}, "292": {"fulltext": "SAUNDERS MEDICAL HAND-ATLASES.\\nVOLUMES NOW READY.\\nAtlas and Epitome of Internal Medicine and Clinical Diagnosis.\\nBy Dr. Chr. Jakob, of Erlangen. Edited by Augustus A. Eshner, M. D.,\\nProfessor of Clinical Medicine, Philadelphia Polyclinic. With 68 colored\\nplates, 64 text-illustrations, and 259 pages of text. Cloth, $3.00 net.\\nThe charm of the book is its clearness, conciseness, and the accuracy and beauty of its\\nillustrations. It deals with facts. It vividly illustrates those facts. It is a scientific work\\nput together for ready reference. Brooklyn Medical Journal.\\nAtlas of Legal Medicine. By Dr. E. R. von Hofmann, of Vienna. Edited\\nby Frederick Peterson, M. D., Chief of Clinic, Nervous Dept., College\\nof Physicians and Surgeons, New York. With 120 colored figures on 56\\nplates, and 193 beautiful half-tone illustrations. Cloth, $3.50 net.\\nHofmann s Atlas of Legal Medicine is a unique work. This immense field finds in this\\nbook a pictorial presentation that far excels anything with which we are familiar in any other\\nwork. Philadelphia Medical Journal.\\nAtlas and Epitome of Diseases of the Larynx. By Dr. L. Grunwald,\\nof Munich. Edited by Charles P. Grayson, M. D., Physician-in-Charge,\\nThroat and Nose Department, Hospital of the University of Pennsylvania.\\nWith 107 colored figures on 44 plates, 25 text-illustrations, and 103 pages\\nof text. Cloth, $2.50 net.\\nAided as it is by magnificently executed illustrations in color, it cannot fail of being of\\nthe greatest advantage to students, general practitioners, and expert laryngologists. St.\\nLouis Medical and Surgical Journal.\\nAtlas and Epitome of Operative Surgery. By Dr. O. Zuckerkandl,\\nof Vienna. Edited by J. Chalmers DaCosta, M. D., Clinical Professor\\nof Surgery, Jefferson Medical College, Philadelphia. With 24 colored plates,\\n217 text-illustrations, and 395 pages of text. Cloth, $3.00 net.\\nWe know of no other work diat combines such a wealth of beautiful illustrations with\\nclearness and conciseness of language, that is so entirely abreast of the latest achievements,\\nand so useful both for the beginner and for one who wishes to increase his knowledge of oper-\\native surgery. M\u00c3\u00bcnchener medicinische Wochenschrift.\\nAtlas and Epitome of Syphilis and the Venereal Diseases. By\\nProf. Dr. Franz Mracek, of Vienna. Edited by L. Bolton Bangs,\\nM. D., Professor of Genito-Urinary Surgery, University and Bellevue Hos-\\npital Medical College, New York. With 71 colored plates, 16 black-and-\\nwhite illustrations, and 122 pages of text. Cloth, $3.50 net.\\nA glance through the book is almost like actual attendance upon a famous clinic.\\nJournal of the American Medical Association.\\nAtlas and Epitome of External Diseases of the Eye. By Dr. O\\nHa ab, of Zurich. Edited by G. E. de Schweinitz, M. D., Professor of\\nOphthalmology, Jefferson Medical College, Philadelphia. With 76 colored\\nillustrations on 40 plates, and 228 pages of text. Cloth, $3.00 net.\\nIt is always difficult to represent pathological appearances in colored plates, but this\\nwork seems to have overcome these difficulties, and the plates, with one or two exceptions,\\nare absolutely satisfactory. Boston Medical and Surgical Journal.\\nAtlas and Epitome of Skin Diseases. By Prof. Dr. Franz Mracek,\\nof Vienna. Edited by Henry W. Stelwagon, M. D., Clinical Professor\\nof Dermatology, Jefferson Medical College, Philadelphia. With 63 colored\\nplates, 39 half-tone illustrations, and 200 pages of text. Cloth, $3.50 net.\\nThe importance of personal inspection of cases in the study of cutaneous diseases is\\nreadily appreciated, and next to the living subjects are pictures which will show the appear-\\nance of the disease under consideration. Altogether the work will be found of very great\\nvalue to the general practitioner. Journal of the American Medical Association.\\n4", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0292.jp2"}, "293": {"fulltext": "SAUNDERS MEDICAL HAND-ATLASES-\\nVOLUMES IN PRESS FOR EARLY PUBLICATION.\\nAtlas and Epitome of Diseases Caused by Accidents. By Dr. Ed.\\nGOLEBIEWSKI, of Berlin. Translated and edited with additions by Pearce\\nBailey, M.D., Attending Physician to the Department of Corrections\\nand to the Almshouse and Incurable Hospitals, New York. With 40\\ncolored plates, 143 text-illustrations, and 600 pages of text.\\nAtlas and Epitome of Special Pathological Histology. By Dr. H.\\nD\u00c3\u0096RCK, of Munich. Edited by Ludvig Hektoen, M.D., Professor of\\nPathology, Rush Medical College, Chicago. Two volumes, with about\\n120 colored plates, numerous text-illustrations, and copious text.\\nAtlas and Epitome of General Pathological Histology. With an\\nAppendix on Patho-histological Technic. By Dr. H. D\u00c3\u00bcrck, of Munich.\\nEdited by Ludvig Hektoen, M.D., Professor of Pathology, Rush Medi-\\ncal College, Chicago. With 80 colored plates, numerous text-illustrations,\\nand copious text.\\nAtlas and Epitome of Gynecology. By Dr. O. Sch\u00c3\u00a4ffer, of the\\nUniversity of Heidelberg. With 90 colored plates, 65 text-illustrations,\\nand 308 pages of text. Edited by Richard C. Norris, A. M\u00e2\u0080\u009e M. D.,\\nGynecologist to the Philadelphia and the Methodist Episcopal Hospitals.\\nIN PREPARATION.\\nAtlas and Epitome of Orthopedic Surgery. By Dr. Schultess and\\nDr. L\u00c3\u00b6NINGj of Zurich. About 100 colored illustrations.\\nAtlas and Epitome of Operative Gynecology. By Dr. O. Sch\u00c3\u00a4ffer,\\nof Heidelberg. With 40 colored plates and numerous illustrations in\\nblack and white from original paintings.\\nAtlas and Epitome of Diseases of the Ear. Edited by Prof. Dr.\\nPOLITZER, of Vienna, and Dr. G. Br\u00c3\u00bchl, of Berlin. With 120 colored\\nillustrations and about 200 pages of text.\\nAtlas and Epitome of General Surgery. Edited by Dr. Marwedel,\\nwith the cooperation of Prof. Dr. Czerny. With about 200 colored\\nillustrations.\\nAtlas and Epitome of Psychiatry. By Dr. Wilh. Weygandt, of W\u00c3\u00bcrz-\\nburg. With about 120 colored illustrations.\\nAtlas and Epitome of Normal Histology. By Dr. Johannes Sobotta,\\nof W\u00c3\u00bcrzburg. With 80 colored plates and numerous illustrations.\\nAtlas and Epitome of Topographical Anatomy. By Prof. Dr.\\nSchultze, of W\u00c3\u00bcrzburg. About 100 colored illustrations and a very\\ncopious text.\\n5", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0293.jp2"}, "294": {"fulltext": "W. B. SAUNDERS\\n*THE INTERNATIONAL TEXT-BOOK OF SURGERY. In\\ntwo volumes. By American and British authors. Edited by J. Col-\\nlins Warren, M.D., LL.D., Professor of Surgery, Harvard Medical School,\\nBoston Surgeon to the Massachusetts General Hospital and A. Pearce\\nGould, M. S., F. R. C. S., Eng., Lecturer on Practical Surgery and Teacher\\nof Operative Surgery, Middlesex Hospital Medical School; Surgeon to the\\nMiddlesex Hospital, London, England. Vol. I. General and Operative\\nSurgery. Handsome octavo volume of 947 pages, with 458 beautiful\\nillustrations, and 9 lithographic plates. Vol. II. Special or Regional\\nSurgery. Handsome octavo volume of 1050 pages, with over 500 wood-\\ncuts and half-tones, and 8 lithographic plates. Prices per volume Cloth,\\n$5.00 net; Half-Morocco, $6.00 net.\\nJust Issued.\\nIn presenting a new work on surgery to the medical profession the publisher\\nfeels that he need offer no apology for making an addition to the list of excellent\\nworks already in existence. Modern surgery is still in the transition stage of its\\ndevelopment. The art and science of surgery are advancing rapidly, and the\\nnumber of workers is now so great and so widely spread through the whole of\\nthe civilized world that there is certainly room for another work of reference\\nwhich shall be untrammelled by many of the traditions of the past, and shall at\\nthe same time present with due discrimination the results of modern progress.\\nThere is a real need among practitioners and advanced students for a work on\\nsurgery encyclopedic in scope, yet so condensed in style and arrangement that\\nthe matter usually diffused through four or five volumes shall be given in one-\\nhalf the space and at a correspondingly moderate cost.\\nThe ever-widening-field of surgery has been developed largely by special\\nwork, and this method of progress has made it practically impossible for one\\nman to write authoritatively on the vast range of subjects embraced in a modern\\ntext-book of surgery. In order, therefore, to accomplish their object, the editors\\nhave sought the aid of men of wide experience and established reputation in the\\nvarious departments of surgery.\\nCONTRIBUTORS\\nDr. Robert W. Abbe.\\nC.H.Golding Bird.\\nE. H. Bradford.\\nW. T. Bull.\\nT. G. A. Burns.\\nHerbert L. Burrell.\\nR. C. Cabot.\\nI. H. Cameron.\\nJames Cantlie.\\nW Watson Cheyne.\\nWilliam B. Clarke.\\nWilliam B. Coley.\\nEdw. Treacher Collins.\\nH. Holbrook Curtis.\\nJ. Chalmers Da Costa.\\nN. P. Dandridge.\\nJohn B. Deaver.\\nJ. W. Elliot.\\nHarold Ernst.\\nDr. Christian Fenger.\\nW. H. Forwood.\\nGeorge R. Fowler.\\nGeorge W. Gay.\\nA. Pearce Gould.\\nJ. Orne Green.\\nJohn B. Hamilton.\\nM. L. Harris.\\nFernand Henrotin.\\nG. H. Makins.\\nRudolph Matas.\\nCharles McBurney.\\nA. J. McCosh.\\nL. S. McMurtry.\\nJ. Ewing Mears.\\nGeorge H. Monks.\\nJohn Murray.\\nRobert W. Parker.\\nDr.\\nRushton Parker.\\nGeorge A. Peters.\\nFranz Pfaff.\\nLewis S. Pilcher.\\nJames J. Putnam.\\nM. H. Richardson.\\nA. W. Mayo Robson.\\nW. L. Rodman.\\nC. A. Siegfried.\\nG. B. Smith.\\nW. G. Spencer.\\nJ. Bland Sutton.\\nL. McLane Tiffany.\\nH. Tuholske.\\nWeiler Van Hook.\\nJames P. Warbasse.\\nJ. Collins Warren.\\nDe Forest Willard.", "height": "4677", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0294.jp2"}, "295": {"fulltext": "CATALOGUE OF MEDICAL WORKS.\\n*AN AMERICAN TEXT-BOOK OF PHYSIOLOGY. Edited by\\nWILLIAM H. Howell, Ph. D., M. D., Professor of Physiology in the\\nJohns Hopkins University, Baltimore, Nfd. One handsome octavo volume\\nof 1052 pages, fully illustrated. Prices Cloth, $6.00 net; Sheep or Half-\\nMorocco, S7.00 net.\\nThis work is the most notable attempt yet made in America to combine in\\nnne volume the entire subject of Human Physiology by well-known teachers\\nwho have given especial study to that part of the subject upon which they write.\\nThe completed work represents the present status of the science of Physiology,\\nparticularly from the standpoint of the student of medicine and of the medical\\npractitioner.\\nThe collaboration of several teachers in the preparation of an elementary text-\\nbook of physiology is, unusual, the almost invariable rule heretofore having been\\nfor a single author to write the entire book. One of the advantages to be derived\\nfrom this collaboration method is that the more limited literature necessary for\\nconsultation by each author has enabled him to base his elementary account\\nupon a comprehensive knowledge of the subject assigned to him another, and\\nperhaps the most important, advantage is that the student gains the point of view\\nof a number of teachers. In a measure he reaps the same benefit as would be\\nobtained by following courses of instruction under different teachers. The\\ndifferent standpoints assumed, and the differences in emphasis laid upon the\\nvarious lines of procedure, chemical, physical, and anatomical, should give the\\nstudent a better insight into the methods of the science as it exists to-day. The\\nwork will also be found useful to many medical practitioners who may wish to\\nkeep in touch with the development of modern physiology.\\nCONTRIBUTORS\\nHENRY P. BOWDITCH, M. D., WARREN P. LOMBARD, M.D.,\\nProfessor of Physiology, Harvard Medi- Professor of Physiology, University of\\ncal School. Michigan.\\nJOHN G. CURTIS, M. D., PP ATTAM TTTqiT Ph n\\nProfessor of Physiology, Columbia Uni- ^AtiAiYl 1\u00c2\u00bbU rn. U.,\\nProfessor of Physiology, ale Medica-\\nand Surgeons).\\nHENRY H. DONALDSON, Ph.D.,\\nHead-Professor of Neurology, Univer-\\nsity of Chicago.\\nW. H. HOWELL, Ph. D.M. D., EDWARD T. REICHERT, M.D.,\\nW. T. PORTER, M.D.,\\nAssistant Professor of Physiology, Har*\\nvard Medical School.\\nPr fessor of Physiology, Johns Hopkins\\nUniversity.\\nFREDERIC S. LEE, Ph.D.,\\nAdjunct Professor of Physiology, Colum-\\nbia University, X. V. (College of\\nPhysicians and Surgeons).\\nProfessor of Physiology, University of\\nPennsylvania,\\nHENRY SEWALL, Ph. D., M. D..\\nProfessorof Physiology, Medical Depart-\\nment, University of Denver.\\nWe can commend it most heartily, not only to all students of physiology, but to every\\nphysician and pathologist, as a valuable and comprehensive work of reference, written by\\nmen who are of eminent authority in their own special subjects. London Lancet.\\nTo the practitioner of medicine and to the advanced student this volume constitutes,\\nwe believe, the best exposition of the present status of the science of physiology in the Eng-\\nlish language. American Journal of the Medical Sciences.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0295.jp2"}, "296": {"fulltext": "8\\nW. B. SAUNDERS\\n*AN AMERICAN TEXT-BOOK OF APPLIED THERAPEU-\\nTICS. For the Use of Practitioners and Students. Edited by\\nJames C. Wilson, M. D., Professor of the Practice of Medicine and of\\nClinical Medicine in the Jefferson Medical College. One handsome octavo\\nvolume of 1326 pages. Illustrated. Prices: Cloth, $7.00 net; Sheep or\\nHalf- Morocco, $8.00 net.\\nThe arrangement of this volume has been based, so far as possible, upon\\nmodern pathologic doctrines, beginning with the intoxications, and following\\nwith infections, diseases due to internal parasites, diseases of undetermined\\norigin, and finally the disorders of the several bodily systems digestive, re-\\nspiratory, circulatory, renal, nervous, and cutaneous. It was thought proper to\\ninclude also a consideration of the disorders of pregnancy.\\nThe articles, with two exceptions, are the contributions of American writers.\\nWritten from the standpoint of the practitioner, the aim of the work is to facili-\\ntate the application of knowledge to the prevention, the cure, and the allevia-\\ntion of disease. The endeavor throughout has been to conform to the title of\\nthe book Applied Therapeutics to indicate the course of treatment to be\\npursued at the bedside, rather than to name a list of drugs that have been used\\nat one time or another.\\nThe list of contributors comprises the names of many who have acquired dis-\\ntinction as practitioners and teachers of practice, of clinical medicine, and of\\nthe specialties.\\nCONTRIBUTORS\\nDr. I. E. Atkinson, Baltimore, Md.\\nSanger Brown, Chicago, lil.\\nJohn B. Chapin, Philadelphia, Pa.\\nWilliam C. Dabney, Charlottesville, Va.\\nJohn Chalmers DaCosta, Philada., Pa.\\nI. N. Danforth, Chicago, 111.\\nJohn L. Dawson, Jr., Charleston, S. C.\\nF. X. Dercum, Philadelphia, Pa.\\nGeorge Dock, Ann Arbor, Mich.\\nRobert T. Edes, Jamaica Plain, Mass.\\nAugustus A. Eshner, Philadelphia, Pa.\\nJ. T. Eskridge, Denver, Col.\\nF. Forchheimer, Cincinnati, O.\\nCarl Frese, Philadelphia, Pa.\\nEdwin E. Graham, Philadelphia, Pa.\\nJohn Guiteras, Philadelphia, Pa.\\nFrederick P. Henry, Philadelphia, Pa.\\nGuy Hinsdale, Philadelphia, Pa.\\nOrville Horwitz, Philadelphia, Pa.\\nW. W. Johnston, Washington, D. C.\\nErnest Laplace, Philadelphia, Pa.\\nA. Laveran, Pans, France.\\nAs a work either for study or reference it will be of great value to the practitioner, as\\nit is virtually an exposition of such clinical therapeutics as experience has taught to be of\\nthe most value. Taking it all in all, no recent publication on therapeutics can be compared\\nwith this one in practical value to the working physician. Chicago Clinical Review.\\nThe whole field of medicine has been well covered. The work is thoroughly practical,\\nand while it is intended for practitioners and students, it is a better book for the general\\npractitioner than for the student. The young practitioner especially will find it extremely\\nsuggestive and helpful. The Indian Lancet.\\nDr. James Hendrie Lloyd, Philadelphia, Pa.\\nJohn Noland Mackenzie, Baltimore, Md.\\nJ. W. McLaughlin, Austin, Texas.\\nA. Lawrence Mason, Boston, Mass.\\nCharles K. Mills, Philadelphia, Pa.\\nJohn K. Mitchell, Philadelphia, Pa.\\nW. P. Northrup, New York City.\\nWilliam Osier, Baltimore, Md.\\nFrederick A. Packard, Philadelphia, Pa.\\nTheophilus Parvin, Philadelphia, Pa.\\nBeaven Rake, London, England.\\nE. O. Shakespeare, Philadelphia, Pa.\\nWharton Sinkler, Philadelphia. Pa.\\nLouis Starr, Philadelphia, Pa.\\nHenry W. Stelwagon, Philadelphia, Pa.\\nJames Stewart, Montreal, Canada.\\nCharles G. Stockton, Buffalo, N. Y.\\nJames Tyson, Philadelphia, Pa.\\nVictor C. Vaughan, Ann Arbor, Mich.\\nJames T. Whittaker, Cincinnati, O.\\nJ. C. Wilson, Philadelphia, Pa.", "height": "4679", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0296.jp2"}, "297": {"fulltext": "CATALOGUE OF MEDICAL WORKS.\\n*AN AMERICAN TEXT-BOOK OF OBSTETRICS. Edited by\\nRichard C. Norris, M. D. Art Editor, Robert L. Dickinson, M. D.\\nOne handsome octavo volume of over iooo pages, with nearly 900 colored\\nand half-tone illustrations. Prices: Cloth, $7.00 net; Sheep or Half\\nMorocco, SS.00 net.\\nThe advent of each successive volume of the series of the American Text-\\nBook^ has been signalized by the most Mattering comment from both the Press\\nand the Profession. The high consideration received by these text-books, and\\ntheir attainment to an authoritative position in current medical literature, have\\nbeen matters of deep international interest, which finds its fullest expression in\\nthe demand for these publications from all parts of the civilized world.\\nIn the preparation of the American Text-Book of Obstetrics the\\neditor has called to his aid proficient collaborators whose professional prominence\\nentitles them to recognition, and whose disquisitions exemplify Practical\\nObstetrics. While these writers were each assigned special themes for dis-\\ncussion, the correlation of the subject-matter is, nevertheless, such as ensures\\nlogical connection in treatment, the deductions of which thoroughly represent\\nthe latest advances in the science, and which elucidate the best modern methods\\nof frocedu\\nThe more conspicuous feature of the treatise is its wealth of illustrative\\nmatter. The production of the illustrations had been in progress for several\\nyears, under the personal supervision of Robert L. Dickinson, M. D., to whose\\nartistic judgment and professional experience is due the most sumptuously\\nillustrated work of the period. By means of the photographic art, combined\\nwith the skill of the artist and draughtsman, conventional illustration is super-\\nseded by rational methods of delineation.\\nFurthermore, the volume is a revelation as to the possibilities that may be\\nreached in mechanical execution, through the unsparing hand of its publisher.\\nCONTRIBUTORS:\\nDr. James C. Cameron,\\nvard P. Davis.\\n:rt L. Dickinson.\\nCharles Warrington Earle.\\nJames H. Etheridge.\\nHenry J. Garripies.\\nBarton Cooke I1\\nCharles Jewett.\\nDr. Howard A. Kelly.\\nRichard C. Norris.\\nChauncey D. Palmer.\\nTheophilus Parvin.\\nGeorge A. Piersol.\\nEdward Reynolds.\\nHenry Schwarz.\\nAt first glance we are overwhelmed by the magnitude of thh work in several respects,\\nviz. First, by the size of the volume, then by the array of eminent teachers in this depart-\\nment who have taken part in its production, then by the profuseness and character of the\\nillustrations, and last, but not least, the conciseness and clearness with which the text is ren-\\ndered. This is an entirely new composition, embodying the highest knowledge of the art as\\nit stands to-day by authors who occupy the front rank in their specialty, and there are many\\nof them. We cannot turn ov thout being struck by the superb illustrations\\nwhich adorn ^0 many of them. We .ire confident that this most practical work will find\\ninstant appreciation by practitioners as well as students. Neiv York Medical Tunes.\\nPermit me to say that your American Text-Book of Obstetrics is the most magnificent\\nmedical work that 1 have ever seen. I congratulate you and thank you for this superb work,\\nwhich alone is sufficient to place you first in the ranks of medical publishers.\\nWith profound respect I am sincerely yours, Alex. J. C. Skene.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0297.jp2"}, "298": {"fulltext": "IO IV. B. SAUNDERS*\\n*AN AMERICAN TEXT-BOOK OF THE THEORY AND\\nPRACTICE OF MEDICINE. By American Teachers. Edited\\nby William Pepper, M. D., LL.D., Provost and Professor of the Theory\\nand Practice of Medicine and of Clinical Medicine in the University of\\nPennsylvania. Complete in two handsome royal- octavo volumes of about\\niooo pages each, with illustrations to elucidate the text wherever necessary.\\nPrice per Volume: Cloth, $5.00 net; Sheep or Half-Morocco, $6.00 net.\\nVOJLUME I. CONTAINS:\\nHygiene. Fevers (Ephemeral, Simple Con-\\ntinued, Typhus, Typhoid, Epidemic Cerebro-\\nspinal Meningitis, and Relapsing). Scarla-\\ntina, Measles, R\u00c3\u00b6thein, Variola, Varioloid,\\nVaccinia, Varicella, Mumps, Whooping-cough,\\nAnthrax, Hydrophobia, Trichinosis, Actino-\\nmycosis, Glanders, and Tetanus.\u00e2\u0080\u0094 Tubercu-\\nlosis, Scrofula, Syphilis, Diphtheria, Erysipe-\\nlas, Malaria, Cholera, and Yellow Fever.\\nNervous, Muscular, and Mental Diseases etc.\\nVOLUME II. CONTAINS:\\nUrine (Chemistry and Microscopy). Kid-\\nney and Lungs. Air-passages (Larynx and\\nBronchi) and Pleura. Pharynx, (Esophagus,\\nStomach and Intestines (including Intestinal\\nParasites)., Heart, Aorta, Arteries and Veins.\\nPeritoneum, Liver, and Pancreas. Diathet-\\nic Diseases (Rheumatism, Rheumatoid Ar-\\nthritis, Gout, Lithaemia, and Diabetes.)\u00e2\u0080\u0094\\nBlood and Spleen. Inflammation, Embolism,\\nThrombosis, Fever, and Bacteriology.\\nThe articles are not written as though addressed to students in lectures, but\\nare exhaustive descriptions of diseases, with the newest facts as regards Causa-\\ntion, Symptomatology, Diagnosis, Prognosis, and Treatment, including a large\\nnumber of approved formulae. The recent advances made in the study\\nof the bacterial origin of various diseases are fully described, as well as the\\nbearing of the knowledge so gained upon prevention and cure. The subjects\\nof Bacteriology as a whole and of Immunity nre fully considered in a separate\\nsection.\\nMethods of diagnosis are given the most minute and careful attention, thus\\nenabling the reader to learn the very latest methods of investigation without\\nconsulting works specially devoted to the subject.\\nCONTRIBUTORS\\nDr. J. S. Billings, Philadelphia.\\nFrancis Delafield, New York.\\nReginald H. Fitz, Boston.\\nJames W. Holland, Philadelphia.\\nHenry M. Lyman, Chicago.\\nWilliam Osier, Baltimore.\\nDr. William Pepper, Philadelphia.\\nW. Oilman Thompson, New York.\\nW. H. Welch, Baltimore.\\nJames T. Whittaker, Cincinnati.\\nJames C. Wilson, Philadelphia.\\nHoratio C. Wood, Philadelphia.\\nWe reviewed the first volume of this work, and said It is undoubtedly one of the best\\ntext-books on the practice of medicine which we possess. A consideration of the second\\nand last volume leads us to modify that verdict and to say that the completed work i-s, in our\\nopinion, the best of its kind it has ever been our fortune to see. It is complete, thorough,\\naccurate, and clear. It is well written, well arranged, well printed, well illustrated, and well\\nbound. It is a model of what the modern text-book should be. New York Medical Journal.\\nA library upon modern medical art. The work must promote the wider diffusion of\\nsound knowledge. American Lancet.\\nA trusty counsellor for the practitioner or senior student, on which he may implicitly\\nrely. Edinburgh Medical Journal.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0298.jp2"}, "299": {"fulltext": "CATALOGUE OF MEDICAL WORKS. II\\nUN AMERICAN TEXT-BOOK OF SURGERY. Edited by Wil-\\nliam AY. Keen, M. I LL.D., and J. William White, M. D., Ph.D.\\nForming one handsome royal octavo volume of 1250 pages (10 x 7 inches\\nwith 496 wood-cuts in text, and 37 colored and half-tone plates, many of\\nthem I from original photographs and drawings furnished by the\\nautnors. Price Cloth, $7.00 net: Sheep or Half Morocco, $S.oo net.\\nTHIRD EDITION. THOROUGHLY REVISED.\\nresent edition, among the new topics introduced are a lull considera-\\ntion of serum-therapy leucocytosis post-operative insanity; the use of dry heat\\nat high temperatures; Kr\u00c3\u00b6nlein s method of locating the cerebral fissures;\\n.is and Lorenz s operations of congenital dislocations of the hip; Allis s re-\\nsearches on dislocations of the hip-joint lumbar puncture; the forcible reposi-\\ntion of the spine in Pott s disease; the treatment of exophthalmic goiter; the\\nsurgery of typhoid fever; gastrectomy and other operations on the stomach;\\nnew methods of operating upon the intestines; the use of Kelly s rectal specula;\\nthe surgery of the ureter; Schleicht infiltration-method and the use of eucain\\nfor local anesthesia Krause s method of skin-grafting the newer methods of\\ndisinfecting the hands; the use of gloves, etc. The sections on Appendicitis,\\non Fractures, and od Gynecological Operations have been revised and enlarged.\\nDsiderable number of new illustrations have been added, and enhance the\\nvaiue of the work.\\nThe text of the entire book has been submitted to all the authors for their\\nmutual criticism and revision an idea in book-making that is entirely new and\\noriginal. The book as a whole, therefore, expresses on all the important sur-\\ngical topics of the day the consensus of opinion of the eminent surgeons who\\nhave joined in its preparation.\\nOne of the most attractive features of the book is its illustrations. Very\\nmany of them are original and faithful reproductions of photographs taken\\ndirectly from patients or from SD-ecimens.\\n\u00c2\u00abOXTRIBtTORS:\\nDr. Phineas S. Conner. Cincinnati.\\nFrederic S. De rk.\\n1. Philadelphia.\\nCharles B Nancrede, Ann Arbor. Mich.\\n11 Park. B Vork.\\nLewis 5. Pilcher. New York.\\nDr. Nicholas Senn, Chicago.\\nFrancis J. Shepherd, Montreal, Canada.\\nLewis A. Siimson, New York.\\nlins Warren, 15 ton.\\nJ. William White, Philadelphia.\\nf If this text-book is a fair reflex of the present position of American surgerv. we must\\nadmit it is of a very high order of merit, and that English surgeons will have to look very\\nV to their laurei it they are to preserve a position in the van of surgical practice.\\nLondon Lancet.\\nMild n t mind it being called TH1 k (instead of A I\\nr no single volume which contains so readal pete an account of the\\nscience and art of EDMUND ber of the i\\nof Examitiers of :h- s r 0/ Surgeons,", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0299.jp2"}, "300": {"fulltext": "12 W. B. SAUNDERS\\n*AN AMERICAN TEXT-BOOK OF GYNECOLOGY, MEDICAL\\nAND SURGICAL, for the use of Students and Practitioners.\\nEdited by J. M. Baldy, M. D. Forming a handsome royal-octavo volume\\nof 718 pages, with 341 illustrations in the text and 38 colored and half-\\ntone plates. Prices Cloth, $6.00 net; Sheep or Half-Morocco, $7.00 net.\\nSECOND EDITION, THOROUGHLY REVISED.\\nIn this volume all anatomical descriptions, excepting those essential to a clear\\nunderstanding of the text, have been omitted, the illustrations being largely de-\\npended upon to elucidate the anatomy of the parts. This work, which is\\nthoroughly practical in its teachings, is intended, as its title implies, to be a\\nworking text-book for physicians and students. A clear line of treatment has\\nbeen laid down in every case, and although no attempt has been made to dis-\\ncuss mooted points, still the most important of these have been noted and ex-\\nplained. The operations recommended are fully illustrated, so that the reader,\\nhaving a picture of the procedure described in the text under his eye, cannot fail\\nto grasp the idea. All extraneous matter and discussions have been carefully\\nexcluded, the attempt being made to allow no unnecessary details to cumber\\nthe text. The subject-matter is brought up to date at every point, and the\\nwork is as nearly as possible the combined opinions of the ten specialists who\\nfigure as the authors.\\nIn the revised edition much new material has been added, and some of the\\nold eliminated or modified. More than forty of the old illustrations have been\\nreplaced by new ones, which add very materially to the elucidation of the\\ntext, as they picture methods, not specimens. The chapters on technique and\\nafter-treatment have been considerably enlarged, and the portions devoted to\\nplastic work have been so greatly improved as to be practically new. Hyste-\\nrectomy has been rewritten, and all the descriptions of operative procedures\\nhave been carefully revised and fully illustrated.\\nCONTRIBUTORS\\nDr. Henry T. Byford.\\nJohn M. Baldy.\\nEdwin Cragin.\\nH. Etheridge.\\nWilliam Goodell.\\nHoward A. Kelly.\\nFlorian Krug.\\nE. E. Montgomery.\\nWilliam R. Pryor.\\nGeorge M. Tuttle.\\nThe most notable contribution to gynecological literature since 1887, and the most\\ncomplete exponent of gynecology which we have. No subject seems to have been neglected,\\nand the gynecologist and surgeon, and the general practitioner who has any desire\\nto practise diseases of women, will find it of practical value. In the matter of illustrations\\nand plates the book surpasses anything we have seen. Boston Medical and Surgical\\nJournal.\\nA thoroughly modern text-book, and gives reliable and well-tempered advice and in-\\nstruction. Edinburgh Medical Journal.\\nThe harmony of its conclusions and the homogeneity of its style give it an individuality\\nwhich suggests a single rather than a multiple authorship. Annals of Surgery.\\nIt must command attention and respect as a worthy representation of our advanced\\nclinical teaching. American Journal of Medical Sciences.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0300.jp2"}, "301": {"fulltext": "CATALOGUE OF MEDICAL WORKS.\\n13\\n*AN AMERICAN TEXT-BOOK OF THE DISEASES OF CHIL-\\nDREN. By American Teachers. Edited by Louis Starr, M. D.,\\nassisted by THOMPSON S. WESTCOTT, M. D. In one handsome royal-8v i\\nvolume o[ 1244 pages, profusely illustrated with wood-cuts, half-tone and\\ncolored plates. Net Prices: Cloth. 57. 00; Sheep or Half- Morocco, $8.00.\\nSECOND EDITION, REVISED AND ENLARGED.\\nThe plan of this work embraces a series of original articles written by some\\nsixty well-known podiatrists, representing collectively the teachings of the most\\nprominent medical schools and colleges of America. The work is intended to\\nbe a practical book, suitable for constant and handy reference by the practi-\\ntioner and the advanced student.\\nEspecial attention has been given to the latest accepted teachings upon the\\netiology, symptoms, pathology, diagnosis, and treatment of the disorders of chil-\\ndren, with the introduction o\\\\ many special formulae and therapeutic procedures.\\nIn this new edition the whole subject matter has been carefully revised, new\\narticles added, some original papers emended, and a number entirely rewritten.\\nThe new articles include Modified Milk and Percentage Milk-Mixtures,\\nLit hernia, and a section on Orthopedics. Those rewritten are Typhoid\\nv. Rubella, Chicken-pox, Tuberculous Meningitis, Hydroceph-\\nalus.* and Scurvy; while extensive revision has been made in Infant\\nFeeding, Measles, Diphtheria, and Cretinism. The volume has thus\\nbeen much increased in size by the introduction of fresh material.\\nCONTRIBUTORS t\\nDr. S. S. Adams, Washington.\\nJohn Ashhurst, Jr., Philadelphia.\\nA. D. Blackader, Montreal, Canada\\nI Bovaird, New York.\\nDillon Brown. New York.\\nEdward M. Buckingham, Boston.\\nCharles W. Burr, Philadelphia.\\nW. E. Casselberry, Chicago.\\nHenry Dwight Chapin, New York.\\nVI S. Christopher, Chicago.\\nArchibald Church, Chicago.\\nd M. Crandall, New York.\\nAndrew F. Currier, New York.\\nind G. Curtin, Philadelphia\\nJ. M. DaCos a, Philadelphia.\\nI. N. Danforth, Chicago.\\nEdward P. Davis, Philadelphia.\\nJohn B. Deaver, Philadelphia.\\nG. E. de Schweinitz, Philadelphia.\\nJohn Dorr. Y rk.\\nCharles Warringl Chicago.\\n\\\\Vm. A. Edwards. San Diego, Cal.\\nF. Forchheimer, Cincinnati.\\nI. Henry Fruitnight, New York.\\nJ. P. Cr zer Griffith, Philadelphia.\\nW. A. Hardawav. St. Louis.\\nM. P Hatfield, Chi\\nBarton Cooke Hir t, Philadelphia.\\nH. Illoway, Cincinnati.\\n-v Jackson\\nCharles I \u00c2\u00bbetroit.\\nHenry Koplik. New York.\\nDr. Thomas S. Latimer, Baltimore.\\nAlbert R. Leeds, Hoboken, N. J.\\nJ. Hendrie Lloyd, Philadelphia.\\nGeorge Roe Lockwood, New York.\\nHenry M. Lyman, Chicago.\\nFrancis T. Miles, Baltimore.\\nCharles K Mills, Philadelphia.\\nJames F Moore. Minneapolis.\\nF. Gordon Morrill, Boston.\\nJohn H. Musser, Philadelphia.\\nThomas R. Neilson, Philadelphia.\\n\\\\V. P. Northrup, New York.\\nWilliam Osier, Baltimore.\\nFrederick A. Packard, Philadelphia.\\nWilliam Pepper, Philadelphia.\\nFrederick Peterson, New York.\\nW. T. Plant, Syracuse, New York\\nWilliam M. Powell. Atlantic City.\\nB. K. Rachford, Cincinnati.\\nB. Alexander Randall, Philadelphia.\\nEdward O. Shakespeare, Philadtlphi;\\nF. C. Shattuck, Boston.\\nT. Lewis Smith, New York.\\nLouis Starr, Philadelphia.\\nM. Allen Starr, New York.\\nCharles W. Townsend, Boston.\\nTames Tyson, Philadelphia.\\nW. S. Thayer, Baltimore.\\nVictor C. Vaughan, Ann Arbor, Mich\\nThompson S. Westcott, Philadelphia.\\nHenry R. Wharton, Philadelphia.\\nJ William Whit\u00c2\u00ab.-, Philadelphia.\\nJ. C. Wilson, Philadelphia.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0301.jp2"}, "302": {"fulltext": "H\\nW. B. SAUNDERS\\n*AN AMERICAN TEXT-BOOK OF GENITO-URINARY AND\\nSKIN DISEASES. By 47 Eminent Specialists and Teachers. Edited\\nby L. Bolton Bangs, M. D., Professor of Genito-Urinary Surgery, Uni-\\nversity and Bellevue Hospital Medical College, New York; and W. A.\\nHardaway, M. D., Professor of Diseases of the Skin, Missouri Medicai\\nCollege. Imperial octavo volume of 1229 pages, with 300 engravings and\\n20 full-page colored plates. Cloth, $7.00 net Sheep or Half Morocco,\\n$8.00 net.\\nThis addition to the series of American Text-Books, it is confidently be-\\nlieved, will meet the requirements of both students and practitioners, giving, as\\nit does, a comprehensive and detailed presentation of the Diseases of the\\nGenito-Urinary Organs, of the Venereal Diseases, and of the Affections of the\\nSkin.\\nHaving secured the collaboration of well-known authorities in the branches\\nrepresented in the undertaking, the editors have not restricted the contributors\\nik regard to the particular views set forth, but have offered every facility for the\\nfree expression of their individual opinions. The work will therefore be found\\nto be original, yet homogeneous and fully representative of the several depart-\\nments of medical science with which it is concerned.\\nCONTRIBUTORS s\\nChas. W. Allen, New York.\\nI. E. Atkinson, Baltimore.\\nL Bolton Bangs, New York.\\nP. R. Bolton, New York.\\nLewis C. Bosher, Richmond, Va.\\nJohn T. Bowen, Boston.\\nJ. Abbott Cantrell. Philadelphia.\\nWilliam T. Corlett, Cleveland, Ohio.\\nB. Farquhar Curtis, New York.\\nCondict W. Cutler, New York.\\nIsadore Dyer, New Orleans.\\nChristian Fenger, Chicago.\\nJohn A. Fordyce, New York,\\nEugene Fuller, New York.\\nR. H. Greene, New York.\\nJoseph Grindon, St. Louis.\\nGraeme M. Hammond, New York.\\nW. A. Hardaway, St. Louis.\\nM. B. Hartzell, Philadelphia.\\nLouis Heitzmann, New York.\\nJames S. Howe, Boston.\\nGeorge T. Jackson, New York.\\nAbraham Jacobi, New York.\\nJames C. Johnston. New Yoik.\\nDr. Hermann G. Klotz, New Yorj?..\\nJ. H. Linsley, Burlington, V t.\\nG. F. Lydston, Chicago.\\nHartwell N. Lyon, St. Louis.\\nEdward Martin, Philadelphia.\\nD. G. Montgomery, San Francisco.\\nJames Pedersen, New York.\\nS. Pollitzer, New York.\\nThomas R. Pooley, New York.\\nA. R. Robinson, New York.\\nA. E. Regensburger, San Francisco.\\nFrancis J. Shepherd, Montreal, Can.\\nS. C. Stanton, Chicago, 111.\\nEmmanuel J. Stout. Philadelphia.\\nAlonzo E. Taylor Philadelphia.\\nRobert W. Taylor, New York.\\nPaul Thorndike, Boston.\\nH. Tuholske, St. Louis.\\nArthur Van Harlingen, Philadelphia.\\nFrancis S. Watson, Boston.\\nJ. William White, Philadelphia.\\nJ. McF. Winfield. Brooklyn.\\nAlfred C. Wood, Philadelphia.\\nThis voluminous work is thoroughly up to date, and the chapters on gemto-unnary dis-\\neases are especially valuable. The illustrations are fine and are mostly original. The section\\non dermatology is concise and in every way admirable, Journal of the American Medical\\nAssociation.\\nThis volume is one of the best yet issued of the publisher s series of American Text-\\nBooks. The list of contributors represents an extraordinary array of talent and extended\\nexperience. The book will easily take the place in comprehensiveness and value of the\\nhalf dozen or more costly works on these subjects which have hitherto been necessary to a\\nwell-equipped librarv. New York Polyclinic,", "height": "4677", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0302.jp2"}, "303": {"fulltext": "\\\\LOGUE OF MEDICAL WORKS.\\n15\\nAN AMERICAN TEXT-BOOK OF DISEASES OF THE EYE,\\nEAR, NOSE, AND THROAT. Edited by George E. de Schweinitz,\\nA. M.. M. D., Professor of Ophthalmology, Jefferson Medical College; and\\nB. Ai EXANDER RAND AI 1 A. M., M. D., Clinical Professor of Diseases of\\nthe Kar, University oi Pennsylvania. One handsome imperial octavo\\nvolume oi 1251 pages; 700 illustrations, 59 of them colored. Prices:\\nCloth, 57.00 net; Sheep or Half-Morocco, 38.00 net.\\nJust Issued.\\nThe present work is the only book ever published embracing diseases of the\\nintimately related organs of the eye, ear, nose, and throat. Its special claim\\nto favor is based on encyclopedic, authoritative, and practical treatment of the\\nsubjects.\\nEach section of the book has been entrusted to an author who is specially\\nidentified with the subject on which he writes, and who therefore presents his\\ncase in the manner of an expert. Uniformity is secured and overlapping pre-\\nvented by careful editing and by a system of cross-references which forms a\\nspecial feature of the volume, enabling the reader to come into touch with all\\nthat is said on any subject in different portions of the book.\\nParticular emphasis is laid on the most approved methods of treatment, so\\nthat the book shall be one to which the student and practitioner can refer for\\ninformation in practical work. Anatomical and physiological problems, also,\\nare fully discussed for the benefit of those who desire to investigate the more\\nabstruse problems of the subject.\\nCONTRIBUTORS\\nHenry A. Alderton, Brooklyn.\\nn Allen, Philadelphia.\\nFrank. All pore, Chicago.\\nYork.\\n\\\\vre-. Cincinnati.\\nR. O Be trd, Minn apolis.\\nClarence I -ton.\\nArthur liladelphia.\\nAlbert 1 Brub ker, Philadelphia.\\nJ. H. Brv C.\\nAlbert H. Buck, New York.\\nII Ian.\\nSwan M. Burnett, Washington, D C.\\nFlemming Carrow, Am Mich.\\nW. E. C selberry, Ch\\nColra in \\\\V. Or rk.\\nrk.\\nDennett, New York.\\nhweinitz, Philadelphia.\\nA\\nJohn \\\\V. 1\\ni, Philadelp\\nH Giffor\\nlis.\\nChristian R incinnati.\\nF. C. Hotz, Chicago.\\nLucien Howe, Buffalo, N. V.\\nDr. Alvin A. Hubbell, Buffalo, N. Y.\\nEdward Jackson, Philadelphia.\\nJ. Ellis Jennings. St. Louis.\\nHerman Knapp, New York.\\nChas. W. Kollock, Charleston, S. C.\\nt. A Leland, Boston.\\nJ. A. Lippincott, Pittsburg, Pa.\\nG. Hudson Makuen, Philadelphia.\\nJohn H. McColl* i\\nII. G. Miller, Providence, R I.\\nB f.. Milliken, Cleveland, Ohio.\\nR \u00c2\u00bbbert C. Myles, New York.\\nJam. 5 I ml), New York.\\nR. J. Phillips, Philadelphia.\\nPiersol. Philadelphia.\\nW. P P rcher, Charleston, S. C.\\nB AU x Randall. Philadelphia.\\nRandolph, Baltimore.\\nJohn O. K Y.\\nPhiladelphia.\\n1 I. Shepp ird, Brooklyn, N. Y.\\nII. Shui y, I troit, Mich.\\nWilli t, Philadelphia.\\nSamu Baltimore, Aid.\\nPhiladelphia.\\nhiladelphia.\\n111.\\nhan Wright, Brooklyn.\\nII. V, W\u00c3\u00bcrdemann. Milwaukee, Wis.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0303.jp2"}, "304": {"fulltext": "i6\\nW. B. SAUNDERS 1\\n*AN AMERICAN YEAR-BOOK OF MEDICINE AND SUR-\\nGERY. A Yearly Digest of Scientific Progress and Authoritative\\nOpinion in all branches of Medicine and Surgery, drawn from journals\u00c2\u00bb\\nmonographs, and text-books of the leading American and Foreign authors\\nand investigators. Collected and arranged, with critical editorial com-\\nments, by eminent American specialists and teachers, under the general\\neditorial charge of George M. Gould, M. D. Volumes for 1896, 97,\\n98, and 99 each a handsome imperial octavo volume of about 1200 pages.\\nPrices Cloth, $6.50 net Half-Morocco, $7.50 net. Year-Book for 1900 in\\ntwo octavo volumes of about 600 pages each. Prices per volume Cloth,\\n$3.00 net; Half-Morocco, $3.75 net.\\nIn Two Volumes* No Increase in Price.\\nIn response to a widespread demand from the medical profession, the pub-\\nlisher of the American Year-Book of Medicine and Surgery has decided to\\nissue that well-known work in two volumes, Vol. I. treating of General Medi-\\ncine, Vol. II. of General Surgery. Each volume is complete in itself, and\\nthe work is sold either separately or in sets.\\nThis division is made in such a way as to appeal to physicians from a class\\nstandpoint, one volume being distinctly medical, and the other distinctly surgi-\\ncal. This arrangement has a two-fold advantage. To the physician who uses\\nthe entire book, it offers an increased amount of matter in the most convenient\\nform for easy consultation, and without any increase in price while the man\\nwho wants either the medical or the surgical section alone secures the complete\\nconsideration of his branch without the necessity of purchasing matter for which\\nhe has no use.\\nCONTRIBUTORS\\nVol. I.\\nDr. Samuel W. Abbott, Boston.\\nArchibald Church, Chicago.\\nLouis A. Duhring, Philadelphia.\\nD. L. Edsall, Philadelphia.\\nAlfred Hand, Jr., Philadelphia.\\nM. B. Hartzell, Philadelphia.\\nReid Hunt, Baltimore.\\nWyatt Johnston, Montreal.\\nWalter Jones, Baltimore.\\nDavid Riesman, Philadelphia.\\nLouis Starr, Philadelphia. _\\nAlfred Stengel, Philadelphia.\\nA. A. Stevens, Philadelphia.\\nG. N. Stewart. Cleveland.\\nReynold W. Wilcox, New York City.\\nVol. II.\\nDr. J. Montgomery Baldy, Philadelphia.\\nCharles H. Burnett, Philadelphia.\\nJ. Chalmers DaCosta, Philadelphia.\\nW. A. N. Dorland, Philadelphia.\\nVirgil P. Gibney, New York City.\\nC. H. Hamann, Cleveland.\\nHoward F. Hansell, Philadelphia.\\nBarton Cooke Hirst, Philadelphia.\\nE. Fletcher lr.eals, Chicago.\\nW. W. Keen, Philadelphia.\\nHenry G. Ohls, Chicago.\\nWendell Reber, Philadelphia.\\nJ. Hilton Waterman, New York City.\\nIt is difficult to know which to admire most\u00e2\u0080\u0094 the research and industry of the distin-\\nguished band of experts whom Dr. Gould has enlisted in the service of the Year-Book, or the\\nwealth and abundance of the contributions to every department of science that have been\\ndeemed worthy of analysis. It is much more than a mere compilation of abstracts, for,\\nas each section is entrusted to experienced and able contributors, the reader has the advan-\\ntage of certain critical commentaries and expositions proceeding from writers fully\\nqualified to perform these tasks. It is emphatically a book which should find a place in\\nevery medical library, and is in several respects more useful than the famous Jahrbucher\\nof Germany. London Lancet.", "height": "4687", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0304.jp2"}, "305": {"fulltext": "CATALOGUE OF MEDICAL WORKS. \\\\J\\nANOMALIES AND CURIOSITIES OF MEDICINE. By George\\nM. Gould, M.D., and Walter L. Pyle, M.D. An encyclopedic collec-\\ntion of are and extraordinary cases and of the most striking instances of\\nabnormality in all branches of Medicine and Surgery, derived from an ex-\\nhaustive research of medical literature from its origin to the present day,\\nabstracted, classified, annotated, and indexed. Handsome imperial octavo\\nvolume o( 908 pages, with 295 engravings in the text, and 12 full-page\\nplates. Cloth, $3.00 net; Half-Morocco, $4.00 net.\\nPOPULAR EDITION REDUCED FROM $6.00 to $3.00.\\nIn view of the gre.it success of this magnificent work, the publisher has decided\\nto issue a Popular Edition at a price so low that it may be procured by every\\nstudent and practitioner of medicine. Notwithstanding the great reduction in\\nprice, there will be no depreciation in the excellence of typography, paper, and\\nbinding that characterized the earlier editions.\\nSeveral years of exhaustive research have been spent by the authors in the\\ngreat medical libraries of the United States and Europe in collecting the mate-\\nrial for this work. Medical literature of all ages and all languages has\\nbeen carefully searched, as a glance at the Bibliographic Index will show. The\\nfacts, which will be of extreme value to the author and lecturer, have been\\narranged and annotated, and full reference footnotes given.\\nOne of the most valuable contributions ever made to medical literature. It is, so far as\\nwe know, absolutely unique, and every page is as fascinating as a novel. Not alone for the\\nmedical profession has this volume value it will serve as a book of reference for all who are\\ninterested in general scientific, sociologic, or medico-legal topics. Brooklyn Medical your-\\nnal.\\nNERVOUS AND MENTAL DISEASES. By Archibald Church,\\nM. D., Professor of Clinical Neurology, Mental Diseases, and Medical\\nJurisprudence, Northwestern University Medical School; and Frederick\\nPeterson, M. D., Clinical Professor of Mental Diseases, Woman s Medi-\\ncal College, New York. Handsome octavo volume of 843 pages, with\\nover 300 illustrations. Prices: Cloth, 55.00 net; Half-Morocco, $6.00\\nnet.\\nSecond Edition,\\nThis book is intended to furnish students and practitioners with a practical,\\nworking knowledge of nervous and mental diseases. Written by men of wide\\nexperience and authority, it presents the many recent additions to the subject.\\nThe book is not filled with an extended dissertation on anatomy and pathology,\\nbut, treating these points in connection with special conditions, it lays particular\\nstress on methods of examination, 1 and treatment. In this respect the\\nwork is unusually complete and valuable, laying down the definite courses of\\nprocedure which the authors have found to be most generally satisfactory.\\nThe work is an epitome of what is to-day known of nervous diseases prepared for the\\nstudent and practitioner ill the light of the author s experience We believe that no work\\npresents the difficult subject of insanity in such a reasonable and readable way. Chicago\\nMedical Recorder.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0305.jp2"}, "306": {"fulltext": "1 8 W. B. SAUNDERS\\nDISEASES OF THE NOSE AND THROAT. By D. Braden Kyle,\\nM. D., Clinical Professor of Laryngology and Rhinology, Jefferson Medi-\\ncal College, Philadelphia; Consulting Laryngologist, Rhinologist, and\\nOtologist, St. Agnes Hospital. Octavo volume of 646 pages, with over\\n150 illustrations and 6 lithographic plates. Cloth, $4.00 net; Half-Mo-\\nrocco, 5. 00 net.\\nJust Issued.\\nThis book presents the subject of Diseases of the Nose and Throat in as con-\\ncise a manner as is consistent with clearness, keeping in mind the needs of the\\nstudent and general practitioner as well as those of the specialist. The arrange-\\nment and classification are based on modern pathology, and the pathological\\nviews advanced are supported by drawings of microscopical sections made in the\\nauthor s own laboratory. These and the other illustrations are particularly fine,\\nbeing chiefly original. With the practical purpose of the book in mind, ex-\\ntended consideration has been given to details of treatment, each disease being\\nconsidered in full, and definite courses being laid down to meet special condi-\\ntions and symptoms.\\nIt is a thorough, full, and systematic treatise, so classified and arranged as greatly to facili-\\ntate the teaching of laryngology and rhinology to classes, and must prove most convenient\\nand satisfactory as a reference book, both for students and practitioners. International\\nMedical Magazine.\\nTHE HYGIENE OF TRANSMISSIBLE DISEASES their Causa-\\ntion, Modes of Dissemination, and Methods of Prevention. By\\nA. C. Abbott, M. D., Professor of Hygiene in the University of Pennsyl-\\nvania; Director of the Laboratory of Hygiene. Octavo volume of 311\\npages, with charts and maps, and numerous illustrations. Cloth, $2.00 net.\\nJust Issued.\\nIt is not the purpose of this work to present the subject of Hygiene in the\\ncomprehensive sense ordinarily implied by the word, but rather to deal directly\\nwith but a section, certainly not the least important, of the subject viz., that\\nembracing a knowledge of the preventable specific diseases. The book aims to\\nfurnish information concerning the detailed management of transmissible dis-\\neases. Incidentally there are discussed those numerous and varied factors that\\nhave not only a direct bearing upon the incidence and suppression of such dis-\\neases, but are of general sanitary importance as well.\\nThe work is admirable in conception and no less so in execution. It is a practical work,\\nsimply and lucidly written, and it should prove a most helpful aid in that department of\\nmedicine which is becoming daily of increasing importance and application namely, prophy-\\nlaxis. Philadelphia Medical Journal.\\nIt is scientific, but not too technical it is as complete as our present-day knowledge of\\nhygiene and sanitation allows, and it is in harmony with the efforts of the profession, which\\nare tending more and more to methods of prophylaxis. For the student and for the practi-\\ntioner it is well nigh indispensable. Medical News, New York.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0306.jp2"}, "307": {"fulltext": "CATALOGUE OF MEDICAL WORKS. ig\\nA TEXT-BOOK OF EMBRYOLOGY. By John C. Heisler, M. D,\\nProfessor of Anatomy in the Medico- Chirurgical College, Philadelphia.\\nOctavo volume of 405 pages, with 190 illustrations, 26 in colors. Cloth\\n52.50 net.\\nJust Issued.\\nThe facts of embryology having acquired in recent years such great interesl\\nin connection with the teaching and with the proper comprehension of human\\nanatomy, it is of first importance to the student of medicine that a concise and\\nyet sufficiently full text-book upon the subject be available. It was with the\\naim of presenting such a book that this volume was written, the author, in his\\nexperience as a teacher of anatomy, having been impressed with the fact that\\nstudents were seriously handicapped in their study of the subject of embryology\\nby the lack of a text-book full enough to be intelligible, and yet without that\\nminuteness of detail which characterizes the larger treatises, and which so often\\nserves only to confuse and discourage the beginner.\\nIn short, the book is written to fill a want which has distinctly existed and which it\\ndefinitely meets commendation greater than this it is not possible to give to anything.\\nMedi New Yurk.\\nA MANUAL OF DISEASES OF THE EYE. By Edward Jack-\\nson, A. M., M. D., sometime Professor of Diseases of the Eye in the Phila-\\ndelphia Polyclinic and College for Graduates in Medicine. I2mo, 604\\npages, with 178 illustrations from drawings by the author. Cloth, $2.50 net.\\nJust Issued.\\nThis book is intended to meet the needs of the general practitioner of medi-\\ncine and the beginner in ophthalmology. More attention is given to the condi-\\ntions that must be met and dealt with early in ophthalmic practice than to the\\nrarer diseases and more difficult operations that may come later.\\nIt is designed to furnish efficient aid in the actual work of dealing with dis-\\nease, and therefore gives the place of first importance to the recognition and\\nmanagement of the conditions that present themselves in actual clinical work.\\nLECTURES ON THE PRINCIPLES OF SURGERY. By Charles\\nB. NANCREDE, M. D., LL.D., Professor of Surgery and of Clinical Surgery,\\nUniversity of Michigan, Ann Arbor. Handsome octavo, 398 pages, illus-\\ntrated. Cloth, $2.50 net.\\nJust Issued.\\nThe present book is based on the lectures delivered by Dr. Nancrede to his\\nundergraduate classes, and is intended as a text-book for students and a practi-\\ncal help for teachers. By the careful elimination of unnecessary details of\\npathology, bacteriology, etc., which are amply provided for in other courses of\\nstudy, space is gained for a more extended consideration of the Principles of\\nSurgery in themselves, and of the application of these principles to -methods\\nof practice.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0307.jp2"}, "308": {"fulltext": "20 W. B. SAUNDERS\\nA TEXT-BOOK OF PATHOLOGY. By Alfred Stengel, M. D.,\\nProfessor of Clinical Medicine in the University of Pennsylvania; Physi-\\ncian to the Philadelphia Hospital; Physician to the Children s Hospital,\\nPhiladelphia. Handsome octavo volume of 848 pages, with 362 illustra-\\ntions, many of which are in colors. Prices: Cloth, $4.00 net; Half-\\nMorocco, $5.00 net.\\nSecond Edition.\\nIn this work the practical application of pathological facts to clinical medicine\\nis considered more fully than is customary in works on pathology. While the\\nsubject of pathology is treated in the broadest way consistent with the size of\\nthe book, an effort has been made to present the subject from the point of view\\nof the clinician. The general relations of bacteriology to pathology are dis-\\ncussed at considerable length, as the importance of these branches deserves. It\\nwill be found that the recent knowledge is fully considered, as well as older and\\nmore widely-known facts.\\nI consider the work abreast of modern pathology, and useful to both students and prac-\\ntitioners. It presents in a concise and well-considered form the essential facts of general and\\nspecial pathological anatomy, with more than usual emphasis upon pathological physiology.\\nWilliam H. Welch, Professor of Pathology Johns Hopkins University Baltimore, Md.\\nI regard it as the most serviceable text-book for students on this subject yet written by\\nan American author. L. Hektoen, Professor of Pathology, Rush Medical College,\\nChicago, III.\\nA TEXT-BOOK OF OBSTETRICS. By Barton Cooke Hirst, M.D.,\\nProfessor of Obstetrics in the University of Pennsylvania. Handsome oc-\\ntavo volume of 846 pages, with 618 illustrations and seven colored plates.\\nPrices: Cloth, $5.00 net; Half-Morocco, $6.00 net.\\nSecond Edition.\\nThis work, which has been in course of preparation for several years, is in-\\ntended as an ideal text-book for the student no less than an advanced treatise\\nfor the obstetrician and for general practitioners. It represents the very latest\\nteaching in the practice of obstetrics by a man of extended experience and\\nrecognized authority. The book emphasizes especially, as a work on obstetrics\\nshould, the practical side of the subject, and to this end presents an unusually\\nlarge collection of illustrations. A great number of these are new and original,\\nand the whole collection will form a complete atlas of obstetrical practice.\\nAn extremely valuable feature of the book is the large number of refer-\\nences to cases, authorities, sources, etc., forming, as it does, a valuable bib-\\nliography of the most recent and authoritative literature on the subject\\nof obstetrics. As already stated, this work records the wide practical ex-\\nperience of the author, which fact, combined with the brilliant presentation\\nof the subject, will doubtless render this one of the most notable books on\\nobstetrics that has yet appeared.\\nThe illustrations are numerous and are works of art, many of them appearing for the\\nfirst time. The arrangement of the subject-matter, the foot-notes, and index are beyond\\ncriticism. The author s style, though condensed, is singularly clear, so that it is never\\nnecessary to re-read a sentence in order to grasp its meaning. As a true model of what a\\nmodern text-book in obstetrics should be, we feel justified in affirming that Dr. Hirst s\\nbook is without a rival. New York Medical Record.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0308.jp2"}, "309": {"fulltext": "CATALOGUE OF MEDICAL WORKS. 21\\nA TEXT-BOOK OF THE PRACTICE OF MEDICINE. By\\nJames M. Anders. M.D., Ph.D., LL.D., Professor of the Practice of\\nMedicine and of Clinical Medicine, Medico-Chirurgical College, Philadel-\\nphia. In one handsome octavo volume of 1292 pages, fully illustrated.\\nCloth, $5.50 net; Sheep or Half-Morocco, $6.50 net.\\nTHIRD EDITION, THOROUGHLY REVISED.\\nThe present edition is the result of a careful and thorough revision. A few\\nnew subjects have been introduced Glandular Fever, Ether-pneumonia, Splenic\\nAnemia, Meralgia Paresthetica, and Periodic Paralysis. The affections that\\nhave been substantially rewritten are: Plague, Malta Fever, Diseases of the\\nThymus Gland, Liver Cirrhoses, and Progressive Spinal Muscular Atrophy.\\nThe following articles have been extensively revised Typhoid Fever, Yellow\\nFever, Lobar Pneumonia, Dengue, Tuberculosis, Diabetes Mellitus, Gout, Ar-\\nthritis Deformans, Autumnal Catarrh, Diseases of the Circulatory System, more\\nparticularly Hypertrophy and Dilatation of the Heart, Arteriosclerosis and\\nThoracic Aneurysm. Pancreatic Hemorrhage, Jaundice, Acute Peritonitis, Acute\\nYellow Atrophy, Hematoma of Dura Mater, and Scleroses of the Brain. The\\npreliminary chapter on Nervous Diseases is new, and deals with the subject of\\nlocalization and the various methods of investigating nervous affections.\\nIt is an excellent book concise, comprehensive, thorough, and up to date. It is a\\ncredit to you but, more than that, it is a credit to the profession of Philadelphia\u00e2\u0080\u0094 to us.\\n\u00e2\u0080\u0094James C. Wilson, Professor of the Practice of Medicine and Clinical Medicine, Jeffer-\\nson Medical College, Philadelphia.\\nThe book can be unreservedly recommended to students and practitioners as a safe, full\\ncompendium of the knowledge of internal medicine of the present day It is a work\\nthoroughly modern in every sense. Medical News, New York.\\nDISEASES OF THE STOMACH. By William W. Van Valzah,\\nM. L)., Professor of General Medicine and Diseases of the Digestive System\\nand the Blood, New York Polyclinic; and J. DOUGLAS NlSBET, M. D.,\\nAdjunct Professor of General Medicine and Diseases of the Digestive Sys-\\ntem and the Blood, New York Polyclinic. Octavo volume of 674 pages,\\nillustrated. Cloth, S3. 50 net.\\nAn eminently practical book, intended as a guide to the student, an aid to the\\n:ian, and a contribution to scientific medicine. It aims to give a complete\\ndescription of the modern methods of diagnosis and treatment of diseases of the\\nich, and to reconstruct the pathology of the stomach in keeping with the\\nrevelations of scientific research. The book is clear, practical, and complete,\\nand contains the results of the authors investigations and of their extensive ex-\\nperience as specialists. Particular attention is given to the important subject of\\ndietetic treatment. The diet-lists are very complete, and are so arranged that\\nselections can readily be made to suit individual cases.\\nThis is the most satisfactory work on the subject in the English language. Chicago\\nThe article on diet and general medication is one of the most valuable in the book, and\\nshould be read by every practising physician. New York Medical Journal.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0309.jp2"}, "310": {"fulltext": "22 W. B. SAUNDERS\\nSURGICAL DIAGNOSIS AND TREATMENT. By J. W. Mao\\nDonald, M. D., Edin., F. R. C. S., Edin., Professor of the Practice of Sur-\\ngery and of Clinical Surgery in Hamline University Visiting Surgeon to St.\\nBarnabas Hospital, Minneapolis, etc. Handsome octavo volume of 800\\npages, profusely illustrated. Cloth, $5.00 net; Half- Morocco, $6.00 net.\\nThis work aims in a comprehensive manner to furnish a guide in matters of\\nsurgical diagnosis. It sets forth in a systematic way the necessities of examina-\\ntions and the proper methods of making them. The various portions of the\\nbody are then taken up in order and the diseases and injuries thereof succinctly\\nconsidered and the treatment briefly indicated. Practically all the modern and\\napproved operations are described with thoroughness and clearness. The work\\nconcludes with a chapter on the use of the R\u00c3\u00b6ntgen rays in surgery.\\nThe work is brimful of just the kind of practical information that is useful alike to\\nstudents and practitioners. It is a pleasure to commend the book because of its intrinsic\\nvalue to the medical practitioner. Cincinnati Lane et- Clinic.\\nPATHOLOGICAL TECHNIQUE. A Practical Manual for Laboratory\\nWork in Pathology, Bacteriology, and Morbid Anatomy, with chapters on\\nPost-Mortem Technique and the Performance of Autopsies. By Frank\\nB. MALLORY, A. M., M. D., Assistant Professor of Pathology, Harvard\\nUniversity Medical School, Boston; and James H. Wright, A. M., M.D.,\\nInstructor in Pathology, Harvard University Medical School, Boston. Oc-\\ntavo volume of 396 pages, handsomely illustrated. Cloth, $2.50 net.\\nThis book is designed especially for practical use in pathological laboratories,\\nboth as a guide to beginners and as a source of reference for the advanced. The\\nbook will also meet the wants of practitioners who have opportunity to do general\\npathological work. Besides the methods of post-mortem examinations and of\\nbacteriological and histological investigations connected with autopsies, the\\nspecial methods employed in clinical bacteriology and pathology have been\\nfully discussed.\\nOne of the most complete works on the subject, and one which should be in the library\\nof every physician who hopes to keep pace with the great advances made in pathology.\\nyournal of American Medical Association.\\nTHE SURGICAL COMPLICATIONS AND SEQUELS OF TY-\\nPHOID FEVER. By Wm. W. Keen, M. D., LL.D., Professor of the\\nPrinciples of Surgery and of Clinical Surgery, Jefferson Medical College,\\nPhiladelphia. Octavo volume of 386 pages, illustrated. Cloth, $3.00 net.\\nThis monograph is the only one in any language covering the entire subject\\nof the Surgical Complications and Sequels of Typhoid Fever. The work will\\nprove to be of importance and interest not only to the general surgeon and phy-\\nsician, but also to many specialists laryngologists, ophthalmologists, gynecolo-\\ngists, pathologists, and bacteriologists as the subject has an important bearing\\nupon each one of their spheres. The author s conclusions are based on reports\\nof over 1700 cases, including practically all those recorded in the last fifty years.\\nReports of cases have been brought down to date, many having been added\\nwhile the work was in press.\\nThis is probably the first and only work in the English language that gives the reader a\\nclear view of what typhoid fever really is, and what it does and can do to the human organ-\\nism. This book should be in the possession of every medical man in America. American\\nMedico-Surgical Bulletin.", "height": "4676", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0310.jp2"}, "311": {"fulltext": "CATALOGUE OF MEDICAL WORKS. 23\\nMODERN SURGERY, GENERAL AND OPERATIVE. By John\\nChalmers DaCosta, M.D., Clinical Professor of Surgery, Jefferson Medi-\\ncal College, Philadelphia; Surgeon to the Philadelphia Hospital, etc.\\nHandsome octavo volume of 911 pages, profusely illustrated. Cloth, $4.00\\nnet Half-Morocco, $5.00 net.\\nSecond Edition, Beitritten and Greatly Enlarged.\\nThe remarkable success attending DaCosta s Manual of Surgery, and the\\ngeneral favor with which it has been received, have led the author in this\\nrevision to produce a complete treatise on modern surgery along the same lines\\nthat made the former edition so successful. The* book has been entirely re-\\nwritten and very much enlarged. The old edition has long been a favorite not\\nonly with students and teachers, but also with practising physicians and sur-\\ngeons, and it is believed that the present work will find an even wider field of\\nusefulness.\\nWe know of no small work on surgery in the English language which so well fulfils the\\nrequirements of the modern student. Medico-Chirurgical Journal Bristol, England.\\nThe author has presented concisely and accurately the principles of modern surgery.\\nThe book is a valuable one which can be recommended to students and is of great value to\\nthe general practitioner. American Journal of the Medical Sciences.\\nA MANUAL OF ORTHOPEDIC SURGERY. By James E. Moore,\\nM.D., Professor of Orthopedics and Adjunct Professor of Clinical Surgery,\\nUniversity of Minnesota, College of Medicine and Surgery. Octavo volume\\nof 356 pages, with 177 beautiful illustrations from photographs made spec-\\nially for this work. Cloth, $2.50 net.\\nA oractical book based upon the author s experience, in which special stress\\nis laid upon early diagnosis and treatment such as can be carried out by the\\ngeneral practitioner. The teachings of the author are in accordance with his\\nbelief that true conservatism is to be found in the middle course between the\\nsurgeon who operates too frequently and the orthopedist who seldom operates.\\nA very demonstrative work, every illustration of which conveys a lesson. The work is\\nexcellent and commendable one, which we can certainly endorse with pleasure.\\nSt. Louis Medical and Surgical journal.\\nELEMENTARY BANDAGING AND SURGICAL DRESSING.\\nWith Directions concerning the Immediate Treatment of Cases of Emer-\\ngency. For the use of Dressers and Nurses. By Walter Pye, F.R.C.S.,\\nlate Surgeon to St. Mary s Hospital, London. Small i2mo, with over 80\\nillustrations. Cloth, flexible covers, 75 cents net.\\nThis little book is chiefly a condensation of those portions of Pye s Surgical\\nHandicraft which deal with bandaging, splinting, etc!, and of those which\\ntreat of the management in the first instance of cases of emergency. The\\ndirections given are thoroughly practical, and the book will prove extremely use-\\nful to students, surgical nurses, and dressers.\\nThe author writes well, the diagrams are clear, and the book itself is small and portable,\\nalthough the paper and type are good. British Medical Journal.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0311.jp2"}, "312": {"fulltext": "24 W. B. SAUNDERS\\nA TEXT-BOOK OF MATERIA MEDICA, THERAPEUTICS\\nAND PHARMACOLOGY. By George F. Butler, Ph.G., M.D.,\\nProfessor of Materia Medica and of Clinical Medicine in the College of\\nPhysicians and Surgeons, Chicago Professor of Materia Medica and\\nTherapeutics, Northwestern University, Woman s Medical School, etc\\nOctavo, 874 pages, illustrated. Cloth, $4.00 net; Sheep, $5.00 net.\\nThird Edition, Thoroughly Revised.\\nA clear, concise, and practical text-book, adapted for permanent reference no\\nless than for the requirements of the class-room.\\nThe recent important additions made to our knowledge of the physiological\\naction of drugs are fully discussed in the present edition. The book has been\\nthoroughly revised and many additions have been made.\\nTaken as a whole, the book may fairly be considered as one of the most satisfactory of any\\nsingle-volume works on materia medica in the market. Journal of the A7nerican Medical\\nAssociation.\\nTUBERCULOSIS OF THE GENITO-URINARY ORGANS,\\nMALE AND FEMALE. By Nicholas Senn, M.D., Ph.D., LL.D.,\\nProfessor of the Practice of Surgery and of Clinical Surgery, Rush Medical\\nCollege, Chicago. Handsome octavo volume of 320 pages, illustrated^\\nCloth, $3.00 net.\\nTuberculosis of the male and female genito-urinary organs is such a frequent,\\ndistressing, and fatal affection that a special treatise on the subject appears to\\nfill a gap in medical literature. In the present work the bacteriology of the sub-\\nject has received due attention, the modern resources employed in the differen-\\ntial diagnosis between tubercular and other inflammatory affections are fully\\ndescribed, and the medical and surgical therapeutics are discussed in detail.\\nAn important book upon an important subject, and written by a man of mature judg-\\nment and wide experience. The author has given us an instructive book upon one of the\\nmost important subjects of the day. Clinical Reporter.\\nA work which adds another to the many obligations the profession owes the talented\\nauthor. Chicago Medical Recorder.\\nA TEXT-BOOK OF DISEASES OF WOMEN. By Charles B.\\nPenrose, M.D., Ph.D., Professor of Gynecology in the University of\\nPennsylvania; Surgeon to the Gynecean Hospital, Philadelphia. Octavo\\nvolume of 531 pages, with 217 illustrations, nearly all from drawings made\\nfor this work. Cloth, $3.75 net.\\nThird Edition, Revised.\\nIn this work, which has been written for both the student of gynecology and\\nthe general practitioner, the author presents the best teaching of modern gyne-\\ncology untrammelled by antiquated theories or methods of treatment. In most\\ninstances but one plan of treatment is recommended, to avoid confusing the\\nstudent or the physician who consults the book for practical guidance.\\nI shall value very highly the copy of Penrose s Diseases of Women received. I have\\nalready recommended it to my class as THE BEST book. Howard A. Kelly, Professor\\nof Gynecology and Obstetrics Johns Hopkijis University, Baltimore, Md.\\nThe book is to be commended without reserve, not only to the student but to the general\\npractitioner who wishes to have the latest and best modes of treatment explained with absolute\\nclearness. Therapeutic Gazette.", "height": "4665", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0312.jp2"}, "313": {"fulltext": "CATALOGUE OF MEDICAL WORKS.\\nSURGICAL PATHOLOGY AND THERAPEUTICS. By John\\nCollins WARREN, M.D., LL.D., Professor of Surgery, Medical Depart-\\nment Harvard University. Handsome octavo, S32 pages, with 136 relief\\nand lithographic illustrations, 33 of which are printed in colors.\\nSecond Edition,\\nwith an Appendix devoted to the Scientific Aids to Surgical Diagnosis, and\\na series of articles on Regional Bacteriology. Cloth, $5.00 net; Half-\\nMorocco. 56.00 net.\\nWithout Exception, the Illustrations are the Best ever Seen in a\\nWork of this Kind.\\nA most striking and very excellent feature of this book is its illustrations. Without ex-\\nthe point ot accuracy and artistic merit, they are the best ever seen in a work\\nof this kind. Many of those representing microscopic pictures are so perfect in their\\ncoloring and detail as almost to give the beholder the impression that he is looking down the\\nbarrel of a microscope at a well-mounted section. Annals of Surgery, Philadelphia.\\nIt is the handsomest specimen of book-making that has ever been issued from the\\nAmerican medical press. American Journal of the Medical Sciences, Philadelphia.\\nPATHOLOGY AND SURGICAL TREATMENT OF TUMORS.\\nBy N. SENN, M. D., Ph. D., LL. D., Professor of Practice of Surgery and\\nof Clinical Surgery, Rush Medical College; Professor of Surgery, Chicago\\nPolyclinic Attending Surgeon to Presbyterian Hospital Surgeon-in-Chief,\\nSt. Joseph s Hospital, Chicago. One volume of 710 pages, with 515\\nengravings, including full-page colored plates. New and enlarged Edition\\nin Preparation.\\nBooks specially devoted to this subject are few, and in our text-books and\\nms of surgery this part of surgical pathology is usually condensed to a de-\\ngree incompatible with its scientific and clinical importance. The author spent\\nmany years in collecting the material for this work, and has taken great pains\\nto present it in a manner that should prove useful as a text-book for the student,\\na work of reference for the practitioner, and a reliable guide for the surgeon.\\nThe m.st exhaustive of any recent book in English on this subject. It is well illus-\\ntrated, and will doubtless remain as the principal monograph on the subject in our language\\nfor some years. The book is handsomely illustrated and printed, and the author has\\ngiven a notable and lasting contribution to surgery. Journal of the America?! M\\nAssociation, Chicago.\\nLECTURES ON RENAL AND URINARY DISEASES. By\\nin., Fellow of the Royal College of Physicians,\\nLondon, and of the Royal Medico-Chirurgical Society; Physician to the\\nGenera] Hospital. volume of 434 pages, with numerous illustra-\\ntions and 4 colored plates. Cloth, $2.50 1\\nThe volume makes a favorable impression at once. The style is clear and succinct.\\nnnot find any part oftl in which th- carefully tl.\\nout and fortified by evidence drawn from the m The book may be cordially\\nrecommended. British Medical Journal.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0313.jp2"}, "314": {"fulltext": "26 W. B. SAUNDERS\\nA HANDBOOK FOR NURSES. By J. K. Watson, M. D., Edin.,\\nAssistant House-Surgeon, Sheffield Royal Hospital. American Edition,\\nunder the supervision of A. A. Stevens, A. M., M. D., Professor of\\nPathology, Woman s Medical College, Philadelphia. i2mo, 413 pages,\\n73 illustrations. Cloth, $1.50 net.\\nThis work aims to supply in one volume that information which so many\\nnurses at the present time are trying to extract from various medical works, and\\nto present that information in a suitable form. Nurses must necessarily acquire\\na certain amount of medical knowledge, and the author of this book has aimed\\njudiciously to cater to this need with the object of directing the nurses pursuit\\nof medical information in proper and legitimate channels. The book represents\\nan entirely new departure in nursing literature, insomuch as it contains useful\\ninformation on medical and surgical matters hitherto only to be obtained from\\nexpensive works written expressly for medical men.\\nA NEW PRONOUNCING DICTIONARY OF MEDICINE, with\\nPhonetic Pronunciation, Accentuation, Etymology, etc. By John\\nM. Keating, M.D., LL.D., Fellow of the College of Physicians of Phila-\\ndelphia; Editor Cyclopaedia of the Diseases of Children, etc.; and\\nHenry Hamilton, with the Collaboration of J. Chalmers DaCosta,\\nM. D., and Frederick A. Packard, M. D. One very attractive volume\\nof over 800 pages. Second Revised Edition. Prices: Cloth, $5.00 net\\nSheep or Half-Morocco, $6.00 net; with Denison s Patent Ready- Refer-\\nence Index without patent index, Cloth, $4.00 net Sheep or Half-\\nMorocco, $5.00 net.\\nPROFESSIONAL. OPINIONS.\\nI am much pleased with Keating s Dictionary, and shall take pleasure in recommending\\nit to my classes.\\nHenry M. Lyman, M. D.,\\nProfessor of Principles and Practice of Medicine Rush Medical College, Chicago, III.\\nI am convinced that it will be a very valuable adjunct to my study-table, convenient in\\nsize and sufficiently full for ordinary use.\\nC. A. LlNDSLEY, M. D.,\\nProfessor of Theory and Practice of Medicine, Medical Dept. Yale University;\\nSecretary Connecticut State Board of Health, New Haven, Conn,\\nAUTOBIOGRAPHY OF SAMUEL D. GROSS, M. D., Emeritus Pro-\\nfessor of Surgery in the Jefferson Medical College of Philadelphia, with\\nReminiscences of His Times and Contemporaries. Edited by his sons,\\nSamuel W. Gross, M. D., LL.D., and A. Haller Gross, A.M., of the\\nPhiladelphia Bar. Preceded by a Memoir of Dr. Gross, by the late\\nAustin Flint, M. D., LL.D. In two handsome volumes, each containing\\nover 400 pages, demy 8vo, extra cloth, gilt tops, with fine Frontispiece\\nengraved on steel. Price per Volume, $2.50 net.", "height": "4684", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0314.jp2"}, "315": {"fulltext": "TALOGUE OF MEDICAL WORKS. 2*]\\nPRACTICAL POINTS IN NURSING. For Nurses in Private\\nPractice. By Emily A. M, Stoney, Graduate of the Traming-School\\ntor Nurses, Lawrence, Mass.; Superintendent of the Training-School for\\nNurses, Carney Hospital, South Boston, Mass. 456 pages, handsomely\\nillustrated with 73 engravings in tne text, and 9 colored and half-tone\\nmates. Cloth. Price, M.Js net.\\nSECOND EDITION, THOROUGHLY REVISED.\\nIn this volume the author explains, in popular language and in the shortest\\npossible form, the entire range of private nursing as distinguished from hospital\\nnursing, and the nurse is instructed how best to meet the various emergencies of\\nmedical and surgical cases when distant from medical or surgical aid or when\\nthrown on her own resources.\\nAn especially valuable feature of the work will be found in the directions to\\nthe nurse how to improvise everything ordinarily needed in the sick-room, where\\nthe embarrassment of the nurse, owing to the want of proper appliances, is fre-\\nquently extreme.\\nThe werk has been logically divided into the following sections:\\nI. The Nurse her responsibilities, qualifications, equipment, etc.\\nII. The Sick-Room its selection, preparation, and management.\\nTIL The Patient duties of the nurse in medical, surgical, obstetric, and gyne-\\ncologic cases.\\nIV. Nursing in Accidents and Emergencies.\\nV. Nursing in Special Medical Cases.\\nVI. Nursing of the New-born and Sick Children.\\nVII. Physiology and Descriptive Anatomy.\\nThe Appendix contains much information in compact form that will be found\\nof great value to the nurse, including Rules for Feeding the Sick; Recipes for\\nInvalid Foods and Beverages; Tables of Weights and Measures; Table for\\nComputing the Date of Labor; List of Abbreviations Dose-List; and a full\\nand complete Glossary of Medical Terms and Nursing Treatment.\\nThis is a well-written, eminently practical volume, which covers the entire range of\\nprivate nursing as distinguished from hospital nursing, and instructs the nurse how best to\\nmeet the various which may arise and how to prepare everything ordinarily\\nneeded in the illness of her patient. American Journal of Obstetrics and Diseases of\\nn and Children, Aug., 1896.\\nA TEXT-BOOK OF BACTERIOLOGY, including the Etiology and\\nPrevention of Infective i and an account of Yeasts and Moulds,\\nkiaematozoa, a By Edgar M. Crookshank, M. B., Pro-\\nthology and Bacteriology, King s College, London.\\nA handsome octavo volume of 700 pages, with 273 engravings in the text,\\nana and colored plates. Price, $6.50 net.\\nhis hook, though nominally a Fourth Edition of Professor Crookshank s\\nManual 01 \\\\V\\\\ rERIOLOGY, is practically a new work, the old one having\\nbeen reconstructed, greatly enlarged, revised throughout, and largely rewritten,\\nforming a text-book for the Bacteriological Laboratory, for Medical Officers of\\nHealth, and for Veterinary InsoecU", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0315.jp2"}, "316": {"fulltext": "28 IV. B. SAUNDERS\\nMEDICAL DIAGNOSIS. By Dr. Oswald Vierordt, Professor of\\nMedicine at the University of Heidelberg. Translated, with additions,\\nfrom the Fifth Enlarged German Edition, with the author s permission, by\\nFrancis H. Stuart, A. M., M. D. In one handsome royal-octavo volume\\nof 600 pages\u00c2\u00ab 194 fine wood-cuts in the text, many of them in colors.\\nPrices: Cloth, $4.00 net; Sheep or Half-Morocco, $5.00 net.\\nFOURTH AMERICAN EDITION, FROM THE FIFTH REVISED AND\\nENLARGED GERMAN EDITION.\\nIn this work, as in no other hitherto published, are given full and accurate\\nexplanations of the phenomena observed at the bedside. It is distinctly a clin-\\nical work by a master teacher, characterized by thoroughness, fulness, and accu-\\nracy. It is a mine of information upon the points that are so often passed over\\nwithout explanation. Especial attention has been given to the germ-theory as a\\nfactor in the origin of disease.\\nThe present edition of this highly successful work has been translated from\\nthe fifth German edition. Many alterations have been made throughout the\\nbook, but especially in the sections on Gastric Digestion and the Nervous System.\\nIt will be found that all the qualities which served to make the earlier editions\\nso acceptable have been developed with the evolution of the work to its present\\nform.\\nTHE PICTORIAL ATLAS OF SKIN DISEASES AND SYPHI-\\nLITIC AFFECTIONS. (American Edition.) Translation from\\nthe French. Edited by J. J. Pringle, M. B., F. R. C. P., Assistant Phy-\\nsician to, and Physician to the department for Diseases of the Skin at, the\\nMiddlesex Hospital, London. Photo-lithochromes from the famous models\\nof dermatological and syphilitic cases in the Museum of the Saint-Louis\\nHospital, Paris, with explanatory wood-cuts and letter-press. In 12 Parts,\\nat $3.00 per Part.\\nOf all the atlases of skin diseases which have been published in recent years, the present\\none promises to be of greatest interest and value, especially from the standpoint of the\\ngeneral practitioner. American Medico-Surgical Bulletin, Feb. 22, 1896.\\nThe introduction of explanatory wood-cuts in the text is a novel and most important\\nfeature which greatly furthers the easier understanding of the excellent plates, than which\\nnothing, we venture to say, has been seen better in point of correctness, beauty, and general\\nmerit. Neiv York Medical Journal Feb. 15, 1896.\\nAn interesting feature of the Atlas is the descriptive text, which is written for each picture\\nby the physician who treated the case or at whose instigation the models have been made.\\nWe predict for this truly beautiful work a large circulation in all parts of the medical world\\nwhere the names St. Louis and Baretta have preceded it. Medical Record, N. Y., Feb. 1,\\n1896.\\nA TEXT-BOOK OF MECHANO-THERAPY (MASSAGE AND\\nMEDICAL GYMNASTICS). By Axel V. Grafstrom, B. Sc,\\nM. D., late Lieutenant in the Royal Swedish Army; late House Physi-\\ncian, City Hospital, BlackwelPs Island, New York. i2mo, 139 pages,\\nillustrated. Cloth, $1.00 net.", "height": "4686", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0316.jp2"}, "317": {"fulltext": "CATALOGUE OF MEDICAL WORKS. 2g\\nDISEASES OF THE EYE. A Hand-Book of Ophthalmic Prac-\\ntice. By G. E. DE SCHWRINITZ, M. D., Professor of Ophthalmology in\\nthe Jefferson Medical College, Philadelphia, etc. A handsome royal-\\noctavo volume of 696 pages, with 255 fine illustrations, many of which are\\noriginal, and 2 chromo-lithographic plates. Prices Cloth, $4.00 net\\nSheep or Half-Morocco, $5.00 net.\\nTHIRD EDITION, THOROUGHLY REVISED.\\nIn the third edition of this text-book, destined, it is hoped, to meet the favor-\\nable reception which has been accorded to its predecessors, the work has been\\nrevised thoroughly, and much new matter has been introduced. Particular\\nattention has been given to the important relations which micro-organisms bear\\nto many ocular diseases. A number of special paragraphs on new subjects have\\nbeen introduced, and certain articles, including a portion of the chapter on\\nOperations, have been largely rewritten, or at least materially changed. A\\nnumber of new illustrations have been added. The Appendix contains a full\\ndescription of the method of determining the corneal astigmatism with the\\nophthalmometer of Javal and Schi\u00c3\u00b6tz, and the rotation of the eyes with the\\ntropometer of Stevens.\\nA work that will meet the requirements not only of the specialist, but of the general\\npractitioner in a rare degree. I am satisfied that unusual success awaits it.\\nWilliam Pepper, M. D.\\nFroz ost and Professor of Theory and Practice of Medicine and Clinical Medicine\\nin the University of Pennsylvania.\\nA clearly written, comprehensive manual. One which we can commend to students\\nas a reliable text-book, written with an evident knowledge of the wants of those entering upon\\nthe study of this special branch of medical science. British Medical Journal.\\nIt is hardly too much to say that for the student and practitioner beginning the study of\\nOphthalmology, it is the best single volume at present published. Medical News.\\nIt is a very useful, satisfactory, and safe guide for the student and the practitioner, and\\none of the best works of this scope in the English language. Annals of Ophthalmology.\\nDISEASES OF WOMEN. By J. Bland Sutton, F.R.C.S., Assistant\\nsc x I [ospital, and Surgeon to Chelsea Hospital, London\\nand Arthur E. Giles, M. D., B.Sc, Lond., F.R.C.S., Edin., Assistant\\non to Chelsea Hospital, London. 436 pages, handsomely illustrated.\\nCloth, 52.50 net.\\nThe author- have placed in the hands of the physician and student a concise\\nyet comprehensive guide to the study of gynecology in its most modern develop-\\nment. It has been their aim to relate facts and describe methods belonging to\\nthe science and art of gynecology in a way that will prove useful to students for\\nmination purposes, and which will also enable the general physician to prac-\\ntice thi- important department of surgery with advantage to his patients and with\\nsatisfacti\\nThe bnok is very well prepared, and i be well received by the medical public.\\nBritish M Hal.\\nThe text has been carefully prepnr N tl ing essential has been omitted, and its\\nteaching are those recommended by the leading authorities of the day. Journal of the\\nAmerican Medical Association.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0317.jp2"}, "318": {"fulltext": "30 m M. SAUNDE S*\\nTEXT-BOOK UPON THE PATHOGENIC BACTERIA. Spe-\\ncially written for Students of Medicine. By Joseph McFarland,\\nM. D., Professor of Pathology and Bacteriology in the Medico-Chirurgical\\nCollege of Philadelphia, etc. 497 pages, finely illustrated. Price, Cloth,\\n$2.50 net,\\nSECOND EDITION, REVISED AND GREATLY ENLARGED,\\nThe work is intended to be a text-book for the medical student and for the\\npractitioner who has had no recent laboratory training in this department of medi-\\ncal science. The instructions given as to needed apparatus, cultures, stainings,\\nmicroscopic examinations, etc. are ample for the student s needs, and will afford\\nto the physician much information that will interest and profit him relative to a\\nsubject which modern science shows to go far in explaining the etiology of many\\ndiseased conditions.\\nIn this second edition the work has been brought up to date in all depart-\\nments of the subject, and numerous additions have been made to the technique\\nin the endeavor to make the book fulfil the double purpose of a systematic work\\nupon bacteria and a laboratory guide.\\nIt is excellently adapted for the medical students and practitioners for whom it is avowedly-\\nwritten. The descriptions given are accurate and readable, and the book should prove\\nuseful to those for whom it is written. London Lancet, Aug. 29, 189\u00c3\u0096.\\nThe author has succeded admirably in presenting the essential details of bacteriological\\ntechnics, together with a judiciously chosen summary of our present knowledge of pathogenic\\nbacteria. The work, we think, should have a wide circulation among English-speaking\\nstudents of medicine. N. Y. Medical Journal, April 4, 1896.\\nThe book wiU be found of considerable use by medical men who have not had a special\\nbacteriological training, and who desire to understand this important branch of medical\\nscience. Edinburgh Medical Journal, July, 1896.\\nLABORATORY GUIDE FOR THE BACTERIOLOGIST. By\\nLangdon Frothingham, M. D. V., Assistant in Bacteriology and Veteri-\\nnary Science, Sheffield Scientific School. Yale University. Illustrated.\\nPrice, Cloth, 75 cents.\\nThe technical methods involved in bacteria-culture, methods of staining, ana\\nmicroscopical study are fully described and arranged as simply and concisely as\\npossible. The book is especially intended for use in laboratory work,\\nIt is a convenient and useful little work, and will more than repay the outlay necessary\\nfor its purchase in the saving of time which would otherwise be consumed in looking up the\\nvarious points of technique so clearly and concisely laid down in its pages. American Med.-\\nSurg. Bulletin,\\nFEEDING IN EARLY INFANCY. By Arthur V. Meigs. M. D.\\nBound in limp cloth flush edges. Price, 25 cents net.\\nSynopsis Analyses of Milk Importance of the Subject of Feeding in Early\\nInfancy Proportion of Casein and Sugar in Human Milk Time to Begin Arti-\\nficial Feeding of Infants Amount of Food to be Administered at Each Feed-\\ning Intervals between Feedings Increase in Amount of Food at Different\\nPeriods of Infant Development Unsuitableness of Condensed Milk as a Sub-\\nstitute for Mother s Milk Objections to Sterilization or Pasteurization y ot\\nMilk Advances made in the Method of Artificial Feeding of Infants.", "height": "4688", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0318.jp2"}, "319": {"fulltext": "CATALOGUE OF MEDICAL WORKS. 3 1\\nMATERIA MEDICA FOR NURSES. By Emily A. M. STQNEY,\\nGraduate of the Training-school for Nurses, Lawrence, Mass. late\\nSuperintendent of the Training-school for Nurses, Carney Hospital, South\\nBoston. Mass. Handsome octavo, 300 pages. Cloth, $1.50 net.\\nThe present book differs from other similar works in several features, all of\\nwhich are introduced to render it more practical and generally useful. The\\ngeneral plan o\\\\ contents follows the lines laid down in training-schools for\\nnurses, but the book contains much useful matter not usually included in works\\no\\\\ this character, such as emergencies, Ready Dose-list, Weights and\\nsures, etc., as well as a Glossary, defining all the terms in Materia Medica,\\nand describing all the latest drugs and remedies, which have been generally\\nneglected by other books of the kind.\\nESSENTIALS OF ANATOMY AND MANUAL OF PRACTI-\\nCAL DISSECTION, containing Hints on Dissection. By Charles\\nB. Nancrede, M. D., Professor of Surgery and Clinical Surgery in the\\nUniversity of Michigan, Ann Arbor; Corresponding Member of the Royal\\nAcademy of Medicine, Rome, Italy late Surgeon Jefferson Medical Col-\\nlege, etc. Fourth and revised edition, lost 8vo, over 500 pages, with\\nhandsome full-page lithographic plates in co.ors, and over 200 illustrations.\\nPrice Extra Cloth or Oilcloth for the dissection-room, 32.00 net.\\nNeither pains nor expense has been spared to make this work the most ex-\\nhaustive yet concise Student s Manual of Anatomy and Dissection ever pub-\\nlished, either in America or in Europe.\\nThe colored plates are designed to aid the student in dissecting the muscles,\\narteries, veins, and nerves. The wood-cuts have all been specially drawn and\\nengraved, and an Appendix added, containing 60 illustrations representing the\\nstructure of the entire human skeleton, the whole being based on the eleventh\\nedition of Gray s Anatomy.\\nA MANUAL OF PRACTICE OF MEDICINE. By A. A. Stevens,\\nA. M M. D., Instructor in Physical Diagnosis in the University of Penn-\\nsylvania, and Professor of Pathology in the Woman s Medical College of\\nPennsylvania. Specially intended for students preparing for graduation\\nand hospital examinations. Post Svo, 519 pages. Numerous illustrations\\nand selected formulae. Price, bound in flexible leather, $2.00 net.\\nFIFTH EDITION, REVISED AND ENLARGED.\\nContributions to the science of medicine have poured in so rapidly during the\\nlast quarter of a century that it is well-nigh impossible for the student, with the\\nlimited time at his disposal, to master elaborate treatises or to cull from them\\nihat knowledge which is absolutely essential. From an extended experience in\\nteaching, the author has been enabled, by classification, to group allied symp-\\ntoms, and by the judicious elimination of theories and redundant explanations\\nto bring within a comparatively small compass a complete outline of the prac-\\ntice of medicine.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0319.jp2"}, "320": {"fulltext": "32 W. SAUNDERS\\nMANUAL OF MATERIA MEDICA AND THERAPEUTICS.\\nBy A. A. Stevens, A. M., M. D., Instructor of Physical Diagnosis in the\\nUniversity of Pennsylvania, and Professor of Pathology in the Woman s\\nMedical College of Pennsylvania. 445 pages. Price, bound in flexible\\nleather, $2.25.\\nSECOND EDITION, REVISED.\\nThis wholly new volume, which is based on the last edition of the Pharma-\\ncopoeia, comprehends the following sections Physiological Action of Drugs\\nDrugs; Remedial Measures other than Drugs; Applied Therapeutics; Incom-\\npatibility in Prescriptions; Table of Doses; Index of Drugs; and Index of\\nDiseases; the treatment being elucidated by more than two hundred formulae.\\nThe author is to be congratulated upon having presented the medical student with as\\naccurate a manual of therapeutics as it is possible to prepare. Therapeutic Gazette.\\nFar superior to most of its class in fact, it is very good. Moreover, the book is reliable\\nand accurate. New York Medical Journal.\\nThe author has faithfully presented modern therapeutics in a comprehensive work,\\nand it will be found a reliable guide. University Medical Magazine.\\nNOTES ON THE NEWER REMEDIES: their Therapeutic Ap-\\nplications and Modes of Administration. By David Cerna, M. D.,\\nPh. D., Demonstrator of and Lecturer on Experimental Therapeutics in\\nthe University of Pennsylvania. Post-octavo, 253 pages. Price, #1.25.\\nSECOND EDITION, RE-WRITTEN AND GREATLY ENLARGED.\\nThe work takes up in alphabetical order all the newer remedies, giving their\\nphysical properties, solubility, therapeutic applications, administration, and\\nchemical formula.\\nIt thus forms a very valuable addition to the various works on therapeutics\\nnow in existence.\\nChemists are so multiplying compounds, that, if each compound is to be thor-\\noughly studied, investigations must be carried far enough to determine the prac-\\ntical importance of the new agents.\\nEspecially valuable because of its completeness, its accuracy, its systematic consider-\\nation of the properties and therapy of many remedies of which doctors generally know but\\nlittle, expressed in a brief yet terse manner. Chicago Clinical Review.\\nTEMPERATURE CHART. Prepared by D. T. Laine, M. D. Size\\n8x 13^ inches. Price, per pad of 25 charts, 50 cents.\\nA conveniently arranged chart for recording Temperature, with columns for\\ndaily amounts of Urinary and Fecal Excretions, Food, Remarks, etc. On the\\nback of each chart is given in full the method of Brand in the treatment of\\nTyphoid Fever.", "height": "4691", "width": "2856", "jp2-path": "atlasepitomeofsp00drck_0320.jp2"}, "321": {"fulltext": "CATALOGUE OF MEDICAL WORKS. 33\\nA TEXT-BOOK OF HISTOLOGY, DESCRIPTIVE AND PRAC-\\nTICAL. For the Use of Students. By Arthur Clarkson, M. B.,\\nC. M., Edin., formerly Demonstrator of Physiology in the Owen s College,\\nManchester; late Demonstrator of Physiology in the Yorkshire College,\\nLeeds. Large Svo, 554 pages, with 22 engravings in the text, and 174\\nbeautifully colored original illustrations. Price, strongly bound in Cloth,\\n54.00 net.\\nThe purpose of the writer in this work has been to furnish the student of His-\\ntology, in one volume, with both the descriptive and the practical part of the\\nscience. The first two chapters are devoted to the consideration of the general\\nmethods of Histology subsequently, in each chapter, the structure of the tissue\\nor organ is first systematically described, the student is then taken tutorially over\\nthe specimens illustrating it, and, finally, an appendix affords a short note of the\\nmethods of preparation.\\nThe work must be considered a valuable addition to the list of available text-books, and\\nis to be highly recommended. New York Medical Journal.\\nOne of the best works for students we have ever noticed. We predict that the book will\\nattain a well-deserved popularity among our students. Chicago Medical Recorder.\\nTHE PATHOLOGY AND TREATMENT OF SEXUAL IM-\\nPOTENCE. By Victor G. Vecki, M. D. From the second Ger-\\nman edition, revised and rewritten. Demi-octavo, about 300 pages.\\nCloth, $2.00 net.\\nThe subject of impotence has but seldom been treated in this country in the\\ntrulv scientific spirit that it deserves, and this volume will come to many as a\\nrevelation of the possibilities of therapeusis in this important field. Dr. Vecki s\\nwork has long been favorably known, and the German book has received the\\nhighest consideration. This edition is more than a mere translation, for, although\\nbased on the German edition, it has been entirely rewritten by the author in\\nEnglish.\\nThe work can be recommended as a scholarly treatise on its subject, and it can be read\\nwith advantage by many practitioners. Journal of the American Medical Association.\\nTHE TREATMENT OF PELVIC INFLAMMATIONS\\nTHROUGH THE VAGINA. By \\\\V. R. Pryor, M. D., Pro-\\nfessor of Gynecology in the New York Polyclinic. i2mo, 248 pages,\\nhandsomely illustrated. Cloth, $2.00 net.\\nIn this book the author directs the attention of the general practitioner to a\\nsurgical treatment of the pelvic diseases of women. There exists the utmost\\nconfusion in the profession regarding the most successful methods of treating\\npelvic inflammation- and inasmuch as inflammatory lesions constitute the ma-\\njority of all pelvic diseases, the subject is an important one. It has been the\\nendeavor of the author to put down every little detail, no matter how insig-\\nnificant, which might be of service.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0321.jp2"}, "322": {"fulltext": "34 W. B. SAUNDERS\\nDISEASES OF WOMEN. By Henry J. Garrigues, A.M., M.D.,\\nProfessor of Gynecology in the New York School of Clinical Medicine;\\nGynecologist to St. Mark s Hospital and to the German Dispensary, New\\nYork City. In one handsome octavo volume of 728 pages, illustrated by\\n335 engravings and colored plates. Prices: Cloth, $4.00 net; Sheep or\\nHalf-Morocco, $5.00 net.\\nA PRACTICAL work on gynecology for the use of students and practitioners,\\nwritten in a terse and concise manner. The importance of a thorough know-\\nledge of the anatomy of the female pelvic organs has been fully recognized by\\nthe author, and considerable space has been devoted to the subject. The chap-\\nters on Operations and on Treatment are thoroughly modern, and are based\\nupon the large hospital and private practice of the author. The text is eluci-\\ndated by a large number of illustrations and colored plates, many of them being\\noriginal, and forming a complete atlas for studying embryology and the anatomy\\nof the female genitalia, besides exemplifying, whenever needed, morbid condi-\\ntions, instruments, apparatus, and operations.\\nSecond Edition, Thoroughly Revised.\\nThe first edition of this work met with a most appreciative reception by the\\nmedical press and profession both in this country and abroad, and was adopted\\nas a text-book or recommended as a book of reference by nearly one hundred\\ncolleges in the United States and Canada. The author has availed himself of\\nthe opportunity afforded by this revision to embody the latest approved advances\\nin the treatment employed in this important branch of Medicine. He has also\\nmore extensively expressed his own opinion on the comparative value of the\\ndifferent methods of treatment employed.\\nOne of the best text-books for students and practitioners which has been published in\\nthe English language it is condensed, clear, and comprehensive. The profound learning\\nand great clinical experience of the distinguished author find expression in this book in a\\nmost attractive and instructive form. Young practitioners, to whom experienced consultants\\nmay not be available, will find in this book invaluable counsel and help.\\nThad. A. Reamy, M. D., LL.D.,\\nProfessor of Clinical Gynecology Medical College of Ohio Gynecologist to the Good\\nSamaritan and Cincinnati Hospitals.\\nA SYLLABUS OF GYNECOLOGY, arranged in conformity witn\\nAn American Text-Book of Gynecology. By J. W. Long, M. D.,\\nProfessor of Diseases of Women and Children, Medical College of Vir-\\nginia, etc. Price, Cloth (interleaved), $1.00 net.\\nBased upon the teaching and methods laid down in the larger work, this will\\nnot only be useful as a supplementary volume, but to those who do not already\\npossess the text-book it will also have an independent value as an aid to the\\npractitioner in gynecological work, and to the student as a guide in the lecture-\\nroom, as the subject is presented in a manner at once systematic, clear, succinct,\\npad practica.!.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0322.jp2"}, "323": {"fulltext": "CATALOGUE OF MEDICAL WORKS. 35\\nTHE AMERICAN POCKET MEDICAL DICTIONARY. Edited\\nby W. A. NEWMAN Dor land, M. D., Assistant Obstetrician to the Hospital\\nof the University of Pennsylvania; Fellow of the American Academy of\\nMedicine. Containing the pronunciation and definition of all the principal\\nwords used in medicine and the kindred sciences, with 64 extensive tables.\\nHandsomely bound in flexible leather, limp, with gold edges and patent\\nthumb index. Price, Si. 00 net with thumb index, $1.25 net.\\nSECOND EDITION, REVISED.\\nThis is the ideal pocket lexicon. It is an absolutely new book, and not a re-\\nvision of any old work. It is complete, defining all the terms of modern medi-\\ncine and forming an unusually complete vocabulary. It gives the pronunciation\\nof all the terms. It makes a special feature of the newer words neglected by\\nother dictionaries. It contains a wealth of anatomical tables of special value to\\nstudents. It forms a handy volume, indispensable to every medical man.\\nSAUNDERS* POCKET MEDICAL FORMULARY. By William\\nM. Powell. M. D., Attending Physician to the Mercer House for Invalid\\nWomen at Atlantic City. Containing 1800 Formulae, selected from several\\nhundred of the best-known authorities. Forming a handsome and con-\\nvenient pocket companion of nearly 300 printed pages, with blank leaves\\nfor Additions; with an Appendix containing Posological Table, Formulae\\nand Doses for Hypodermatic Medication, Poisons and their Antidotes,\\nDiameters of the Pemale Pelvis and Fcetal Head, Obstetrical Table, Diet\\nList for Various Diseases, Materials and Drugs used in Antiseptic Surgery,\\nTreatment of Asphyxia from Drowning, Surgical Remembrancer, Tables\\nof Incompatibles, Eruptive Fevers, Weights and Measures, etc. Hand-\\nsomely bound in morocco, with side index, wallet, and flap. Price, $1.75\\nnet.\\nFIFTH EDITION, THOROUGHLY REVISED.\\nThis little book, that can be conveniently carried in the pocket, contains an immense\\namount of material. It is very useful, and as the name of the author of each prescription is\\ngiven, is unusually reliable. New York Medical Record.\\nA COMPENDIUM OF INSANITY. ByJOHN B. Chapin, M.D., LL.D.,\\n\u00e2\u0096\u00a0ician-in-Chief, Pennsylvania Hospital for the Insane; late Physician-\\nSuperintendent oPthe Willaid State Hospital, New York; Honorary Mem-\\nber of the Medico-Psychological Society of Great Britain, of the Society of\\nMental Medicine of Belgium, I2mo, 234 pages, Must, (loth, $1.25 net.\\nThe author has given, in a condensed and concise form, a compendium of\\nfthe Mind, for the convenient use and aid of physicians and students.\\nIt contains a clear, concise Statement of the clinical aspects of the various ab-\\nnormal mental conditions, with directions as to the most approved methods of\\nmanaging and treating the insane.\\nhe practical parts of Dr. Chapin s book are what constitute its distinctive merit. We\\nespecially, however, to call attention to the fa t that in the subje\u00c2\u00ab t of the therapeutics\\nof insanity the work is exceedingly valuable. The author has made a distinct addition to the\\nliterature of his specialty. Philadelphia Mcdi al Journal", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0323.jp2"}, "324": {"fulltext": "3 6 W. B. SAUNDERS\\nAN OPERATION BLANK, with Lists of Instruments, etc. re-\\nquired in Various Operations. Prepared by W. W. Keen, M. D.,\\nLL.D., Professor of Principles of Surgery in the Jefferson Medical Col-\\nlege, Philadelphia. Price per Pad, containing Blanks for fifty operations,\\n50 cents net.\\nSECOND EDITION, REVISED FORM.\\nA convenient blank, suitable for all operations, giving complete instructions\\nregarding necessary preparation of patient, etc., with a full list of dressings and\\nmedicines to be employed.\\nOn the back of each blank is a list of instruments used viz. general instru\\nments, etc., required for all operations and special instruments for surgery of\\nthe brain and spine, mouth and throat, abdomen, rectum, male and femah\\ngenito-urinary organs, the bones, etc.\\nThe whole forming a neat pad, arranged for hanging on the wall of a sur-\\ngeon s office or in the hospital operating-room.\\nWill serve a useful purpose for the surgeon in reminding him of the details of prepa-\\nration for the patient and the room as well as for the instruments, dressings, and antiseptics\\nneeded New York Medical Record\\nCovers about all that can be needed in any operation. American Lancet.\\nThe plan is a capital one. Boston Medical and Surgical Journal.\\nLABORATORY EXERCISES IN BOTANY. By Edson S. Bastin,\\nM. A., Professor of Materia Medica and Botany in the Philadelphia Col-\\nlege of Pharmacy. Octavo volume of 536 pages, 87 full-page plates. Price,\\nCloth, #2.50.\\nThis work is intended for the beginner and the advanced student, and it fully\\ncovers the structure of flowering plants, roots, ordinary stems, rhizomes, tubers,\\nbulbs, leaves, flowers, fruits, and seeds. Particular attention is given to the gross\\nand microscopical structure of plants, and to those used in medicine. Illustra-\\ntions have freely been used to elucidate the text, and a complete index to facil-\\nitate reference has been added.\\nThere is no work like it in the pharmaceutical or botanical literature of this country, and\\nwe predict for it a wide circulation. American Journal of Pharmacy.\\nDIET IN SICKNESS AND IN HEALTH. By Mrs. Ernest Hart,\\nformerly Student of the Faculty of Medicine of Paris and of the London\\nSchool of Medicine for Women; with an Introduction by Sir Henry\\nThompson, F. R. C. S., M. D., London. 220 pages illustrated. Price,\\nCloth, J 1. 50.\\nUseful to those who have to nurse, feed, and prescribe for the sick. In\\neach case the accepted causation of the disease and the reasons for the special\\ndiet prescribed are briefly described. Medical men will find the dietaries and\\nrecipes practically useful, and likely to save them trouble in directing the dietetic\\ntreatment of patients.", "height": "4689", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0324.jp2"}, "325": {"fulltext": "CATALOGUE OF MEDICAL WORKS.\\nA MANUAL OF PHYSIOLOGY, with Practical Exercises. For\\nStudents and Practitioners. By G. N. Stewart, M. A., M. D., D. Sc,\\nlately Examiner in Physiology, University of Aberdeen, and of the New\\nMuseums, Cambridge University Professor of Physiology in the Western\\nReserve University, Cleveland, Ohio. Handsome octavo volume of 848\\npages, with 300 illustrations in the text, and 5 colored plates. Price, Cloth,\\n53.75 net.\\nTHIRD EDITION, REVISED.\\nIt will make its way by sheer force of merit, and amply deserves to do so. It is one oj\\nthe very best English text-books on the subject. London Lancet.\\nM Of the many text-books of physiology published, we do not know of one that so nearly\\ncomes up to the ideal as does Professor Stewart s volume. British Medical Journal.\\nESSENTIALS OF PHYSICAL DIAGNOSIS OF THE THORAX.\\nBy Arthur M. Corwin, A. M., M. D., Demonstrator of Physical Diagno-\\nsis in the Rush Medical College, Chicago; Attending Physician to the\\nCentral Free Dispensary, Department of Rhinology, Laryngology, and\\nDiseases of the Chest. 219 pages. Illustrated. Cloth, flexible covers.\\nPrice, $1.25 net.\\nTHIRD EDITION, THOROUGHLY REVISED AND ENLARGED.\\nSYLLABUS OF OBSTETRICAL LECTURES in the Medical\\nDepartment, University of Pennsylvania. By Richard C. Norris,\\nA. M., M. D., Lecturer on Clinical and Operative Obstetrics, University\\nof Pennsylvania. Third edition, thoroughly revised and enlarged. Crown\\n8vo. Price, Cloth, interleaved for notes, $2.00 net.\\nThis work is so far superior to others on the same subject that we take pleasure in call-\\ning attention briefly to its excellent features. It covers the subject thoroughly, and will\\nprove invaluable buth to the student and the practitioner. The author has introduced a\\nnumber of valuable hints which would only occur to one who was himself an experienced\\nteacher of obstetrics. The subject-matter is clear, forcible, and modern. We are especially\\npleased with the portion devoted to the practical duties of the accoucheur, care of the child,\\netc. The paragraphs on antiseptics are admirable, there is no doubtful tone in the direc-\\ntions given. No details are regarded as unimportant; no minor matters omitted. We ven-\\nture to say that even the old practitioner will find useful hints in this direction which he can-\\nnot afford to despise. New York Medical Record.\\nA SYLLABUS OF LECTURES ON THE PRACTICE OF SUR-\\nGERY, arranged in conformity with An American Text-Book\\nof Surgery. By X. Si. NN, M. D., Ph. D., Professor of Surgery in Rush\\nMedical College, Chicago, and in the Chicago Polyclinic. Price, $2.00.\\nThis work by so eminent an author, himself one of the contributors to\\nAn American Text-Book of Surgery, will prove of exceptional value to\\nthe advanced student who hns adopted that work as his text-book. It is not\\nonly the syllabus of an unrivalled course of surgical practice, but it is also an\\nepitome of or supplement to the larger work.\\nThe author has evidently spared no pains in making his Syllabus thoroughly comprehen-\\nsive, and har. added new matter and alluded to the most recent authors and operations. Full\\nreferences are aUo given to all requisite details of surgical anatomy and pathology. British\\nMedical Journal, London.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0325.jp2"}, "326": {"fulltext": "38 W. B. SAUNDERS\\nTHE CARE OF THE BABY. By J. P. Crozer Griffith, M. D.,\\nClinical Professor of Diseases of Children, University of Pennsylvania;\\nPhysician to the Children s Hospital Philadelphia, etc. 404 pages, with\\n67 illustrations in the text, and 5 plates. i2mo. Price, #1.50.\\nSECOND EDITION, REVISED.\\nA reliable guide not only for mothers, but also for medical students and\\npractitioners whose opportunities for observing children have been limited.\\nThe whole book is characterized by rare good sense, and is evidently written by a mas.\\nter hand. _ It can be read with benefit not only by mothers, but by medical students and by\\nany practitioners who have not had large opportunities for observing children/ American\\nJournal of Obstetrics.\\nTHE NURSE S DICTIONARY of Medical Terms and Nursing\\nTreatment, containing Definitions of the Principal Medical and Nursing\\nTerms, Abbreviations, and Physiological Names, and Descriptions of the\\nInstruments, Drugs, Diseases, Accidents, Treatments, Operations, Foods,\\nAppliances, etc. encountered in the ward or the sick-room. By Honnor\\nMorten, author of How to Become a Nurse, Sketches of Hospital\\nLife, etc. i6mo, 140 pages. Price, Cloth, $1.00.\\nThis little volume is intended for use merely as a small reference-book which\\ncan be consulted at the bedside or in the ward. It gives sufficient explanation\\nto the nurse to enable her to comprehend a case until she has leisure to look up\\nlarger and fuller works on the subject.\\nDIET LISTS AND SICK-ROOM DIETARY. By Jerome B. Thomas,\\nM. D., Visiting Physician to the Home for Friendless Women and Children\\nand to the Newsboys Home Assistant Visiting Physician to the Kings\\nCounty Hospital Assistant Bacteriologist, Brooklyn Health Department.\\nPrice, Cloth, $1.50 (Send for specimen List.)\\nOne hundred and sixty detachable (perforated) diet lists for Albuminuria,\\nAnaemia and Debility, Constipation, Diabetes, Diarrhoea, Dyspepsia, Fevers,\\nGout or Uric- Acid Diathesis, Obesity, and Tuberculosis. Also forty detachable\\nsheets of Sick-Room Dietary, containing full instructions for preparation of\\neasily-digested foods necessary for invalids. Each list is numbered only, the\\ndisease for which it is to be used in no case being mentioned, an index key\\nbeing reserved for the physician s private use.\\nDIETS FOR INFANTS AND CHILDREN IN HEALTH AND\\nIN DISEASE. By Louis Starr, M. D., Editor of An American\\nText-Book of the Diseases of Children. 230 blanks (pocket-book size),\\nperforated and neatly bound in flexible morocco. Price, $1.25 net.\\nThe first series of blanks are prepared for the first seven months of infant\\nlife; each blank indicates the ingredients, but not the quantities, of the food,\\nthe latter directions being left for the physician. After the seventh month,\\nmodifications being less necessary, the diet lists are printed in full. Formula\\nto trie preparation of diluents and foods are appended.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0326.jp2"}, "327": {"fulltext": "CATALOGUE OF MEDICAL WORKS. 39\\nHOW TO EXAMINE FOR LIFE INSURANCE. By Jofn M.\\nKeating, M. D., Fellow of the College of Physicians and Surgeons of\\nPhiladelphia; Vice-President of the American Pediatric Society; Ex-\\nPresident of the Association of Life Insurance Medical Directors. Royal\\n8vo, 211 pages, with two large half-tone illustrations, and a plate prepared\\nby Dr. McClellan from special dissections also, numerous cuts to elucidate\\nthe text. Third edition. Price, Cloth, $2.00 net.\\nThis is by far the most useful book which has yet appeared on insurance examination, a\\nsubject of growing interest and importance. Not the least valuable portion of the volume is\\nPart II., which consists of instructions issued to their examining physicians by twenty-four\\nrepresentative companies of this country. As the proofs of these instructions were corrected\\nby the directors of the companies, they form the latest instructions obtainable. If for these\\nalone, the book should be at the right hand of every physician interested in this special branch\\nof medical science. The Medical News, Philadelphia.\\nNURSING: ITS PRINCIPLES AND PRACTICE. By Isabel\\nAdams Hampton, Graduate of the New York Training School for\\nNurses attached to Bellevue Hospital; Superintendent of Nurses and\\nPrincipal of the Training School for Nurses, Johns Hopkins Hospital,\\nBaltimore, Md. late Superintendent of Nurses, Illinois Training School\\nfor Nurses, Chicago, 111. In one very handsome i2mo volume of 512\\npages, illustrated. Price, Cloth, $2. 00 net.\\nSECOND EDITION, REVISED AND ENLARGED.\\nThis original work on the important subject of nursing is at once comprehensive\\nand systematic. It is written in a clear, accurate, and readable style, suitable\\nalike to the student and the lay reader. Such a work has long been a desidera-\\ntum with those entrusted with the management of hospitals and the instruction of\\nnurses in training-schools. It is also of especial value to the graduated nurse\\nwho desires to acquire a practical working knowledge of the care of the sick\\nand the hygiene of the sick-room.\\nOBSTETRIC ACCIDENTS, EMERGENCIES, AND OPERA-\\nTIONS. By L. CH. Boisliniere, lit. D., late Emeritus Professor of\\nObstetrics in the St. Louis Medical College. 381 pages, handsomely illus-\\ntrated. Price, $2.00 net.\\nFor the use of the practitioner who, when away from home, has not the\\nopportunity of consulting a library or of calling a friend in consultation. He\\nthen, being thrown upon his own resources, will find this book of benefit in\\nguiding and assisting him in emergencies.\\nINFANT S WEIGHT CHART. Designed by J. P. Crozer Griffith,\\nM. D., Clinical Professor of Diseases of Children in the University of Penn-\\nsylvania. 25 charts in each pad. Price per pad, 50 cents net.\\nA convenient blank for keeping a record of the child s weight during the first\\ntwo years of life. Printed on each chart is a curve representing the average weight\\nof a healthy infant, so that any deviation from the normal can readily be detected", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0327.jp2"}, "328": {"fulltext": "Saunders\\nNew Series\\nof Manuals\\nfor Students\\nand\\nPractitioners*\\nTHAT there exists a need for thoroughly reliable hand-books on the leading\\nbranches of Medicine and Surgery is a fact amply demonstrated by the\\nfavor with which the SAUNDERS NEW SERIES OF MANUALS have been\\nreceived by medical students and practitioners and by the Medical Press.\\nThese manuals are not merely condensations from present literature, but\\nare ably written by well-known authors and practitioners, most of them being\\nteachers in representative American colleges. Each volume is concisely and\\nauthoritatively written and exhaustive in detail, without being encumbered\\nwith the introduction of cases, which so largely expand the ordinary text-\\nbook. These manuals will therefore form an admirable collection of advanced\\nlectures, useful alike to the medical student and the practitioner to the latter,\\ntoo busy to search through page after page of elaborate treatises for what he\\nwants to know, they will prove of inestimable value to the former they will\\nafford safe guides to the essential points of study.\\nThe SAUNDERS NEW SERIES OF MANUALS are conceded to be\\nsuperior to any similar books now on the market. No other manuals afford so\\nmuch information in such a concise and available form. A liberal expenditure\\nhas enabled the publisher to render the mechanical portion of the work worthy\\nof the high literary standard attained by these books.\\nAny of these Manuals will be mailed on receipt of price (see next page\\nfor List).", "height": "4685", "width": "2995", "jp2-path": "atlasepitomeofsp00drck_0328.jp2"}, "329": {"fulltext": "SAUNDERS NEW SERIES OE MANUALS,\\nVOLUMES PUBLISHED.\\nPHYSIOLOGY. By Joseph Howard Raymond, A. M., M. D., Professor\\nof Physiology and Hygiene and Lecturer on Gynecology in the Long\\nIsland College Hospital, etc. Price, $1.25 net.\\nSURGERY, General and Operative. By John Chalmers DaCosta,\\nM. D., Professor of Clinical Surgery, Jefferson Medical College, Philadel-\\nphia. Second edition, revised and greatly enlarged. Octavo, 911 pages,\\n3S6 illustrations. Cloth, $4.00 net Half-Morocco, $5.00 net.\\nDOSE-BOOK AND MANUAL OF PRESCRIPTION- WRITING.\\nBy E. Q. Thornton, M. D., Demonstrator of Therapeutics, Jefferson\\nMedical College, Philadelphia. Price, $1.25 net.\\nMEDICAL JURISPRUDENCE. By Henry C. Chapman, M. D., Pro-\\nfessor of Institutes of Medicine and Medical Jurisprudence in the Jeffer-\\nson Medical College of Philadelphia, etc Price, $1.50 net.\\nSURGICAL ASEPSIS. By Carl Beck, M.D., Surgeon to St. Mark s\\nHospital and to the German Poliklinik Instructor in Surgery, New York\\nPost-Graduate Medical School, etc. Price, $1.25 net.\\nMANUAL OF ANATOMY. By Irving S. Haynes, M.D., Adjunct\\nProfessor of Anatomy and Demonstrator of Anatomy, Medical Department\\nof the New York University, etc. Price, $2.50 net.\\nSYPHILIS AND THE VENEREAL DISEASES. By James\\nNevins Hyde, M. D., Professor of Skin and Venereal Diseases, and\\nFrank H. Montgomery, M. D., Lecturer on Dermatology and Genito-\\nurinary Diseases in Rush Medical College, Chicago. Price, $2.50 net.\\nPRACTICE OF MEDICINE. By George Roe Lockwood, M. D.,\\nProfessor of Practice in the Woman s Medical College of the New York\\nInfirmary, etc. Price, $2.50 net.\\nOBSTETRICS. By W. A. Newman Dorland, M. D., Assistant Demon-\\nstrator of Obstetrics, University of Pennsylvania Chief of Gynecological\\nDispensary, Pennsylvania Hospital. Price, $2.50 net.\\nDISEASES OF WOMEN. By J. Bland Sutton, F. R. C. S., Assistant\\nSurgeon to the Middlesex Hospital, and Surgeon to the Chelsea Hospital\\nfor Women, London; and Arthur E. Giles, M. D., B. Sc. Lond., F. R. C. S.\\nEdin., Assistant Surgeon to the Chelsea Hospital for Women, London. 436\\npages, handsomely illustrated. Price, $2.50 net.\\nIN PREPARATION.\\nNERVOUS DISEASES. By Chari.es W. Burr, M. D\u00e2\u0080\u009e Clinical Profes-\\nsor of Nervous Diseases, Medico-Chirurgical College, Philadelphia, etc.\\nThere will be published in the same series, at short intervals, carefully prepared works\\non various subjects, by prominent specialists.", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0329.jp2"}, "330": {"fulltext": "SAUNDERS QUESTION COMPENDS.\\nArranged in Question and Answer Form,\\nTHE LATEST, MOST COMPLETE, and BEST ILLUSTRATED\\nSERIES OF COMPENDS EVER ISSUED.\\nNow the Standard Authorities in Medical Literature\\nStudents and Practitioners in every City of the United\\nStates and Canada.\\nTHE REASON WHY.\\nThey are the advance guard of Student s Helps that DO HELP; they are\\nthe leaders in their special line, well and authoritatively written by able men,\\nwho, as teachers in the large colleges, ktiow exactly what is wanted by a student\\npreparing for his examinations. The judgment exercised in the selection of\\nauthors is fully demonstrated by their professional elevation. Chosen from the\\nranks of Demonstrators, Quiz-masters, and Assistants, most of them have be-\\ncome Professors and Lecturers in their respective colleges.\\nEach book is of convenient size (5x7 inches), containing on an average 250\\npages, profusely illustrated, and elegantly printed in clear, readable type, on\\nfine paper.\\nThe entire series, numbering twenty- four subjects, has been kept thoroughly\\nrevised and enlarged when necessary, many of them being in their fourth and\\nfifth editions.\\nTO SUM UP.\\nAlthough there are numerous other Quizzes, Manuals, Aids, etc. in the mar-\\nket, none of them approach the Blue Series of Question Compends; and\\nthe claim is made for the following points of excellence\\n1. Professional distinction and reputation of authors.\\n2. Conciseness, clearness, and soundness of treatment.\\n3. Size of type and quality of paper and binding.\\nAny of these Compends will be mailed on receipt of price (see next\\npage for List).\\n42", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0330.jp2"}, "331": {"fulltext": "SAUNDERS QUESTION-COMPEND SERIES.\\nPrice, Cloth, $J*00 per copy, except when otherwise noted*\\n1. ESSENTIALS OF PHYSIOLOGY. 4th edition. Illustrated. Revised and enlarged.\\nBy H. A. Hare, M. D. (Price, $1.00 net.)\\n2. ESSENTIALS OF SURGERY. 7th edition, with a chapter on Appendicitis. 90 illus-\\ntrations. By Edward Martin, M. D. (Price, \u00c2\u00a3t.oo net.)\\n3. ESSENTIALS OF ANATOMY. 6th edition, thoroughly revised. 151 illustrations.\\nBy Charles B. Nancrede, M. D. (Price, $1.00 net.)\\n4. ESSENTIALS OF MEDICAL CHEMISTRY, ORGANIC AND INORGANIC.\\n5th edition, revised, with an Appendix. By Lawrence Wolff, M. D. ($1. 00 net.)\\n5. ESSENTIALS OF OBSTETRICS. 4th edition, revised and enlarged. 75 illustra-\\ntions. By W. Easterly Ashton, M. D.\\n6. ESSENTIALS OF PATHOLOGY AND MORBID ANATOMY. 7 th thousand.\\n46 illustrations. By C. E. Armand Semple, M. D.\\n7. ESSENTIALS OF MATERIA MEDICA, THERAPEUTICS, AND PRE-\\nSCRIPTION-WRITING. 5th edition. By Henry Morris, M. D.\\n8. g. ESSENTIALS OF PRACTICE OF MEDICINE. By Henry Morris, M.D.\\nAn Appendix on Urine Kxamin ation. Illustrated. By Lawrence Wolff, M. D.\\n3d edition, enlarged by some 300 Essential Formulae, selected from eminent authori-\\nties, by W.m. M. Powell, M. D. (Double number, price $2.00.)\\n10. ESSENTIALS OF GYNECOLOGY. 4th edition, revised. With 62 illustrations.\\nBy Edwin B. Cragin, M. D.\\n11. ESSENTIALS OF DISEASES OF THE SKIN. 4th edition, revised and enlarged.\\n71 letter-press cuts and 15 half-tone illustrations. By Henry W. Stelwagon, M.D.\\n(Price, $1.00 net.)\\n12. ESSENTIALS OF MINOR SURGERY, BANDAGING, AND VENEREAL\\nDISEASES. 2d edition, revised and enlarged. 78 illustrations. By Edward\\nMartin, M. D.\\n13. ESSENTIALS OF LEGAL MEDICINE, TOXICOLOGY, AND HYGIENE.\\n130 illustrations. By C. E. Armand Semple, M. D.\\n14. ESSENTIALS OF DISEASES OF THE EYE, NOSE, AND THROAT. 124\\nillustrations. 2-i edition, revised. By Edward Jackson, M. D., and E. Baldwin\\nGlkason, M. D.\\n15. ESSENTIALS OF DISEASES OF CHILDREN. 2d edition. By William M.\\nPowell, M. D.\\n16. ESSENTIALS OF EXAMINATION OF URINE. Colored Vogel Scale,\\nand numerous illustrations. By Lawrence Wolff, M. D.. (Price, 75 cents.)\\n17. ESSENTIALS OF DIAGNOSIS. 2d edition, thoroughly revised. 60 illustrations.\\nBy S. OH EN, M. I)., and A. A. Eshner, M. D. (Price, $1. 00 net.)\\n18. ESSENTIALS OF PRACTICE OF PHARMACY. 2d edition, revised. By L.\\n\u00e2\u0096\u00a0.VRE.\\n20. ESSENTIALS OF BACTERIOLOGY. 3d edition. 82 illustrations. By M. V.\\nBall, M D.\\n21. ESSENTIALS OF NERVOUS DISEASES AND INSANITY. 48 illustrations.\\n3d edition, revised. By John C. Shaw, M. D.\\n22. ESSENTIALS OF MEDICAL PHYSICS. 155 illustrations. 2d edition, revised.\\nBy Fred J. Bro kway, M. D. (Price, $1.00 net.)\\n23. ESSENTIALS OF MEDICAL ELECTRICITY. 65 illustrations. By David D.\\nART, M. 1).. and Kdwahd S. Lawrance, M. D.\\n24. ESSENTIALS OF DISEASES OF THE EAR. 114 illustrations. 2d edition, re-\\nvised and enlarged. By E. Baldwin Gleason, M. D.\\n43", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0331.jp2"}, "332": {"fulltext": "Some of the Books in Preparation for\\nPublication during 1900.\\nAMERICAN Text=Book of Pa=\\nthology.\\nEdited by Ludvig Hektoen, M.D., Pro-\\nfessor of Pathology, Rush Medical College,\\nChicago; and David Riesman, M.D., De-\\nmonstrator of Pathological Histology, Uni-\\nversity of Pennsylvania.\\nAMERICAN Text=Book of Legal\\nMedicine and Toxicology.\\nEdited by Frederick Peterson, M.D.,\\nChief of Clinic, Nervous Department, College\\nof Physicians and Surgeons, New York City\\nand Walter S. Haines, M.D., Professor of\\nChemistry, Pharmacy, and Toxicology, Rush\\nMedical College, Chicago.\\nBECK\u00e2\u0080\u0094 Fractures.\\nBy Carl Beck, M.D., Professor of Surgery\\nin the N. Y. School of Clinical Medicine.\\nB\u00c3\u0096HM, DAVIDOFF, and HU=\\nBER\u00e2\u0080\u0094 A Text=Book of Human\\nHistology.\\nIncluding Microscopic Technic. By\\nDr. A. A. B\u00c3\u00b6hm and Dr. M. von Davidoff,\\nof the Anatomical Institute of Munich, and\\nG. C. Huber,M.D., Junior Professor of Anat-\\nomy and Histology, University of Michigan,\\nAnn Arbor.\\nEICH HORST- A Text=Book of\\nthe Practice of Medicine.\\nBy Dr. Herman Eichhorst, Professor of\\nSpecial Pathology and Therapeutics and Di-\\nrector of the Medical Clinic, University of\\nZurich. Translated and edited by Augustus\\nA. Eshner, M.D Professor of Clinical\\nMedicine in the Philadelphia Polyclinic.\\nFRIEDRICH Rhinology, La=\\nryngology, and Otology in\\ntheir Relations to General\\nMedicine.\\nBy Dr. E. P. Friedrich, of the Univer-\\nsity of Leipsig.\\nLEVY AND KLEMPERER\\nThe Elements of Clinical Bac=\\nteriology.\\nBy Dr. Ernst Levy, Professor in the\\nUniversity of Strassburg, and Dr. Felix\\nKlemperer, Privat-Docent in the Univer-\\nsity of Strassburg. Translated and edited\\nby Augustus A. Eshner, M.D., Professor\\nof Clinical Medicine in the Philadelphia Poly-\\nclinic. Just Ready. Cloth, $2 5c net.\\nMcFARLAND\u00e2\u0080\u0094 A Text=Book of\\nPathology.\\nBy Joseph McFarland, M.D., Professor\\nof Pathology and Bacteriology, Medico-Chi-\\nrurgical College, Philadelphia.\\nOGDEN Clinical Examination\\nof the Urine.\\nBy J. Bergen Ogden, M.D., Assistant in\\nChemistry, Harvard Medical School.\\nPYLE\u00e2\u0080\u0094 A Manual of Personal\\nHygiene.\\nEdited by Walter L. Pyle, M.D., Assis-\\ntant Surgeon to Wills Eye Hospital, Philada.\\nSCUDDER\u00e2\u0080\u0094 The Treatment of\\nFractures.\\nBy Charles L. Scudder, M.D., Assistant\\nin Clinical and Operative Surgery, Harvard\\nUniversity.\\nSENN\u00e2\u0080\u0094 Practical Surgery.\\nBy Nicholas Senn, M.D., Ph.D., LL.D.,\\nProfessor of the Practice of Surgery and of\\nClinical Surgery, Rush Medical College, Chi-\\ncago. Octavo volume of about 800 pages,\\nprofusely illustrated.\\nThe Pathology and Treatment\\nof Tumors.\\nBy Nicholas Senn, M.D., Ph.D., LL.D.,\\nProfessor of the Practice of Surgery and of\\nClinical Surgery, Rush Medical College, Chi-\\ncago. A New and Thoroughly Revised Edi-\\ntion in preparation.\\nSTENGEL AND WHITE The\\nBlood in its Clinical and Patho=\\nlogical Relations.\\nBy Alfred Stengel, M.D., Professor of\\nClinical Medicine, University of Pennsyl-\\nvania; and C. Y. White, M.D., Instruc-\\ntor in Clinical Medicine, University of Penn-\\nsylvania.\\nSTEVENS\u00e2\u0080\u0094 The Physical Diag=\\nnosis of Diseases of the Chest.\\nBy A. A. Stevens, A.M., M.D., Lecturer\\non Terminology, and Instructor in Physical\\nDiagnosis, University of Pennsylvania.\\nSTONEY Surgical Technique\\nfor Nurses.\\nBy Emily A. M. Stoney, late Superin-\\ntendent of the Training Schools for Nurses,\\nCarney Hospital, South Boston, Mass.", "height": "4691", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0332.jp2"}, "333": {"fulltext": "", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0333.jp2"}, "334": {"fulltext": "", "height": "4720", "width": "2915", "jp2-path": "atlasepitomeofsp00drck_0334.jp2"}, "335": {"fulltext": "", "height": "4642", "width": "2938", "jp2-path": "atlasepitomeofsp00drck_0335.jp2"}, "336": {"fulltext": "MAY 31 1900", "height": "4716", "width": "3024", "jp2-path": "atlasepitomeofsp00drck_0336.jp2"}, "337": {"fulltext": "VOLUMES NOW READY.\\nAtlas of Internal Medicine and Clinical Diagnosis. By\\nDr. Chr. Jakob, of Erlangen. Edited by Augustus A.\\nEshner, M.D., Professor of Clinical Medicine in the Phila-\\ndelphia Polyclinic Attending Physician to the Philadelphia\\nHospital. 68 colored plates. Cloth, $3.00 net.\\nAtlas of Legal Medicine. By Dr. E. von Hofmann, of\\nVienna. Edited by Frederick Peterson, M.D. Clinical\\nProfessor of Mental Diseases, Woman s Medical College, New\\nYork; Chief of Clinic, Nervous Dept., College of Physicians\\nand Surgeons, New York. With 120 colored figures on 56\\nplates, and 193 half-tone illustrations. Cloth, $3.50 net.\\nAtlas of Diseases of the Larynx. By Dr. L Gr\u00c3\u00bcnwald,\\nof Munich. Edited by Charles P. Grayson, M.D., Lec-\\nturer on Laryngology and Rhinology in the University of\\nPennsylvania; Physician-in -Charge, Throat and Nose Depart-\\nment, Hospital of the University of Penna. With 107 colored\\nfigures on 44 plates, and 25 text-illustrations. Cloth, $2.50 net.\\nAtlas of Operative Surgery. By Dr. O. Zuckerkandl, of\\nVienna. Edited by J. Chalmers DaCosta, M.D., Clinical\\nProfessor of Surgery, Jefferson Medical College, Philadelphia\\nSurgeon to the Philadelphia Hospital. With 24 colored plates,\\nand 217 illustrations in the text. Cloth, $3.00 net.\\nAtlas of Syphilis and the Venereal Diseases. By Prof.\\nDr. Franz Mracek, of Vienna. Edited by L. Bolton\\nBangs, M.D., late Professor of Genito-Urinary and Venereal\\nDiseases, New York Post-Graduate Medical School and Hos-\\npital. With 71 colored plates from original water-colors by\\nA. Schmitson. Cloth, $3.50 net.\\nAtlas of External Diseases of the Eye.\u00e2\u0080\u0094 By Dr. O. Haab,\\nof Zurich. Edited by G. E. de Schweinitz, M. D., Profes-\\nsor of Ophthalmology, Jefferson MedicaJ College, Philadel-\\nphia. With 76 colored illustrations on 40 plates. Cloth,\\n$3.00 net.\\nAtlas of Skin Diseases. By Prof. Dr. Franz Mracek, of\\nVienna. Edited by Henry W. Stelwagon, M. D., Clinical\\nProfessor of Dermatology, Jefferson Medical College, Phila-\\ndelphia. With 63 colored plates and 39 beautiful half-tone\\nillustrations. Cloth, $3.50 net.\\nIN PREPARATION.\\nAtlas of Pathological Histology. Atlas of Operative Gynecology.\\nAtlas of Orthopedic Surgery. Atlas of Psychiatry.\\nAtlas of General Surgery. Atlas of Diseases of the Ear.", "height": "4675", "width": "2946", "jp2-path": "atlasepitomeofsp00drck_0337.jp2"}, "338": {"fulltext": "", "height": "4640", "width": "2802", "jp2-path": "atlasepitomeofsp00drck_0338.jp2"}}