Studi dei laboratori del Dipartimento di Chirurgia . actmucosal surrf>undcd per submucosa e edematoso ispessito, infiammabile. In questi vetrini è stato mostrato solo uno dei tubi mucosali che lo collegano al sito del lume originale dell'appendice. Questo era anche rivestito con 23 mucose intatte mentre passava attraverso l'ampio difetto dei muscularis. SeveralAlaltri grandi difetti nei muscularis sono stati osservati, attraverso i quali sono passati vasi sanguigni e linfatici e tessuto connettivo denso. Sorprendentemente poca evidenza della reazione infiammatoria acuta è apparsa nella sezione eccetto nella formadi un fib

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Studies from the laboratories of the Deptof Surgery . actmucosa surrf>undcd by submucosa and the thickened edematous, inflamedmesentery. Only one of the mucosal tubes connecting it with the site of theoriginal appendix lumen was shown in these slides. This was also lined with 23 intact mucosa as it passed through the broad defect in the muscularis. Severalother broad defects in the muscularis were seen, through which passed bloodand lymphatic vessels and dense connective tissue. Surprisingly little evidenceof the acute inflammatory reaction appeared in the section except in the formof a fibrinopurulent exudate on the serosa and fibroblastic reaction in themesentery, together with a moderate edema and dilation of Ivmphatic vessels(Fig. 6). Case 5.—History.—J. F. D., man, aged 21, single. American, a clerk, sufferedsudden sharp cramplike pains in the abdomen which were not relieved by anymeasures taken. The bowels moved, and he vomited once. He had had sixsimilar attacks during the past year. He was usually constipated. The tempera-. Fig. 6 (Case 4).—Photumicrograph of the appendix shown in Figure .^. i m-diverticulum lined with mucosa and submucosa in the mesenteric fat is shown atA. The afferent i)ortion of the lumen leading from the cecal end of the appen-dix to the diverticulum sac is shown at B. The continuity of the diverticulumwith the lumen of the appendix at the tip C is not shown in this section but isclear in Figure 5. DDD are four of the broad defects in the mesenteric borderof the muscularis filled with blood vessels and connective tissue. The ball-likeexpansions of these outside the muscular coats (so-called false diverticula) arewell shown. ture was 100.6 F. The wliite blood cells numbered IZ.dOO; polymorphonuclears.90 per cent. Tenderness was noted on both sides of the midline below theumbilicus. There was rectal tenderness anteriorly, and marked distention ofthe colon. Operation (Dr. H. A. Murray, supervised by Dr. W. G. Penfield).—Jan. 9.1

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• bookcentury1900
• bookdecade1910
• bookpublishernewyork
• bookyear19