Copyright © 2011 by University of Nebraska–Lincoln, all rights reserved. Redistribution or republication in any medium, except as allowed under the Fair Use provisions of U.S. copyright law, requires express written consent from the editors and advance notification of the publisher, the University of Nebraska–Lincoln.
Selected for photographic illustration is a specimen in which the solitary glands are enlarged to the size of bird-shot, but in which a little ulcer has formed on the apex of each, although the patient had been sick but a few weeks. The case was one of typhoid fever accompanied by a smart catarrhal inflammation of the colon:
CASE 882.—Autopsy: The arachnoid at the base of the brain was opaque, and there was some effusion of lymph on the posterior portion of the spinal cord just below the medulla oblongata. All the viscera appeared healthy with the exception of the intestinal canal. The solitary glands of both large and small intestine were greatly enlarged and ulcerated at their apices, and there was considerable thickening and ulceration of the patches of Peyer. The intestinal canal was forwarded to the
Nos. 815 to 821, Medical Section, are from this case. Nos. 815, 816 and 817 are successive portions of the ileum, in which Peyer's patches are much thickened and ulcerated; the villi are greatly hypertrophied. In Nos. 815 and 816 the solitary glands are enlarged to rounded tumors, many of them as much as a fifth of an inch in diameter, or even larger, and some of them, especially in No. 816, ulcerated at their apices. In No. 817 the enlarged solitary glands have the same character, but are much less numerous. No. 818 consists of the last inch of the ileum, with the ileo-cæcal valve and cæcum. Both the ileum and cæcum present a number of enlarged solitary glands similar to those above described; those in the cæcum are ulcerated at their apices. No. 819 is from the ascending, No. 820 from the transverse, and No. 821 from the descending colon; all present enlarged solitary glands ulcerated at their apices, similar to those shown in the plate representing No. 820. These little tumors in No. 819 are smaller, in No. 821 larger, but in both less numerous than those in No. 820.
The plate facing page 306 is reproduced from a photograph of No. 820, which, as just mentioned, is a portion of the transverse colon from this case. The numerous enlarged glands vary from one-tenth to one-fifth of an inch in diameter, and project from the surface as small sessile tumors. The ulcers vary from little circular dot-like depressions to more irregular excavations one-tenth of an inch in diameter. The mucous membrane is nowhere ulcerated or abraded except on the summits of the enlarged glands.
PLATE VII. TRANSVERSE COLON WITH ENLARGED GLANDS ULCERATED AT THEIR APICES. No. 820. MEDICAL SECTION.