glands and the spleen the same changes may be seen in the blood-vessels as are seen in the medulla. (d) In myelogenic leukæmia it is rarer than in the lymphatic form to find nodules of myeloid tissue outside the hæmopoietic and lymphopoietic organs; nevertheless he has seen them between the glands in the connective tissue and a diffuse myeloid infiltration of the serosa of the stomach and intestine. Banti thinks that the medulla is the primary seat of the disease, but he cannot exclude the possibility of a splenic origin in some cases. The secondary myeloid foci are metastatic, the cells being carried by the blood-stream. Against the generally accepted theory that the process is due to a hyperplasia of the myeloid tissue are, among others, the following arguments: -The myeloid tissue wherever found shows a more or less atypical structure when compared with the normal medulla; it invades the vessel walls, especially that of the veins, and destroys the endothelium and gets into direct contact with the blood; the tissue also gives rise to blood and lymphatic metastases which behave as those from malignant growths; the cells of the organs in which the metastases are do not take part in the formation of the secondary nodules; the rarefaction and condensation of bone and the infiltration of the periosteal and parosteal tissues are all seen in the sarcoma. The white mono-nucleated cells circulating in the blood (myelocytes of Ehrlich) often show atypical characters when compared with the normal medulla. Just as there exists a lymphatic pseudo-leukæmia so there exists a myeloid pseudo-leukæmia characterised by a more or less intense anæmia, by the presence in the blood of a number of mononucleated cells having the characters of the myelocytes of Ehrlich. The total number of the white cells is almost normal; sometimes gradually, at other times rapidly, the blood acquires the typical characters of myelogenic leukæmia. Splenomegaly is sometimes present, and is sometimes absent during the pre-leukæmic period. Banti has not been able to find any infective agent, but he believes that the diseases belong to the group of infective diseases whether the specific pathogenic agent is animal or vegetable. PRIESTLEY LEECH. PARODI (UMBERTO). On the Grafting of Fatal Suprarenal Capsule. Lo Sperimentale Arch. d. Biol. Norm. a Path., Anno 58, Fasc. 1. Ar the commencement of the account of his own experiments Dr. Parodi points out that previous observers, with the exception of Galeotti, have dealt mainly with the adult organ when attempting to ingraft suprarenal capsule, and his resumé of the work of previous observers makes it evident that, from a practical point of view, the results hitherto obtained are not satisfactory, for it is not certain either that the transplanted capsule will remain and retain its individuality for any length of time, or that, during the period it remains, it is capable of preventing the death of the animal into which the transplantation has been made if the suprarenal capsules of the latter are removed. Different observers have obtained opposite results with regard to both points of the research, and the question still remains undecided, for Dr. Parodi's observations deal only with the possibility of transplanting foetal suprarenal capsule. His experiments were made upon rabbits, and segments of foetal suprarenal tissues were transplanted into wounds in the kidneys, liver and sciatic nerve. Foetal tissues were chosen because the experiments of Leopold, Zahn, and others, had previously shown that foetal tissues have a greater power than adult tissues of adapting themselves to altered circumstances. The conclusions which Dr. Parodi arrives at from the results of his experiments are that (1) transplanted portions of foetal suprarenal capsule only attain a partial connection with the tissues into which they have been transplanted, the cortical portion of the capsule becoming adherent to its surroundings over the greater part of its surface, whilst the medullary portion remains unattached; (2) till the sixth day karyokinetic movements occur in the cells of the capsule in the usual way, and they continue, but with less intensity, till the fiftieth day; (3) the transplanted capsule attains to a certain grade of development, but after a time it is invaded and destroyed by the surrounding connective tissue; (4) the transplanted capsule maintains itself for a longer time. when embedded in a younger tissue than it does when embedded in an older tissue; (5) speaking generally, the results obtained are the same whether the capsule is embedded in the kidney, the liver or the sciatic nerve. ARTHUR ROBINSON. PEARCE (R. M.). Development of the Islands of Langerhans. Univ. of Pennsylvania Med. Bulletin, 1903, xvi. EXAMINATIONS of the pancreas in 21 human embryos show the islands at first as small rounded masses of differentiated cells with granular acidophile protoplasm lying in direct continuity with the cells of the glandular tubules. Later, the connection is by a stalk-like, solid process of cells. Complete separation is apparently due to the pressure of the investing connective tissue. Vascularisation of the islands is complete by the time they have become isolated. Later the cells of the islands become arranged in columns and a fine reticulum appears between these. The further development of the pancreatic acini results in the islands becoming surrounded and intra-lobular in distribution. In congenital syphilitic pancreatitis the islands still remain attached to the pancreatic acini by the solid processes, an arrest of development due to the extensive interstitial proliferative changes. RAVENEL (M. P.). Passage of Tubercle Bacilli through the Normal To ten healthy dogs a purge of castor oil was given; they were then starved for 24 hours, and to each a single dose of an emulsion made of equal parts of melted butter and warm water, containing a large number of tubercle bacilli, rubbed into a smooth paste, was administered by the stomach tube. Three and a half to four hours later the dog was killed, and as much chyle as possible collected together with the mesenteric glands. With this material guinea-pigs were inoculated intra-peritoneally. The entire intestine was then carefully examined after washing it out, and in two cases micro-sections were made from several portions of the gut. In no instance could any lesion be detected. The guinea-pigs inoculated gave positive results with the material from eight of the ten dogs. These results warrant the conclusion that under certain conditions tubercle bacilli pass through the normal intestinal wall with great facility and rapidity. The most favourable condition appears to be the digestion of food made up largely of fat. F. CRAVEN MOORE. CAPPS (J. A.). A Study of Volume Index: Observations upon the Volume of Erythrocytes in Various Disease Conditions. Journ. of Med. Research, 1903. Vol. x., p. 367. VOLUME index designates the volume of the erythrocytes relative to the normal. It is best determined by the combined use of the centrifuge and the hæmocytometer. In pernicious anæmia the volume index is increased more constantly and usually to a greater measure than the hæmoglobin index. Cases of secondary anæmia of moderate degree show only a slight loss in cell volume, of high degree a marked loss. In a large proportion of cases of chlorosis the cell volume suffers as well as the hæmoglobin, although always to a less extent. The volume index is of great prognostic significance. Cases with normal or nearly normal. volume index recover quickly even if the Hb is much deficient. Those with a low volume index respond slowly to treatment and make a tedious convalescence. In all forms of anæmia the colour loss is greater and obtains more rapidly than the loss in volume. During recovery the volume is restored before the Hb index reaches the normal. The Hb content of a normal erythrocyte, as indicated by a colour and volume index of 100, represents the point of saturation of the protoplasm. When the colour index rises about above 100 it implies a corresponding increase in the cell volume. Supersaturation of the cell protoplasm with Hb probably does not obtain. The cell may, however, lose Hb without necessarily losing volume. Cell volume apparently is chiefly altered by influences affecting cell growth or degeneration. The large erythrocytes of pernicious anæmia are probably young cells. Small cells may result from a malnutrition of the bone marrow as in chlorosis or from an actual degeneration as in sepsis. The cell volume suffers very little change from osmotic influences. Dropsy, cyanosis, the hydræmia following acute hæmorrhage and jaundice do not materially alter the volume of the cells. F. CRAVEN MOORE. MALLORY (F. B.). An Undescribed Fibrillar Substance Produced by Connective Tissue Cells. Journ. of Med. Research, 1903. Vol. x., p. 334. CONNECTIVE tissue cells produce, in addition to elastic fibres and the ordinary intercellular fibrils, a third variety of fibrils (fibroglia fibrils), which differ from them chemically and morphologically, and which have apparently the same staining properties as the coarse differentially staining (myoglia) fibrils of smooth-muscle cells. The fibroglia fibrils bear the same relation to connective tissue cells that neuroglia fibrils bear to neuroglia cells. They are present in great numbers in all actively growing connective tissue, both of inflammatory and of neoplastic origin. They are scanty in normal tissues; they appear to form the true basement membrane of the renal tubules, of the sweat glands and of the glands and ducts of the mamma. They also occur in abundance beneath the endothelium lining arteries and the larger veins. WOLBACH (S. B.) and ERNST (H. C.). Observations on the Morphology of Bacillus Tuberculosus from Human and Bovine Sources. Journ. of Med. Research, 1903. Vol. x., p. 313. THE writers have studied the well-known morphological variability of the tubercle bacillus in its relation to culture media, and have found that change of culture media induces marked changes in morphology, that for each medium the morphological characteristics of the fullydeveloped culture are fairly constant, but by no means fixed, for after cultivation through several generations on any medium the change in form following transference to another medium is just as prompt as when the first generation itself is so transferred. The explanation of these changes does not lie with the suitability or the reaction of the medium, since media of identical reaction and equal suitability yield cultures of diverse morphology. The greatest variations in form and staining reaction are found in rapidly growing cultures. These results the writers interpret as manifestations of the pleomorphism of the tubercle bacillus, which accordingly should be classed with the higher bacteria. F. CRAVEN MOORE. PATON (NOËL) and GOODALL (ALEXANDER). The Thymus Gland. Journal of Physiology, 1904. Vol. xxxi., p. 49. IN guinea-pigs the thymus increases in size until the animal is two months old, viz., when the animal is capable of reproduction, and it then begins to degenerate. The removal of the thymus at birth does. not interfere with the growth of the animal, produces no change in the number or characters of the red blood corpuscles, but is accompanied by a slight decrease in the number of leucocytes, all the varities sharing equally. When the animals from which the thymus has been removed become pregnant there is a normal leucocytosis; similarly, the production of tuberculosis shows the same increase or altered proportion of leucocytes as is manifested by animals with the gland intact. The injection of both cultures of staphylococci and streptococci is not followed, however, by the marked leucocytosis which appears after similar injections into normal guinea-pigs. The thymus-less animals were also less resistant to the toxins of staphylococci and streptococci, although their resistance to diphtheria toxin was undiminished. WALKER HALL. MERRINS (E. M.). Pathology of Osteo-Arthritis. Medical News, 1904, p. 152. IN a recent paper on the relation of articular rheumatism to other arthritic affections, Predtetscheusky enumerates no less than sixteen varieties of joint disease. Such elaborate classifications are not desirable; efforts should be rather made towards simplicity and unification. Osteo-arthritis is largely a secondary affection, and if it could be always so regarded and linked with the primary condition of disease or injury, the classification of joint diseases would become intelligible and orderly. The conditions associated with osteo-arthritis may be conveniently divided into those arising from infective or toxic causes, those due to nutritional changes and those resulting from trauma. 1. Infective or Toxic Diseases. The characteristic lesions of osteoarthritis occur in the course of locomotor ataxia, tuberculosis, leprosy, syphilis, gonorrhoea, rheumatism, gout, rheumatoid arthritis and in syringo-myelia. They are also found in cases of chronic gastrointestinal lesions, particularly in the form of Heberden's nodes, in uterine disease and in chronic pulmonary affections. As the osteoarthritis is simply the terminal expression of the original disease, it' is well to specify such disease. Hence under this head we may consider (a) Rheumatic osteo-arthritis-really the terminal stage of acute and subacute articular rheumatism which follows in cases in which the joints have not regained their vitality, and which progresses to fibrous thickening of the synovial membrane and cartilage and to the formation. of osteophytes. (b) Gouty osteo-arthritis. Osteophytes often appear in gouty joints, and may perhaps be due to the retention of the increased amount of phosphorus liberated by the decomposition of endogenous nucleins, since the prolonged administration of small doses of phosphorus to animals induces a very marked hyperplasia of bone. (c) Rheumatoid osteo-arthritis. This is not a very desirable designation, but its meaning is perhaps sufficiently clear, in that it indicates that osteoarthritis may follow rheumatoid arthritis, simply as the effect of the lingering irritation of the tissues of the joints by the toxins of the primary disease from which only an imperfect recovery has occurred. 2. Nutritional. Imperfect or perverted nutrition will account for certain hypertrophic affections of joints. Changes in the pituitary body |