페이지 이미지
PDF
ePub

the result of recent research has been to show, that while a general analogy in the constitution of the ova of animals may be admitted, the deviations from a common type are such as to render it inexpedient to insist, in the meantime, upon a complete homology of the component parts. Thus, the general relations of germ-cell, vitelline substance, and vitelline membrane, are the same in most animals; but, to say nothing of differences in the first of these parts and its macula, it is apparent from what has been previously stated, that the vitelline substance is of two kinds at least in animals, viz., the primitive, finely granular, or formative; and the secondary, largely cellular, or nutritive yolk'; and the vitelline membrane is either a primary zona or membranous condensation of the outer part of the primitive yolk substance, or it is formed secondarily outside the nutritive yolk from the external layer of the granular cells of the ovarian follicle. I am glad to have in support of this view similar opinions from Professor Owen privately communicated to me.

Description of the figures in the Plate. Fig. 1. Early condition of the ovum in the ovarian follicle of a bird or mammal; f, wall of the primitive follicle (ovisac of M. Barry); c, cells which line it, forining afterwards membrana granulosa, etc. ; 9, germinal vesicle or germcell, with a single macula or nucleus ; y, primitive yolk substance, consisting of small highly-refracting granules round the germinal vesicle, and deposited in a clear gelatinous matter.

Fig. 2. A somewhat more advanced stage in the bird_about so in diameter; y, granular or primitive yolk substance increased in quantity, and collected into a globular form ; 2, clear external portion, bounded by a dotted line, indicating its outer surface, which afterwards becomes consolidated into the zona pellucida, or covering of the primitive ovum; y, the germinal vesicle ; its macula now become subdivided.

Fig. 3. Ovarian ovum of the fowl in its ovi-capsule, about zo" in diameter; 0, substance of the ovary; f, inner surface of the ovarian follicle ; c, the nucleated cells of the follicle, become prismatic, surrounding completely the primitive ovum; at c', a part of these cells is represented as they are seen when brought into focus over the ovum ; elsewhere they are represented only in profile, or as in a section ; y, finely granular primitive yolk substance; z, zona or primitive vitelline membrane, which is of temporary existence in the bird, but permanent in the mammal; I, germinal vesicle.

Fig. 4. Small portion of the ovarian ovum of the fowl from near the surface, diameter of the ovum about 10"; y, the primitive or finely granular yolk substance, which is still in the form of a spherical mass, and encloses the germinal vesicle ; x, the zona pellucida or primitive vitelline membrane, analogous to that of the mammiferous ovum, but not presenting the same clearness nor consistence; c,c, the prismatic cells of the ovarian follicle seen in profile ; c', a small portion of the same seen endways on the surface ; at cc' this layer is partially drawn off from the surface of the zona; m, v, a thin clear film visible on the outer surface of the prismatic cells, in the place afterwards occupied by the secondary or outer vitelline membrane.

Figs. 5 and 6 are diagrammatic views in section of the ovarian capsules, etc. in the bird and mammal near the stage of maturity, intended to show the relation of position of the parts to each other, but without any attempt to represent the true relative size of the parts.

Fig. 5. Bird ; 0, ovarian capsule at its pedicle ; f, the wall of the ovarian fol. licle; m, v, secondary or permanent vitelline membrane ; c, layer of prismatic cells covering the germ and yolk, now proportionally much expanded and sur• rounding cry, the large mass of the cellular or nutritive yolk; y,9, germinal

vesicle in the vitelline disc (formative yolk), or remains of the primitive ovum.

Fig. 6. Portion of the ovary of a mammal ; o, ovarian substance; f, inner surface of the ovarian follicle ; c, the cells of the membrana granulosa; l, the fluid of the follicle ; 7,4, , the ovum with zona, granular (or formative) yolk substance and gerininal vesicle; l', a less advanced follicle and ovum.

ARTICLE II.—Notes of Hospital Practice. By John Hughes

BENNETT, M.D., F.R.S.E., Professor of the Institutes of Medicine, and of Clinical Medicine, in the University of Edinburgh.

EXPULSION OF THE TENIA SOLIUM BY THE (

ETIERIAL EXTRACT OF THE MALE SHIELD FERN.

Of all the vermifuge remedies proposed for the expulsion of tapeworm, I have found the ætherial extract of the male shield fern the most effectual. That it readily dislodges large masses of the parasite, has been witnessed by all who have tried it, although in every instance it has not succeeded in permanently preventing a return. In the following case it seems, at all events for a time, to have been most effectual :

Catherine Watt, æt. 25, married, with children, admitted into the clinical ward November 20th, 1854. She has always enjoyed good health, until three years ago, when joints of tape-worm passed from her involuntarily when out working, and they have continued to pass from her involuntarily, and sometimes in large quantities by stool ever since. On one occasion she passed blood at stool, with portions of tape-worm. Has taken various kinds of medicine, but, with the exception of turpentine, does not know what they were. They have all been ineffectual. On adinission, complained of tenderness in the left iliac region, and of tenesms when at stool ; but, with the further exception of the frequent passage of joints of tape-worm, the functions of the body were performed with regularity. She was ordered Jij of the ætherial extract of the male shield fern, to be followed in the morning by zj of castor oil. This caused the evacuation of seven joints of the worm, each of which were longer than they were broad. Another Oj dose of the extract were ordered at night, also to be followed by zj of castor oil in the morning. Nov. 22.-Only three joints of the worm passed. To have this evening 5ss. of the extract. Nov. 23.—This morning, after taking the oz. dose of castor oil, she passed many separate joints, and several long portions of tonia. The whole together, when measured, was calculated to be about fifteen yards long. One portion was evidently formed of the joints of the worm near the head, as they were broader than they were long, and not above the tenth of an inch in breadth. Some joints were square, and others longer than they were broad, measuring from half an inch to three quarters of an inch in length. No head could be discovered, though carefully searched after. She remained in the house till the 6th of December ; but although she took 3ss. of the extract three times, and one dose of Pij, no more joints of the worm came away. This woman has returned to the hospital, twice since her dismissal, to say that she is quite well.

In the last volume of this Journal, p. 35, Dr Paterson of Tiverton has recorded three cases of tape-worm, which resisted the action of the male shield fern, of the kousso, and of turpentine. It would

be interesting to ascertain whether the parasite is more common in Devonshire than it is in Scotland. In Devon, pork is a very common article of diet, whilst in Scotland certainly it is not much employed as food. I carefully interrogated the woman, whose case is given above, as to whether she had eaten pork, and she admitted, that about the time the disease commenced, her husband being out of work, her diet had been very poor, had consisted in some measure of salt pork, and occasionally of rabbits. Whether the cysticercus cellulose, commonly found in the flesh of pigs, could have retained its vitality in the salt pork eaten by this woman, cannot of course be stated with certainty. But it is worthy of remark, that the flesh of pork is frequently sold cheap to the lower orders, after it has been laid in brine for a very short period, so that the tenacious vitality of these cysticerci, or of the ova of toniæ, is by no means necessarily destroyed. Then rabbits are known to be very commonly infested with cysticerci, so that her indulgence in either kind of animal food may have been the means of introducing tæniæ into the economy.

The recent observations of Siebold, Van Benedin, Nelson, Kuchenmeister, and others,'have now satisfactorily shown that the ova of tape. worms, often find their way into the alimentary canal of various animals, and are, in the different tissues of their bodies, converted into cystic worms. Those, existing in the blood and flesh of such animals as are used for the food of man, are, in his alimentary canal further transformed into taniæ. Thus the flesh of sheep, pigs, or rabbits, and perhaps the water of certain pools to which infected animals have access, may be made the medium of conveying toniæ, in an early stage of development, into the human intestines. In future, therefore, the observations of medical men should be more particularly directed to the food and drink of their patients, so as to cut off the origin of the disease. Is it not possible that in such cases as have been recorded by Dr Paterson, where the patients, after taking vermifuge remedies, enjoyed immunity for several months, that an indulgence in pork may have caused a re-introduction of casticerei, and a new formation of tape-worms? This is a point which, in pork-eating counties, such as Devonshire, seems to me worthy ol! further investigation. Should this supposition prove correct, it would explain the fact, that whilst, in the experience of Dr Paterson, the worm is difficult to eradicate—in Scotland, according to the observations of Dr Christison, and of myself, the oleo-resin of the male shield fern is more effectual in its operation.

EPILEPTIC CONVULSIONS—HEMIPLEGIA OF THE RIGHT SIDE-LOS

OF SMELL-BLINDNESS OF THE LEFT EYE-AMYLOID BOD IES 15 THE BRAIN.

John Bookless, æt. 48, a plasterer, admitted January 7, 1855. He

has

1 Monthly Journal, June 1852, p. 561.

joyed good health until two years ago, when he first complained of giddiness and gradual impairment of sight, and of smell. Twelve months ago he was attacked with "fits,” three or four appearing in the course of the first night. They have occurred occasionally, at considerable but irregular intervals, ever since. His general health has reinained good, until the 3d instant, when, about 12 o'clock at night, a violent “fit” appeared, which was repeated from eighteen to twenty times before six o'clock on the following morning. On the 4th and 5th he was comparatively free from them ; but, on the 6th, during the night, they recurred more frequently. On the morning of the 7th, it was observed that the right arm and leg were paralyzed, and he was sent into the Infirmary.

On admission, it was observed that the body was tolerably robust ; that he was hemiplegic on the right side ; that the head was obstinately kept turned towards the right side ; that speech was slow and thick; and that although conscious, he was some time in framing an answer to a question. To have 3j of castor oil. Careful investigation on the following day elicited the following facts, viz., complete blindness of the left eye-sight in the right eye perfect smell absent-cephalalgia-frequently applies his left hand to the left side of the head-other special senses normal-loss of voluntary motion over right side, with considerable impairment, but not absence of sensibility-left side normalpulse 96, full- other functions healthy. Bowels have been freely open, from the action of the castor oil. Whilst I was examining the patient he passed through two attacks of an epileptic character—there was no scream, only a slight groan--the muscles of all the limbs became rigid—the toes and fingers incurvated-the face flushed, and the head tetanically twisted towards the right side--the mouth was drawn somewhat to the left—the left arm and leg convulsed, the right arm and leg rigid and trembling—there was complete loss of consciousness. This state continued about one minute, when the face becawe pale, there was foaming at the mouth, the rigidity and convulsions subsided, and in another minute he was again conscious and fully restored to his former condition. To be cupped in the neck to the extent of 8 oz.-ice to be applied to the head. From this period he lay, in the intervals of the attacks, tolerably tranquil—the evacuations were passed involuntarily--took nourishment without difficulty. The whole of the 12th was free from convulsive attacks, but on the 13th they returned-pulse 106, soft. A blister to the neck, and ziv of wine. On the 14th the epileptic attacks returned every ten minutes, until 1 o'clock in the morning of the 15th. From this time he remained free from them. At the visit he was still conscious, slowly answered questions, put out his tongue, etc. The respirations, however, were slightly laboured, and gradually became more so, until he sank, at 9 p.m., on the 16th.

Sectio Cadaveris, January 17.-On removing the calvarium, the subarachnoid cellular tissue was infiltrated with serum, which elevated the arachnoid in some places above the level of the convolutions. On slicing the brain from above downwards, its substance was healthy. Both lateral ventricles were distended with clear seruin, which, on being carefully removed with a pipette, measured 1 oz, and 7 drachms. The ventricles were somewhat enlarged, but their lining walls healthy. The foramen of Monro was the size of a fourpenny piece, its edges very thin. White substance of the fornix and central portion of the brain healthy. The left corpus striatum atrophied and shrunk throughout, externally of a dull mahogany colour, and, on section, composed of a diffluent fawn-coloured substance, which flowed out, leaving an irregular cavity the size of a hazel nut. Below the left corpus striatum, the optic thalamus presented, on section, a cribiform appearance, over a space the size of a shilling, dependent on chronic enlargement and thickening of small vessels, the open mouths of which, on being cut, were retracted into its substance. In the anterior portion of the right corpus striatum there was also a diffluent softening, Occupying a space ahout the size of a pea. On removing the cerebral lobes from the cranium, a dense chronic adhesion, which it was necessary to cut through, existed between the inferior surface of the left anterior lobe and the dura mater, which involved the optic and olfactory nerves of that side, and extended so far on the right side as to include also the right olfactory nerve. The portion of brain in immediate connection with this adhesion was unusually indurated to the feel, throughout a portion of substance in the left lobe, about the size of a nutmeg ; but, in the right, confined to a thin layer of cerebral substance externally, about an eighth of an inch in thickness, and about the size of a shilling in its area. On cutting through the indurated substance on the left side, it felt like soft bees-wax under the knife, was of a very pale straw colour, gradually disappearing, as did the induration into the healthy structure, without any obvious limit whatever. About another oz. of sanguineous serum was found collected in the depending portions of the cranial cavity after the brain was removed. The other portions of the brain were healthy.

Thoracic and abdominal viscera healthy.

Microscopic Examination.— The fawn-coloured softenings in the corpora striata consisted of numerous molecules, granules, granular masses, and cells, mingled with vessels coated with granular exudation, and fragments of the tubes of the cerebral substance. In and around the cribiform alteration of the left optic thalamus, numerous round colourless transparent bodies were obseryed, which refracted light strongly, and were apparently solid. They varied in size, from the dogth to the oth of an inch in diameter. Some contained an included globular body, around which faint concentric circles were discernible. On the addition of diluted sulphuric acid and iodine, they did not give the reaction of starch or cellulose. They were unaffected by water, acetic and nitrie acids. Here and there they seemed to split up, not unlike starch bodies. The indurated portion of brain in the anterior lobes presented an obscure amorphous appearance, consisting apparently of the normal elements, infiltrated with a brownish, exceedingly fine, molecular substance. The serum of the ventricles only contained a few epithelial cells, distended with water by endosmose.

The symptoms observed during the life of this man were all clearly explained by the morbid changes demonstrated after death. Before the post-mortem examination took place, I ventured to diagnose chronic softening of the left corpus striatum, with a tumour so situated below it as to press upon the left optic nerve, and both olfactory nerves. Such were the principal lesions discovered, as the indurated brain and dense adhesion may in one sense be looked upon as a tumour, producing the destruction of the special nerves, whilst the extensive lesion of the left corpus striatum sufficiently explained the hemiplegia on the right side of the body. Two other lesions, however, were discovered, viz., 1st, The limited disease in the right striated body; and, 2dly, The effusion of serum into the lateral ventricles and subarachnoid cavity. To the first of these lesions may probably be ascribed the convulsions which more especially attacked the left side of the body, although alone this would be insufficient to account for its paroxysmal character,-a phenomenon which I have elsewhere endeavoured to explain, can only be referred to congestions within the cranium. As to the effusion of serum, I am inclined to consider it as having occurred during the last few hours of life ;-lst, Because he was conscious within twelve hours of his death, and was free from delirium and stupor; 2dly, Because, after death, little im- ;

See Articles by the writer on Apoplexy, Epilepsy, etc., in the second volume of the Library of Medicine.

« 이전계속 »