Appendicitis : its pathology and surgery . club; small ovoid bacilli in chains of four orfive ; small ovoid bacilli with spores; small irregular groups ofbacteria undergoing irregular fission ; and lastly, some largebacilli with rounded ends. No true spherical bacteria seemto be present. Tubercle is also absent. Thus the appendix is full of actively multiplying intestinalbacilli, which are in contact with the denuded and ulceratedlymphoid tissue. Where the basement membrane of theepithelial lining is intact, they have not penetrated itsinterstices; but where it is destroyed, they have penetrat
Appendicitis : its pathology and surgery . club; small ovoid bacilli in chains of four orfive ; small ovoid bacilli with spores; small irregular groups ofbacteria undergoing irregular fission ; and lastly, some largebacilli with rounded ends. No true spherical bacteria seemto be present. Tubercle is also absent. Thus the appendix is full of actively multiplying intestinalbacilli, which are in contact with the denuded and ulceratedlymphoid tissue. Where the basement membrane of theepithelial lining is intact, they have not penetrated itsinterstices; but where it is destroyed, they have penetrated to v ULCERATION OF THE MUCOSA 49 almost half the depth of the tubular glands. The lymphoidtissue around them is full of granular cells, probably puscorpuscles. Apparently, only one of the several species of bacilliwhich fill the lumen has invaded the mucous largest of the invaders are about 2 /u, long and veryslender; the smallest 1 fx long. The latter are single, inpairs, or in short chains. I find it difficult to say whether. Fig. 10.—Bacteria penetrating the mucosa. x 1000. The lumen ofthe appendix is above. any of the bacteria are cocci, as bacilli, viewed endways, lookso like cocci. I did not see any of the attacks of appendicitis in thiscase. The description of them, however, shows that theywere of the same type as those of another case (Case 30,p. 116), in which the contents of the appendix consisted ofhardly anything else but cocci and streptococci. But when we contrast these two cases more closely, decideddifferences appear. The defects of my method of investigationare also seen as well as the absence of the scientific precision ofexperimental pathology. The clinical symptoms were alike in E 5o APPENDICITIS both cases. In one, the appendix was filled with cocci andfew bacilli; in the other, with bacilli and few if any here the resemblances cease. In one, the appendix wasstenosed, but its epithelium intact; in the other, the appendixwas not steno
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