Report on Dermatology

James C. White
1874 Boston Medical and Surgical Journal  
Heft, from Deutsch. Arch, f. klin. Med.)-Heller reports the results of the dissection of a case of Bclcroderma, which proved fatal after a year's duration, under symptoms of general anaemia and ascites. There were found extensive scleroderma of the face, neck, chest and upper abdominal region ; fibroid nodules and lymphangiectases in tho subcutaneous tissue ; obliteration of tho ductus thoracicus ; múltiplo diffuse and miliary newgrowths in the heart, muscles, serous membranes, kidneys and
more » ... s, kidneys and other parts ; oedema of the lungs ; incipient cirrhosis of the liver ; induration of the spleen ; hyporplasy of the uterus ; hypertrophy of the walls of the stomach ; induration of Peyer's patches ; and atrophy of the mesentery. A microscopic examination of the nodules from these various sources showed that they consisted of firm, fibrous tissue and a peculiar cell infiltration. They interrupted the course of the lymph-vessels, with which the collections of cells seemed intimately connected, and upon tho serous membranes the new-growths showed a similar relation to the lymphangiectases. Heller concludes, as the result of his investigations, that scleroderma is an affection occurring in the lymph system, and that, in this case, its starting-point was the ductus thoracicus, as this was most changed. Through disturbances in the lymph-vessels, an escape of lymph is caused, which leads to the connective new-formation of fibrous tissue, analogous to tho proceas in elephantiasis Arabum.
doi:10.1056/nejm187412100912403 fatcat:6siecn5dgfatfoupsrb4nwj54e