3-Wing thc- Originals of the Photo relief Cuts. in: Part ILYoII. MedicalHistow, Seep.Xll of that Work. Diagram showing the monthly ratio of the cases of diarrhoea and dysentery among colored troops. — Atlantic Region. Central Region. Year ending June 30, 1864. Year ending June 30, 1865. J?S ?a*/ £ rZ/ I 10000 Fig. 2. Minute vegetable forms from normal feces, X 1900 Uiam. by Powell and Lealand’s l-16th immersion, a, Spherical elements, (Micrococ- cus.) b, Kod-like bodies, (Bacteria.) c, Filaments composed of both the foregoing. 4 FIG 13 —Portion of a perpendicular section through the submucous connective tissue of the ileum in a case of dysentery. Magnified 480 diameters. Copied from a photo-micrograph (Neg. 902, N. S.) of iso. 725(1, Microscopical Section. The lymph spaces are dilated, and lying free in these and adhering to their walls are numerous rounded, granular, nucleated cells, and also a number of smaller granular bodies, (lymphoid elements.) The granules in the lower portion of the piece are micrococcus groups. JW JT.Z^Z, Pig. 14._ Diagram explanatory of the plate facing page 472, representing a perpendicular section of a diphtheritic colon cut transversely. A. Mucous membrane, in which a, a, a, a, are rents made by the razor. B. Muscle of Briicke. C. Thickened submucous connective tissue. 6. b, b, b. Bloodvessels cut across. D. Circular, E. Longitudinal, muscular coat of the intestine. E. Point of entrance of bloodvessels. H. Diphtheritic layer. 7l 77/ - FIG. 15.—Portion of a perpendicular section through the submucous connective tissue of the colon in a case of dysentery. Magnified 175 diameters by Powell & Lealand’s immersion Jth. Copied from a photo-micrograph (Neg. 922, N. S.) of No. 7250, Microscopical Section. The nearly circular vessel to the left and below the centre of the piece is a small artery. The larger elliptical form to the right is a vein. Several smaller vessels are cut across in other parts of the piece. The connective tissue throughout is infiltrated with lymphoid elements. 'VYz irM.r FIG. 16. Portion of a perpendicular section through the eschar in a case of diphtheritic dysentery. Magnified 960 diameters by Powell & Lealand's 2Vth immersion. Copied from a photo micrograph (Keg. 932, N. S.) of No. 7223, Microscopical Section, which is a cut of No. 72, Medical Section. The field is crossed obliquely by a cavity, (the former site of one of the glands of Lieberkiihn.) in which are several micrococcus groups and a number of rod-like forms. The rest of the field is occupied with micrococcus, with a few rod-like elements near the edges of the central cavity. v** r. FIG. 17. Perpendicular section of a diphtheritic colon cut longitudinally. Magnified 22 diameters. Copie4 from a photo-micrograph (Neff. 939 N. S.) of No. 7224, Microscopical Section, which is a out of No. 72, Medical Section. A. Mucous membrane, a part of which, cor- responding to I. has been removed by the separation of a slough. At K, an enlarged solitary follicle. The pseudomembrane layer, which coated the surface of the mucous membrane, has for the most part broken away; on the left of K a little of it still remains, B. Muscle of Briioke. C. Upper portion of the submucous connective tissue infiltrated with lymphoid elements, the size of which is considerably exaggerated in the figure. H. Bower portion of the submucous connective tissue; the dark branching figures constitute the micrococcus network. D. Cir- cular muscular coat of the intestine. E. Longitudinal muscular coat. F. Subperitoneal connective tissue. JLyz '//s JW // z'A/ jrt Fig. 18.—Perpendicular section of a dysenteric colon, showing the micrococcus network in the sub- mucosa. Magnified 475 diameters. Copied from a photo-micrograph (Neg. 947, N. S.) of No. 7269, Microscopical Section, which is a cut of No. 462, Medical Section. The specimen is from case 318. U/6- FIG. 19.—Perpendicular section of a dysenteric colon, showing sloughing of the circular muscular coat. Magnified 70 diameters. Copied from a photo-micrograph (No. 959, N. S.) of No. 7295, Microscopical Section. A. Represents the circular muscular layer which hangs in shreds into the cavity of the intestine. B. Scattered fasciculi of muscular fibre-cells belonging to the longitudinal coat, pushed apart by con- nective tissue infiltrated with lymphoid elements. A similar infiltrated connective tissue may be observed between the fasciculi of the circular muscular coat, especially on the right of the picture. Towards the upper part of the piece several dark oval bodies can be observed near the free extremities of the sloughs. These are the micrococcus nests described in the text; those lettered a, A, are represented as seen with a higher power in the next figure. /Aye ;/;/y ,/w FIG. 20. Micrococcus nests in a slough of the circular muscular coat of the intestine. Magnified 480 diameters by Powell & Lealand’s Jth immersion. Copied from a photo-micro- graph, [No. 960, N. S.] The two nests represented are those marked a, «, in the last figure. 'S '/*- %*** /Z- Z- Fig. 21.—Diagram explanatory of plate facing page 480. A. Mucous membrane, a, a. Adhe- rent pseudomembrane. B. Muscle of Briicke. O. Submucous connective tissue, b, b. b. Blood- vessels cut across. D, D. Circular, E, E. Longitudinal muscular coat. F. Subperitoneal con- nective tissue. 11. Follicular ulcer. I. Superficial diphtheritic ulcer. K. Deep diphtheritic ulcer. /r. FIG. 22.—Perpendicular section through a cyst of the colon. Magnified 25 diameters by Beck’s 3-inch. Copied from a photo-micrograph (Neg. 9G5, N. S.) of No. 7272, Microscopical Section. A, is the point at which the contents of the cyst become continuous with the lower portion of the glands of Lieberktihn. B. Glue-like mass filling the greater part of the cyst; the action of alcohol has caused it in many places to shrink away from the cyst-walls. C. Mucosa. D. Muscle of Briicke. E. Submucous connective tissue infiltrated, especially in the neighborhood of the muscle of Briicke and in the course of the venous radicles, with swarms of lymphoid cells. F. Circular muscular coat of the colon. G. Longitudinal muscular coat; on the right the edge of one of the ligamenta coli. H. Subperitoneal connective tissue. S' ys Z/crS, 2- ~ Fjg 23 View of part of the region marked Ain the section represented in the last figure, showing dilated and distorted gland tubules lined by a columnar epithelium similar to that of the glands of LieberkUhn. Magnified 200 diameters by Powell & Zealand’s i immersion. Copied from a photo- micrograph, (Neg. 940, N. S.) The space between the gland tubules is filled with a granular tissue densely infiltrated with lymphoid cells.. The delicate granular substance in the interior of the dilated tubules, in which lymphoid elements are less numerously scattered, closely resembles the substance described in the text as filling the greater part of the cyst. S6'S, ZZ, TZo-Z 21, FIG. 24.—Outline of a perpendicular section through three cysts of the colon, n^Sub- of No. 7216, Microscopical Section, (colon of case 173.) Magnified 20 diameters. A. Mucosa. B. Muscle of mucosa- b b, b, b, bloodvessels cut across. D. Circular muscle of the intestine. E. Longitudinal muscle. 1. Subpentoneal connective tissue. H, H, H. The three cysts described in the text. OS's: -ZZT- Fig. £5. Diagram explanatory of the plate facing page sf>B. A. Mucous membrane. B. Muscle of Brticke. C. Submucous connective tissue ; b, b, b, distended bloodvessels cut across. B. Circular, E. longitudinal, muscular coat; the latter, on the right, passes through one of the hgamenta cob. F. Subperitoneal connective tissue. H, H. Nearly normal solitary glands. I. Solitary gland en- larged and ulcerated at its apex. sty, &<***> //. M. Fig. 26.—Diagram explanatory of the plate facing p. 570. A. Mucous mem- brane ; a. a, a, a. glands of Lieberkiihn. B. Muscle of Brttcke. C. Submucous connective tissue infiltrated, especially near the muscle of Brttcke, wi i y P elements; b. b, b, b, bloodvessels cut across filled with coagula. D. Circular B, longitudinal, coat of the intestine ; in the latter, on the right, the cut passes through one of the ligamenta coli. F. Subpintoneal connective tissue. Lr. Peritoneal epithelium. H. H. Two solitary follicles. <568, tAxyJ' Fjg 27.—Diagram explanatbry of the plate facing page 572. A. Mucous mem- brane: a, a, a, a, glands of Lieberkiihn pushed apart by the lymphoid swarm in the adenoid tissue of the mucous membrane. B. Muscle of Brttcke. C. Submu- cous connective tissue; b, b. 6, 6, bloodvessels cut across; c c, lymph sinuses be- neath the enlarged solitary follicle. D. Circular. B, longitudinal, muscular coati of the intestine; their arrangement shows the cut to have been a longitudinal one. F. Subperitoneal connective tissue, which, in the right of the plate, passes into the mesocolon; in the latter some bloodvessels, b, b, 6, are seen cut across. H. Bnlargeu and ulcerated solitary gland. sty -zc Pin. “M.—Perpendicular section of tho colon of a child, cat longitudinally. Magnified 100 diameters by Powell and Lealand’s £ inch objective. Copied from a photo-micrograph, (Neg. 925, N. S.) A. Macons membrane. I?. Muscle of Brttcke. C. Submucous connective tissue. In the centre of the piece, below D, is an enlarged solitary gland ulcerated at its apex, and showing cystic forms in its deeper part. Paxte, SJO IT /T FlS.‘29.—Perpendicular section through a follicular ulcer of the colon. Magnified 57 diameters. Copied from a photo-micrograph, (Neg. t)64 of No. 7291, Microscopical Section, N. S.) A. Mucous membrane, its surface partly destroyed by ulceration.' B. Muscle of Briicke. C. Submucous con- nective tissue much infiltrated with lymphoid elements. D. Cavity of follicular ulcer; a, a, a. a, gland tubules and cystic forms derived from the outgrowth of the glands of Lieberktihn. See p. 570. S// ;/**/. V /; Fig. 30.—Perpendicular section through a portion of No. 684, Microscopical Section, showing a follicular ulcer of the colon; from a photo-micrograph, (Iseg. 912, S.) Ihe scale is in TJ-5 and xSW of an inch. See p. 571. JJJZ, ZT, ZK4.JT, 1 100 PIG 31 —Diagram explanatory of the plate facing page 574 A. Mucous membrane; a, a, glands of Lioberkilhn pushed apart by the infiltration of the adenoid tissue with Ivmnhoid elements. B. Muscle of Briicko. C. Submucous connective tissue, (i, 5, 5, dis- tended bloodvessels cut across; c, lymph sinus. D. Circular, E, longitudinal, of the muscular coat of the intestine. F. Subperitoneal connective tissue. If. C^*t^of r~o ulcer. I. Solitary follicle at the apex of which ulceration has just commenced. Seep. ~. SJ3 %*** ZT7M..X. PIG. 32. Perpendicular section of the colon from case 310, showing a small superficial ulcer H, H, in the centre of which an intact solitary follicle, I, protrudes as a minute nipple-Uke elevation. Halt- diagrammatic drawing from a photograph (Neg. 563, N. S.) of No. 666, Microscopical Section. Magni- diameters. A. Mucous membrane. B. Muscle of Briioke. C. Submucous connective tissue; ft ft. ft, small veins cut across. D. Circular, E, longitudinal, muscular coats of the intestine; these are divided by the entrance of an artery, a, from the mesocolon, which is accompanied by a vein ot con- siderable size and surrounded with connective tissue. 3Lr 5= vS. c pI(; 33 Tubercular girdle-sore, natural size. From a photograph of No. 439, Medical Section, Army Medical ! Museum. (Case 413.) See p. 584. JU** SfJ. ft** & FIG. 34.—A number of small tubercular ulcers in a very slightly thickened Peyer’s patch, natural size. From a photograph of No. 430, Medi- cal Section, Army Med. Mu- seum. Sffy/ 2f. / ; FIG. 35.—Tubercular ulcer of the caecum, natural size. From a photograph of No. 431, Medical Section, Army Medical Museum. SB¥-. // /. Fig. 36.—Tubercular ulcers of the ileum, natural size. From a photograph of No. 77G, Medical Section, Army Medical Museum. PIG. 37.—Perpendicular section through a small tubercular ulcer of the ileum. Magnified 15 diameters. Prom a photo-micrograph [Keg. 978, N. S.l of No. 7540, Microscopical Section, from case 413. A. The mucous membrane, with its tubular glands pushed apart by the accumulation of lymphoid elements; its villi greatly hypertrophied. B. The muscle of Briickc. C. Submucous connective tissue infiltrated with lymphoid elements, containing a number of tubercles in various stages; its bloodvessels dilated. D. Circular muscular coat cf the intestine. E. Longitudinal muscular coat, F. Pcritonmum. IT. Cavity, of the ulcer, f, t, t. t, t. IJnsoftencd tubercles. The two letters below the lower edge point to tubercles, in the centres of which peculiar oval forms are seen, (lymphatic vessels cut across? giant-cells?) the nature of which will be discussed further on. T hero are besides several unsoftonod tubercles which are not lettered. V, t\ t\ V. Tubercles' with central softening in which part of the cheesy mass has fallen out. t", i". Softened tubercles whose cavities form part of the ulcer. Ja ae, <5~87. Zf. A FIG. 38.—Perpendicular section cut transversely through the edge of a tubercular girdle-sore of the ileum, from a photo-micrograpn lin eg. via, N. S.l of No. 7519, Microscopical Section. A. Mucous membrane; its tubular glands pushed apart by an accumulation of Ij-raphoid elements in the adenoid tissue; its villi hypertrophied, but most of them accidentally broken off in making the section. B. The muscle of Bruoke. C. Submucous connective tissue, infiltrated with lymphoid elements, especially in the vicinity of the muscle of Briicke and near the edges of the ulcer; its bloodvessels dilated; it contains also a number‘of tubercles. D. Circular muscular coat of the intestine. E. Longitudinal muscular coat. 1. bubperitoneal con- nective tissue, much thickened, and containing tubercles. 1.1, t, t, t, t. Tubercles; there are also several not lettered; near the centre ot the lower edge of the section five tubercles grouped together form a compound one. i', t', V. Softened tubercles from whose interior the cheesy mass has dropped ou in making the section, t". A tubercle containing one of the peculiar bodies alluded to in the description of Fig. 37. V . A tubercle in the substance of which a vascular loop (arteriole ?) can be clearly seen. Such vessels ultimately cease to be permeable. Magnified 20 diameters. -6 88