ORGANIZATION OF HYGIENIC LABORATORY. RUPERT BLUE, Surgeon General, United States Public Health Service. ADVISORY BOARD. Maj. Eugene R. Whitmore, Medical Corps, United States Army; Medical Inspector E. R. Stitt, United States Navy; Dr. A. D. Melvin, chief of United States Bureau of Animal Industry; and George W. McCoy, United States Public Health Service, ex officio. Prof. William H. Welch, Johns Hopkins University, Baltimore, Md.; Prof. Simon Flexner, Rockefeller Institute for Medical Research, New York; Prof. Victor C. Vaughan, University of Michigan, Ann Arbor, Mich.; Prof. William T. Sedgwick, Massachusetts Institute of Technology, Boston, Mass.; Prof. M. P. Ravenel, University of Missouri, Columbia, Mo. LABORATORY CORPS. Director. Surg. George W. McCoy. DIVISION OF PATHOLOGY AND BACTERIOLOGY. In charge of division.—Surg. George W. McCoy. Assistants. Surgs. Hugh S. Cumming, Leslie L. Lumsden, Lunsford D. Fricks, Carroll Fox, Taliaferro Clark, A. M. Stimson; Passed Asst. Surgs. H. E. Hasseltine, James P. Leake; Ass't. Surgs. M. H. Neill, N. E. Wayson, and G. C. Lake. Sanitary bacteriologists.-H. B. Corbitt, B. S., and Miss Ida A. Bengtoon. DIVISION OF ZOOLOGY. Professor of zoology.-Ch. Wardell Stiles, Ph. D. Assistant.-Surg. Joseph Goldberger. Technical assistant.-Walter D. Cannon, LL. B., A. B., M. D. DIVISION OF PHARMACOLOGY. Professor of pharmacology.-Carl Voegtlin, Ph. D. Technical assistants.-Atherton Seidell, Ph. D.; Murray Galt Motter, A. M., M. D.; George B. Roth, A. B., M. D. Organic Chemist. Chester N. Myers, Ph. D. DIVISION OF CHEMISTRY, Professor of chemistry.-Earle B. Phelps, B. S. Sanitary chemist.-Albert F. Stevenson, B. S. Technical assistant.-Elias Elvove, M. S., Pharm. D. 2 CONTENTS. 1. Tissue alteration in malnutrition and pellagra; by John Sundwall..... Part I. Tissue alterations in animals resulting from various vegetable diets. 1. Monkeys. Various diets deficient in essential constituents....... 2. White rats, Series I. Cellular changes resulting from diets of corn- 5. Rabbit. Tissue changes due to administration of aluminum lactate. 43166 Cerebrospinal fluid collected at autopsy. Spinal fluid collected during life... Pericardial fluid............. Appendix II. Summary of individual experiments made on each monkey. I. TISSUE ALTERATION IN MALNUTRITION AND PELLAGRA.1 By JOHN SUNDWALL, Assistant Surgeon. While at the United States Public Health Hospital at Savannah it was my privilege to examine numerous tissues that had been obtained at necropsies of pellagrins. Effort was made to determine by special fixations and differential microchemical staining whether in pellagra any cellular changes or organisms are present which could be considered as characteristic of the disease. While these observations were not so extensive perhaps as they might have been, sufficient examinations were made to warrant certain conclusions. These are discussed under appropriate headings. Later it was the writer's opportunity to examine numerous tissues which had been obtained at autopsies of certain animals which Prof. Carl Voegtlin had had under observation. These animals had been fed various diets by him with a view of producing, if possible, symptoms and tissue changes which are found in pellagra. In most instances the animals died in varying stages of emaciation. Lists of these diets, together with the clinical histories and autopsy findings, obtained from Prof. Voegtlin's notes, are included in this report. There was a striking similarity of cell alterations seen in these animals and in those previously observed in the tissues procured from pellagrins. In fact, practically all the changes noted in the latter were observed in these animals.2 With a view of comparing these changes there are included in this report the morbid changes noted in the tissues of both series-pellagrins and experimental animals. The changes observed in the latter series are reported first, after which the alterations found in pellagrous tissue are considered. PART I. TISSUE ALTERATIONS IN ANIMALS RESULTING FROM VARIOUS VEGETABLE DIETS. In most instances the tissues were procured immediately after the death of the animals. They were preserved in various fixation fluids, depending upon the particular structures to be preserved. The series 'Manuscript submitted for publication Aug. 20, 1915. The great resemblance of the chemical changes in the central nervous system of these experimental animals with those observed in pellagra were described by M. L. Koch and Carl Voegtlin in Hygienic Laboratory Bulletin No. 103. consisted of monkeys, rats, pigs, and rabbits. The following is a summary of the findings: 1. MONKEYS.-VARIOUS DIETS DEFICIENT IN ESSENTIAL CONSTITUENTS. MONKEY I. Monkey fed on corn-oil cake. Began feeding May 13; progressive loss of weight from 3,675 grams to 2,150 grams at time of death, June 6. AUTOPSY FINDINGS. Very emaciated body; brain and cord removed and vertical sections taken of cerebrum near optic nerve-one in each hemisphere. Two sections of cord near first lumbar region also taken. Lungs normal; liver normal-53 grams spleen dark; pancreas hemorrhagic; kidneys pale; adrenals normal; stomach, mucosa has small hemorrhages; small intestines, walls thin, hemorrhagic; colon shows profuse hemorrhages; entire gastro-intestinal tract empty. MICROSCOPIC APPEARANCES. Heart.-Myocardium: The muscle fibers are granular in appearance, cloudy swelling-much pigment in evidence but this pigment is not the typical pigment of brown atrophy-it is more or less diffuse throughout the cell, and in many instances it is difficult to distinguish it from the granular cytoplasm. The transverse striations are indistinct, many blood cells are seen beween the fibers a mild degree of congestion. Lungs. This particular section shows much congestion of the alveolar capillaries, and the alveolar walls are thickened; much greenish brown pigment is also seen in these thickened walls and around the larger vessels and bronchi; no leucocytic infiltrations are observed. Small areas of lymphoid cells are seen near the bronchi in some instances; but these can not be considered as abnormal. Liver. For the most part this appears normal; slight congestion is seen in both the central and portal veins; many blood cells are also observed in the intercellular capillaries; the cytoplasm of the cord cells appears somewhat cloudy and not distinct as in the normal; the nuclei are vesicular; one very small focus of polymorphonuclear leucocytes is observed. Spleen. This organ shows pronounced pathological changes. The capsule is thickened; the entire spleen pulp is congested and hemorrhagic-in fact, the red blood cells practically obscure the pulp cells-the larger vessels are intensely congested; all the malpighian areas are undergoing amyloidosis; in some practically all the lymphoid cells are masked by amyloid which stains violet red in gentian violet; Van Gieson's stain shows hyalin changes in many of the central arteries. (See Fig. 3.) Kidney. The capsule is congested and torn away from the parenchyma; the stellate veins are also congested; the glomeruli for the most part are congested; the cells of the urinary tubules, especially convoluted tubules, are swollen; the cytoplasm is granular; a granular detritis fills many of these tubules, which stains red in eosin; the intertubular vessels in many instances are slightly congested. Sections from other portions of kidneys show great dilatation of both the collecting and urinary tubules. |