On dilatation of the lacteals / by T. Grainger Stewart, M.D.

  • Stewart, Thomas Grainger, 1837-1900.
Date:
[1863]
Catalogue details

Licence: Public Domain Mark

Credit: On dilatation of the lacteals / by T. Grainger Stewart, M.D. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    the mucous membrane; others were smooth, rounded, and lobulated like little fatty tumours, and evidently lay in the submucous layer^ for by a little careful dissection tbey could be separated from the mucous membrane on the one side, and from the muscular layer on the other; a third set, again, much less frequent, consisted of a combination of the other two. On microscopic examination, those of the first kind were found to be made up of groups of villi greatly distended, as in the process of digestion—they were dark and opaque. On tearing them, a milk-like fluid escaped, which pre- sented microscopically the characters of milk or chyle. The villus then collapsed, and there was no appearance of the bloodvessels having been distended ; and indeed it was obvious that the whole enlargements depended upon the presence of the milk-like fluid. As this is the matter naturally present in the lacteals during digestion, and as these take origin in the villi, we seem to be warranted in concluding that this class of patches results fi-om the retention of chyle in the blind extremities of the lacteal vessels of a number of adjacent villi. The whitish-yellow colour arose from the chyle shining through the coats of the villus, and the granular appearance of the surface from the patch being composed of numerous villi. Those of the second kind resembled small fatty tumoui'S, and were situated between the mucous and muscular coats, tiorae con- sisted of a single lobule, others of several. On pricking any of them, a milk-like fluid, closely corresponding to that above described, but containing in addition cell-like aggregations of fatty granules, flowed out, and the walls of the particular lobule collapsed. I could not satisfy myself as to the structures of the bounding walls j but some of the patches presented peculiar elongations from the main mass, like tails proceeding from the body, which evidently consisted of some tubular structure. But these did not pass into bloodvessels, nor did they seem to bear any special relation to them, and were therefore to be regarded as portions of lacteal vessels. On the whole, from the character of the contained fluid, the structure and appearances, and the observations previously made, we may conclude that these patches consisted of dilatation of the small lacteal vessels. Only one theory as to the origin of this lesion occurs to me— namely, that the extreme backward pressure iipon the blood, which arose from the disease of the heart and lungs and the general dropsy, acted upon the lymphatic vessels also in some unexplained way, and led to their distention at some points. This view is in accordance with all tlie facts observed, the chief of which were recapitulated in the account of the examination of the body. I regret that I neglected to ascertain the condition of the thoracic duct, the large lacteal vessels, and the mesenteric glands. It arose from my not having noticed the patches till the intestines were removed, nor suspected their nature until it was too late to investi- gate the other points.