Report of the Committee appointed to examine into the condi-
tion of the mucous membrane of the intestinal canal in persons
dying of Cholera.
tThe following “Report” made to the College of Physicians of
Philadelphia, is copied from the printed “ Transactions” of that
body. The inaccessibleness of the original to the profession gen-
erally, and the value of the paper itself, will, it is hoped, be suffi-
cient explanation for its appearance among the original communi-
cations. The gentlemen who compose the committee are eminently
reliable, as regards accuracy and experience, and we regard the
“ Report” as one of the most valuable contributions to the
pathological anatomy of cholera. It will be seen that they have
refrained from expressing any opinion as deduced from these
appearances, but have preferred leaving each one to make for him-
self the application of them in the investigation of the pathology
of this disease.—Ed. Ex.]
Science is positive only when its facts are positive. A subject,
the phenomena of "which are numerous and complex, can be
understood only when each of its phenomena or facts have been
analysed, and positively ascertained.
In Epidemic Cholera, the most prominent and constant phe-
nomena, are purging and vomiting: and in ninety or more, of one
hundred cases, these phenomena appear to induce the condition
that usually terminates fatally.
It is, therefore, an important object in determining the phe-
nomena of Cholera, to ascertain whether any, and if any, what
constant anatomical alterations can be detected in the intestinal
canal of cholera patients who have succumbed under the disease.
The College, with the view to obtain, as far as possible, accurate
information on this single question, appointed the undersigned,
at the meeting held on the 19th day of June last, a committee to
investigate this subject.
The Committee having attended to this duty, submit the follow-
ing report:
The ordinary autoptical examinations, heretofore practised, have
failed to yield any satisfactory information, and are nearly useless
for the purposes of science.
Extensive structural lesions may exist, that cannot be seen, or
very imperfectly discerned by the unaided sight, and without pro-
per preparation.
It was determined by the Committee that the intestines, before
being submitted to examination, should be finely injected, and
subsequently inspected with the microscope.
This task was undertaken for the committee, by Dr. John Neill,
demonstrator of Anatomy in the University of Pennsylvania.
The admirable manner in which he has performed this duty, can
be judged of by the beautiful preparations now on the table, which
he has presented to the College for its museum.
The injections are made with turpentine colored with vermil-
lion. It was found by Dr. Neill, that when he employed size, it
did not penetrate well, and numbers of capillaries were not filled ;
the same result occurred when Canada Balsam was used. It led,
at first, to the supposition that the capillaries were destroyed by
the disease.
The committee, confining themselves strictly to the single object
for which they were appointed, report the following facts as the
result of their investigation.
1st. in the recent subject, the peritoneal coat, like all the se-
rous membranes, was in all, remarkably dry. The lubricating
serosity is deficient in the serous membranes.
2nd. The epithelial layer of the intestinal mucous membrane,
was, in all the specimens, either entirely removed, or was detach-
ed, adhering loosely as a pulpy layer, mixed with mucus, or an
albuminoid substance.
3rd. Peyerian Glands. Peyer’s Glands, were developed to a
greater or less extent in all the cases examined.
4th. Solitary Glands. These were also developed, and con-
tained, in the recent subject, a minute quantity of white substance.
These enlarged solitary glands have the appearances designated
by Serres and Nonat, as Psorenterie.
The villi covering the glands of Peyer, and the solitary glands,
present the same appearances as in other parts of the same intes-
tine.
5th. Villi. They are denuded of the epithelial covering, but
are unchanged in other respects.
6th. Capillary Vessels. These are entire, and manifest no depar-
ture from their normal state. The appearances of the capillaries
of a cholera intestine, are identical with those of the healthy
mucous membrane when the epithelium has been removed. In the
natural state, the epithelium, from its thickness, conceals the
injected capillaries.
In no instance was a vesicular eruption observed. In some of
the dry specimens, there is an appearance that might be mistaken
for it, but it is an emphysematous state, resulting from commenc-
ing putrefaction.
The foregoing facts are derived from the examination of twenty-
five subjects.
Samuel Jackson, M. D.
John Neill, M. D.
Henry H. Smith, M. D.
William Pepper, M. D.