Studies in Scurvy. Figures of histo-pathological examinations

STI]DIES II\ SOI]RYY BY J. ÂXEL HÕJEB X'omer ¡'i¡st ¡.ssistant at the Chil¡hen's Clinic of the Karolinska Institutef, gtockholm. (Chiet: Professo¡ I. Jundeu.) Thi.s worlc l¿as been, carried, out by øid, of gra,nts fronx the l{aroli,nslea Institattet ancl the Stced,ish Soci,ety for Medôcal, Research. UPPSALA 1924 ÀLMQVIST & \ryIKSEL],S BOKTRYCI(ERI-Ä.-B ACTA P.ry,DIATRICA REDÂCTORES: lN DANfA: C. E. BLOCH, xöreNnevN, S. MONRAD, rösnxul.v¡{. IN X'ENNIA: ELIS LöVEGREN, nor,- sINGFoRS, ARVP YLPPö, HELSINGFoRS. IN TIOLLANDIÄ: E. GORTER, LEIDEN, J.ITAVERSCITMIDT, IrrREcHr, CORNELIA DE LANGE, alrsronoau. IN NORVEGIA: TH, F.RöLICH, KRISTIANIA, AXEL JOHANNESSEN, xnrsrrlxr,l, CARL LOOFT, BERcEN. IN SUECIA: I. JUNDELL, srocrnor,nr,.{.. LICHTENSTEIN, srocxHow,WILH.'WERNSTEDT, srocKHoLM. EDrroR: I. JUNDELL, srocKHoLM Yol. III. Supplementum 17:Y. 1924 Almqoist û Witcselts Bolctrgclcer¿-Aktiebolag UPPSAI.A 1924 To Ørofn""or" -Qtn/ 9{o/"t ',/ TÁeodor Tral¡oÁ This worlt is reryectfully insuibed,.bg T.HE AUTHOR CONTENTS Preface Ïntroductory l'Iethods of experimental sc.rvy, from Holst to the lâtesô investigators Part I. Enanzinal,ion of the antiscorbttt'ic aaltte of som,e Desetuble ltroclucts. Survey of experiments Summary; discussion; concltrsions Part If. Hísto -p atho lo gi,c al s tt c d,i, es. Preliminary notes. Introclucúory The macroscopic changes Technique Nomenclatu¡e Classification of scurvy in different st¿ùges Grouping of the material within these stâges Chapter f. The bone formation in scurvy. ?èeth The endosmal ossification The enchontlral ossification. Cartilage * Four cases of infantile scurvy . t Summary ancl conclusions of Chapter I. Chapter II. Museìes. 'Ihe skeleton musculature Hearü Ohapter III. Liver Chapter IV. Spleen . . .. . Chapter V. Kiclney Chapter VI. Atlrenal Chapter VII. Salivary glancls . Chapter VIII. Lung Chapter IX. Blood ancl vessels. Hemorrhages in scurvy Chapüer X. Connective tissue . 8 I 2g 30 31 QO 0Õ so 38 48 50 60 64 18 22 68 79 QÐ 91 96 100 104 107 109 L74 Pørt III. Discussion of some scurug problems. Chapter I. Scurvy and infection Chapter II. Disposition Chapter III. Latent scurvy Chapter IY. The ca'lcium metabolism in scurvy Chapter Y. Scurvy ancl rickets Chapter VI. fnanition anil scurvy Chapter VII. ,t mocliûecl methotl for experimental rating of the antiscorbutic value of a protlucú Chapter VIII. Pathogenesis of scurvy. Relation of scurvy to other 11ó 1.22 r23 726 128 729 130 cleficiency tliseases Summarg a,nd, conclusi,ons of Parts fI and III Part IV. Scuruy and, tuberculos'is. Chapter I. Historical Chapter II. Experimental study on guinea-pig. Technique ancl survey of experiments fnfluence of scurvy on úuberculosis . fnfluence of tube¡culosis on scurvy . . . Chapter III. Experimental stutly on man. Survey of experiment Criticism ancl conclusion , . . Swm,marg and, concltcs'ions of Part IV . Part V. Re)cortls oÍ cases. Cases belonging to Part I . u), ,, Ð ,t oIY, , II ,),),,,IV,,ilI Literature cited: List of authors 94 nicrophotogrâms. 33 curves in the text. 6 colured plates. . t32 139 I40 t64 169 170 748 \64 L62 172 200 206 234 , 265 . 276 Preface. The work which is here presented was begun in July, 7922. rt would have been impracticable to fulfir it without the possibilities of technical aid offered by clinical laborato. ries. To Professors F. Hnrvscn¡w and G. Ificceulsr, who have allowed me to avail myself of these possibilities and, to whom I am also indebterl for much helpful advice, f beg to express my gratitude. My thanks are also due to professors I. ]u¡vopr,r and U. QurNsnr,, to Assistant professor Dr. C. Kr,rrve, Doctors R. Nonocnnr, G^. Vnsrnr:cr, II. D¡.v¡on, A. WlssÉN, S. Srvn, A. IMllr,cnnrv, Å. Årnnr,urvr, the Dental Surgeon Dr. G. \{.usrrrv, and others, for various reasons, some of which I have mentioned more particurarry in my book. speciar thanks are due to Doctor F. \4f^nr,annrv and Fil. Doctor L. G. Ro¡rnr,r, who have kinclly reacl the proofs. My late father, the historian Nrrs J. Ilö.rrn, who during all his life, beside his practical activity as a teacher, d.evoted himself to scientific work for science's sake, has been my model. My wife, Src¡rp Ilörnn, has been my helper. f have allowed myself as a respectful token of ad.mira_ tion to inscribe my work to professors Äxnr, rror,sr ancilrn¡ooon x'nör,rcn in christiania, the first investigators in the fieltt of experimental scuryy, whose work still remains unrivallecl. Even though the exaggeration is evicrent in x'unk's utterance (7922): usince the experiments of Ifoht and FröIich, no real progress has been macle (in.experimental seurvy), in spite of the numerous publications that have appearedr, yet his worcts show how high Holst and. Frölich's works rank among all the rest. Hagalund' sweden' T'ebruary 1924' J. Aret Höjer. Fig. l. Location of the sectiou at right angles to ilre longituclinal axis of the lower jan, through the micldle of the ffrst molar. ,""b l'ig. 2. I)iagramrnatic section through the lower ja.w,. .l ^jaw-bon-e,. ,?¿?¿ müscles of tonguc, sr g¿ glandula subliDgualis, i ctoss sectiDì of root of incisor,, mo longitudinal sèctiot of molar, rä2 m carìalis ltrarìdi_ bulæ with ycsscls and neryes- J sL.9 t l"' & & c.n Fig. 3. No scurvy. No. 188. Oross section of normal incrisor, Lolporver. j ja\-bone, p¿ od perio(ìoni.iuD, rj r¿ cctxctìt rDelDbrarl(', r¿ dcutin, ,}¿d Þrcd(,¡ìtin, o¿¿ ð¿ odontoblests, 21. pÌìlp, (r¡ ò/ arnl'loblasts, 1' bloodYcssols, t rttarucl. l'ig. 4. Scorbut latens gravior, 8 clays. No. 3Éi. Cross secti<in of incisor'. 'Ihc ploclcntirt (1n'erQ is aruolphousl¡' calcifictì. // dr'Ììtiìr, r elìaùìcl, "s¿ í¿ silbliDgtìaI glaDcl, c ar tl¡c \Yi(l('ììc(l r'¡ualis t¡ta¡lrlillttl¡'. e J Þ(.od P. b. ost.tl. od.bl Fig. 5. Scorbut latens gravior, 12days. No. 29. P¡eclentin (ltrerQ amorphously calcified, Tomes' canals (d. c) rvidenecl. Oclontoblasts (od ðl) in tìisortter. ¿ €na,mel. l'ig. 6. Scorbut latens mitior. No. 18. Oloss section of incisor. Ilone(Itb) glorvingintopul¡r oúf ¿r¿ osteol)lasts, ? tlilatecl veiD, 0r¿ ö, otloÌìtoblasts iD disoxler, p¿ od periodontium, j j a\-boue. Fc.o ^ P.b. H4v ost. b[. eqn !'ig. I t3. Scorltut rnanifestus rnitior, 46 tla¡'s. No. 7ó. (iloss section of incisor', Iorv porver. l)ul¡ra bouo (Pb) fills the pnl¡r. os/ l)/ osteolttsts, pe od pcliotlontiurrr. Fig. 19. Healing sctrvJ:. (iloss scction of incisor, lorv porvcr (ost d) fills the pulP. Hat' cat¿ bolìtì clùals. No. 7{i. Osteoclontil ":t . d, ac n1, o ¿. h1. a. P ¿. "¿.H. Ì,'ie. 2(). I)etail of lrig. l9. rl(t¡l (aù rlctrtal ctrrirl, a)// ¿)¿ o(ì(Drfol)lasts. l'ig. 21. Healing scuryJ': No. 7u. Cross scction of incisor, lorv pol'cr'. Il thc dclltin, rvich is foldetl and irlcgullr, bone canals (IIat can) irr('secrì in the otrtcr Ìa¡'cr'. otl ül irrlgulrr odorrtoblasts, p¿ od l)eriodorìtiuÌ¡¡,.f jil\r l)oD(.. ,¡1 r/ ostoo(lcnti|. ¡/ rlcutil. l'ig. 22. Scorbut manifestus mitior, 0.1 m. pr. cl. 42 days. No. 122. Oloss section of incisor, lorv powcr. Pulpu bone Ql¡) ñlls the pulp. r1 oltl rlt'rrtirr \ritlì (ìililted rl f'l'or¡cs'r'rlals. Fig. 23. Scorbut mitior latens extensus, 0.2 m. pr. cl. 29 clays. No. 130. Oloss section ol'incisot', lorv porvet. Pulpl bone (2;Ó) fìlls the ¡rulp. // olrì d(,1ìtiD sitlì (liltt('rl tlelìl cãIt'foDìcs cltlills. P. Þ. ost.6 I Pb. J.e. o l. l¡l Fig. 24. Scorbut ruitior lateus extenstrs, 0.3 m. pr. d. 83 alâys. No. 135. Cross sectiol of incisor, los' porrer'. ¡tü ¡rl1ra borc, o'l ¡,¿ odo¡ìtol)lasts iD (lisorder, osl öl osteoblasts. Fig. 2-o. Scorbut mitior latens Ìevior, 0.õ m. pr. cl. 92 clays. No. 144. oßt f¡ ostcodeDtirr, 2ö pulpa l)oDe, Ìf¿1, c¿¿ bone ( ¿Dals, r¿ (ìentin // 4 rìental (,aDals. osl,a P.b J.c. À I'ig. 26. Scorbut mitior latens levior, 0,7 m. pr. d. 22 days. No. 152. Abbreyiâtions : tr'is. 2t. l'ig. 27. Scorbut mitior latens levior, 0.7 m. pr. d. 92 clavs. No. 156. ..!llbreriatioils , tr'ig. 2õ. o5r. ¿. - å-.c. ,.f&ilt!r:i: d n.¿ l'ig 29. 0.8 l'n Scorbut mitior la,ter-rs levior', pr. cl. 92 c-[a¡s. No. I61. .\l)l)reviatiors : l'ig. 28- '.. ¿. o.å lrl l'ig. 28. Scorbut mitior latens lel'ior, 0.8 rn. pr. cl. 29 clays. No. ló9. ()lcl tlentin (rl) rvithout tlistinct chnugcs. Nerv dentin Ó¡ r1) lighter, l'ith ilrcguìar inncr.etlgc. o¿l L¡/ ocloDtoblasts irr rìisordrrr. $ !'ig.3tt. No scurr.\'. ) I m. pr. tl. Iio. l7ti. 1)c o(¿ pcriodontiuÌ!, (¿ dcDtin, ?rr¿d ptederìtir, 0s1 ¿)l ostcoì)lâsts, pü pnlp, .l jarv borc. llig. iì1. Scolbut manifestus gravior, 38 cla.1-s. No. 3. Oblirltrc cross sectiou of molar'. No frcc pulp. llrt in the nretlulìaly spaces (rteerl s7r) aucl bonc atna'ls (Har crtn) pnlpa cells :rrc "r'cl¡. o¿.Èl J 'rn.sP. 'P.1' lr rrolar, ,l jeN-bor)e, t¡ ileDtiD, or¿ ä¿ odottolllûsts. !'ig.33. Scorbut rnanifestus rnitior',0.1 nr. ¡rr. il. 42 da,ys. No. 67. C)r'oss section of lol-or jnrr, high porver'. Iìorrn:rtion tit sporrg.v lrlre fs_¡.r D) orrtside thc old jnrr- (y'), r'hich shol's osteoporosis. ,¿ad r/j rue(ììrll¿r) spr(.r.s, rìillte¡ì, ir rp(,\ of ¡nol¿r \rith ì)rÌlp¿ l¡ot¡e,pl¡,. F ig. iì2. No scurvr'. Soctiorr oI ctlrbrvonal j¡rrr o'l cI cc P".'b. sP b. !'ig. 34. Scorbtrt manifestus gravior,24 days. No. 1. Cross section of lol'er jurv, high pou'cr. Itcsor¡rtion of the nerv, spong"v bone. o"cf cl ostcrlr'la¡ts", F'ig. 35. Scorbus mitiot' laterts extensus, 0.3 m. pr. c-1. 43 clays. No. 140. Irontal section of rib. Periosteal bone r¡f slrong)' character. 2¿?¿ atrophietl muscle, r ¿ cattilege colulu¡ls. lor'. P" b. Ìr c.c. ho..l,. (r hÉ h or.b. !-ig. 3{-i. No scurvr-. No. 96. I¡r'ontal s('ctioìt of rib. \oln¿rl pictur('. l c c{rtililge colurDlìs, ¿/ l)onc, ?¿(¿ ùatro\r, c cilrtililg(, ,¡/c Ì)(.rio$tcurD, r¿¿¡ nillsclcs, l'ig. 37. Scorbut manifestus mitior, 0.1 m. pr. ¿1. ó9 days. No. fJ8. Irront¿rl scction ol rib, shosilg t¡'1iir.rl scorbutic t'han¡¡cs in tìre cnì:rrgcrì costodrolclral junctiorr. I cartilagc, ú a c¿rtilagc colìtrDlls iD disoxlcr, cele c lrti rtr¿lil-v cal(fified cartil{gc, grrrrrirrg irrto tìrc ùrarrorv, /rolr å lÌoilìogeÌrcoìls scorbuti(: boDc, iD tlìc out('t atìglo coììDc(it(r'l Nitlì (:artilagc aud l)oDc r.olnrnrrs, 1/c ¿ sl)oùí:i] l)cÌiostcrl l)oìì(',,/),?/,r¿ Tr¿ìÌùc-\'orli DrarÌ.olr, f (lilatcd r.ein, p Iet.iostcurn, ,/ x I tÌ oIhicd I¡ilsi.lo fil)tl's, ¿ oì (ì l)orrr. ì[.itlgc, à lr0rrorrhagr'. ñ.b. ho*.1 I * ho*.Ë. 'no". t l'ig. rtti. Scurv; healing since 30 clays. Ir¡outal seotiorì of rib. a) Lol' pou'er, No. 76. b) High poÌyer No. Ìi. lìerraius of the lrornogeneolts scolbutic bone (lnnt ly' is seen in sevcrnl lilaces in flrc svstem of noLr¡ral bone colnrrrns ú¿ ü). ¡ cartilagc. n.! h"q. È osì.cl c o*l <1 I.'ig. 47. Scorbut nlânifestus gravior, 24 days. No. 1. Longitutlinal sectiol.r of thc tibia, lorvcr encl; high ¡rorver. Horrrogencous nerv scorbutic l¡<>nt (hom, l¡) in resorption. oS¿ r/ ,ostoocl¿sts', sI-Ì(,)-tiuìì of l¡oile-cells. Fig. 48, Frontal section of rib, embrJ-onâl )n'im colc ¿ prir¡arill' calcifled câftilegc. osÎ.< 1. ì1 n.b. c.b i.t n.b. l'ig. 49 a. Infantile scurvy, Case 1. lrregular pieces of bone (l ó) are prescnt in the system of more norural bone columns (n l,). Fentur, lon'cr epiphyseal ent'[. Higlt porver, F'ig. 49 b. Infantile scurvy, Case L In the angle betrveen periosteum (p) and. cartilage (c) therc ¿re numerous splinters of poorly tìel'elopecl bone (srb). Tibia, uppcr encl. Lorv power. ...b. J..w.n. 1'.m. ho *. F'ig. 49 c. Irrfautile scurv-r', Case 1. Hornogene<rus Dla,ae (honx D) in otherl'ise ruolc rrorÌlaì llr¡nc. 'l'ibia, up¡reI encl. Higlr ¡ion'cr. !'ig. ó0. Infantile scur\¡J-. Case 3. l¡curul, upper epiph-vsis. High polver'. Old bonc colnmns ú¿ ò) thlough abundant homogeneous scorbtrtic honc (hom. D) joiuerl to cartilago lr). n n.b. ûd hon.Lc. f ig. ó 1. Infantile sculv)-. Case 4. Ilib, postcrior entl. I:lono colunrls (r¿ Ö), l)'ing iu thc fianre-rvork lu¿lrrou- (J't'u; nt), joined to the etr1ilflse lr) thlougìt a s¡'stcur of lnolo ltottrogelteolìs llo¡c (ltott lt). l'ig. 52. No scurvy, 142 c'taYs. Longitutlinal section of l'ib interstice. f,orv pol-t'r. Nolmal musclc. J/?/ rÌ)rìsclo. lil)r(., /)¿ potiost{!rtÌlr, ¡/ l)où('. (lP ildil)os{' tissrlr'. he mu \Ì I'ig. 53. Scorbut gravior manifestus, 32 clays. No. 28. Longituclinal section of rib interstice. Lorv porver'. Atlophv of tl¡e muscle lil¡res (nnù. I)il¿tation of the veins (lj. !'ig. 54. Scorbut gravior manifestus, 26 clays. No.21. Longitudinal seclion of rib interstice. f,orv porver. llhe same muscular atroph¡' is seen all through as in thc neighbourhootl of the hemorrhages (åe). r' (ìilâto(l r(,sscls, .(cor'Ò 0 lcn' horuogcneous scot.ì)utic bonc iI thc costal a1\glc, lrc pcrioster¡m. om a.n.c. crslr lnu l'ig. ó5. Scorbut mitior manifestus, 0,1 rn' pr. cì. ó9 claYs. No. 88. Longitudinal section of rib interstice' f'olt'p-orver' -itrJulrv nt rnuscle frhres, ¡rtttly honrogenized (hott¡) , prittì' sith letnnining eross-striation ftr str)' Fig. 56. Scorbut mitior manifestus, ()'1 m' pr' d' 60 claYs. No. 58' Lonsitualinâl section of rib interstice. Lorç pol't'r" Atrophl ni tiu t"u*"tu fibres (nttt). Connective tissue lc /) iucrersecì' c.t. mu hÀ h.¿. er .l I.-ig. 57. Scorbut manifestus gravior, 3lì days No. 3. I.ongitutlinal scction of I'ib interstice. úiglt Atrophv of rnuscle fìltres. Cross-striation lcnraining in the linc filrros. /? {¿ lìomogenizo(ì (ìot. l'ig. 58. Scorbut rnitior manifestlrs, 0,J ür. pr. cl. 60 c'tays. No, ó8. Longitn<linal section of rib interstico. f,ol-¡rol-cr. ,\trophic musclc (tzu) rvith ìarge calcifiod nccrosis (ttect). f( l)eriostcrr¡ìr, à 1,on., ?, di1;::r:11 \'css.,ls ir) ttìc tr¡.Þer('rìÌic ry po\YeÌ'. (er sh') neqr. hecf n ecr ecr. 'r,"æ &. l-ig. ó9. Scorbut gravior manifestus, 22 days, No. 48. LonEituclillal sectioll o[ l'ib intct'sticr'. High pon'et" "Crlcifctt nccrosis (necr) of lttttsle filrrcs' F'ig. 60. Scorbnt mitior latells extensus, 0,:i m. pr. cl. 29 daYs. No' 63' Lougitutlinal scction of elbolv.' High pos'er' Àtrorhitl rrtusclc rrith incrcasctl conncct'içe tissrrc ('/) ' ,,tt.l c¡rìciliecì tlcclosis (llrt't')' åËÇ "*t,å* ***4 9nc 9.n'c q'n.c. teì O*' *¡¡r *.-. 9nc 9.,c 9.n.c l'ig 61. Scorbut mitior manifestus, 0,2 m. pr. cl. 59 days. No. 88. Longituilinal section of ¡ib interstice. Yer,y high po\\:er. Giant-nuclci cells (gn) in atro¡rhic tnuscle. Fig. 62. Scorbut manifestus gravior, 35 ctays. No. 35 Longitudinal section of rib interstice. Very high porvcr.. Ginnt-nuclci cells (¡¡n) in atr.ophic lnusclc. n€cr. Ir ecr. Fig. 74. Scorbut gravior manifestus, 30 clays. No' 4ó Liver. f,olporr'er'. f,ar¡4c necroses (necr), negr, tip Fig. 75 Scorbut mitior manifestus, 0,2 m' pr. c-1. 39 cìays. No. 84. Lir.cr. sud¡n. f,orv porver. Large necroses (necr) rvith smtìl flt drops iliffusely, l:rger (lip) at the cclge. I rv. Þig tta ecr cL. l'ig. 76. Scorbut mitior mauifestus, 0,2 m. pr. cì., .13 clays. No. 86. Li¡'er. .l,ou porvcr'. Crìcilìe<ì necrosis (rtcri) uith 1i)n'oblirsts il the pcriphcr¡'. l-ig. 77. Scorbut gravior rlanifestus, 28 clal's. No. 7il. Lir,el'. l-orv porver. Ltrge ilregular ììc(,roses, some rvith ìrilions pignrr.nt (lir ¡tiønr), othcrs ctrleilìerì á'ø) 4.c a.c -.{ !'ig. 7iì. Scorbut mitior rnanifestus. 0,i m, 43 c'tay's. No. 86. Livcl stltincd rrccolrìing tti v. I{ossa. J,o\\: ì)o\\'eì' tìoeì'osos, srtrroulltlerì lrv ell<,ificrì glairrs. Pr. (l. Lirlgc l'ig. 79. No Scurvy. No. 11. S¡rÌecn. Lolpol'er. Nornt¿l ¡rir,tulo. g c flalt)iglìiâlì r.oLpusclc. 1.e g.c. q.c Fig. 80. Scorbut graviol manifestus, 37 clays' No. 41. Spleen. [,olporvet'. -{.tloplr¡ rtI thc l¡ nrplroitl tissuc' ' csliocialì¡: in tìrc nlllliighirn cor'¡rrtsclcs (¡¡ a)' Fig. 81. Scorbut mitior manifestus, 0,3 m' pr' cl' 60 claYs' No. 58. Splccl. l,ol' polcr'. '\tloph¡ of tìrc l¡'rlpìloid tissutl, t:spc' .i,'.rllt itt tìrt: lrcriphor¡- oIttìe l'htpigirinn colpnscles (4 r')' -*rt l-ig. 82. No scurv¡'. No. 11. Splt'etr. High pol'er. Norm¿¡l pictule of pul¡r. L¡'nrpìrocvtcs (l/) numerons. &ú¡ l'ig. tÌ3. Scolbut gravior manifestrìs,37 ilal-s. No. 4l. Splettt. High pol'cr'. A.trolilrv of the lvrnphoitl tisstrc. llìhc ìr'nrphocvtas (ll) \'erì' sprìrse. 1r r.f. 1f '.f 9.c 9.( he rcr. lt(cr lLecr. I,'ig. iJ4. licorJ¡ut mitiol manifestus, (),1 m. pr. d 15 cla¡'s. No. 120. S¡rlecn, irr ft'cl iol. Lor' lrott t:t. L¡'nrpìrocr-tic rt'¿ct iotl l'citìi \rrnrt,r'ons lect'oses (lic,r't'). 4 r' ìInìl,ithirll (oll)lls(lls. Irig. 8,'r. Scorl,iut nìitiot l¿ttens extcnslts, 0,:i 11¡ pr. tl. -[0 tla¡'s. No. I 33. .(1tlectt, iIlfr'<:tiotl. [,ol' llttler'. \\-r'lli lrnr¡lìrocvtic It¡itt' - tirnr. Ì,rtt'gc rt't-'toscs (natr) tttrtì ltt'lttorl'lllgos (llc). lqb. gL. qt gr. Fig. 86. No scurvy. No. 168. I(idney, cortex. Low power. Nornral pictule, g¿ glomerul¡, ú¿0 tubules. Fig. 87. Scorbut gravior manifestus, 19 clays. No. 1 13. I(irlney, cortex. f,ou' porver. Atrophy wióh shrunk g,lomeruli (gl). ! dilatcd vcssels. -"Ü ** tub eP. rP. rc alc eP. cal. c tt Fig. 88 a. Scorbut rnitior latens extensus, 0.3 m. pr. cl. 76 clay,-s. No. 142. I{irlnov, Dr[ìÌro\\'. Higìr ¡rorver. Ctlcium ctotctetion (calc). ¿o¿c c¿rlciurì bct\ïecrì tllc ¡ìÌr(ileus arìd cafillar}' /¿rrlrl ot thc upithcliullr cclls. Fig. 88 b. Scorl¡ut mitior lateus extensus, 0.:l m. pr. tl. 76 d.ays. No. 142. f¿ù t:alcificd tùblìlcs, a1) cpitllcliullì cclls. å* {)"' ,* Fig. 88 c. Scorbut nitior latens extensus, 0.8 m pr. d. 76 clays. No. 142. lilÒ calcilìetl tubule. '.* l\', o ¡\r & \b 1 !. \ e" ¡L * s|rD siì¡ ..i¡ I. b8 ry it tc I T tt \ * tFl a a tub Qt * 1l q6 ç \ I ,.. & t¡ e alc. \ )\Ð .! -n.l \ a. \* I rr? at., ''-'l.L \ t- .n. Fig. 88 cl. Scorbut mitior latens extensus, 0.,3 rn pr. c-t. 76 cla¡'s. No. 142. c¿¿c c¿lcium co¡tcrctiot iu the luDctì of a ttrl)ulc_ Pr,¡"rn 3 No scurvy. Complete clietary. No. 108. 102 clays. Tuberculous focus in muscle. Necroses penetrateil autl surrountlecl by connective tissue lvith strong collagen fibrils. Pr,¡,r:n 4 Scorbut uritior nranifestus, 0,1 m. pr. tl. 24 days. No. I24. 'I'ubercuìous focus in muscle. Nècrosis. fnconsiderable collagen substance. Pr,¡,rn 5 . No scurvy. Complete clietary. No. 172. 24 ctays. Tuberculous necroses in regional lymph glantl, penetrated and surrounderl by connective tissue with strong collagen fibrils. Pr,lr:p 6 Scorbut mitior manifestus, 0,1 m. pr Tuberculous necroses in regional collagen su b. 43 days. s. fnconsiderable lymphglancl bstance.