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Recently Joly described congenital hernia of the stomach in a man of thirty-seven, who died from collapse following lymphangitis, persistent vomiting, and diarrhea. At the postmortem there was found a defect in the diaphragm on the left side, permitting herniation of the stomach and first part of the duodenum into the left pleural cavity.
A corn is usually hard, dry, and white; but it may be sodden from moisture, as in "soft corns" between the toes. A bursa may form beneath a corn, and if inflamed constitutes one form of bunion. When suppuration takes place in relation to a corn, there is great pain and disability, and it may prove the starting-point of lymphangitis.
In this manner, in examining a case where laminitis or other inflammation of the feet is suspected, one may arrive at a fairly accurate conclusion without the employment of other means. Throbbing vessels are not always easily recognized if the subject is a victim of chronic lymphangitis.
In old subjects used for dissection or surgical purposes, it is very evident that in the ones which have suffered from chronic lymphangitis there exists an excessive amount of sub-facial connective tissue, making subcutaneous neurectomies quite difficult in some instances. A sequel of chronic lymphangitis is a condition known as elephantiasis.
Admitting the frequency of non-infectious lymphangitis, the practitioner must not confuse this type with similar lymphatic inflammation occasioned by nail punctures of the foot.
It is very embarrassing indeed to make a diagnosis of lymphangitis expecting that the disturbance will terminate favorably and uneventually and later to discover a sub-solar abscess caused by a nail prick in the region of the heel. Recurrent attacks of this disturbance cause hypertrophy of the lymph vessels and in some cases lymphangiectasis.
When the blister forms near the tip of the finger, the pus burrows under the nail which corresponds to the stratum corneum raising it from its bed. There is some local heat and discoloration, and considerable pain and tenderness, but little or no constitutional disturbance. Superficial lymphangitis may extend a short distance up the forearm.
If the injury be of sufficient extent, considerable extravasation of blood will take place and the painfully swollen parts necessarily impair locomotion. In such instances lymph vessels participate in the disturbance, and the condition then becomes one wherein lymphangitis is the predominant disturbing element.
Lymphangiomas are met with in the abdomen in the form of omental cysts. #Lymphadenitis.# Inflammation of lymph glands results from the advent of an irritant, usually bacterial or toxic, brought to the glands by the afferent lymph vessels. These vessels may share in the inflammation and be the seat of lymphangitis, or they may show no evidence of the passage of the noxa.
Specific infectious forms of lymphangitis are seen in glanders and in strangles; infectious types of this disturbance are found in many instances where, initially, a localized or circumscribed infection has occurred the contagium having been introduced by way of an injury.
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