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Updated: May 5, 2025
Thiersch contends that healing of a granulated surface results first from a conversion of the soft, vascular granulation-papillae, by contraction of some of their elements into young connective-tissue cells, into "dry, cicatricial papillae," actually approximating the surrounding tissues, thus diminishing the area to be covered by epidermis; and, secondly, by the covering of these papillae by epidermic cells.
The term sarcoma is applied to any connective-tissue tumour which exhibits malignant characters. The essential structural feature is the predominance of the cellular elements over the intercellular substance or stroma, in which respect a sarcoma resembles the connective tissue of the embryo. The typical sarcoma consists chiefly of immature or embryonic connective tissue.
The poisons circulating in the blood produce waxy degeneration in certain viscera, notably the liver, spleen, kidneys, and intestines. The process begins in the arterial walls, and spreads thence to the connective-tissue structures, causing marked enlargement of the affected organs.
The induration is due not only to the dense packing of the connective-tissue spaces with lymphocytes and plasma cells, but also to the formation of new connective-tissue elements. It is most marked in chancres situated in the furrow between the glans and the prepuce.
The glands are usually larger than in tuberculosis, and they remain longer discrete and movable; they are firm in consistence, and on section present a granular appearance due to overgrowth of the connective-tissue framework. In time the glandular masses may form enormous projecting tumours, the swelling being added to by lymphatic œdema of the overlying cellular tissue and skin.
The affected part becomes swollen and hardened, and sometimes attains an enormous size. It is neither reducible by position nor pressure. There is a corresponding dilatation and multiplication of the blood-vessels with the connective-tissue hypertrophy. The muscles waste, the skin becomes coarse and hypertrophied.
According to Thomson there is little doubt that this disease is caused by non-pyogenic bacteria gaining access to the sweat-glands. The irritation produced by their presence gives rise to proliferation of the connective-tissue corpuscles. Jamieson reports a case of mycosis in a native of Aberdeenshire aged thirty-eight. There was no history of any previous illness.
To this process Metchnikoff gave the name of phagocytosis, and he recognised two forms of phagocytes: the microphages, which are the polymorpho-nuclear leucocytes of the blood; and the macrophages, which include the larger hyaline leucocytes, endothelial cells, and connective-tissue corpuscles.
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