On the Presence of Certain Bodies in the Skin and Blister Fluid from Scarlet-fever and Measles

In sections of control and normal skin, the nuclei of the epithelial cells were often indented by the cell protoplasm, giving them an appearance similar to those indented by Mallory's bodies. It would seem that if these bodies of Mallory's were protozoa they would have been found in the sections from both the living and the dead skin of scarlet-fever and measles, as they were present in the blister fluid. Their absence is certainly more suggestive of a degeneration than of a protozoon. This view is also borne out by the fact that they were not found immediately after death, but were present in another specimen from the same case removed twenty-four hours later. It would seem probable also that the bodies found in the blister fluid were the products of degeneration and cytolytic activity, because they were found in the antitoxin rashes as well as in the cases of scarlet-fever and measles. The histological changes in the skin of these two diseases leads us to expect the presence of cytolytic products both in the blister fluid and in the sections. It certainly cannot be stated that none of these bodies is a protozoön, but it can be positively stated that a great majority of them arise from degenerating cells; and in many cases, I think, it is not possible to differentiate a degeneration from a protozoön by the study of its morphology and staining reactions. The bodies present in blister fluid resemble very closely those granular bodies found in blood under certain conditions, and seen in vaccine lymph and in emulsions of tissues and in exudates. I think, therefore, that they are for the most part, if not wholly, products of degenerating tissue cells and of leucocytes, and within certain limits specific to scarlet-fever and measles.