156 PATHOLOGY OF TYPHUS IN MAN 



marrow was present in our earliest autopsies (seventh' day) 

 in the form of small red areas. The volume of erythroblastic 

 tissue seems to increase with the progress of the disease and 

 cases of fourteen days and longer usually presented completely 

 red marrows. 



(h) The respiratory tract: Some degree of bronchitis and 

 bronchopneumonia were present in thirty-seven of our autop- 

 sied cases. In eight cases extensive (confluent) bronchopneu- 

 monia was the apparent immediate cause of death. There 

 were no distinctive appearances of the bronchopneumonic 

 lesions, or of the lungs as a whole, which could serve to dis- 

 tinguish the process from secondary bronchopneumonia in 

 general. 



(i) The alimentary tract: We found no characteristic pa- 

 thology of the alimentary tract and the esophagus, stomach, 

 and intestines, with but few exceptions, showed no gross 

 lesions. Shallow ulcerations of the stomach and duodenum 

 were found in two cases. In appearance and situation these 

 ulcerations were like those encountered frequently in other 

 infections than typhus. Intense hyperaemia and punctate 

 hemorrhage of various portions of the intestines and stomach 

 was occasionally found as in deaths from other causes. 



(j) Salivary glands: The sub-maxillary glands in one case 

 were the seat of an acute suppurative exudate into the ducts 

 and contained small abscesses. 



(k) The pancreas: No acute changes were found in the gross. 



(1) The liver: Focal necroses visible to the unaided eye were 

 found in three instances, giving appearances in no way dis- 

 tinguishable from those occurring in other infections. In each 

 of these cases there were other factors than typhus, respec- 

 tively, phlegmon of the leg, suppuration of the sub-maxillary 

 gland, and confluent bronchopneumonia. In the other autop- 

 sies no gross changes were found. 



(m) Urinary tract: The kidneys in three cases only showed 

 acute gross changes, once pyelitis and twice the changes usu- 

 ally called cloudy swelling. In these two latter instances the 

 kidneys were above normal weight, and were pale and bulged 



