THE INFECTIOUS DISEASES. 235 



with lobjil^r pneumonia or with infarctions, or as an independent condi- 

 tion. Fibrinous pleurisy and empyema are not infrequent. 



The Genito-TJrinary Organs. The kidneys are occasionally the seat of 



J ", *- *7 ** iy 



an acute inflammation. ( artarrhaT and croupous and nodular inflam- 

 mation o^the bladder may occur, "haemorrhage and gangrenous inflam- 

 matioiTin the ovajies have been recorded; the uteru^may be involved. ' 

 Orchitis^iiul epididymiiis may develop during convalescence. 2 



The Nervous System. In addition to chromatolytic changes in the gan- 

 glion celjs which are commqn^to many infectious diseases, 'TheTe may~be 

 thrombosis of the venous sinuses and obliterating endarteritis. Acute 

 meningitis is rare. 4 Degeneration and inflammation of flie peripheral 

 nerves^niay occur. 



Suppurating Inflammation may occur, in almost^auj part of the b_odv 

 in typlioid^fever. This may be in the form of boils or of jieep abscesses. 

 Post - pharyn gea^ suppuration is often^ one^ of the most serious of these 

 complication^ Post- typhoid bone lesions are often important.' 



SEPTICLEMIC FORMS OF TYPHOID FEVER WITHOUT CHARACTERISTIC 

 LOCAL LESIONS. 



Typhoid^fever^ may^ occur jvithout the characteristic intestinal and 

 associated lesions. In this septicaemictype of the disease there may be 

 no demonstrable^ lesions otngr than those which are due to the toxae- 

 mia^ On the other hand, inflammatory processes in the viscera lungs," 

 kidney, spleen^etc. may be dependent on the presence of the typhoid 

 bacilluS| The lesions in such cases are not, so far as we yet know, char- 

 acteristic, and the post -mortem diagnosis depends largely upon the iden- 

 tification of the bacillus. ' 



1 Lartiqau, New York Med. Journal, June 16th, 1900, bibliography. 

 "See Kinnieutt, Trans. Assn. Amer. Phys., vol. xvi., p. 145. 



3 For a study of ganglion cells in cases of typhoid fever see KicJioh, Jour, of Exp. 

 Med., vol. iv., p. 189, 1899, bibliography. See also Ewing, "Studies on Ganglion 

 Cells," Archives of Neurology and Psychopathology, vol. i., p. 263, 1898. 



4 For bibliography of typhoid meningitis see Wenticorth, Trans. Amer. Pediatrio 

 Soc., vol. xi., p. 145, '899. 



8 Parsons, Johns Hopkins Hospital Reports, vol. v., p. 417, 1895. 



6 Consult in this connection for cases and bibliography, Chiari, Zeitschrift f. Heil- 

 kundo, 1897; Lartigaii, New York Med. Journal, vol. Ixx., p. 158, 1899: also Johns 

 Hopkins Hospital Bulletin, April, 1899; Ophuls, N. Y. Med. Jour., May 12th, 1900. 



1 For summary of studies on the typhoid bacillus and typhoid fever, with bibliog 

 raphy, consult Duitbar, "Ergebnisse der allg. Aetiologie der Menscheu- w. Thierkrank- 

 heiten," Jahgr. I., Abth. 1, p. 605, 1896. 



