68 INFLUENZA. 



eccliymoses in connection with the endocardium that have 

 been observed as existing beneath the hning membrane of the 

 pericardium. 



In many cases which have disaj^pointed our expectations of 

 recovery by a rather sudden death, certain textural changes 

 may be looked for, as thrombi, blood-clots in the cavities of 

 the heart, or growths of a fibrous and warty character on the 

 valves, or both. The cases of cardiac thrombi and valvular 

 excrescences are most common when the fever has been of 

 that form in which the fibrous, fibro-serous, and connective 

 tissues of the body have been largely implicated. 



In the abdominal form of the disease, in addition to the 

 lesions met with in the respiratory system, the characteristic 

 or peculiar structural changes, evidences of the enteric com- 

 plications, are to be looked for in connection with the viscera 

 and structures of the peritoneal cavity. The peritoneum is 

 sometimes marked with petechise and vibices, blood-spots and 

 blood-rays, while the cavity itself may contain a perceptible 

 increase of the fluid usually present there. 



In the stomach, duodenum, and other portions of the intes- 

 tine, we observe a varied arrangement of textural changes. 

 In the first of these situations, in some manifestations of this 

 form, particularly where sanitary and other extrinsic condi- 

 tions are unhealthful, large, irregularly formed hasmorrhagic 

 spots in connection with the mucous membrane are of common 

 occurrence. 



In the intestines, with a general and uniformly swollen 

 state of the entire mucous membrane, much infiltration of 

 the submucous tissue, and a yellowish-coloured gelatinous 

 exudate, there are scattered over the membrane smaller 

 hfumorrhagic patches similar to the larger ones seen in the 

 stomach ; while spread over extensive tracts there may be the 

 appearance of much irritation, Avith denudation and removal 

 of the epithelial structures, the result of the specific catarrhal 

 inflammation. 



These changes, although encountered more or less exten- 

 sively throughout the entire boAvel, are usually most con- 

 spicuous in the ccucum caput coll, and Avherc gland-structures 

 are most abundant. 



In the urinary bladder a somewhat analogous condition of 



