Petechial Fever. 145 



mucosa, and narrowing the lumen almost to complete occlusion. 

 Sloughing is not rare, and the resulting ulcers may extend into 

 the subjacent tissues, so as to penetrate the septum nasi or the 

 thin plate of the turbinated bone. 



The buccal i?iucosa and sub-mucosa are often involved in common 

 with the skin of the lips, cheeks, and intermaxillary space, the 

 tissues being involved in one common infiltration of blood and 

 serum. In some cases circumscribed necrosis and ulcerations are 

 formed. 



In the pharynx and larynx infiltration of the mucosa and ad- 

 jacent parts of a deep blood red, with or without ulceration, causes 

 serious narrowing of the passage, that on the vocal cords threatening 

 suffocation. Suppuration of the pharyngeal glands and guttural 

 pouches is not uncommon. Alimentary matters are frequently 

 found in the larynx, and bronchia. 



Beside the petechiae and haemorrhages in the lungs, oedematous 

 infiltration in dependent parts, hepatization, abscess, and limited 

 areas of necrosis are met with. The pleural sacs often contain a 

 sanguineous effusion. 



The stomach and intestines are usually more or less mottled 

 with petechiae involving mucosa, serosa or muscular coat ; they 

 are raised in rounded or irregular elevations by cedemas ; or they 

 are the seats of more or less extensive and even perforating ulcers. 

 The contents of the bowels may be deeply discolored by the 

 escaping blood. 



The kidneys may be pale except where blood stained and 

 oedematous infiltration of the surrounding tissue may be marked. 

 Serous effusion into the peritoneum is not rare. 



The eyelids are often implicated, infiltrated thickened, and rigid, 

 and the conjunctiva, bulbar and palpebral, the seat of extensive 

 petechiae. 



Barreau mentions extravasations on the divisions of the lumbo- 

 sacral plexus causing sudden paraplegia. 



Petechiae and haemorrhages mark endocardium, pericardium 

 and cardiac muscle, otherwise the muscle is pale. The blood is 

 sometimes in firm clot, at others diffluent or nearly incoagulable. 



Symptoms. If hyperthermia is not already present as a feature 

 of the pre-existing malady it usually shows itself early, at first 

 slight, it may be (101 F.), and afterward rising in some cases to 

 10 



