146 



Purulent Pneumonia. 



surface is uneven and villous, the surrounding pulmonary 

 tissue is tougli and void of air in consequence of cellular in- 

 filtration. On the other hand, whole pulmonary lobes may 

 be infiltrated showing on the cut surface grayish-yellow points 

 of the size of a pin head. Older abscesses have their own 

 connective tissue walls and well established cases show in- 

 spissated pus or dry caseous masses in their interior. The 

 pleura shows evidences of a seropurulent or purulent inflam- 

 mation whenever the abscesses are situated superficially. 



Symptoms. The s^nnptoms of the disease vary very much 

 from case to case. If suppuration has followed upon croupous 



Fig. 22. Fever curve in purulent ])neunionia in a Jiorse. 



or catarrhal pneumonia, the liquefaction of the exudate is 

 retarded, an elevation of temperature again occurs and the 

 grave symptoms of acute pneumonia again stand in the fore- 

 ground of the clinical picture. Embolic purulent pneumonia 

 develops rapidly and leads in a short time to severe symptoms. 

 The symptoms point to grave acute pneumonia with high 

 fever (Fig. 22) and respiratory disturbances; later on the signs 

 of a septic infection are present. Percussion either shows no 

 deviation from the normal or there may be more or less dull- 

 ness, or tympanitic sounds in circumscribed places ; eventually 

 also metallic sounds. One hears rales, sometimes also bronchial 



