306 DISEASES OF THE INTESTINES. 



death. Patches of redness are also visible in different places upon the 

 membrane (the mucous follicles being larger than common) ; sometimes 

 superficial ulcerations, petechia? even, and gangrenous eschars, which may 

 be nothing more than ecchyraoses. Similar appearances are found in the 

 small intestines, whose mucous membrane in many parts is reddened, in- 

 jected, softened, and studded with assemblages of pointed eruptions : a 

 grey, thick, glairy mucus and some petechial spots are also visible. In 

 some cases, the matters contained in the small intestines are solid, and 

 look as though they had been dried ; though this is an appearance more 

 common in the large guts, unless there happened to have existed diarrhoea 

 before death : in the cascum we almost always find this, and for some 

 way also, though in a less marked degree, within the cells of the colon. 

 More or less inflammation is observable in the mucous membrane of the 

 fauces ; the sides of the tono;ue are covered with ulcerations resembling 

 aphthse ; and the surface of the pharynx, which is more or less deeply 

 reddened, sometimes presents a cribriform or worm-eaten appearance. 

 Its follicles also often acquire such considerable development that they 

 might be mistaken for buds with their orifices wide open. Some of these 

 alterations are perceptible at times within the oesophagus. When the 

 disease has proved complicated, we also find after death alterations in 

 those organs which have shown a disposition to partake of it. The liver 

 is often tumid, its veins are gorged with blood, and its substance is pale 

 and without firmness : in some subjects ecchymoses and recent adhesions 

 are apparent upon its exterior, evidently the consequences of inflamma- 

 tion. The lungs at one time are simply engorged ; at another, within the 

 anterior appendices and extremities of the lobes, they exhibit the red in- 

 duration ; or they are hepatised in places, or inflamed around their peri- 

 phery, and contain spumous blood. In certain subjects, the pleurae are 

 reddened and thickened, and covered with layers of albumen, a part of 

 which forms false membranes and points of adhesions to the walls of the 

 thorax. Effusion is rare; notwithstanding, it has been observed by me 

 in two instances, and in one of them so considerable was the quantity that 

 the case nowise differed from hydrothorax. According to M. Girard, 

 whose observations we are now borrowing, the heart is the organ most 

 and oftencst affected. The pericardium, commonly infiltrated in substance 

 with yellow fluid, contains more or less serosity, sometimes bloody, and 

 affords evident marks of acute inflammation. In many subjects, the heart 

 is twice its natural volume, its substance pale and discoloured, and, void 

 of tenacity, rends with fiicility: its exterior, in a state of inflammation, 

 exhibits black spots, the effects either of ecchymosis or gangrene (most 

 probably of the former). Its cavities always contain black thick blood, 

 semi-coagulated ; and often yellow, consistent, fibrinous, albuminous 

 concretions. These productions, large or small, exist sometimes, says 



