LESIONS IN ABDOMINAL CAVITY 133 



atic glands, producing well-marked discoloration. The color of 

 the coal-dust particles, however, is decidedly different from that 

 due to hemorrhage. In such cases also there is absence of other 

 signs of acute inflammation, such as sweUing, softening, and degen- 

 eration of the tissue of the gland. Under the microscope the 

 appearance of the two forms of discoloration are entirely different, 

 and no mistake should be made in this direction. 



LESIONS IN ABDOMINAL CAVITY 



After having made the incisions for examination of the cervical 

 and submaxillary glands, and the second incision in the inguinal 

 fold to examine the superficial inguinal glands, an incision should 

 be made in the median line of the belly to allow of examination 

 of the abdominal organs. This incision goes through skin, sub- 

 cutaneous tissues, and through the peritoneum, thus opening 

 up the abdomen. Care should be used that the knife does not 

 penetrate too deeply and open into one of the bowels, which are 

 often distended with gas and pushed right up against the belly 

 wall. This incision should extend from the margin of the anus 

 to the midline of the neck. 



Pulling the sides of the abdominal incision apart, we are able to 

 get a view of the contents of the abdomen. Frequently we will 

 find that the cavity contains a considerable amount of a blood- 

 colored fluid which is formed as a result of the overfilling of the 

 smaller blood-vessels in the abdomen, causing fluid and blood-cells 

 to pass out into the empty peritoneal space. 



The Intestines. — The intestines, or bowels, are now taken out 

 through the opening in the belly wall and examined. In severe 

 hemorrhagic cases we can frequently see blood-stained areas shining 

 through the outer coat of the bowel, and especially so the small in- 

 testine. Also in many severe cases the large bowel will be found 

 to be discolored very markedly, in fact, to have an almost black 

 appearance. This is due to the severe type of bowel inflammation 

 which is often an accompaniment of cholera. 



We will now proceed to examine the different parts of the intes- 

 tinal tract in order, beginning with the stomach. 



The Stomach. — This organ frequently shows, even on its outer 

 surface, a markedly congested and reddened appearance. On 



