386 DISEASES OF THE G ASTRO-INTESTINAL TRACT. 



perforation and localized purulent collections, or a general 

 septic peritonitis. Not infrequently the whole organ becomes 

 almost immediately gangrenous (Figs. 175 and 176). 



Specific Inflammations of the Intestines. 



Asiatic cholera is an acute infectious disease characterized 

 by an intense inflammation of, and a copious serous exudate 

 from, the small and large intestine ; due to the spirillum 

 cholera?, first described by Koch. Clinically, also, the main 

 features of the disease are referable to the intestinal tract, the 

 constitutional disturbances being due to the absorption into 

 the general circulation of toxins produced by the micro- 

 organisms there localized. The mucous membrane, particu- 

 larly in the lower part of the ileum, is swollen, congested, and 

 frequently the seat of ecchymoses ; the solitary and agminated 

 lymphatic follicles are often swollen, as may be likewise the 

 mesenteric glands. The bowel is distended as if paralyzed, 

 and filled, often with large quantities, of a serous transuda- 

 tion containing small white flakes of desquamated and de- 

 generated epithelial cells, similar to the characteristic " rice- 

 water" dejections. 



Later in the disease, in some epidemics, the mucous mem- 

 brane may be ulcerated or covered by a pseudo-membrane, 

 the colon presenting an appearance similar to that in dysen- 

 tery possibly the result of secondary infections. Outside of 

 the intestinal tract one of the most marked features of the 

 disease is the pronounced thickening of the blood due to the 

 enormous serous transudations. 



The heart, liver, spleen, and kidneys may be the seat of 

 parenchymatous degenerations characteristic of other toxaemias 

 as well, however, and in no way distinctive of this disease. 



Typhoid fever is an acute infectious disease produced by the 

 bacillus of Eberth, the characteristic lesions being almost 

 entirely confined to the lymphadenoid structures of the lower 

 part of the ileum and upper part of the colon. Contaminated 

 water or milk is the chief source of infection. 



The morbid changes in typhoid fever may begin as a diffuse 

 inflammation of the intestinal mucosa, but almost immediately, 

 at least within twenty-four hours, the solitary follicles and 



