390 DISEASES OF THE G ASTRO-INTESTINAL TRACT. 



The lesions of other organs are in no way characteristic of 

 the disease. Parenchymatous or granular degenerations are 

 found in all toxaemias of sufficient degree and duration ; the 

 liver, kidneys, and heart-walls are so affected. 



Inflammation of the pericardium, endocardium, or myo- 

 cardium is not uncommon. 



A peculiar waxy or hyaline degeneration, which may occur 

 also in other infectious diseases, involves the voluntary muscles, 

 the fibres being converted into a homogeneous, colorless, shin- 

 ing mass resembling amyloid degeneration, but not giving its 

 characteristic reaction with iodine and sulphuric acid, and 

 affecting most frequently the abdominal muscles, adductors 

 of thighs, the pectorals, the diaphragm, and sometimes the 

 myocardium. 



Bronchitis, lobar and lobular pneumonia are frequent com- 

 plications ; gangrene of the lungs a rare one. Occasionally 

 there is an inflammation of the parotid gland, which tends to 

 terminate in abscess-formation. A grave peritonitis is gener- 

 ally the result of perforation, though it may have its starting- 

 point in a deep ulcer which involves, but does not perforate 

 the serosa ; or it may be due to the inflammation involving 

 the mesenteric glands. 



An obliterating endarteritis may occur, especially during 

 convalescence, leading to thrombosis and necrosis of the tissue 

 supplied. Thrombosis may also occur in the veins, especially 

 the femoral, rarely in the cerebral sinuses. 



An orchitis occurring during convalescence, and frequently 

 terminating in suppuration, has been described. 



Tuberculosis, though scarcely ever noted in the oesophagus 

 or stomach, very frequently affects the intestinal tract in fact, 

 is one of the most common pathological conditions met in the 

 intestine. While not necessarily confined to the lymphadenoid 

 tissue, these structures are especially involved, the lesions 

 being most numerous in the lower part of the ileum and in 

 the colon. It may be primary rarely in adults, though some- 

 what more frequently in infants ; generally it is secondary to 

 tuberculosis of the lungs, and the result of swallowing infected 

 sputum. 



The tubercle appears beneath the mucous membrane 



