MORBID ANATOMY 36 1 



Usually the most conspicuous changes are in the spleen. 

 This organ is much enlarged and increased from two to four 

 times its normal weight. The normal markings, Malpighian 

 bodies and trabeculae, are hidden in the dark brownish-red, 

 glistening pulp which distends the capsule. The pulp may be 

 firm or it may be in a semi-fluid condition so that it oozes out 

 if the surface is cut. The enlargement and color of the spleen 

 are due to an engorgement of red blood cells. There may 

 also be present a greater or less number of large cells contain- 

 ing granules, red corpuscles or clumps of 3'ellowish pigment. 

 Free pigment is much more abundant than it is in healthy 

 spleens. 



The liver is extensively affected. It is enlarged, con- 

 gested, edges rounded, the bile ducts more or less distended 

 and the parenchyma is usually in a state of fatty degenera- 

 tion. The color is paler than normal and usually the surface 

 is somewhat mottled. On section the color of the cut surface 

 is brownish-yellow or it may be mottled like the surface. The 

 mottling is due to a discoloration owing to degeneration of a 

 zone bordering the intralobular vein. This zone varies in 

 width and its peculiar color seems to be due to a tendency to 

 necrosis. It is characterized by parenchymatous degeneration 

 and the loss of the nucleus. It may involve a third or more of 

 the lobule. This portion stains very feebly or not at all. The 

 explanation for the necrosis of the liver cells is suggested by 

 Smith as being due to the plugging up of the ultimate bile 

 canals with solid bile which may interfere in some way with 

 the nutrition of the adjacent liver cells. The bile stasis he 

 considers as a result of the breaking up in the capillaries of 

 the liver of enormous numbers of infected corpuscles. This 

 results in an abnormal fluid containing an excess of .solids 

 which the bile ducts are unable to carrj' away. When 

 examined in fresh condition or in sections of tissue fixed in 

 Miiller's fluid the engorgement of the bile canaliculi is seen. 

 The bile stasis may occur over a portion or a whole of the 

 lobule. The gall bladder contains usually an abnormal quan- 

 tity of changed bile. It is thick and often semi-solid in con- 



