HEMORRHAGE. 433 



diphtheria of the mucous surface. Contact with putrid matter 

 also contributes to cause those diphtheritic lesions which occur; 

 not on a catarrhal, but on a denuded surface. I refer to diph- 

 theria of the womb and vagina immediately after parturition, 

 when the shedding of the decidua has left the uterine parenchyma 

 unprotected and raw, like an amputated stump ; I refer to the 

 diphtheria which occasionally complicates the second stage of 

 Asiatic cholera, after the violent catarrh of the first stage has 

 stripped the mucous membrane of all its epithelium, and left it 

 a prey, in this its "flayed" condition, to the direct influence of 

 the intestinal contents ; finally I refer — although this has really 

 nothing to do with the mucous tract — to that diphtheria of 

 wounds which is known as hospital gangrene. 



On the other hand, it cannot be denied that the element of 

 putridity may also reside within the organism ; that there is a 

 state of the fluids in the individual which predisposes him to 

 become affected by diphtheritic inflammations — or, to speak 

 more accurately — which predisposes any inflammation, otherwise 

 excited, to take on a diphtheritic character. Many diphtheritic 

 inflammations of the pharynx and alimentary canal, complicating 

 the last stages of maladies which profoundly affect nutrition, 

 may be thus explained. In conclusion, I must not omit all 

 reference to a statement which has over and over again been 

 repeated (Letzerich), to the effect that diphtheritic inflamma- 

 tion is due to the germination of a fungus upon ulcerated and 

 mucous surfaces. Although I am by no means hostile to this 

 view, I do not reofard it as well enouojh established to warrant 

 my bestowing any lengthy notice upon it on the present 

 occasion. 



b, HEMORRHAGE. 



§ 372. I am by no means sure that my grouping the various 

 matters which I propose to discuss in the present chapter, under 

 the common head of " Haemorrhage," will meet with universal 

 approval. The reader's attention has already been called (§§ 353 

 and 240) to the facilities afforded by the arrangement of the 

 capillaries in the gastro-intestinal mucous membrane, for the 

 occurrence of hypera^mia and hoemorrhage. In the more lively 

 contractions of the muscular coat, which accompany catarrhs even 

 of trifling intensity, but which are especially characteristic of 



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