MORBID ANATOMY 35 



states that it may first assume the form of pharyngitis, purulent 

 pneumonia, and pleuritis without any well-marked morbid 

 affection of the lymph glands. The urine generally remains 

 alkaline; it frequently contains a considerable quantity of al- 

 bumen. 



At times, strangles is accompanied by a cutaneous exan- 

 thema which takes the form of an eruption of wheals, nodules, 

 vesicles, and even pustules may appear, chiefly on the sides of 

 the neck, shoulders, and sides of the chest. These exanthe- 

 mata are characterized by their sudden appearance, and often 

 by their equally rapid disappearance. An eruption of vesicles 

 may break out on the nasal raucous membrane. The contents 

 of the vesicles is at first limpid, but later it becomes purulent. 

 Rabe states that the streptococcus of strangles can produce 

 ulcers on the nasal mucous membrane. 



§ 26. Morbid anatomy. The lesions in strangles are 

 interesting from the fact that in the beginning the disease is 

 general but later in its course it becomes a series, exceedingly 

 variable in different individuals, of localized morbid foci. 

 The lymphatic glands seem to suffer most, although any organ 

 may be involved. As indicated by the symptoms, the lesions 

 in most cases are characterized by an acute inflammatory pro- 

 cess followed by suppuration. 



The glandular swellings about the head usually terminate 

 in suppuration, the pus discharging either externally or into 

 the oral cavity. In other cases, the pus undergoes caseation. 

 Frequently the inflamed glands become confluent, resulting in 

 a single large abscess. Small abscesses may occur under the 

 pharyngeal mucosa. 



The inflammation may extend to the superficial lymph 

 vessels of the skin, especially of the head, resulting ui the for- 

 mation of a large number of small abscesses. This may be 

 followed by a diffuse phlegmonous swelling of the parts. 

 Metastatic abscesses are liable to occur in a great variety of 

 organs. The metastasis seems to take place through both 

 lymph and blood vessels although the lymphatic glands are 

 most often affected. Suppurating foci have been described in 

 nearly every lymphatic gland in the body. The discharge of 



