MORBID ANATOMY 43 



merous yellowish colored flakes which form a sediment when 

 the liquid is allowed to stand in a glass. The pleuritic exudate 

 sometimes consists of pure pus and less frequently of blood. 

 The pleuritic exudate when present in large amount com- 

 presses the lungs and pushes them away from the thoracic 

 walls. In cases of recovery, the pleuritic exudate may be- 

 come organized, binding the lungs to the costal walls and dia- 

 phragm. Various forms of fibrous, villous growths develop 

 on the pleurae. 



The records show that the other organs of the body are 

 usually in a state of parenchymatous inflammation and fatty 

 degeneration. The muscular tissue of the heart is, as a rule, 

 brownish-grey in color, .soft and suffers from cloudy swelling. 

 In severe cases, it shows well-marked fatty degeneration, is of 

 a clay color, and is occasionally infiltrated with a large number 

 of small, yellowish-white foci. The liver is enlarged, of a 

 cla}' color or sometimes icteric, and presents signs of fatty de- 

 generation. The spleen is flaccid, its pulp increased and often 

 sprinkled with haemorrhages. The kidneys ma}' be swollen, 

 friable and sometimes show numerous haemorrhagic foci. 

 The lymph glands, especially the bronchial and mediastinal 

 glands, are enlarged, softened, and exhibit on section a greyish- 

 red color. The muscles of the body are soft, and of a yellow- 

 ish-brown color. Small haemorrhages under the serous mem- 

 branes are frequently reported. Slight endocarditis ma}' 

 occur. The blood is said to suffer less change than any of 

 the solid organs. 



The mucous membrane of the stomach and intestines is 

 frequently hyperaemic, swollen, sprinkled with haemorrhages, 

 and sometimes even ulcerated. The bronchial mucous mem- 

 brane is also swollen and inflamed. 



In other cases, the lesions are those of lobar pneumonia, in 

 which the stages of hyperaemic, red hepatization, grey hepa- 

 tization and resolution (in favorable cases) follow each other 

 in regular order. In a fatal case postmortemed by the writer 

 the right lung was entirely involved, the left one being but 

 slightly hyperaemia. In non-fatal cases, the crisis is reached 

 on the 5 or 6 day, after which resolution begins. 



