IN CONTINUED FEVER. 37*7 



interior, consisting of the somewhat altered mucous and sub- 

 mucous tissue. 



The morbid changes which the glandulse aggregates of the 

 ileum undergo during continued fever, appear, from the 

 observations I have just detailed, to be of the following 

 nature viz. the development of cells within the constituent 

 vesicles of the patches to such an extent as at last to burst 

 them, or cause their solution; the continued increase in the 

 number of the cells, proceeding from as many centres as there 

 are vesicles in the patch ; the conglomeration of the whole 

 into one mass above the submucous and under the mucous 

 membrane ; the distension of the latter, and the necessary 

 ulceration and sloughing of the mass arising from this circum- 

 stance. 



The whole mass'; as detached from the gut, is not there- 

 fore to be considered as a slough ; that portion only which 

 consists of the upper halves of the vesicles and of the mucous 

 membrane being dead ; the greater part, consisting of the 

 cellular mass, being merely detached from the submucous 

 tissue, consists of those nucleated cells, which, at first con- 

 fined within their generative vesicles, had at last vegetated 

 so much as to break their natural bounds, and become one 

 mass of cells, constantly increasing in numbers, except below, 

 where the separate centres from which they originally pro- 

 ceeded are indicated by the processes and little pellets which 

 are situated in the remains of the vesicle-capsules. 



It will have been observed that I have not employed the 

 term " inflammation " in the course of the description I have 

 just given. Whether the changes I have described originate 

 in inflammatory action or not, of this I am certain, that the 

 ulceration and pseudo-sloughing is an immediate effect of the 

 distension from the submucous vegetating mass, and would 

 occur whether the latter were produced by inflammation or 

 not. 



