74 BACTEBIAL POISONS OF INFECTIOUS DISEASES. 



softened. The patches of Peyer in the intestine at times showed up 

 with a prominence sufficient to enable them to be detected through 

 the serosa of the intestine. The peritoneal cavity often contained an 

 excess of clear fluid ; hydrothorax also occurred, and in rare instances 

 reached such a high degree as to completely compress both langs, the 

 apices alone being spared and insufflated. The pericardial sac was 

 also unduly distended with a clear serous fluid. The adrenal glands 

 presented a reddish color externally, and on section the medulla ap- 

 peared deeply congested or even hemorrhagic. The kidneys were 

 often pale. The liver was, as a rule, congested and exhibited upon 

 its surface and within its substance a variable number of yellowish 

 or yellowish-white areas, some not larger than a pin-point, others 2 

 mm. in extent, which were usually surrounded by a hyperemic zone. 

 In some cases a few of such foci could be discovered with the naked 

 eye ; in others they were almost innumerable. The spleen, as a rule, 

 was not greatly enlarged, it was more often pale than congested, and 

 the Malpighian bodies showed distinctly. The lungs varied in ap- 

 pearance, the difference depending apparently not so much upon any 

 pathological alterations of which they were the seat, but rather upon 

 the quantity of fluid present in the pleural cavities. The heart was 

 pale, the chambers, especially of the right side, were distended with 

 dark, clotted blood. Subserous hemorrhages, especially in the peri- 

 toneal cavity, were an interesting but variable feature of the disease." 

 The same observer made a close microscopical study of the various 

 tissues of animals treated with crude diphtheria toxin. In the 

 lymph glands, the earliest changes were found to consist of swelling 

 of the nucleus and perhaps also of the protoplasm. Under larger 

 doses of the poison the nuclei were often observed to be homogeneous 

 and seemed converted into granular balls of variable size, staining 

 evenly and intensely but exhibiting a metachromatic reaction. 

 Under still larger doses, the nuclei were observed to undergo disin- 

 tegration. The fragmentation was irregular, indicating the powerful 

 effect of the toxin. In some cases the detritus was seen within the 

 protoplasm of the original cell, while in others the fragments had 

 become free, owing to the destruction of the cell body. Necrobiotic 

 foci, such as have been described by Oertel after death from diph- 

 theria, were observed in the lymph glands in certain cases. The 

 spleen was generally hyperemic, the excess of blood being contained 

 within the sinuses of the pulp. The earliest changes were found to 

 consist of swelling of the cells of the Malpighian bodies. Mitotic 

 division was observed in the cells but did not seem to progress 

 actively. Pathological alterations were found in the pulp affecting 

 the framework and the vascular contents. In the intestines, the 

 most pronounced changes were encountered in the epithelium. These 

 alterations consisted of proliferation by mitosis and of degeneration. 

 There was extensive fragmentation of cells within the crypts of 



