SYMPTOMS 53 



the symptoms differ from those of fibrinous pneumonia by the 

 absence of distinct evidences of local lesions which are found 

 in that disease. The first regular symptom is a rapidly 

 increasing temperature frequently accompanied by a chill. The 

 pulse rate is increased. There is general depression, usually 

 loss of appetite and muscular weakness ; the conjunctivae and 

 other visible mucous membranes become congested. There 

 may be from the beginning marked indications of localized 

 lesions in the lungs, or the general symptoms may continue 

 without evidence of pronounced lung disturbance. The dura- 

 tion of the disease depends almost entirely upon its course. 

 In the more typical cases, the fever lasts from 5 to 8 days. 

 The period of convalescence is much longer, lasting from two 

 to three weeks. Many symptoms may be exhibited, corres- 

 ponding to the variations in the morbid processes. If the 

 heart, digestive tract, liver, kidneys or brain become the local- 

 ized seat of the disease, symptoms referable to impaired func- 

 tions of these organs are in evidence. The septicemic form 

 has been described as being followed by localized suppurative 

 lesions. 



§ 35. Morbid anatomy. The morbid changes in the 

 tissues and organs vary according to the course of the disease, 

 which is exceedingly irregular. It may exhibit a regular 

 form of lobar inflamation of the lungs or the disease may run 

 an atypical, complicated, acute, chronic, and not infrequently 

 an abortive course. Further, authorities agree that many com- 

 plications may arise modifying or changing completely the 

 morbid anatomy of the disease from the conditions found in 

 the more typical cases. In the few cases examined post-mor- 

 tem by the writer, the gross lesions were restricted to the lungs. 

 They were either in a state of congestion, or exhibited 

 changes of fibrinous pneumonia in the cephalic (anterior) 

 portions of one or both organs. Pneumonia is the most com- 

 mon localized lesion. Several quite distinct forms of lung 

 disturbances are described. 



In the lobular form of pleuro-pneumonia, which it is 



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