Pathologic Anatomy and Histology. 31 



between the two adjacent lobules and especially at the 

 bottom of the indentation between two of the lobules. 

 Sometimes they entirely circumscribe the lobule. The 

 fleck is not a depression as in interstitial hepatitis. 

 Neither is it an elevation as in fat infiltration. Some- 

 times the boundaries of the flecks become obscure spread- 

 ing over the liver (especially on its indented surfaces) 

 as large gray markings. Upon touching such a liver 

 one finds that it is rather hard and compact {vide his- 

 tologic changes). 



In the acute cases the kidney is enlarged, softened, 

 turbid and covered with small petechiae. It is richer in 

 blood than any of the other organs, and consequently 

 appears juicy and readily putrefies. Even in the chronic 

 cases petechiae are sometimes found in the cortex. In 

 the papillae haematoidin infarct is sometimes seen. In 

 many cases the mucous membrane of the urinary bladder 

 has ecchymoses both new and old. 



In the pleural cavity a small quantity of fluid is 

 present. On the pleural membrane and on the diaphragm 

 many petechiae of various sizes ranging from that of 

 millet, or linseed to a pea are always met with. The lungs 

 do not show any changes peculiar to the disease, but 

 sometimes hyperaemia, haemorrhage, oedema and rarely 

 bronchopneumonia are found. 



In the pericardium a large quantity of transparant 

 yellowish exudate is present (200-1500 c.c, usually 400- 

 500 c.c). In the adipose tissue are usually found nume- 

 rous thickly set petechiae, though this change is not so 

 marked in the chronic cases. 



The heart is relaxed dilated and with little contents. 

 The heart muscles are soft and turbid. In the endo- and 

 epicardium ecchymoses are invariably found and in the 

 extreme cases they appear as though they were injected 



