MORBID ANATOMY 4I 



depression, usually loss of appetite and muscular weakness: 

 the conjunctivae and other visible mucous membranes become 

 congested. There may be from the beginning marked indica- 

 tions of localized lesions in the lungs, or the general symptoms 

 may continue without e\-idence of pronounced lung disturb- 

 ance. The duration 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 convalesence is much longer 

 lasting from two to three weeks. Many symptoms may be 

 exhibited corresponding to the variations in the morbid pro- 

 cesses. If the heart, digestive tract, liver, kidneys or brain 

 become the localized seat of the disease, symptoms referable 

 to impaired functions of these organs are in evidence. The 

 septicaemic form has been described as being followed by 

 localized suppurative lesions. 



§33. Morbid anatomy. The morbid changes in the tis- 

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

 which is exceedingly irregular. It may exhibit a regular form 

 of lobar inflammation of the hmgs 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 completeh- 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. 

 Thev 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 is stated 

 furnishes the largest number of subjects for a post mortem ex- 

 amination, there is a multiple haemorrhagic, gangrenous 

 pneumonia with secondary pleuritis and possibly parenchy- 

 matous degeneration of the vital organs of the body. Areas 

 of the lung tissue of greater or less size are thickened and 

 hepatized. These are located more especially near the base of 

 the lungs and in the lower (ventral) portions. Bright foci 



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