DISEASES OF THE BLOOD. 53 



ulceration of the bowels and the case is desperate. Colicky 

 pains are not unfrequently present, and after death a very- 

 considerable portion of the bowel may be found spas- 

 modically contracted. 



In the respiratory form of the disease the symptoms are 

 those of bronchitis of an extremely asthenic type, and 

 corresponding lesions are found post mortem, in addition 

 to those indicative of general derangement of the blood. 



In the hepatic form there is severe jaundice, with its 

 ordinary indications, and the depression of the system is 

 most extreme. 



Skin eruption, varying from puncta to large purulent ac- 

 cumulations beneath the cuticle, sometimes occurs. Farfrom 

 constituting a favorable critical evacuation, it is generally 

 considered to indicate the imminence of fatal termination 

 to the case. In India it has seemed to me much less 

 ominous, and skin eruption is frequently followed by re- 

 covery, the blebs burst and repair rapidly ensues, the 

 skin* remaining scurfy for some time. The most frequent 

 seat of this eruption is over the belly. 



Semmer of Dorpat records as present on post-mortem 

 examination the following appearances : — Body emaciated, 

 eyes and nostrils glued with purulent mucus. Lungs 

 reddish brown, heavy, dense in consistency, and having 

 their parenchyma infiltrated with fibrinous exudate. Com- 

 mencing cell-infiltration of the alveoli, respiratory mucous 

 membrane reddened, tumefied, and covered with mucus 

 (or muco-pus) . Brain and spinal cord oedematous (and 

 their membranes highly congested and the seat of serous 

 effusions in some cases). Liver bright yellow and of 

 nutmeg-like appearance, and studded with brick-red and 

 brownish-red streaks and spots, these appearances being 

 due to fatty degeneration. Spleen enlarged and with a 

 marrow-like infiltrate. Kidneys congested and fatty, but 

 this state (as also the granular degeneration of the liver) 

 not constant. The digestive and% urinary. -mucous mem- 

 branes present stellate patches of hyperemia and ecchy- 

 moses. Muscular tissue of heart pale, and commencing 

 to undergo fatty degeneration. Blood watery, serum 



