5o 



Scientific Proceedings (51). 



ing and occasionally adhesions. In the pleurae one finds as a 

 rule a simple serous exudate without deposits but occasionally 

 heavy deposits of fibrin also. In the peritoneum also the condition 

 commences with fibrinous deposits and eventually leads to marked 

 peritoneal thickening more especially in the upper part of the 

 peritoneal cavity. The capsules of liver and spleen are much 

 thickened and the contraction of the thickened capsule often 

 causes marked deformity of the liver. The lesions produced in 

 this way are closely analogous to Curschmann's "Zuckerguss- 

 leber." The spleen is always more or less enlarged, but this is due 

 to the excessive destruction of erythrocytes by the lead and is 

 found in all animals. 1 



It was only natural to suspect the presence of a bacterial 

 infection of the serous membranes in these cases. A very careful 

 bacteriological examination was made in several of the cases, but 

 it was entirely negative. 



Whether the hemorrhagic exudation which ushers in the 

 process is due to the lead anemia appears to me a question well 

 worth debating. Smears of the exudate show few leucocytes and 

 often many nucleated red blood corpuscles, even megaloblasts. 



In one case (46) adhesions had formed in the upper part of the 

 peritoneal cavity with partial strangulation of duodenum and 

 intestine and extreme dilatation of the stomach. 



In the liver the periportal connective tissue is moderately but 

 distinctly thickened in some cases. One always finds small areas of 

 fatty degeneration and necrosis of the liver tissue. In one case 

 (46) they were quite large and show beginning liquefaction in the 

 center (due to apparently secondary invasion of bacteria) . Whether 

 these degenerative lesions are due to circulatory disturbances pro- 

 duced by the shrinkage of the thickened capsule or whether they 

 are independent of this and toxic in origin, it is difficult to decide, 

 although in one case the lesions in the liver were well marked but 

 those in the capsule only slight. The bearing this may have on 

 the modern conception of cirrhosis as closely connected with 

 certain types of anemia is evident. 



1 It is interesting to know that Charcot and Gombault found acute pericarditis 

 in their guinea pig 4, hemorrhagic pericarditis in their guinea pig 9, subacute peri* 

 carditis in their guinea pig 15, and pericardial thickening in their guinea pigs 6 and 14 

 (S out of 15). 



