MORBID ANATOMY 



enlarged and hyperaemic. The colon may be found adherent to 

 the liver, the spleen, or the wall of the pelvis, while internally the 

 mucosa will be found to be reddened and inflamed, and to show 

 more or less numerous areas of ulceration and infiltration. These 

 areas are most commonly found in the caecum, the hepatic flexure, 

 and the sigmoid colon, but may occur anywhere along the course 

 of the large intestine. In places small nodules surrounded by a ring 

 of dilated vessels may be observed, between which the mucosa may 

 or may not be normal, while the nodules may show superficial or 

 deep ulceration. Deeper circular or oval ulcers may be noted with 

 their surface covered with a dark reddish slough, their edges under- 



FiG. 762. — The Colon in a Case of Amcebic Dysentery. 



mined, and their base formed by the muscular coats. In the case 

 of the oval ulcers, the longer diameter lies transverse to the long 

 diameter of the bowel, as a rule. The peritoneal coat may be 

 normal, inflamed, or softened and gangrenous. Usually the mus- 

 cular coat is thickened, as are the remains of the submucosa. 

 Scrapings from these ulcers reveal blood cells, leucocytes, bacteria, 

 and amoebae. The small intestine may show small bright red 

 nodules, and the Peyer's patches may be enlarged. The vermiform 

 appendix is usually normal, but occasionally may be ulcerated. 



The liver is often fatty, but may be congested and inflamed, or 

 may show one or more abscesses. The pancreas is generally normal. 



