83
the branching and peculiarities of the vessel, which they occupied. The lining
membrane of the right auricle and ventricle, and much less frequently the cavi-
ties on the left side, are observed to be stained a dusky red or claret colour; but
the pathological change, which gauges the gravity of the disease in each indivi-
dual case, must be looked for and estimated by the number and extent of the
sub-endocardial extravasations. These in cases under treatment, when the
hæmatozoon has been absent for some ten days, have been found to be entirely
absent; in other cases they may be represented by a few petechiæ, and again in
more severe attacks, extensive extravasations of blood may be present. These
sub-endocardial changes are usually more frequently present in the right ven-
tricle than in the left, and have been noticed in the cavities on the right side of
the heart, when they have been entirely absent from the left. They are least
frequently found In the left auricle. A common situation for them to occupy is
the surface of the musculi papillares, but they may appear on any portion of the
muscular wall of the cavity, as well as frequently involving the inner surface
of the flaps of the tricuspid and mitral valves. The ventricles occasionally pre-
sent well marked signs of fatty degeneration, and although in the human being,
the left is the more frequently affected, in these cases the right ventricle has
been observed to present the most marked changes, near to the apex of the
organ. In cases where the visible mucous membranes have been stained yellow
during life, the same colouration of the tissues of the internal surface of the
heart has been found well marked. In all the cases the yellow deposit of gela-
tinous material was present round the base of the organ.
Naturally contracted.—In four of these cases, ecchymoses or more extensive
extravasations were found on the external surface, lying under the visceral
pericardium (Nos. III, LXX, LXXI), and well marked in one (No. LVI). Sub-
endocardial extravasations were present on the bicuspid valves in Nos. (LVI,
LXX), and involving the tricuspid valve in No. LXX.
Inoculated cases:—In twelve cases, ecchvmoses were present on the
external surface of the heart, in (Nos. V, VI, XIV, XX, XXIV, XXX, XXXIII,
XXXVIII, XLIV, L, LIV, LIX), and internal sub-endocardial extravasations
as follows:—
In the right auricle, in two (Nos. LIX, XXXIII).
„
„
ventricle, in twelve (Nos. XIV, XV, VIII, XXII, XXIV, LIX,
XX, XXXIII, XXXIV, XL, XXXI, L),
„
left auricle, in three (Nos. LV, XXXIII, XXXIV).
„
left ventricle in fourteen (Nos. XIV, XV, VIII, XXX, XXI, XXIV,
LIV, LIX, XX, XXXIII, XXXIV, XLI, XL, XXXI).
The musculi papillares were involved in four cases (Nos. XIV, XV, XXI,
LIV).
E.—Organs of Respiration.
The Larynx usually presents nothing abnormal.
The Trachea is sometimes the seat of congestion, as in case No. LXXI,
and contains a quantity of frothy mucus.
The Bronchi are usually healthy, but occasionally present the signs of
bronchitis, or contain purulent material when pneumonia is present.
TJie Pleurae rarely present signs of inflammation (case No. VIII, however,
showed signs of recent changes), but sometimes petechias are seen lying under
the parietal pleura. The cavity of the pleurae seldom contains any fluid, but in
three cases (Nos. V, VIII, LIX) several ounces were found in each.
The Lungs,—The most common morbid appearances in Surra, according to
frequency, are emphysema in nearly all ecchymoses lying under the visceral
pleurae, and a localized pneumonia is by no means uncommon; in one case
(No. LXXI) broncho-pneumonia was present, but in all the other twelve
(Nos. II, X, V, XXI, XXVI, XVIII, XIX, XXVII, XI, VII, XXXIII, XXXI)
the lobules were surrounded by a gelatinous exudation, the change resembling