. A text-book of medicine for students and practitioners . .Not infrequently the signs of a hemorrhagic diathesis (epistaxis, hemorrhagefrom the gums, etc.) become evident early in the disease. In the later stagesthe hemorrhages may become quite serious. Hemorrhages into the brain maylead to hemiplegia, or may be a direct cause of death. Hemorrhages of thestomach, intestine, kidney, and into the skin and muscles, have also beenobserved. We once saw a hemorrhagic tonsillitis with a fatal outcome froma?dema of the glottis. The splenic enlargement is the most striking change, clinically, in thein


. A text-book of medicine for students and practitioners . .Not infrequently the signs of a hemorrhagic diathesis (epistaxis, hemorrhagefrom the gums, etc.) become evident early in the disease. In the later stagesthe hemorrhages may become quite serious. Hemorrhages into the brain maylead to hemiplegia, or may be a direct cause of death. Hemorrhages of thestomach, intestine, kidney, and into the skin and muscles, have also beenobserved. We once saw a hemorrhagic tonsillitis with a fatal outcome froma?dema of the glottis. The splenic enlargement is the most striking change, clinically, in theinternal organs. In the beginning this may be of slight degree, but finally itmay reach such enormous dimensions that the spleen may reach far over intothe right half of the abdominal cavity. As a rule, the enlarged spleen is offirm consistence, and presents a sharp medial edge, usually with one or twocharacteristic notches. In the beginning, subjective symptoms, particularlypain in the spleen, are usually only slight. With larger spleens, however, PLATE V. T-


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