Manual of pathology : including bacteriology, the technic of postmortems, and methods of pathologic research . ic wall. Cases occur in which it is possible to believe that theinfection involved the heart muscle as a result of dissemination throughthe blood by way of the coronary artery. Microscopic abscesses are sometimes to be recognized in the valvetissue, and similar areas of a larger size are occasionally observed inthe myocardium. The extension of the infection to the myocardiummav lead to penetration or perforation of the ventricular septum, aneu-rvsm, or rupture of the heart. The calcif
Manual of pathology : including bacteriology, the technic of postmortems, and methods of pathologic research . ic wall. Cases occur in which it is possible to believe that theinfection involved the heart muscle as a result of dissemination throughthe blood by way of the coronary artery. Microscopic abscesses are sometimes to be recognized in the valvetissue, and similar areas of a larger size are occasionally observed inthe myocardium. The extension of the infection to the myocardiummav lead to penetration or perforation of the ventricular septum, aneu-rvsm, or rupture of the heart. The calcific deposits occasionally ob-served in this form of endocarditis may be due to the fact that the lesionis ingrafted upon an old endocardial change in which calcification waspresent. In other instances there is reason to believe that the infiltra-tion is secondary to the acute process with which it is found. The structural alterations produced by this form of endocarditisare often striking; entire leaflets may disappear and penetration ofthe cardiac senta ma\- Live rise to abnormal communication between the. Fig. 256.—Adjacext Aortic Cusps, Showing aSmall Vegetation- Jcst Below THE POIST OF OLO .VdHESION. Calcareous areas are indicated by the white areas onthe valve leaflet. \ case of acute en ocardial in-flammation int;ratted on chronic lesion. 512 SPECIAL PATHOLOGY. cavities. The disease is often rapidly fatal, although Herricks con-tention that many typical cases recover is now generally rapid formation and prompt necrosis of vegetations induce a con-stant change in the morphology of the affected valves and fibrin masses,resulting in sudden alterations in the ph^^sical signs, usually absent inother types of endocarditis. In some cases the symptomatologv islargeh^ restricted to the heart manifestations; this form of the affectionis called the cardiac type. In other instances the symptomatology is notunlike typhoid fever {typhoid type). In the pyem
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