Elements of pathological anatomy . less affected will be the ag-minated glands, and the mucousmembrane between them. , from Cruveilhier, showsthe ravages, at this advancedstage, of the disease, and the en-larged condition of the mesen-teric ganglions. It is not often that these ulcerserode the peritonaeal covering,an,d so lead to perforation. Ne-vertheless such an occurrence isoccasionally met with, and isalways rapidly fatal. The per-foration is generally single, from two to three lines in diameter, irregularlyrounded and near the ileo-coecal valve. It is most frequent in the mildergra
Elements of pathological anatomy . less affected will be the ag-minated glands, and the mucousmembrane between them. , from Cruveilhier, showsthe ravages, at this advancedstage, of the disease, and the en-larged condition of the mesen-teric ganglions. It is not often that these ulcerserode the peritonaeal covering,an,d so lead to perforation. Ne-vertheless such an occurrence isoccasionally met with, and isalways rapidly fatal. The per-foration is generally single, from two to three lines in diameter, irregularlyrounded and near the ileo-coecal valve. It is most frequent in the mildergrades of the disease, and commonly takes place during convalescence, orwhen the patient is considered as out of danger When death occurs early, before the establishment of ulceration, thesubmucous cellular tissue o the affected glands is sometimes converted into ahard friable substance of the consistence of crude tubercle or solid cheese itl^^^Jll^0^ C°l0r destitute of any trace of organization, and This appearance has been noticed. exhibits a dry, glossy surface when cut. 582 SMALL DOWELS. by Louis in somewhat less than one-third of his cases. Professor B&rtlett ;ilsonoticed it in several subjects, during the grave epidemic of L833-4, in the cityof Lowell. The cause of this transformation is unknown. The small bowel is moderately distended with air, and usually contains moreor less mucus tinged with bile. The duodenum and jejunum are almost con-stantly healthy. The alterations of the mucous tissues of the ileum, in theintervals of elliptical patches, are various. In a considerable proportion ofcases, the isolated follicles are reddened, softened, and enlarged to three orfour times the natural volume. After the second week they are occasionallyfound ulcerated, (Edematous, or infiltrated with purulent matter. These changesare always most strongly marked in the lower portion of the tube. The mucousmembrane itself is, in a majority of instances, more or less altered in man
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