X. The post-mortem appearances observed in those who die in consequence of the introduction of vitiated fluids into the blood, cannot, for the most part, be distinguished from similar changes produced by other causes; yet there are some effects which are peculiar, and may be directly associated with the reception of foreign matter into the circulation. The most characteristic circumstance, attending the extension of disease to different organs of the body through the medium of the blood, is that several parts of these organs, or even different organs, will be simultaneously attacked. The disease will appear at once in various spots, which will become rapidly disorganized, while the surrounding textures will remain unaltered, either in structure or colour. The appearances observed upon dissection will vary according to the part attacked, and the stage of development in which the disease is found. The lungs are the organs in which the successive changes may best be observed. When puriform fluid has entered the circulation, the first appearance produced in the structure of the lungs, is that of one or more congested or dilated veins[33] of very small diameter. This will be followed by a well defined spot, of much darker colour than the surrounding texture. Several of these spots will probably appear at the same time, and each one of them will soon become surrounded by a hard spherical patch of purple congestion. Effusion of lymph will now take place, commencing in the centre of each affected portion, and gradually extending towards its circumference. If the disease continue, each spot will suppurate, and the different parts will become softened and broken down, in the same order in which they were previously solidified. [33] For the knowledge of this fact, I am indebted to Mr. Cæsar Hawkins, of St. George's Hospital. The liver frequently becomes the seat of secondary inflammation. In the early stage, brownish-red spots may be observed scattered through its substance. These, as they extend, assume a bluish or slate-colour; and the structure of the liver thus affected is found to have lost its consistence, and to be very easily broken down by pressure. Every part affected here, as in the lungs, proceeds rapidly to suppuration; and the usual appearance presented after death, is that of several small circumscribed abscesses, around which the structure of the liver has been condensed only to a very small extent. It sometimes happens, that the larger veins in the liver become inflamed. These vessels, being held open by the firm structure of the part, are not so readily obliterated as in other situations; and it consequently happens, that the lymph and pus poured into them become irregularly mixed with the blood, more or less perfectly coagulated, which they contain: a very peculiar mottled appearance, resembling granite, is thus occasionally produced.