distinct in atrophy and chronic hyperplasias. In anthracosis of
the spleen black granules are seen in the pulp, particularly about
the trabeculæ. Tubercles appear as grayish-white, semitranslucent
nodules, elevated above the surface, and can be scraped out with the
knife-point. When caseation has begun their centres are opaque and
yellowish. Gummata are grayish-white, with opaque centers, and have
a periphery of vascular granulation-tissue or hyaline scar-tissue.
The most important pathologic conditions of the spleen are: acute
and chronic passive hyperæmia, embolic infarctions, abscess, acute
and chronic hyperplasias (typhoid, malaria, plague, pneumonia,
septicæmia, leukæmia, pseudoleukæmia, splenic anæmia, hepatic
cirrhosis, syphilis, Kala-azar, other forms of tropical splenomegaly,
tuberculosis, rachitis, idiopathic splenomegaly of the Gaucher type,
etc.), wandering spleen, absence of spleen, amyloid disease, atrophy,
syphilis, tuberculosis, actinomycosis, traumatic rupture, cysts
(peritoneal), neoplasms (primary are rare [angioma, angiosarcoma,
fibroma, chondroma, osteoma, lymphangioma, endothelioma]; secondary
sarcoma [chiefly lymphosarcoma and melanosarcoma] and carcinoma
are also infrequent; secondaries of malignant syncytioma are
more frequently found), parasites (echinococcus, cysticercus and
pentastomum).
3. =Intestines.= In the examination of the _large intestine_,
_appendix_ (average length about 9 cms.), _small intestine_ and
_duodenum_ note the _contents_ of the various portions with respect
to amount, color, odor, consistence, presence or absence of bile,
food-remains, parasites, foreign-bodies, blood, pus, concretions,
etc. Note _character of wall_, _size of lumen_, _color_ (normally
gray) and _character of mucosa_, _folds_ and _villi_, _solitary
follicles_, _Peyer’s patches_, _mouths of bile-duct_ and _pancreatic
ducts_, _ileocæcal valve_ and _opening into appendix_. Postmortem
digestion of the mucosa, often leading to perforations, postmortem
hypostasis, imbibition of bile, pseudomelanosis, and contractions
of portions of the bowel must not be mistaken for pathologic
conditions. Redness of a portion of the intestine does not in itself
mean inflammation; the latter condition is shown by excess of mucus,
swelling of the mucosa, hyperplasia of the follicles, hæmorrhage,
etc. The contents of the small intestine are usually gruel-like in
consistence, thinner in the upper part, thicker toward the ileocæcal
valve. The _hook-worm_, _ascaris lumbricoides_ and _intestinal
trichina_ occur in the duodenum; _tænia solium_, _saginata_ and the
_bothriocephalus latus_ in the jejunum and ileum, _tricocephalus
dispar_ in the cæcum, and _oxyuris vermicularis_ in the large
intestine and rectum. _Ulcers_ of the intestine may be due to typhoid
fever, tuberculosis, carcinoma, dysentery, embolism or thrombosis
of mesentery vessels, etc. Diphtheritic ulcers are caused by a
variety of infections and poisons. They are usually found in the
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