He had not fully
recollected the conditions met with in post-mortem examinations had
formerly made, and was therefore at first surprised to meet with quite a
different state of things. For he soon found that in a large majority of
cases remarkably severe lesions were present in the intestines. In other
cases the changes were slighter, and eventually he met with some which, to
a certain extent, corresponded with the type described in text-books. But
it was some time, and after many inspections, before he was enabled to
correctly interpret the varied changes met with. In spite of a most
careful examination of all other organs and of the Mood, nothing was found
to establish the presence of an infective material, and attention was
finally concentrated on the intestinal conditions.
There were cases in which the lower segment of the small intestine, most
marked immediately above the ileocaecal valve, extending thence upward, was
of a dark reddish-brown color, the mucous membrane being covered with
superficial haemorrhages. In many cases the mucous membrane appeared to be
superficially necrosed, and covered with diphtheritic patches. The
intestinal contents in such cases were not colorless, but consisted of a
sanguinolent, ichorous, putrid fluid.
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