FIG. XXVII. AUTOPSY NO. 115. HERE THE HEMORRHAGIC CONSOLIDATION INVOLVES THE DEPENDENT PORTION OF THE LUNG; CONTRAST THIS WITH THE EDEMATOUS AND EMPHYSEMATOUS UPPER LOBE.
FIG. XXVIII. AUTOPSY NO. 118. THE CONSOLIDATION IS GREY IN COLOR AND LOBAR IN TYPE. IN THE CENTER OF THE HEPATIZED LOBE THERE IS A LARGE HEMORRHAGE. THE UPPER LOBE IS CONGESTED AND EDEMATOUS.
Cultures of the blood, lung, and pleural fluid showed gram-positive, bile insoluble diplococci which formed chains, and morphologically and culturally were Streptococcus mucosus capsulatus.
These two examples differ widely in the distribution of the pulmonary involvement. They show the acute inflammatory process persisting and complicating the attempt at repair, which manifests itself, not only by the formation of granulation tissue, but also by extensive epithelial proliferation.
Still a third type of chronic lesion is manifested in Autopsy No. 209, where the necrotizing and organizing process in the pulmonary parenchyma is associated with typical saccular bronchiectatic cavities.
Autopsy No. 209.
A white woman, aged 55 years, was admitted to the New Haven Hospital complaining of weakness and ill health following pleurisy. For the past seventeen years she had suffered from a gradually progressing arthritis, which had resulted in marked deformity and disability. Five weeks before admission she became ill with chills, fever, cough, and pain on both sides of the chest. Thereafter, her general condition had gradually grown worse.
Physical examination showed a markedly emaciated white woman with a high degree of arthritis deformans. Dullness and fine râles were present at the left apex. The temperature was but slightly elevated until three days before death, when it rose to 101°F. and slight dullness developed at the right base with bronchial breathing and fine râles. The white blood count, which on admission had been 9,200 cells per cubic millimeter, rose to 15,000 per cubic millimeter. She died after a seven-weeks’ illness.