The product of typhous blood-stasis deposited, in intestinal typhus in the follicular apparatus of the bowel, in broncho-typhus in the bronchial glands, and probably in plague-typhus in different superficial lymphatic glands, appears to us so analogous in many points with medullary carcinoma that we do not hesitate, in accordance with an opinion long entertained, to award it a place here.

Typhous substance appears, in extreme cases where it is rapidly produced under violent symptoms, as a grayish or whitish red, or a gray, or a white, lax, - in the mesenteric glands almost diffluent, - fluctuating, medullary substance, which, in its external features, bears the most striking similarity to encephaloid cancer.

This typhous substance, after abiding for a certain period in its primitive crude state, enters into a process of loosening up and sloughing, which becomes the medium of its removal from the normal textures. In some instances, and some epidemics, this breaking up manifests itself as a development of the typhous substance, both in the follicular apparatus and in the lymphatic glands, to a luxuriating, bleeding, partially necrosed, fungoid growth (Hensinger's muco-membranous fungus). The latter in particular, offers the greatest analogy with medullary fungus.

The elementary composition of the typhous substance is embryonic elementary granules, nucleus-forms. Nucleated cells are commonly present in inconsiderable number. This relates, however, more especially to typhous substance in the bowel. That in the mesenteric glands frequently shows nucleated cells, - even parent-cells with several nuclei. Even the albuminous constitution of the typhous substance, and the genuine typhous crasis itself, to which fibrinous exudation is a stranger, involve an analogy with medullary carcinoma and its crasis. All fibrinous products occurring in the typhous substance itself, or along with it upon the same textures - the intestinal mucous membrane - or in any other organ, are not proper to the true typhous process, but to a secondary croupous crasis, into which the typhous crasis so often degenerates at various periods of its progress.