Splenic Infarction.

Etiology.—This stands next to the kidney in the frequency with which embolism and infarction occur, it being found in from forty-five to fifty per cent of cases examined. The most frequent cause being ulcerative endocarditis; portions of the diseased valves or shreds of fibrinous deposits being carried into the circulation are deposited in the terminal arteries of the spleen.

Pathology.—There may be but a single infarct, though generally they are quite a number. In size they vary, sometimes being quite small, at other times involving the greater part of the organ. The infarct, which is wedge-shaped, has its apex towards the hilum and its base beneath the capsule.

At first the infarcts are of a dark-red color, quite hard, and resemble a hepatized lung; as the disease advances they grow lighter in color, and if the embolus be of an infective character, the infarct may undergo rapid softening, terminating in an abscess.

Symptoms.—Embolism may present little or no symptoms to call attention to the real condition. If, however, in the course of acute or chronic endocarditis the patient is seized with a chill, attended by pain in the left hypochondrium, the diagnosis would be quite certain.

Prognosis.—Where the infarcts are small, the prognosis is usually favorable.

Treatment.—The treatment would be along the line suggested for abscess of the spleen, and consists principally in the judicious selection of antiseptics.

The Eclectic Practice of Medicine, 1907, was written by Rolla L. Thomas, M. S., M. D.