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736 
Autopsy five hours after death: Body of native about 20 to 25 years old. 
Rather strong, heavy set; normal development; cutaneous surface slightly aedem- 
atous; slight pitting on pressure over tibial region; rigor mortis moderate 
in upper extremities; very marked in lower ones and jaws. On section, the fat 
and the subcutaneous tissue are found to be moderately oedematous. Muscles 
very moist and of a pale-pink color. Superficial veins discharge much dark, 
fluid blood. The peritoneal cavity contains 650 cubie centimeters of a clear, 
amber-colored fluid. The diaphragm reaches to the lower border of fourth rib. 
Pericardial fluid considerably increased. Heart contains a large amount of dark 
fluid blood, also chicken-fat clots. On the anterior surface of the right ventricle 
are seen a number of small, confluent, subepicardial petechiw; right auriculo- 
ventricular opening easily admits four fingers; right side much dilated; 
myocardium of right side moderately hypertrophied; pockets of pulmonary valves 
deep; left ventricle slightly hypertrophied; myocardium of fair consistency, of a 
general pink color with here and there a slight yellow mottling; valves in general 
normal. Kndoecardium smooth; at the beginning of the aorta a few atheromatous 
spots; coronary arteries normal; weight, 305 grams. Lungs collapsed; poor 
in air; grayish-pink in color with some purplish-blue spots on posterior surface 
of lower lobes. Pleuree smooth; no adhesions. Lungs on section, dry; poor in 
blood; bronchial glands not enlarged; bronchial mucosa normal. Larynx normal; 
tonsils hypertrophied and congested; crypts deep and ragged. Spleen, tense, 
capsule transparent except over a small, circumscribed, opaque and thickened 
patch in the middle of the posterior border. On section, of a dark, chocolate- 
brown color and congested; pulp of good consistency; trabecule and _ follicles 
both distinct; follicles enlarged; weight, 365 grams. Midneys: perirenal fat 
cwdematous; both kidneys normal in size; capsules smooth; color, pinkish-gray ; 
consistency increased; on section, congestion of a moderate degree is seen, the 
surface is dull, slightly yellowish, pelves smooth, relation of cortex to medulla, 
normal. Ureters, normal. Suprarenals, normal in size, deeply pigmented. 
Bladder contracted, mucous membrane pale. Prostate small and normal. Stom- 
ach and duodenum normal in outline and size, mucosa quite markedly hyperemic ; 
pancreas normal. Liver swollen, capsule transparent, purplish-blue with yellowish 
mottling, lobules indistinet, congested; gall bladder and bile duets normal. 
Intestines: serosa pale and shining; wall of entire tract is edematous. Mucosa 
of small intestine, except that of duodenum, pale; that of large intestine, swollen 
and hyperemic, the hyperemia not being uniform but generally present as 
small, irregular patches at the apices of the folds, and particularly well marked 
at the ileo-cecal valve. Brain: weight 1,375 grams; dura adherent, thickened 
and opaque. Pacchionian granulations large; fluid in ventricles normal; brain 
tissue slightly hyperemic, otherwise normal. Peripheral nerves, pneumogastie, 
obturator (crural branch), and popliteal have a normal appearance, 
ANATOMICAL DIAGNOSIS.—H ydropericardium, dilatation and moderate hyper- 
trophy of the right, moderate hypertrophy of the left ventricle, moderate fatty 
degeneration of the myocardium, subepicardial petechia, enlargement and con- 
gestion of the spleen, congestion, fatty and parenchymatous degenerations of 
the kidneys and liver, marked hyperamia of the gastric and duodenal mucosa, 
chronie catarrhal inflammation of the mucosa of the large intestine; ascites. 
General adema of the subcutaneous connective tissue. Acute pernicious beriberi. 
MICROSCOPICAL EXAMINATION.—The fibers of the myocardium show a somewhat 
indistinet striation, the longitudinal striw in particular are hazy and not sharp. 
The interstices between the fibers are rather wide; fragmentation and vacuolation 
are occasionally seen. Hidneys: the vessels of both cortex and medulla are 
moderately congested; glomeruli normal, but the lining epithelia of the con- 
voluted tubules of the cortex generally show a marked degree of cloudy swelling. 
