of fair consistency ; somewhat grayish-pink but without any signs of marked fatty 
or parenchymatous degeneration. Coronaries, highly injected. Weight of heart, 
315 grams. Lungs; the pleure are smooth. The anterior surfaces of the 
lungs are rather pale, purplish-pink; the posterior surfaces are dark purple. <A 
few subpleural ecchymotic spots are noticeable. The lungs are inflated, very 
heavy and highly edematous. The mucosa of the trachea and bronchi is 
somewhat swollen, highly edematous, and the bronchial tree contains a consider- 
able amount of a thin, somewhat blood-tinged, foamy liquid. Larynx normal, 
with the exception of hyperemia of the mucosa, particularly of the epiglottis. 
Tonsils, uvula, ete., normal. Spleen: somewhat enlarged, firm in consistency ; 
on section, dark brown-red. Trabeculie, distinct; follicles, obscure. The kidneys 
are both distinctly small, the right one larger than the other. They are pinkish- 
gray in color; capsules smooth, peeling off easily. On section, their surfaces 
present moderately congested vessels. Relation of medulla to cortex, normal; 
tubules decidedly grayish-white; pyramids quite dark in consequence of vascular 
congestion. Pelves very small, the left one contains a few drops of a creamy, 
yellowish, purulent fluid. Ureters, normal. Prostate, normal. The bladder 
is small and almost as solid and muscular as a uterus. Its muscularis measures 
almost 1 centimeter in diameter, mucosa likewise thick, corrugated, somewhat 
hyperemic, but otherwise normal. The organ contains a very small amount of 
turbid urine. The ureters and the testicles are normal, but the prepuce is long 
and its opening is not larger than a small pin head. The skin covering the glans 
penis resembles a delicate mucous membrane. The inner surface of the prepuce 
is covered with desquamated epithelium. The liver is normal in size, capsule 
smooth, external surface somewhat mottled. On section, interlobular vessels 
and capillaries much injected; rows of liver cells, pale gray. Gall-bladder wall 
quite edematous. Stomach and intestines: normal except that the mucosa of the 
small intestine is very hyperemic. Brain: normal; weight, 1,270 grams. 
ANATOMICAL DIAGNOSIS.—Hydropericardium, moderate hypertrophy of the 
myocardium, subepicardial and subpleural petechia, enlargement and cyanotic 
induration of the spleen; parenchymatous nephritis, hypertrophy of the muscu- 
laris of the urinary bladder, congenital phimosis, moderate chronic passive conges- 
tion of the liver. Acute beriberi. 
MICROSCOPICAL EXAMINATION.—In the myocardium the striation of the cells 
is generally very indistinct and in places completely obliterated; fine vacuola- 
tion is frequently seen and fragmentation is very pronounced. There is also 
some increase in the interstitial connective tissue. In the pulmonary sections 
the most marked histological change is found in the alveoli, many of which are 
more or less completely filled either with a granular, or a homogeneous, coagulated 
material, (serious exudate, coagulated by the fixing process). Some of the air 
spaces also contain red blood corpuscles. The spleen shows considerable increase 
in connective tissue and some proliferation of the pulp endothelia. In the 
renal tissue the epithelia of the convoluted tubules generally show cloudy 
swelling. The intralobular capillaries of the hepatic sections are injected, the 
parenchyma cells in the central part of the lobule show fatty changes. The 
interlobular connective tissue exhibits some small, round-cell periportal inflam- 
matory areas. In transverse sections of the wall of the urinary bladder it is 
found that the muscularis is not only very much thickened as a whole but 
that the individual muscle fibers are considerably hypertrophied, so that many 
measure in length from 200-250 uw. Sections of the gastrocnemius show no 
marked changes. The peripheral nerves (the popliteal and its branches), exam- 
ined both in transverse and in longitudinal sections, show advanced degenera- 
tion of the myelin sheath, consisting of irregularities, “rosary swelling,” and 
rarefaction. In places there is loss of the sheath. 
