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of the lower lobes, which are purplish-blue; in general they contain much serous 
fluid, the lower lobes much dark blood. Bronchial and tracheal mucosa, smooth 
and pale. Bronchial glands not enlarged. Spleen very large, weight 910 grams, 
general configuration that of a normal spleen. Capsule, smooth, tense, not wrinkled ; 
in general, transparent, except over the left half of the upper surface where it is 
nontransparent, grayish-white, considerably thickened. Pulp, moderately soft, 
dark brown-red, cut surface smooth. ‘Trabecule, quite distinct, broadened; fol- 
licles, fairly distinct. Kidneys of normal size, capsules smooth, peel off easily. 
External color, bluish-purple; cut surface, dark, pinkish-purple; vessels, much 
injected; tubules of cortex grayish-white; pyramids rather pale. Relation of 
cortex to medulla, normal; pelves, normal; ureters and bladder, normal. Suprare- 
nals, small, rather hard, dark-brown yellowish. Liver: large, greatly congested ; 
externally purplish; on section, brownish-yellow; acini, distinct; interacinous 
connective tissue possibly somewhat increased. Gall bladder and ducts: normal. 
The former contains a considerable quantity of dark, greenish-yellow bile. 
Pancreas: normal. Stomach and intestines: normal, with the exception of consid- 
erable congestion of the gastric veins and a marked hyperemia of the gastric 
mucosa. Intestinal mucosa in general pale, except that of the rectum, which is 
somewhat hyperemic. No ameebic ulcerations. Scrotum much distended. The 
left side contains a hydrocele enclosing about 50 cubie centimeters of a straw- 
colored, serous fluid. On the right side, the testicle is surrounded by a fibrous 
mass about 0.6 to 1 centimeter in diameter. The fibrous tissue is very tough and 
is continuous with the tunica albuginea. The testicle contained in this fibrous 
mass is small, but appears otherwise normal and not atrophic. Brain: the dura 
mater is quite tense, amount of cerebro-spinal fluid, large; brain pale but cedema- 
tous, ventricles contain an increased amount of fluid. Otherwise the brain is 
normal. Weight, 1,335 grams. 
ANATOMICAL DIAGNOSIS.—Moderate hypertrophy, dilatation and fatty degenera- 
tion of the myocardium, adema of the lungs, splenomegaly and perisplenitis, 
congestion of the liver, hydrocele of the left side, chronic fibrosis of the right tunica 
albuginea, general anamia, general, moderate adema. Chronic or subacute, wet 
beriberi. 
Smears from the spleen show neither malarial parasites nor the Leishman- 
Donovan. bodies. 
MICROSCOPICAL EXAMINATION.—Myocardium striation quite distinct, no well- 
marked evidences of fatty degeneration; fragmentation and segmentation pro- 
nounced. Lungs: inter-alveolar septa broadened, many alveoli contain considera- 
ble granular and coagulated serous material. There is marked vascular conges- 
tion. Kidneys: considerable cloudy swelling of uriniferous epithelia. Spleen: 
much increase in connective tissue, particularly of the trabecule; very little, if 
any, endothelial proliferation; crowding of the pulp spaces with blood elements ; 
moderate amount of pigment, no malarial parasites or Leishman-Donovan bodies. 
The liver in this case, aside from great congestion, fatty degeneration of paren- 
chyma cells, and a moderate amount of pigment, shows subacute interlobular 
periportal inflammatory foci. The other organs examined (the stomach, pancreas, 
suprarenals, testicles) show nothing abnormal. The popliteal nerve and branches 
show the typical degenerative changes of the myelin sheath and axis cylinders. 
Case No. 6.—Acute, wet, beriberi complicated by malaria.—Necropsy No. 1190, 
May 23, 1905: Eustaquio Alvarez, a prisoner of Bilibid, 28 years old, native 
Visayan, was suddenly taken seriously ill on May 21, 1905, and was admitted to 
the hospital during the night of May 22, with a temperature of 37°.5. The fol- 
lowing morning at 8 o’clock his temperature was 36°.9. He complained of 
shortness of breath and weakness. On examination the pulse was weak, soft, 
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