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746 
fragmentation well marked in some places; many poorly stained nuclei, Pul- 
monary alveoli contain much granular material; interalveolar capillaris, dis- 
tended and densely filled; peribronchial and perivascular connective tissue some- 
what increased. Spleen: increase in connective tissue, considerable; proliferation 
of pulp endothelia. Kidneys: tubular epithelia show cloudy swelling of a 
moderate degree and extent. Here and there, granular material in tubules. 
Otherwise, no changes. The liver in some parts shows great congestion of intra- 
lobular capillaries with fatty and granular degeneration, necrosis of parenchyma 
cells and interlobular, subacute inflammatory foci; in other parts, an advanced 
necrosis and atrophy of parenchyma cells of the central areas of the lobules is 
seen. The gastric and intestinal mucosa, aside from vascular congestion, shows 
no marked changes. The popliteal nerve and branches show advanced degener- 
ative changes and a marked increase in the neurolemma nuclei; however, no 
inflammatory changes of any kind are present. 
Case No. 9.—Subacute, wet beriberi.—Necropsy No. 1536, November 17, 1905: 
Agaton Caber, 24 years old, male Filipino, prisoner at Bilibid, died November 16 
at midnight. 
Autopsy twelve hours after death: Body of a strong, young male Filipino. 
Post-mortem rigidity and lividity well marked. The whole surface of the body 
is edematous; this is most marked at the lower extremities, where the skin 
pits on pressure. On section, the subcutaneous areolar tissue discharges a consid- 
erable amount of a clear, serous fluid. The muscles are, moist and of a rather 
pale-pink color. The pericardium is smooth and shiny, tensely expanded, and con- 
tains an increased amount of clear, amber-colored pericardial fluid. The heart is 
moderately enlarged. There is hypertrophy with some dilitation of the right 
ventricle. Both sides contain chicken-fat clots; the tricuspid opening is somewhat 
enlarged. The endocardium and the epicardium are smooth and otherwise normal. 
The myocardium is of very fair consistency, dull-pale-pink in color. The heart 
weighs 340 grams. Lungs: The pleural sacs contain an increased amount of 
clear fluid; the pleurz are smooth, they show a very few small, subpleural 
petechie. In general, the external color of the lungs is of a pink-purple, 
except on the posterior surface of the lower lobes, where the color is a deep 
hluish-purple. The lower lobes, on section, discharge much dark blood; the 
upper ones are very cedematous. The pulmonary tissue is comparatively poor 
in air. The bronchial glands are normal, the bronchi contain a considerable 
amount of a thin, foamy fluid. The spleen is enlarged to about twice its normal 
size; capsule, of a steel-blue color, very tense. The pulp protrudes slightly on 
section. It is moderately soft, and much congested; trabecule, enlarged; fol- 
licles, fairly well visible; color, dark-brown. Aidneys, normal in size; capsules, 
smooth, pink-purplish with grayish-yellow mottling. On section, tubules grayish- 
white, vessels moderately injected; relation of medulla to cortex, normal; pelves, 
normal, capsules peel off easily ; suprarenals, small, edematous, quite intensely 
pigmented; bladder, ete., normal. Stomach and duodenum, serosa slightly 
hyperemic; mucosa, markedly so, otherwise nothing abnormal. Jejunwm and 
ileum, serosa and mucosa hyperemic, intestinal wall as a whole somewhat 
edematous. Large intestine, normal. The peritoneal cavity contains a consid- 
erable amount of clear, straw-colored fluid. The liver is somewhat swollen; 
capsule, smooth, tense, dark-purplish-blue. On section, liver lobules indistinct, 
yellowish mottling. Vessels discharge much dark fluid blood. Brain, cdematous, 
otherwise normal. Weight, 1,385 grams. 
ANATOMICAL DIAGNOSIS.—Moderate hypertrophy of the right side of the heart, 
cedema of the lungs, moderate fatty degeneration of the kidney and liver, 
enlargement of the spleen, hyperamia of the gastric and intestinal mucosa, oedema 
of the brain, general moderate anasarca, Subacute, wet beriberi. 
a AA tres ae 
