544 The Philippine Journal of Science 1922 
Morbid anatomy.—Autopsy 2191. Body is that of a well-nourished and 
well-developed muscular Filipino. Considerable increase of clear yellowish 
fluid in the peritoneal cavity. The sigmoid shows the presence of three 
large and hard nodules, measuring from 2.5 to 3 centimeters in diameter, 
attached to its serous coat in the line of the appendices epiploice (Plate 
1, fig. 1). The intestinal wall at this portion is thickened. The lymph 
nodes in the mesocolon opposite these tumors are slightly enlarged but not 
extraordinarily so. As the palpating finger passes over them they feel 
like small grains of sand or miliary tubercles. The appendix is 11 centi- 
meters long; it is free except for the attachment of its mesocolon, which 
is rather prominent. Two centimeters from its beginning there is a slight 
stricture in the appendix; at its distal point it is enlarged, measuring 1.3 
centimeters in diameter; it is rather firmer than normal. Five centimeters 
from its distal end there is another enlargement which measures 1.5 cen- 
timeters in diameter. This is also firm, and corresponds in feeling and 
appearance to the nodules that were found on the sigmoid. The liver is 
roughened and rather firmly attached by adhesions to the undersurface 
of the diaphragm. 
Pericardial sac shows an increase of a greenish yellow fluid which con- 
tains a few flocculi. The right side of the heart is considerably dilated and 
hypertrophied. 
The left lung is bound by numerous fibrous adhesions to the parietal 
wall, practically obliterating the pleural cavity. Parietal pleura is much - 
thickened. The lung is light purple, crepitant for the most part, but 
there are a few nodules present; these are in the anterior portion of the 
lower lobe and lower anterior portion of the upper lobe. The two lobes 
are bound together by firm adhesions. The nodules that were noticed are 
on the surface, and the visceral pleura covering them has a mottled, yellow- 
ish appearance. Section through the nodules shows a yellowish gray 
appearance but apparently no increase of fibrous tissue. Another section 
through the nodule reveals yellowish gray areas, apparently of necrosis. 
These are irregular in outline, most of them communicating with the surface, 
but some are deeper in the tissues. The edges of these gray nodules are 
yellower than the central portion. Section through the lung substance 
shows a peculiar mottling of dark red lung tissue with darker hemorrhagic 
areas scattered here and there. Considerable increase of fluid is present in 
the right pleural cavity. One small nodule was encountered in the central 
portion of the upper lobe of the right lung. 
Spleen is bound by adhesions to the abdominal wall and diaphragm and 
is removed with difficulty. | 
Liver measures 2.5 by 17 by 9.5 centimeters. Liver surface is very 
rough, covered by numerous tags and adhesions which contain considerable 
cedematous fluid (Plate 1, fig. 2). The edges of the liver are rounding. 
Where adhesions are not present, the liver is dark brown. Capsule is 
thickened. The liver oozes considerable blood. The cut surface is moist 
and firm, and a few old scar formations are present in its substance (Plate 
2). Most of these are darker than the surrounding tissue. A few pin- 
point, grayish white areas are scattered through the liver substance. The 
lobulation of the liver is not clearly defined. Liver weighs 1,617 grams. 
Urinary bladder contains some turbid urine. Mucosa normal. 
