556 The Philippine Journal of Science 1922 
EIGHTH CASE 
T. A., male, 65 years old (?), Filipino, laborer, was found unconscious 
in Plaza Goiti, Manila. Admitted to the Philippine General Hospital on 
November 25, 1921. He is well built, robust, and well nourished. Right 
pupil is smaller than the left which is distinctly dilated. Eyeballs are 
prominent and the intraocular pressure is increased. Patient is snoring. 
Area of dullness of the heart is slightly increased to the left. Heart 
beat is slow, with an extra systole every five or ten beats. Liver and 
spleen not palpable. Both extremities of the right side are paretic and 
placid; patient unable to extend or flex them as he can those of the left 
side. Radial artery is rigid and cannot be compressed. Blood pressure: 
Systolic, 230 millimeters; diastolic, 100 millimeters. 
Blood examination: White count, 27,000, with 98 per cent neutrophiles, 
4 per cent small lymphocytes, and 3 per cent large mononuclears. 
* Urine examination, albumen, very strongly positive; specific gravity, 
1,006; casts, hyaline and granular; sugar, negative. 
Clinical diagnosis——Cerebral hemorrhage, arteriosclerosis, and chronic 
interstitial nephritis. 
Morbid anatomy.—Autopsy 8716. A well-developed and well-nourished, 
old Filipino man. The peritoneal cavity does not contain any fluid. The 
intestinal coils are pinkish and apparently normal. The urinary bladder 
is distended with urine, otherwise it is apparently normal. The spleen is 
very small and attached with fibrous adhesions to the surrounding tissue. 
The left pleural cavity is completely obliterated by fibrous adhesions. The 
heart is very large and slightly hypertrophied. Arteriosclerotic patches 
are found in the aorta and in the aortic valves. The left side is slightly 
atelectatic on account of the thick fibrous pleura. In the posterior sur- 
face of the inferior border of the superior lobe there is a piece of the lung 
and pleura which has changed into bone. The liver is soft and flabby 
and apparently normal in size. On section it shows congested surface. 
The liver weighs 1,468 grams. The alimentary tract is apparently normal. 
The brain shows meningeal hemorrhages in the left hemisphere and 
over the cerebellum. Section of the left side shows a large clot of blood 
in the internal capsule, and the left ventricle is completely filled with 
blood. The corpus collusum is intact. The right side shows a small 
amount of bloody fluid, but no destruction of brain tissue. 
HISTOPATHOLOGY 
Liver.—Few isolated ova in the portal areas with scanty cellular re- 
action. 
ANATOMIC DIAGNOSIS 
Cerebral and meningeal hemorrhages, left; dilatation and hypertrophy 
of the heart; arteriosclerosis, senile; chronic interstitial nephritis; acute 
congestion of the lungs; obliterative pleurisy; ossification of lung, local; 
— of the spleen; distension of the urinary bladder; schistosomiasis, 
iver. 
NINTH CASE 
Clinical data.—B. S., male, 25 years old, Filipino, foreman, residing in 
Manila, was admitted to the Philippine General Hospital on January 27, 
1914, complaining of fever, chest pain, and cough. 
