in mild cases, and the same may be said of the yellow tinge of the 

 conjunctivae and skin, which is often, however, scarcely perceptible. 



Pathological Anatomy. — After death the yellow colour of the skin and 

 eyes becomes well marked in the generalilty of cases, even when it has 

 been but slight during life. The frequency of this post-mortem symptom 

 is estimated at over 80 per cent. Petechiae, effussions of blood under the 

 skin or in the intermuscular spaces, are sometimes seen. The sinuses, 

 veins, and capillaries of the brain and viscera are mostly filled with dark 

 fluid or blood. The serous cavities often contain some excess of fluid tinged 

 with yellow, as are also most of the tissues. The epithelium of the mucous 

 membranes (gums and tongue) appears degenerated or peeled off. The 

 liver is altered in its outward appearance and in its histological structure ; 

 its colour is generally a mixture of yellow with red, brown, or black. The 

 liver cells at places show fatty degeneration or necrosis, while at others 

 they retain their normal appearance. The kidneys often present a 

 parenchymatous nephritis. Hamorrhagic spots may be found over the 

 surface of the cortex; the epithelium of the tubules may be degenerated, 

 and their lumen contains hyaline, granular, or epithelial casts. The glo- 

 meruli often contain granular exudation and hyaline masses within the 

 capsular space. The stomach almost always contains black vomit or blood. 

 Neither ideerations nor excoriations are commonly found upon the mucous 

 membrane, but the latter is always more or less hyperaemie ; the congestion 

 is commonly not general, but is confined to smaller or larger spots or 

 districts, in which it is observed to proceed from one or more centres. 

 From these centres, it extends or radiates in a lesser degree, either gra- 

 dually to be lost or to pass over to another congested district. It is owing 

 to this peculiarity of the congestion that it presents no uniformity of 

 character, but is observed to spread irregularly over larger or smaller por- 

 tions of the membrane (Schmidt). The small intestines commonly contain 

 more or less black matter, either fluid, like that found in the stomach, or 

 mixed with mucus and smeared over the mucous coating, specially of the 

 ileum. This, no doubt, comes partly from the mucous membrane of the 

 intestine itself. This membrane presents arborescent patches of conges- 

 tion. The large intestine occasionally presents similar arborescent pat- 

 ches, but usually it has its normal appearance (Sternberg). 



A lesion of a more general characer, and to which considerable impor- 

 tance is atrributed by competent observers, and by them considered as 

 one of the most constant, is a fatty degeneration of the walls of the small 

 blood vessels and capillaries of the various organs. (See Dr. G. Sternberg's 

 "Account of Yellow Fever", in Wood's Reference Handbook of Medical 

 Sciences). 



In 1881, the proportion of red globules in the blood was determined 

 by Dr. Delgado and myself (by Fayem's method) in seventeen healthy 

 Spainsh soldiers recently arrived from Spain, and also in thirty-eight 



