17 



erythrocytes, degenerated epithelial cells, and nuclear fragments 

 many of which seem to have coalesced to form irregular, deeply 

 staining masses of chromatin. Here some islands of degenerating 

 epithelial tissue, probably the remains of papillary pegs, may be 

 seen. No giant cells are present. A very prominent feature is 

 the widespread and extensive destruction of the nuclei of the 

 fixed and infiltrating cells. This varies from simple vacuolation 

 to complete karyorrhexis. A number of normal polynuclear cells 

 may be seen with their protoplasm filled with rounded or rod- 

 shaped nuclear fragments. The blood vessels of the subcutis show 

 great congestion. The underlying muscular and glandular tissues 

 appear normal. There are no signs of proliferation everywhere 

 those of degeneration. 



CASE II. 



This patient was a Filipino, 38 years of age, living in Santa 

 Cruz, Manila. His previous history was obtained through the 

 kindness of Dr. Edwin Shattuck, of Station G, Board of Health. 

 It is as follows : 



The case of Atanacio Castro was reported by Dr. Canute Reyes, municipal 

 physician, to Dr. R. L. Bartlett and myself. After seeing the case 

 together we were unable to arrive at a diagnosis. The house was quaran- 

 tined immediately and Dr. Brinckerhoff was notified of the peculiar eruption, 

 with the result that he visited the case and secured a culture. About an 

 hour after the culture was taken the patient died and the body was sent 

 to the San Lazaro Morgue. The deceased was 38 years old, married, and 

 a clerk by occupation. " He was taken sick on the 2d of October, 1903, with 

 chills and fever, tertian in character. In December of the same year he 

 had an abscess on the posterior portion of the right leg, which was 

 opened by the doctor who attended him. Again, in February of the 

 present year, he had an abscess in the anterior and upper portion of the 

 right side of the chest, which underwent resolution witKout operation. 

 The fever and chills continued until (on June 27), an eruption appeared 

 on the face and later on the chest and abdomen. On the third day of 

 the eruption he died, namely, the day he was reported to Station G. 

 The deceased had also suffered from articular pains. He was the owner 

 of a stable where horses and vehicles were kept for hire. Furthermore, 

 he lost several of his horses recently from glanders. Any credit for 

 this report is due to Dr. Bartlett and Dr. Reyes. 



Autopsy (about nine hours after death). The body appears 



quite emaciated. A papulo-vesicular eruption is scattered over the 



skin surface (see PL IV, fig. 1). These lesions are most numerous 



on the face, back of the trunk and upper arms, buttocks and back 



24877 2 



