304 MARSHALL. 



Thorax. — Clear; lungs occupied less than one-lialf of thoracic cavity; were very 

 pale and cushiony; uniform in appearance; noiinal on section; bronchi and pul- 

 monary vessels clear. 



Heart. — Pericardium clear; a number of pin-point occliymoses aiound the 

 auriculo-ventricular groove; muscle pale, firm, uniform; valves and endocardium 

 normal; aorta clear. 



Abdominal cavity. — 'Spleen moderately enlarged and firm; surface normal; on 

 section trabecule prominent; the color distinctly pale. Liver of normal si/e, pii!e 

 and firm; on the anterior surface of right lobe directly over gall bladder and 

 10 cubic centimeters from the anterior margin of the liver, a puckered scar was 

 situated with adhesions to the anterior wall of chest. On section, the scar of an 

 old sinus was found leading for 6 cubic centimeters to a firm, yellow-white scar 

 near the center of the lobe. Right and left kidneys were alike, both large; the 

 capsule stripped readily, leaving an extremely pale, soft cortex. On .section, the 

 cortex was extremely pale; the structure cloudy but otherwise normal; the 

 pyramids were also very pale. The suprarenals, pancreas and stomach appeared 

 normal. In the small intestine niunerous vncinaria were found in the upper part 

 where red points studding the mucosa were observed. In the lower portion several 

 specimens of ascaris occurred; otherwise the small intestine was normal. 



The large intestine contained a large amount of dark red, almost 

 black, past}' material in which amw'bw were numerous. From the ile- 

 ocsecal valve to the lower part of the rectum the mucosa was studded witli 

 nodular elevations which varied from about 6 millimeters to 12 millime- 

 ters in diameter and which rose about an equal distance aljove the level 

 of the mucosa. In most cases the elevation was surmounted by a mass 

 of necrotic tissue which could be scraped off, leaving a deep crater-like 

 ulcer extending well down through the mucosa. Only one or two small, 

 typical, irregular amoebic ulcers were observed. Many active amcebte 

 were found in tlie detritus taken from the crater-like ulcers. On section 

 through such a nodule a red, dirty looking mass was seen extending into 

 the submucosa and radiating for 1 cubic centimeter or more in this layer. 



Microscopic examination, hcematoxylin and eosin stain. — Lungs, alve- 

 olar septa delicate, tissue normal, very little pigment. Spleen, capsule 

 of normal thickness; section was very cellular so that the Malpighian 

 bodies did not stand out conspicuously. The sinuses were for the most 

 part flattened and collapsed. The cells lining them were usually small 

 with clear cytoplasm. There was little evidence of destruction of red 

 blood corpuscles. The vessels, stroma and Malpighian bodies appeared 

 normal. A few cells were found with small, dark nuclei and cytoplasm 

 staining a coppery-red. Tlie section of the liver showed a diffuse 

 cloudiness and numerous areas of focal necrosis. These areas were quite 

 extensive and often were seen to be located around the sublobular veins. 

 In these areas the liver tissue had lost the normal staining power and 

 tlie cells were opaque, red, swollen, devoid of nuclear material and either 

 homogeneous or vacuolated. There was no evidence of reaction around 

 the areas of focal necrosis. 



Sections of the large intestines were made through several of the 



