CHOLERA IN CHILDREN. 367 



Lungs. — Left voliuninous, crepitant. Cut section, reddish-brown from which 

 a fi'othy blood-tinged fluid can be expressed. Right lung similar, slight increase 

 of pleural fluid in both cavities. 



Kidneys. — Foetal lobulations obliterated, capsule strips easily. Cut section, 

 cortex and medulary portion dull gray in color, striations indistinct. 



Urinary bladder contains about 30 cubic centimeters of pale turbid urine. 



Brain. — Meninges of brain are deeply congested, otherwise apparently normal. 

 Slight amount of blood-tinged fluid in lateral ventricles; blood vessels are 

 engorged. 



Intestines distended with gas, slightly congested, mucosa intact throughout. 

 Contain semi-fluid, brownish yellow fluid, slight in amount. Solitary lymph 

 follicles slightly enlarged, especially in the lower end of the ileum. Peyer's 

 patches are not involved excej)t those immediately above the ileo-coecal valve. 



Examination of intestinal contents reported positive for cholera by the Bio- 

 logical Laboratory, Bureau of Science. 



Case 11. — T. N. — Age, 10 months. Female. History and diagnosis of acute 

 meningitis by Dr. B. Taken sick on September 14 with fever. September 15, 

 two bowel movements of yellow color. September 16, temperature 38° C, nausea, 

 strabismus and evidence of headache. Calomel prescribed. September 17, no bowel 

 movements. September 18, temperature normal, strabismus and general convul- 

 sions. September 19, same. September 20, 21 and 24, adynamic and semi- 

 comatose condition. Died at 3 p. m. September 22. 



Necropsy by Doctor Andrews : 



Body of small infant, rigor mortis absent, nails bluish. Skin shriveled, expres- 

 sion of face drawn; eyes sunken, half open. 



Subcutaneotts tissues and muscles dry. 



Peritoneum moist but no fluid in cavity. 



Pericardial sac contains a few drops of fluid. Right side of heart distended, 

 left side firm. 



Lungs. — Left voluminous, heavy, light purple in color. Posterior part of lower 

 lobe has a slight consolidation present. Cut section of the lower lobe shows a 

 dark cherry surface in which two or three dark slightly elevated areas are seen. 

 These are drier than the surrounding tissues and more granular. Right lung, 

 dark gray anteriorly, dark purple posteriorly. Posterior border firmer than 

 anterior part. Lung is voluminous, slight amount of frothy material can be 

 expressed. 



Kidneys are soft, foetal lobulations absent, surface grayish purple in color. 

 Cut section shows cortex and medullary portion to be of a dull gray color. Stria- 

 tions indistinct. 



Urinary bladder empty. 



Brain. — 'Meninges are very much congested. Basal part of brain shows con- 

 siderable congestion with slight increase of spinal fluid. No inflammatory exudate 

 present. Choroid plexus in lateral ventricles much congested. No fluid present. 

 Section of brain shows intense congestion throughout its substance. 



Examination of intestinal contents reported positive for cholera by the Biolog- 

 ical Laboratorj', Bureau of Science. 



Case 12. — T. G. — Age, 3 years. Female. History by Medical Inspector A. 

 Diagnosis, acute meningitis by Dr. R., private physician. September 22, had 4 

 liquid stools without fever or vomiting. September 23, no bowel movements. 

 September 24, calomel and castor oil administered by Dr. R. Slight fever and 

 convulsions. Semi-comatose, dyspnoea and death at 4 p. m. 



Necropsy by Doctor Andrews. 

 91670 5 



