ETIOLOGY OK BERIBERI. 381 



and the lunprs are less crepitant than normal. A few ecchymoses are present 

 on the pleura covering the outer margin of the right lower lobe. On section 

 of the lungs the cut surfaces are smooth, dark red throughout, exuding 

 abundant blood and a moderate amount of frothy fluid. No consolidated 

 areas are found, but the general consistence is increased by the diminished 

 air content, this being especially true of the left lower lobe. The mucosa 

 of the larger bronchi is reddened, its longitudinal striations prominent, and 

 there is present considerable frothy pale fluid. 



Organs of neck. — Tongue broad and flat, the papillae at its base being 

 not prominent. Faucial tonsils not enlarged. Walls of the pharynx are 

 congested. Mucosa of oesophagus is smooth and pale. Mucosa of larynx 

 and trachea is somewhat reddened and a small amount of frothy fluid is 

 found in the trachea. Thyroid gland is not enlarged, and is dark and 

 moist showing the presence of moderate colloid. Cervical lymphatic glands 

 not enlarged. 



Spleen lies well posteriorly and is nonadherent. It is somewhat increased 

 in size, and its capsule tense and steel-blue in color. On section, the con- 

 sistence is somewhat inci-eased, the pulp prominent but firm, being of a dark 

 red color. Lymphoid tissue is scarcely visible, and there is no apparent 

 interstitial increase. No haemorrhages are seen in the capsule or substance 

 of the gland. 



Adrenals are of normal size, the cortex being yellowish with a rather 

 broad pigmented zone. The medulla is relatively prominent. 



Kidneys are embedded in a moderate amount of perinephric fat, there 

 being a small haemorrhage into the peritoneum at the lower pole of the 

 right kidney. The kidneys are of about normal size, and the capsules strip 

 readily from the surfaces, which are smooth and of a dark red color with 

 a few punctate haemorrhages. On section the cortex is a little broadened 

 and bulges considerably. The cut surface of the cortex is pale reddish 

 brown with a moist glassy appearance. The vascular striae are not prom- 

 inent, and the glomeruli are easily visible, enlarged, and for the most 

 part of a red color. The pyramids are very pale and firm. The mucosa 

 of the calyces, pelves, and ureters is pale with the exception of a few small 

 ecchymoses in the pelvis of the left kidney. Renal vessels are in good 

 condition. Urinary bladder, prostate gland, urethra, testes, and seminal 

 vesicles are normal in appearance. A few ecchymoses are present over the 

 dome of the bladder. 



Intestines. — The mesentery is fatty and (edematous, its lymphatic glands 

 being small and pink. The large intestine shows no appreciable lesions; 

 it contains a small amount of formed dark faeces. There is possibly a 

 slight excess of mucus in the small intestine. The lymphoid structures of 

 the lower part of the ileum are not unduly prominent. The duodenum 

 shows marked changes in its mucosa. The mucosa is thickened, cedematous, 

 boggy, and as a whole is very red. In addition to its general red color, very 

 numerous small haemorrhages are readily visible after removing the excessive 

 mucus. The papilla of Vater is unchanged and delivers a golden yellow 

 bile on pressure on the gall bladder. 



Stomach is somewhat dilated and contains a small amount of watery 

 fluid. On its posterior surface in the region of the pylorus are very 

 numerous ecchymoses scattered over a rather large area, and the mucosa 

 as a whole is reddened and swollen. 



