354 CROWELL. 



the medullary vessels are visible with perhaps a small amount of cortical 

 substance at the periphery. 



Semilunar ganglia. — On the two sides considerably larger than normal, but 

 very flat and i'ather firm in consistence. 



Kidneys. — The kidneys are embedded in a small amount of perinephric fat, 

 and are of about normal size with thin capsules which strip easily from pale 

 surfaces. On section they are of diminished consistence (owing to post-mortem 

 changes ) . The cortex is of normal width, rather pale with irregular red 

 striations. The pyramids are also rather pale. The pelves and ureters are free. 



Urinary bladder. — Contracted and empty. A few ecchymoses on the posterior 

 wall. 



Intestines. — -The lower half of the small intestine shows many raised hyper- 

 trophic lymphoid follicles. All the Peyer's patches are raised, and hyperplastic, 

 and are occupied by a follicular, stippled mass of tissue. Some of the Peyer's 

 patches show mottled greenish and black pigmentation. The large intestine in 

 its lower portion contains a fairly solid mass of faeces. The follicles are every- 

 where numerous, prominent and flat, with pigmented borders. The mesenterj' 

 contains a moderate amount of fat. 



Stomach. — Normal in size, without distension. Its mucosa is clean and 

 covered with mucus. No lymphoid hyperplasia is visible. 



Liver. — Normal in size. The capsule is smooth. The organ is dark brown 

 in color. Section shows a normal appearance with rather indistinct markings. 

 The gall bladder is normal, and slightly distended. The portal vessels are 

 normal. The bile duct is patent. 



Pancreas. — Pinkish in color. Normal in size and lobulations. It measures 

 160 millimeters in length, 12 millimeters in average thickness, the head being 

 45 rnillimeters wide and the tail 30 millimeters and weighs 65 grams. 



Neck organs. — Tongue is large, papillse at base being prominent. The lingual 

 tonsils are very large. The pharyngeal tonsils are enlarged irregularly and in- 

 durated. The lymphoid tissue of the pharynx and laiynx is hypertrophic. Tliere 

 is a slight laryngeal oedema. The trachea is normal. The oesophagus in its lower" 

 portion shows several raised, whitish, linear patches. 



Thyroid. — Rather large. On section it shows normal colloid appearance. It 

 weighs 45 grams, each lateral lobe being 50 by 30 by 20 millimeters and the 

 isthmus proportionate in size. 



The parathyroids are small. 



Lymph nodes.- — The cervical and axillary lymph nodes are small and pale. 

 The mesenteric lymph nodes are very small and pale, except for one rather large 

 one (about 1 centimeter in diameter). There are some flat nodes in the ileo-coecal 

 chain. 



Brdin. — The skull and scalp are normal. The dura is normal. The pia shows 

 no oedema. The vessels at base are normal. The ventricles and ependyma are 

 normal. Section of brain substance reveals no gross lesion. Ears normal. The 

 pituitary is normal in size. 



After excision of the hip joint, a transverse section through the trochanter 

 and head of the femur and the acetabulum shows the neck of the femur con- 

 siderably shortened, and the head of the bone firmly fixed in the acetabular 

 cavity, so that the outline of the margin between the femur and the acetabulum 

 is very indistinct. About this line there is a considerable amount of firm, white, 

 bone tissue. The marrow of the head shows one area of complete destruction 

 about 2 centimeters in diameter. The marrow is replaced by fibrous tissue in 

 some places, and in others is destroyed and replaced by a yellowish-white substance 

 which is softer than the bone. 



