156 MCLAUGHLIN AND ANDREWS. 



along the junction of the lobes. Occasionally there is a slight increase of the 

 pleural fluid. 



A cut section shows a pinkish-gray surface, which may or may uot exude some 

 blood. Air can be expressed from all portions of the lung and usually also a 

 slight amount of cedematous fluid. The posterior part of the lung is of a darker 

 color and is heavier than the anterior and more fluid can be expressed from it 

 than from the anterior part. The bronchi do not appear to be hyperoemic, but 

 contain more or less frothy material and mucus. Sometimes this can be ex- 

 pressed from the smaller bronchi. 



Spleen. — This organ may be very hyperamiic and show slight increase of splenic 

 tissue, partially obliterating'the normal markings. 



Kidneys. — The kidneys are of a reddish-gray color, fcetal lobulations are prom- 

 inent. A cut section is very moist and a considerable amount of blood oozes 

 from it. Striations of the cortex are plainly seen. Except for congestion, the 

 kidneys, in the greater number of cases, present a normal appearance. Occasion- 

 ally a slight degree of albuminous degeneration, or a few subcapsular hcemorrhages 

 occur. The adrenals show congestion. 



Liver. — The liver is dark reddish-brown in color and firm. Section shows con- 

 gestion and rarely a slight "nutmeg" appearance is seen. The lobulations are 

 usually clearly defined. Here, also, we may find some albuminous degeneration. 



Stomach. — The stomach nearly always contains some curdled milk and mucus. 

 The mucosa is smooth and anaemic. No rice or other artificial food was found 

 in the stomachs of any of the cases; sometimes there is a trace of frecal material 

 present. 



Intestines. — They are normal in appearance. The intestinal contents are 

 semiliquid, apparently digested, and have a yellow color. The mesenteric glands 

 may be slightly enlarged and soft. 



Urinary bladder. — It may or may not contain urine. 



Throat organs.— -Except for some froth and mucus present in the larynx and 

 trachea, these organs are normal. 



Thymus. — The thymus is usually prominent and full. Some milky fluid can 

 almost, always be expressed from the cut surface. 



Meninges and brain. — The meninges are congested and (edematous, and there 

 is usually an increase of the cerebro-spinal fluid. The brain substance may be 

 of normal consistency, or soft and very moist. 



Many of the bodies were not subjected to necropsy until twenty-four 

 or thirty-six hours after death, because of our inability to transport 

 them to the morgue at a sufficiently early time, and in this warm climate 

 decomposition very rapidly sets in. However, in the above description 

 of the gross pathology three points are prominent : First, the dilated and 

 hypertrophied right heart ; second, the congestion of all internal viscera ; 

 third, the anasarca. The two last conditions naturally follow the first, 

 and we turn to the lungs for a possible explanation. Microscopically 

 they present a varied condition, being in part emphysematous and the 

 more dependent portions being heavily congested, with the alveoli filled 

 with epithelial cells, leucocytes, and granular oedematous material. In 

 some places small haemorrhages have occurred and the red cells are found 

 in the alveoli and tissues. 



