70 The Philippine Journal of Science ms 



This patient died March 22, 1912. 



Clinical diagnosis : Variola bone lesion ; dysentery, acute, bacil- 

 lary ; colitis, chronic, tuberculous ; tuberculosis, pulmonary. Au- 

 topsy was performed by Crowell, who reports his findings as 

 follows : 



Anatomic diagnosis: Pneumonia, lobar, left lower lobe; tuber- 

 culosis, chronic pulmonary; hydrothorax, left; pleurisy, chronic 

 obliterative, double; colitis, acute ulcerative; fatty degeneration 

 of liver; pachymeningitis hsemorrhagica interna acuta; ade- 

 noma of thyroid, left lobe; dental caries; deformity of long 

 bones. 



Body is that of an emaciated, adult Filipina of short stature, being 

 132 cen.timeters in length and weighing 21.80 kilograms. Anterior upper 

 teeth are missing, and the two lateral incisors are loose. Inferior molars 

 are carious. Joints are enlarged and flat. The epiphyses of the long 

 bones are enlarged as are their condyles. Bones of the arms and legs 

 are shortened and bent outward. Apparently there is a partial dislocation 

 of the wrist and knee joints. Posterior aspects of both knees are flat. 

 Costal cartilages are curved backward and inward, pulling the sternum 

 backward, so that the chest is flat and shows a slight depression on its 

 anterior midportion. Scars of smallpox are on the body, being especially 

 numerous over the face. Legs pit on pressure. Rigor mortis is marked. 

 Abdomen is depressed and scaphoid. Panniculus adiposus is scant. 

 Tissues are rather dry. 



Peritoneum is smooth. Intestines are contracted. Diaphragm reaches 

 the lower border of the fourth rib on the right and fifth on the left. 



Thorax. — Left pleural cavity contains about 60 cubic centimeters of 

 yellowish clear fluid. Left lung is adherent posteriorly. Its lower lobe 

 is consolidated with grayish, firm areas over its surface. In the upper 

 lobe there are 3 old nodules of tuberculosis as large as beans. Section 

 through the lower lobe shows a grayish, uniformly firm surface. On 

 pressure a grayish exudate is expressed. Right lung is also adherent to 

 the chest wall, and shows about 7 tuberculous nodules similar to those of 

 the upper left lobe. Bronchi contain grayish exudate. Bronchial glands 

 are intact. 



Pericardium is smooth and shining, and contains a normal amount of 

 fluid. Heart is apparently normal in size and consistence. Its chambers 

 contain post-mortem clot. Valves are thin and delicate. Musculature is 

 firm and brownish in color. Aorta measures at the base 5.4 centimeters, 

 at the isthmus 4.4 centimeters, at the coeliac axis 4 centimeters, at the 

 bifurcation 2.6 centimeters. A few calcareous patches are present on the 

 intima of the coronary arteries. Four or five fibrous areas are present 

 on the base of the aorta. Heart weighs 135 grams. 



Spleen is moderately firm, apparently normal; weighs 43 grams. 



Kidneys apparently normal; weight, 150 grams. 



Liver shows extensive fatty degeneration; weighs 654 grams. 



Gall bladder and bile ducts are free. 



Stomach contains a whitish, clear, viscid fluid. Its mucosa is intact. 



Duodenum shows lymphoid tissue very clearly, otherwise normal. 



