AUTOPSIES AT THE PHILIPPINE MEDICAL SCHOOL. 217 



The lesions most frequently met with in the entire series of cases 

 were ulcerations of the large bowel. The lining of the large intestine 

 in 32 cases showed active amoebic ulcerations of typical appearance, while 

 in 22 additional individuals there were abundant evidences of previous 

 lesions as shown b} r numerous, irregular pigmented scars and depressions. 

 While these lesions were spread generally over the entire extent of 

 membrane from the ileo-csecal valve to the rectum, in 11 eases the ulcer- 

 ations were confined to the terminal few centimeters of the rectum. 



Intestinal worms were found in 32 cases, Ascaris lumbricordes alone 

 in 17, Trichocephalus clispar in 7, and the two together in 8. A liver 

 fluke, pisthorchis sinensis, was encountered in one body. 



A persistent Meckel's diverticulum was present in a female child, dead 

 of pneumonia, and an imperf orate anus in a male child. 



LESIONS OF THE LIVER. 



Only one case of abscess of the liver occurred in the series. The 

 body was that of a Japanese aged 36, in whom the entire large bowel 

 was lined with amoebic ulcerations. The abscess occupied the lateral 

 portion of the right lobe of the liver and measured 10 centimeters in 

 diameter. The cavity was limited above by the diaphragm and contained 

 a thick, yellow-brown pus. Numerous amoebae appeared in the sections 

 of the wall of the cavity. 



The livers from 2 cases of typhoid fever, 1 of broncho-pneumonia, 

 and 2 of pulmonary tuberculosis, showed well-marked areas of focal 

 necrosis, in addition to a general parenchymatous degeneration. In 38 

 cases the same organ evidenced chronic passive congestion. The en- 

 larged, dark red, firm organ was more frequent than the so-called 

 "nutmeg" liver. The majority of the 38 cases were those of patients 

 dead of pulmonary tuberculosis, and in addition they showed degenerative 

 changes in the myocardium. 



A mild grade of fatty infiltration was demonstrated in 17 of the 

 livers from cases of tuberculosis and a very marked grade in 4 additional 

 instances, 2 of tuberculosis, 1 of amoebic dysentery, and 1 of chronic 

 heart disease. The general picture in the series of sections of fatty 

 livers was of large fat-droplets occupying the greater part of an entire 

 cell and of ten- causing complete disappearance of the cell plasm. 



Amyloid occurred in the livers in two of the tuberculous cases. 



In nine cases the liver was the seat of cirrhotic changes. The organ 

 was generally enlarged and firm. Three of the eases had fluid in 

 considerable amount in the peritoneal cavity. The new tissue through- 

 out the liver substance was rather closely confined to the jteriphery of 

 the lobules, often inclosing groups of several lobules, the inclosed cells 

 showing atrophy. Of the 9 cases, 5 died of pulmonary tuberculosis, 

 and 1 of peritoneal tuberculosis. No marked "hobnailed" liver was 



