AUTOPSIES AT THE PHILIPPINE MEDICAL SCHOOL. 219 



there was no cirrhosis of the liver. The enlarged spleen was attached 

 by oedematous adhesions to the former organ, the stomach, kidney and 

 bowel. The thymus and lymphatic glands were not enlarged. There 

 were eleven smaller accessory spleens, measuring from 0.5 to 1.8 centi- 

 meters in diameter, extending in an irregular chain along the tail of 

 the pancreas from the hilum of the main organ to the mid-line of the 

 body. The accessory organs showed a shrinkage of the Malpighian areas 

 and proliferation of the endothelial lining of the cavernous spaces in 

 common with the main organ. 



In addition to the above case, accessory spleens were encountered 

 in three other subjects. 



LYMPHATIC SYSTEM. 



The bronchial lymph glands were involved in 27 of the tuberculous 

 cases. A general involvement of the mediastinal glands also occurred 

 in 3 cases. The bronchial glands were diseased twice in company with 

 the mesenteric, and in 3 other cases the latter showed a general involve- 

 ment alone. 



The glands of the axilla were enlarged in but one instance in the 

 entire series of cases. The glands of the groin, on the other hand, were 

 found as a rule to be somewhat enlarged and firm. Histologically, they 

 showed an increased growth of reticular tissue. Old scars, proving 

 previous abscess formation in the glands of the groin, were found in two 

 cases. In none of the glands could signs of syphilitic induration and 

 cell change be detected, and in but one case was there evidence of a 

 primary syphilitic lesion. In this instance there was a perforation of 

 the hard palate. 1 



NEOPLASM. 



Carcinoma as a cause of death was found twice, once involving the 

 stomach, and once the cheek and antrum. There is a belief prevalent 

 among some medical men that malignant disease is rare in this part of the 

 world, but if reference be made to records of the department of surgical 

 pathology this is shown not to be the case. Of 100 specimens sent 

 from the surgical clinic at St. Paul's for routine examination, 6 were 

 malignant, 4 sarcomata, and 2 carcinomata. The sarcomata were all of 

 periosteal origin and of the lower limb. 



There was one case of dermoid cyst of the ovary among the autopsies, 

 the tumor measuring 14 centimeters in diameter. It contained several 

 areas of calcification, in addition to the usual cuticular structures. 



Uterine myomata — all subserous — were found in 3 cases. 



1 This case was clinically considered one of gangosa. 



