154 The philip'pine Journal of Science 1917 



not friable. The mucosa is more or less ulcerated through- 

 out its entire length. In the rectum and adjoining 5 to 

 10 centimeters of the descending colon it shows the most 

 ulceration, and here the mucosa is reddened, thickened, and 

 riddled with ulcers. In the caecum it shows almost as numerous 

 ulcers, but here they are more extensive than in the rectum. In 

 the transverse colon and other parts of the colon the ulcers are 

 scattered more widely apart. 



The ulcers may be divided into three stages according to the 

 degree of involvement of the colon wall : an early, medium, and 

 late. All three stages are found throughout the entire colon, 

 but predominate as follows: Those in the caecum are mostly in 

 a late stage with some early and medium found here and there ; 

 those of the rectum are mostly of the medium stage with the 

 late stage next in frequency; those of the transverse colon are 

 of all three stages, of which the medium predominates, with one 

 very large late ulcer measuring 4 to 5 centimeters in diameter, 

 which has very irregular, undermined, reddened edges, with a 

 flat base upon which the muscle is visible. The early ulcer is 

 evidenced by a slight, firm elevation of the mucosa, which is 

 reddened and shows a pale central depressed area, which meas- 

 ures from pin point to 1 or 2 millimeters. The medium ulcer 

 is evidenced by a distinct, slightly raised, hemispherical area with 

 a depressed, necrotic center, which measures from 1 millimeter 

 to 1 centimeter. The edges are puckered, irregular, undermined, 

 and deeply reddened and have a reddened areola of mucosa about 

 them. The bases are pale and necrotic, appear flat, and are 

 located in the submucosa. The late ulcers average about 2.5 

 centimeters in diameter. They are very irregular in shape, 

 with edges that are not elevated but are deeply undermined. 

 The bases are flat and smooth, are located on the muscular coat, 

 and are covered with necrotic material. 



The mucosa of the small intestine is pale, smooth, and moist 

 and is apparently normal. 



The stomach is normal. 



The pancreas is pale and firm, but shows no other changes. 



The mesentery is practically free from fat, and the lymphatic 

 glands are very pale, but apparently normal. 



The liver weighs 1,235 grams. It retains its shape after re- 

 moval and is slightly firmer than normal. The capsule is smooth, 

 glistening, and bluish brovm. The liver cuts easily, showing 

 a smooth dark brown surface which is rather moist ; the lobules 

 are not distinct. The bile ducts and vessels are apparently 

 normal. 



