﻿362 The Philippine Journal of Science i9u 



fections which ends the life of those who were previously the 

 victims of a more chronic disease. Forty-eight of our cases had 

 no marked evidence of disease other than cholera, while 17 had 

 also lesions of tuberculosis, and smaller numbers had syphilis, 

 marked arteriosclerosis, beriberi, lymphatic leukaemia, strangu- 

 lated hernia, suppurative hepatitis, Banti's disease, status lym- 

 phaticus, bronchopneumonia, and splenomegaly. There were 4 

 full-term pregnant women in the series, one of whom aborted. 



The post-mortem appearances, like the clinical manifestations 

 of the disease, are due to the loss of fluid from the tissues and to 

 the action of the toxin of the cholera vibrio on the tissues. 

 These appearances may be modified by treatment or associated 

 disease. 



Rigor mortis. — Rigor mortis appears early, and is stronger 

 than that following any other known disease. The tissues of 

 the hands and feet especially appear shrunken so that the bones 

 and interosseous spaces are prominent. The nails are blue, and 

 the fingers are usually strongly flexed. The soft tissues covering 

 the skeleton feel very dry, and have a doughy consistence. 

 Frequently evidences of the diarrhcea are present about 

 the buttocks. The abdominal muscles are usually rigid, and 

 present the dull, homogeneous, waxy appearance of Zenker's 

 degeneration. 



On section the subcutaneous tissues are dry, and the peritoneum 

 and pleura are usually devoid of fluid and are sticky. In no case 

 has the pericardium been devoid of fluid or sticky. In cases 

 that have been treated by the administration of large quantities 

 of fluid, this dryness of the tissues may not be a marked feature. 

 The small intestine is usually somewhat dilated, and presents a 

 dry, sticky, rosy, or pink serosa, sometimes with marked injec- 

 tion of the vessels, standing out in marked contrast to the pallor 

 of the peritoneum covering the large intestine, stomach, and 

 parietes. In other cases the serosa of the small intestine has a 

 slaty gray color. The large intestine is usually contracted. The 

 liver is frequently retracted above the costal margin. The lungs 

 are as a rule poorly inflated, and the pleura is exceedingly dry. 

 In cases which have lost much fluid, the cut surfaces of the lungs 

 are red but very dry, while in the very early cases, or in those 

 which have received fluid, congestion and oedema of the lungs 

 may be marked. The mucosa of the bronchi is usually reddened. 

 Pleural ecchymoses are not infrequent. 



The heart. — The heart presents evidence of degeneration of 

 the muscle and sometimes a dilated right ventricle. The blood 

 within the heart is poorly coagulated and is very dark. This is 



