3i8 Hermann Michael Biggs 



local applications. On admission the left arm was enormously 

 swollen and showed extensive hemorrhages into the skin and 

 subcutaneous tissue. There was a small elevated abraded 

 point on the wrist with a hemorrhagic areola ; temperature 

 varied from loi to 104 ; pain was severe. Under treatment 

 the swelling diminished, the pain almost disappeared ; he slept 

 well and felt well and wanted to sit up. On the third day af- 

 ter his admission at about 3 p. m. he complained of pain and 

 heat in his head. One hour later he became delirious, his 

 temperature rose to 106 F. He grew rapidly worse, and died 

 18 hours after the appearance of the first cerebral symptoms. 



Autopsy: — Arm enormously swollen, with blebs over wrist 

 and extensive hemorrhages into skin and subcutaneous tissue. 

 The blood everywhere in the body was completely fluid and 

 dark colored. The spleen was very large and .soft, and the 

 other abdominal and the thoracic organs were congested. 

 The pia mater of the brain over both the convexity and the 

 base was studded with hemorrhages, and the meshes of the 

 pia both in the fissures and over the convolutions were dis- 

 tended with sero-pus. Cultures were made from the fluid in 

 the subcutaneous tissue from various portions of the wrist and 

 arm, from the heart blood, the spleen, and the pial exudate 

 on both sides of the brain. In all of the tubes inoculated 

 from the brain, a pure culture of the anthrax bacillus devel- 

 oped. All of the other tubes remained sterile. The media em- 

 ployed and the conditions under which the cultures were made 

 and kept after inoculation were the same. The identity of the 

 anthrax bacillus was established by microscopical examina- 

 tion, by culture reaction and by inoculation of animals 



Cover-glass preparations were also made from the fluid in 

 the subcutaneous tissue of the arm, from the .spleen and the 

 blood contained in the heart cavities. No organisms were 

 found microscopically in these situations. 



It is hardly necessary to direct attention to the extraordi- 

 nary character of the localization and the findings in this case, 

 and there seems to be no satisfactory explanation to offer to 

 account for them. The results are stated as obtained, and 

 their accuracy vouched for. 



