562 DR JAMES W. DAWSON ON 



Kidneys. — Left, 220 grams. Left suprarenal gland is large. No special change. 

 On section, kidney slightly enlarged. Cortex as a whole is diminished in breadth. 

 It is pale. At upper end there are several opaque white areas with haemorrhage 

 around them. General dilatation of pelvis. Capsule strips easily and leaves smooth 

 lobulated surface (foetal). Right kidney, 200 grams. Right suprarenal is also large 

 but shows no special change. Right kidney distinctly enlarged. On section shows 

 numerous abscesses. Pelvis dilated and shows pyelitis. 



Other Abdominal Organs. — Spleen, 75 grams. Not abnormal in size. Pale 

 colour and soft in consistence. Haemorrhage into substance. Stomach dilated. 

 Mucous membrane pale. Covered with glairy mucus. Shows minute haemorrhages. 

 Some chronic gastritis. Early marked dilatation of veins in lower part of 

 oesophagus. Mucous membrane of duodenum is somewhat congested and shows a 

 few small haemorrhages. Pancreas is pale and appears healthy. Small and 

 large intestines show nothing abnormal in mucous membrane. Bladder shows 

 some thickening ; interior grey and necrotic in places. Uterus and appendages 

 appear normal. 



Brain. — No clots in superior sinus. Convolutions atrophied. Some general 

 opacity of pia arachnoid. Fluid in subarachnoid space. 



Cord. — Shows irregularly scattered areas of bluish-grey colour varying in size 

 and shape. Cord as a whole is small. Similar areas in pons and medulla. 



Macroscopically the cerebral and spinal meninges were in the main normal, but 

 in places where the grey and greyish-blue areas in the cord reached the surface the 

 pia over these areas appeared slightly opaque. On section of the cord at various 

 levels, numerous gelatinous grey areas were found, and also parts of a softer con- 

 sistence with a whiter colour than the normal tissue of the cord. Sections of the 

 medulla oblongata and pons indicated the same two types of areas, parts of the pons 

 appearing so affected that there were only islands of normal tissue, and the floor 

 and immediate neighbourhood of the IVth ventricle were also markedly involved. 

 Numerous areas were found in the horizontal sections of the cerebral hemispheres 

 at various levels, not only in the basal ganglia and white matter, but also in the 

 cortex and subcortical white matter. There was a well-marked peri- ventricular 

 sclerosis, especially of both the posterior horns of the lateral ventricle extending 

 down into the descending horn on both sides. The ventricles were not dilated, 

 and their surface was smooth but cloudy, and raised in slight ridges corresponding 

 to the venous branches which are present underneath the ependyma, especially at 

 the posterior and anterior horns of the lateral ventricle. These veins were distinctly 

 outlined and surrounded by a zone of gelatinous tissue. 



The size of the areas varied very considerably : in the cord it was impossible to 

 define macroscopically, either on the surface or on section any of the areas, as 

 they seemed to run into one another. In the brain, however, isolated areas were the 

 rule, though here also irregular areas of different size and form coalesced. Those 



