3 o THOMPSON YATES AND JOHNSTON LABORATORIES REPORT 
condition less marked ; tongue coated and dry but steady ; complains of sleepiness 
and dozed during examination. 
January 25. Lies in bed all day, is drowsy but does not sleep much, is irritable 
and querulous. 
February 2. Seldom asleep, and then at once aroused, is bright and intelligent ; 
complains of pains 'all over' and of insomnia at night ; staggers with weakness on 
attempting to walk. 
February 12. Is much weaker, can hardly walk ; speech is thick, weak, and 
monosyllabic ; lips flabby and glued together ; sleeps a good deal but easily aroused. 
February 16. Lies in a drowsy condition all day; complains that she cannot 
walk. Food is brought to her, but unless assisted she does not eat. 
February 24. Sleeps lightly all day ; is almost too weak to sit up alone ; calls 
for assistance to go to stool. 
Marc// 7. Pulse rapid and weak ; patient has not slept during night ; com- 
plains of pains all over; cries out when touched, owing to bed-sores forming on 
sacrum and scapulae ; pupils equal and widely dilated ; axillary and femoral glands 
enlarged, but not nearly so large as when admitted to hospital ; cannot take her food, 
either milk or soup. Knee jerks increased ; arms persistently flexed at elbow ; hands 
tremulous. No oedema. 
March 8. Died 4 p.m. 
Necropsy commenced three-quarters of an hour after death. Body much emaciated ; bed-sores 
over sacrum and both scapulae ; skin clean, dry, and shows slightly on extremities the previously noted 
' imbricated appearance.' No oedema ; pupils widely dilated, left slightly more. 
Thorax : Left pleura contained 30 c.cm., very turbid fluid with floating flakes of lymph, right pleura 
contained 10 c.cm. of similar fluid. Pericardium contained 40 c.cm. slightly turbid yellow fluid. 
Heart : Weight, 223 grammes ; normal ; full of firm clot. 
Lungs, each weighed 23 1 grammes. Marked hypostatic congestion, with sub-acute bronchitis of 
both lungs. At posterior border of left lung, level of seventh dorsal vertebra, there was a recent deposit 
of fibrous lymph on pleura, with intense subjacent congestion. 
Abdomen : Peritoneum dry, mesenteric vessels congested ; spleen and liver adherent to parietes and 
adjacent organs by fairly extensive, old, fibrous adhesions. 
Liver: Weight, 1,585 grammes, large, nutmeg, with commencing fatty change. 
Gall bladder filled with thick grumous bile. 
Spleen : Weight, 335 grammes, 19 , 11 . p. 5 c.cm. Anterior border deeply notched, substance dark, 
firm, but friable. 
Kidneys weighed' together 225 grammes, normal. 
Pancreas and suprarcnals : Normal. 
Alimentary canal : Mouth, stomach, large intestine, and jejunum normal. A Peyer's patch about 
60 cm. above ileocaecal valve was greatly congested. On either side of patch for some 10 cm. were 
numerous disseminated congested areas, varying in diameter from 1 to 4 mm. Ascaris and anchylostomes 
present. 
Genitals : Uterus small, nonparous small myoma. All genital organs firmly bound together by old 
adhesions ; vagina normal. 
