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PART II. POST-MORTEM EXAMINATIONS WITH DESCRIPTION 
OF MACROSCOPIC AND MICROSCOPIC CHANGES 
I. EXAMINATION OF ORGANS IN MAN (four cases) 
A. — Case of the Native, Kitambo 
Death, June 12, 1904, eight p.m. ; post-mortem six hours later. 
External appearances. — Body of middle height, very emaciated ; muscular 
development poor ; no exanthemata ; no oedema ; rigor mortis marked ; 
configuration of skull normal, markedly dolicho-cephalic. Conjunctivae and sclerae 
very pale and slightly jaundiced ; mucous membranes pale. The cervical and 
inguinal lymphatic glands were distinctly prominent. Thorax long ; intercostal 
spaces prominent ; abdomen retracted. External genitals normal. Superficial ulcers 
about three cm. in diameter on the soles of the feet (probably produced by chiggers). 
Brain and Spinal Cord. — The under surface of the scalp was very pale. Skull 
rather thin, the vessels on its inner surface occupied deep sulci. Circumference of 
skull fifty-two cm. The dura mater adherent in places to the bone. The sinuses 
contained dark fluid blood and a few clots. The inner surface of the membrane was 
smooth and glossy. Cerebro-spinal fluid increased in quantity. The surface of the 
brain was of normal configuration ; the gyri appeared a little flattened. The 
superficial veins were very large, many were tortuous and they contained dark venous 
blood. The arteries were also engorged so that the whole surface of the brain was 
covered with a dark blue network, and greatly congested capillaries (Fig. 1). The 
leptomeninges were thickened, and in places whitish but not adherent to the brain. 
The pial vessels of the cerebellum were much congested and could be traced to the 
finest capillaries. The basal arteries showed no sclerosis. On section the brain 
substance showed irregularly distributed congested areas ; the basal ganglia showed 
puncta cruenta. The brain substance was doughy, soft, and very oedematous ; the 
ventricles were dilated ; the ependvma roughened ; the vessels very congested. 
The pons and medulla showed no macroscopic changes except congestion and some 
small haemorrhages about the size of pin heads. In the vertebral canal was a fair 
quantity of cerebro-spinal fluid. The inner surface of the spinal dura mater was 
smooth and glossy ; the pial vessels were enlarged and filled with dark blood ; the 
congestion was not equally distributed, being more pronounced in parts ; in others 
the vessels were only moderately filled. The cauda equina presented a striking 
appearance ; it was surrounded by a gelatinous tissue and its nerves were sheathed 
in networks of dilated vessels ; on section the congested vessels were seen as dark 
