128 The Philippine Journal of Science 1920 
irregular and more interstitial. Usually a portion of the wall 
was still preserved, in a few the wall was completely absent. 
The perivascularly infiltrating cells have maintained their rel- 
ative position and indicate the boundaries or site of disappeared 
vessel walls. Here and there were minute, diffuse, irregular, 
interstitial hemorrhages. In most sections the extravascular 
blood was seen as minute dissecting hemorrhages about the 
intact vessels, which had evidently ruptured at some other level. 
Among these infiltrating cells there were occasionally present a 
few of the large mononuclear type. Hyaline thrombi were also 
seen. The spinal cord in this case showed no microscopic lesion. 
There was much engorgement of the capillaries and vessels 
of all the viscera. In the lungs the alveoli were filled with red 
blood corpuscles in certain places. In the heart there were 
hemorrhages between the fibers. Anaerobic cultures from 
the brain and cord of these were made with negative results. 
Subdural injection of filtered and unfiltered emulsions from the 
brain, cord, and pharyngeal scrapings of these gave negative 
result. It may be of interest, particularly in view of reports 
of successful transmission of the infection to monkeys else- 
where, that the monkeys used here had been immunized with 
the so-called Bacillus influenzse several months previously. 
The third case came to the morgue with the clinical diagnosis 
of malaria, cerebral type, after staying in the hospital for 
fifteen days. Autopsy was performed by Doctor Wade, seven 
hours after death. Gross examination of the body revealed 
little to indicate the immediate cause of death. There was 
visceral congestion with superficial hemorrhages in the right 
lung and perivascular hemorrhages in the brain. Heart showed 
myocardial degeneration and dilatation. Because of these 
findings and our previous experience, a diagnosis of encepha- 
litis lethargica was made. 
Microscopically, as in the previous cases, there were found 
general marked vascular engorgement and, in the lungs, hemor- 
rhages into the alveoli. 
Sections of the brain at different levels presented the same 
microscopical picture as in the first case, except that engorge- 
ment, hemorrhages, and infiltration here appeared more intense. 
The spinal cord, as in the first case, was affected and with 
considerable severity. The other viscera showed infection and 
slight degeneration. 
In the kidneys there was marked tubular degeneration and 
