109 
perature was usually normal, and ranged between 98.5° and 99.5° F. A tendency to 
hemorrhage was nowhere to be seen, except from the intestinal tract. The feces 
gave the prussian-blue reaction for iron. 
“The examination of the eye grounds was twice carried out under difficulties. 
No retinal hemorrhage was apparent. 
“The blood findings throughout were of a most suggestive nature; an anemia,, 
at first of the secondary type, progressing until it corresponded in most respects to a 
i primary pernicious anemia. The individual corpuscles grew larger and held an 
i ever-increasing amount of hemoglobin, the color index rising from 38 to 88 per cent, 
and the volume index reaching 122 per cent. The poikilocytosis was sufficiently 
I outspoken, as well as the polychromatophilia, for a primary anemia. The scarcity 
■ of nucleated red corpuscles and the entire absence of megaloblasts is unusual in 
r the primary pernicious form, yet some such cases have been reported. What 
I convinced us that the anemia was not of the usual primary type was the eosinophilia 
.jiof 13 per cent, for in the primary disease the eosinophiles are rarely increased. On 
i»the other hand, the Uncinariae and most of the other intestinal parasites are char- 
j acterized by an increase in the eosinophilic cells. 
' Autopsy . — The post-mortem examination was made Xovember 13 by Dr. Harris, 
resident pathologist of the hospital. His report is as follows: 
“Body is that of a fairly well-developed and fairly well-nourished man 162 cm. 
tall. Post-mortem rigidity and lividity present. 
“There is a scar 0.5 cm. long on left arm, some edema of lower extremities. 
• Paniculus adiposus well preserved and of a light-yellow color. 
“ Abdominal cavity: Diaphragm reaches to the fifth rib on the right side and to the 
sixth rib on the left. Some free straw-colored fluid in peritoneal cavity. Omentum 
extends down to the pelvis over the intestines and contains a considerable quantity 
;|-of fat. 
“Pleural cavities: Some firm fibrous adhesions at right apex. About 1,000 c. c. 
-'straw-colored fluid in right pleural cavity; about 250 c. c. in left. Lungs do not 
E' meet in median line. 
“Pericardial cavity: About 500 c. c. of straw-colored fluid in the pericardial cavity. 
<|This fluid contains a few fibrinous flocculi. The pericardium is thin and surface is 
smooth. 
u “Tongue, pharynx, larynx, not examined. Thymus absent. Esophagus and 
trachea negative. 
“Lungs: Left lung smooth externally, marginal emphysema, crepitates through- 
|i!Out, floats in water, cut surface smooth, pale, and drips fluid. On the diaphragmatic 
jfeurface is a caseated nodule 8 mm. in diameter. Right lung with the exception of 
the caseous nodule corresponds to the description of the left. Both lungs are quite 
iifree of pigment and weigh 2,870 grams. Peribronchial lymph glands are negative 
lexcept for anthracosis. 
i “Heart: Cavities are quite empty, left ventricle contracted; aortic and pulmonary 
ifeemilunar valves are competent, read by water test. Some fibrous thickening at the 
ifcase of the aortic valves. One of the valves has small fenestration 3 mm. long. 
;Pulmonary valves show no change. The mitral orifice admits three fingers, and the 
fvalve shows a small amount of fibrous thickening, especially near the free borders. 
jp?he tricuspid orifice admits five fingers; the valves show no changes. The left 
), Ijventricle has an aberrant corda tendina extending from the septum to the left wall. 
D jiVentricular wall measures 16 mm.; right ventricular wall measures 5 mm. Heart 
a nffiuscle is firm and very yellow, but not mottled. Heart weight, 300 grams. There is 
^ slight increase of the subepicardial fat. There are a few atheromatous patches in 
the ascending aorta. 
“Spleen: About one-half larger than normal; capsule is smooth, parenchyma is 
^uite firm; malphigian bodies prominent; there is an evident increase of connective 
issue. The organ weighs 225 grams. 
