33 
set. but not coalescent. The epiderinis over the scrotum was slouo’hecl 
» otf from area about 2 to 5 cm. in diameter. On the left chest 3 cm. 
from middle line and just above the left biceps were two small recent 
scars. (See historv of tick bite.) 
Post mortem lividitv on dependent portions of skin and thig'hs. 
Entire skin deeply jaundiced. 
Lungs: There was no adhesion of the pleura. Lungs were nor- 
malkc inflated, containing no consolidated areas except a veiy few 
points resembling emboli. 
Pericardium: Xormal; cavity contained about two ounces of fluid. 
Right heart half filled with blood; left contracted. Small chicken-fat 
clots in auricles. A few small hemorrhages over left ventricle near 
inter-ventricular groove under the pericardium. Myocardium some- 
what pale and flabby. 
Endocardium apparently normal. 
Spleen : Greatly enlarged (weight, 20 ounces) one hour after removal ; 
very soft, dark, and difliuent. 
Stomach: Apparently normal, except hydrostatic congestion over 
dorsal surface of fundus. 
Small intestine: Empty and showing no inflammation or cong'estion 
except h}"postatic. Pe^’er's patches pale and not congested. 
Mesenteric and retroperitoneal glands pale and not enlarged. 
Liver: Enlarged (weight. 92^ ounces) one hour after removal. Pale, 
fatty in appearance, and in some areas outlined by engorged bile 
ducts. 
Pancreas: Normal in appearance, except enlargement (weight 5 
ounces), one hour after removal. 
Kidnevs: Enlarged. Weight of left 10 ounces one hour after 
removal. Capsule adherent; minute subcapsular hemorrhages, espe- 
cially over greater curvature. On section, cortex congested: pyra- 
mids well outlined. Small hemorrhages about 1 mm. in diameter in 
pelves. 
Bladder wall: Apparently normal; cavit}^ contained about 1 ounces 
of urine. 
Cultures in broth and on Lotfler's serum were made from pericardial 
fluid, heart's blood, spleen pulp, lAer and kidney substance. Smear 
preparations were made from lung substance, heart wall, spleen pulp, 
liver and kidne}" substance, and red marrow of rib. Portions of skin, 
lung, heart wall, spleen, liver, small intestine (including Pe^^er’s 
patches), pancreas, and kidneys were preserved in Zenker’s fluid, 95 
per cent alcohol and 10 per cent formalin. Portions of rib were fixed 
in picro-sulphuric and nitro-sulphuric acid solutions. 
3 
