DISEASES OF BLOOD AND BONE MARROW 99 
tion. The diagnosis at autopsy was primary anemia, fatty degeneration 
of the liver, hemorrhages in intestines and spleen, hyperplastic bone 
marrow. The external appearance is of general good condition, fair 
skin, mucous membranes pale. Lungs collapsed, and gray red. There 
are several small hemorrhages scattered irregularly throughout respira- 
tor}' tissue. Lymph Nodes — small, soft mottled gray-red. Pericardium 
had slight excess clear fluid, and no adhesions. Heart normal in size, 
and of pale brown color. The liver of normal size, smooth surface 
and shsaj) edges, of a pale brown color, soft and friable. Has indis- 
tinct markings like yellow brown mottlings on section surface. Gall- 
bladder contains some viscid brown bile. Spleen, normal or slightly 
less in size, consistency firm, capsule pale pearl gray, apparently not 
thickened. There are numerous small hemorrhagic spots on section 
surface. Interlying pulp is homogeneous deep red. Follicles not visible. 
Kidney, normal in size and shape. Trabeeulae faint. Capsule smooth, 
strips easily, smooth surface, and brown. Consistency soft. Medulla 
prominently striated, cortex homogeneous salmon pink. Stomach con- 
tains a little glistening mucus. Mucosa pale, flat yellowish, slightly 
opaque. There is a recent clot lying in some mucus just above pyloric 
valve. There is, however, no open vessel nearby. From pylorus to 
anus lumen contains some rather fresh smeared out or slightly clotted 
blood and mixed in with mucus. Mucosa is flat translucent, submucosa 
slightly injected in a mosaic fashion, otherwise gut wall is negative. 
No recognizable food present. Follicles not visible. Mesentery glands 
small, soft, pale yellow. Bones seem entirely normal. Marrow of 
long bones is firm, bloody. Marrow of ribs also deep red. Blood 
in intestinal tract is probably a recent slow oozing from intestinal 
walls, and was probably the last straw. Cause of this anemia could 
not be determined. Blood preparation not made because it was too 
long after death. Liver shows moderate fatty infiltration of marginal 
areas. Pigment is scarce, only a few granules being present in the 
Kupffer cells, not more than is often seen without marked anemia. 
There is a slight increase in interstitial nuclei but not in fibres. No 
obstruction or increase of bile ducts. 
Kidney. — Very mild swelling of tubular epithelium but no exuda- 
tive processes. Glomeruli show a few vacuoles but capsular space is 
negative to pigment. Bone marrow (Femur) fairly cellular in con- 
struction, but fat well mixed. Cellular areas well arranged, active, 
most of cells are small members of the larger mononuclear variety. 
Small lymphocytes abundantly represented. Most of the larger cells 
are non-granular, with centrally placed nucleus. Megakaryocytes fairly 
numerous, nuclei seem closely jammed into centre. No recognizable 
certain nucleated red blood cells, moderately number stippled cells, 
few adult red cells. Eosinophiles and basophiles quite few. Pigment 
small quantity. 
This is a case of primary anemia of moderate severity 
and short duration, and probably of hemolytic character 
