387 
marrow  taken  from  the  ribs.  The  marrow  is  also  frequently  the  seat 
of  congestion  and  haemorrhages.  Nucleated  red  corpuscles  are  by 
no  means  abundant,  and  evidences  of  nuclear  activity  in  any  of  the 
types  of  marrow  cells  are  very  rarely  met  with. 
Numerous  examinations  of  the  spleen-pulp,  which  was  either 
withdrawn  during  life,  or  obtained  shortly  after  death,  have  been 
carried  out,  the  result,  as  regards  parasites,  being,  as  above  stated, 
uniformly  negative.  The  material  withdrawn  from  the  spleen-pulp 
during  life  consists  almost  entirely  of  red  corpuscles  with  a  consider¬ 
able  number  of  lymphocytes.  Very  few  of  the  large  mononuclear 
phagocytes  of  the  spleen  are  found  in  the  contents  of  a  syringe 
introduced  into  the  enlarged  and  indurated  organ  so  frequently 
accompanying  the  condition.  In  films  made  post-mortem,  however, 
the  latter  class  of  cell  occurs  in  considerable  numbers  and,  both  in 
films  and  sections,  instances  of  phagocytosis  in  this  type  of  cell  are 
common.  The  presence  of  considerable  numbers  of  granular  cells 
(eosinophiles  as  well  as  neutrophiles)  which  occur  in  post-mortem 
preparations  of  the  spleen-pulp  has  been  frequently  noted,  fragments 
of  such  cells  being  often  found  in  the  macrophages  of  the  spleen. 
To  a  certain  extent,  however,  the  assemblage  of  the  granular  cells  in 
the  spleen-pulp  may  be  an  ante-mortem  phenomenon. 
Condition  of  the  liver.  The  comparatively  frequent  occurrence 
of  cirrhosis  of  the  liver  in  various  degrees,  with  the  usual  morbid 
changes  which  are  associated  with  this  condition,  is  a  fact  which 
soon  impresses  itself  on  the  attention  of  any  one  engaged  in  post¬ 
mortem  work  in  Egypt.  After  the  exclusion  of  types  of  cirrhosis 
which  owe  their  origin  to  alcohol,  tertiary  syphilis  or  Bilharziosis, 
there  yet  remain  a  very  considerable  majority  of  all  the  cases  of 
cirrhosis  encountered  for  which  some  other  explanation  must  be 
sought.  With  regard  to  alcoholic  cirrhosis,  it  may  be  said  at  once 
that  its  occurrence  amongst  a  largely  Moslem  population  is  extremely 
rare.  Tertiary  syphilis  also  does  not  appear  to  manifest  itself 
amongst  Egyptians  in  the  form  of  gumma-formation  and  extreme 
cirrhotic  change  in  the  liver  so  frequently  as  amongst  Europeans,  and 
lastly,  Bilharzial  cirrhosis  is  not  only  comparatively  rare,  but  when 
present  is  so  characteristic  in  appearance  that  it  can  be  easily 
differentiated.  An  analysis  of  the  post-mortem  records  of  the  Kasr- 
El-Ainy  Hospital,  Cairo,  for  the  last  four  years  reveals  the  presence 
