3

The line of demarcation between the pale tissue and the darker liver tissue was
very distinct. Microscopical examination shewed that the above appearances
were due to the fact that in the centre of the lobule the liver cells were markedly
atrophied, and the liver substance almost replaced by the large cells described in
the last report.

       Intestines.—The mucous membrane was pale, but otherwise quite normal in
appearance.

       The lymphatic glands behind the mesentery were about the size of beans
and of normal appearance.

       A large hæmorrhage was present under the peritoneum of the under
surface of the diaphragm extending over several square inches. Several smaller
hæmorrhages were present in the neighbourhood. Prior to death the spleen had
not been punctured.

       The œsophagus was examined closely with a lens but no unusual appear-
ances were seen in the muscular coats.

       The muscles were examined in several situations with a lens but shewed no
unusual appearances.

       The heart, kidneys, pancreas, suprezrenals and bladder were normal in
appearance.

       The lungs shewed areas of congestion and there were small subpleural
hæmorrhages over the bases.

       Distribution of the bodies.—Bodies were present in large numbers in the
spleen, liver and bone-marrow. Sections of the liver and spleen shewed, as in the
tissues of the first three autopsies, many large cells crowded with the bodies lying
in the capillaries. In the spleen large branched cells which appeared to assist in
forming the splenic reticulum also contained many bodies in their cytoplasm. In
blood from the hepatic veins bodies were seen in cells of mononuclear and endo-
thelial type as well as in polymorphonuclear cells. In blood taken from a small
vessel in the muscles of the thigh a fair number of bodies were present in large
mononuclear cells.

       Various connective tissues were closely examined for the parasites but with-
out result.

       Muscle spread upon the slide by the " half-drying method " and stained by the
modification of Romanowski described in the first report did not reveal any bodies.

       AUTOPSY 5.—Man aged about 40. Fairly well nourished. Death from
peritonitis.

       Abdomen contained about two pints of purulent fluid which was collected
especially in the neighbourhood of the cæcum.

       Spleen somewhat enlarged. There were two large infarcts and many smaller
ones visible.

B 2