Page:Archives of dermatology, vol 6.djvu/19

 surface covered with yellowish-gray nodules. Kidneys show no marked evidence of disease ; they are small ; moderately firm ; sur- face smooth; substance congested, especially pyramidal portion; capsule moderately adherent, leaving on removal a fairly smooth surface ; have a slightly urinous odor ; cortex is of normal thick- ness.

The liver is small ; deeply notched on its right border ; bile-duct patulous; gall-bladder very much enlarged, containing thick, dark- greenish bile, and a single olive-sized, rounded gall-stone. The sur- face of the liver has a mottled, yellowish-white color ; on section the mottling is very distinct ; fibrous tissue increased, and very resistant to finger. There are no nodules present.

The stomach contains a greenish-black, thin fluid ; stomach-walls moderately softened, especially towards the cardiac end, apparently by post-mortem changes. The vessels are full of blood, giving the surface a dark color. The submucous connective tissue is not increased in amount. J'ancreas normal. Uterus normal and ovaries contracted.

A small amount of urine is found in the bladder. Its internal sur- face appears at first sight as though ulcerated, but on close examination distinct lesions are seen. They are flat, variously sized, mostly ovalish, firmly-seated, with broad bases, dark-reddish, slightly raised, soft but organized patches, covered with mucous membrane. One of the lesions rises to the height of a half-inch, and is the size and shape of an almond. There are no enlarged glands about the blad- der. None of the mesenteric glands are increased in size.

The mucous membrane of the intestines is everywhere stained dark-red, but nowhere is there any thickening. The lower end of the ileum and the head of the colon show no enlargement of Peyer's patches nor of the solitary glands ; nor is there any enlargement of the retro-perineal glands.

MICROSCOPICAL EXAMINATION.

Specimens for microscopical examination were removed as fol- lows :

An ovalish, large olive-sized piece of integument, containing in its centre an almond-sized, ovalish, sharply-defined, well-formed, slightly-elevated, reddish tumor (a recent growth), surrounded with healthy skin, — from the front of the right leg to the left side of the tibia.

A finger-nail-sized piece of integument from an old abdominal patch which had almost disappeared by absorption.

A subcutaneous enlarged cervical gland from supra-clavicular region.

A portion of enlarged parotid gland.

A section of heart from left ventricle.

Two sections from the liver ; one from the surface, the other from a deep-seated part of the organ.

A piece from the stomach, including mucous membrane and mus-