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The intestines, and in particular the small intestine, present a somewhat typical appearance. The slaty-grey colour, the thickened walls and swelling of the intestinal mucous membrane are quite characteristic. In a few cases punctiform hæmorrhages may be present either in the serous or in the mucous membranes.
The liver is generally enlarged, with increased specific gravity and weight. This is mainly due to venous hyperemia and the presence of an increased amount of fibrous tissue. A large majority of livers examined show fine cirrhosis.
The pancreas is usually fibrous.
The kidneys are congested and slightly cirrhotic. Occasionally nephritis or hæmorrhage is present.
The spleen is very variable in size, and is in the majority of cases fibrous. It is very congested.
The brain and spinal cord are usually infiltrated with serous fluid. They are firm on consistence and hyperæinic.
To recapitulate, one may say that the main changes met with are dropsical accumulations, venous hyperemias, and general fibrotic accumulations in the various internal organs.
In the liver and spleen this fibrotic change is usually well marked by the occurrence over the capsule of these organs of localised whitish
grey thickenings which ramify and branch in a tree-like fashion. This peculiar form of capsular thickening is met with in other diseases, such as chronic malaria, etc., but in beri- beri it is usually peculiarly well defined.
In atrophic cases the appearance of the dead body is one of anæmia. The dropsy is absent and the body appears usually in a state of extreme emaciation. The condition of the heart and other internal organs are in correspondence with those in the dropsical form, only there is the absence of fluid accumulation.
In a few instances microscopical preparations have been made of the organs, muscles and nerves of cases of Beri-beri, but the results have not so far been completed.
The routine bacteriological examination of dead and living cases of Beri-beri has been carried out in a few cases, but so far the results have been unsatisfactory.
Typhoid Fever.
Seven cases of Typhoid Fever were examined at the Public Mortuary during the year 1902.
No.
1
Age. 6 years
Sex.
M.
2
36
13
F.
33
M.
#
2
""
6
7
13
2
""
F.
3
Remarks.
Post-mortem appearances typical.
"
Severe post-mortem lesions present. Post-mortem appearances typical. Severe ulceration and perforation. Severe post-mortem lesions present.
All the cases were among Chinese.
21
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BODIES TOO DECOMPOSED FOR POST-MORTEM EXAMINATION.
During the year 1902, 402 bodies, including one skeleton, were returned as "too decomposed." These figures show a marked increase as compared with the preceding year, and this is probably accounted for by an approximate increase in the number of bodies found in the harbour, on neighbouring islands, the hillside and the streets. This question of decomposed bodies at the Public Mortuary is one of the greatest importance. During the cooler months there are naturally fewer, but during the hotter seasons of the year-at a time when the Mortuary is