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In Dropsical Beri-beri the bodies externally appear to be well nourished. This appearance, however, is but a false impression, and is largly dependent upon the development of general anasarca before death. The rate of decomposition of the bodies is when compared with those of the acute infectious fevers, relatively slow. Further, the condition known as foaming organs is not so frequently found in Beri-heri corpses as amongst those of the acute specific fevers.
Post-mortem lividity is usually pronounced especially on the face, neck and back. This discolouration is not so pronounced as one finds in the case of a cons- titutional infectious disease, e.g., Pest. Rigor mortis may be present. In some cases it is practically absent.
The skin is usually normal in appearance. Old scars which have nothing to do with the disease are frequently found scattered over the body surface. Erup- tions may be present but it is questionable if they have anything to do with the disease. Subcutaneous haemorrhages may be found but are not frequent in the type of cases met with here.
No special pigmentation of the skin or mucous membranes has ever been noted.
On section of a Beri-beri corpse the first thing which strikes the eye is the amount of watery fluid in the subcutaneous tissues and body spaces. In well- marked cases of the dropsical variety, a mere cut in the skin occasions a regular outflow of clear serous fluid. The subcutaneous tissue has a jelly-like or mucoid appearance and from this the fluid pours continuously. Subcutaneously a consi- derable quantity of fatty tissue may be found, but its consistence and colour, etc., shew this layer to be in a state of degeneration. Indeed the appearance of the subcutaneous tissue, apart from the large amount of fluid present, in a well-marked cadaver resembles that found in newly-born children. This great infiltration of the subcutaneous tissue with serous, and mucoid-like fluid is characteristic of drop- sical Beri-beri.
The pericardial sac in marked cedematous cases is usually distended with fluid. The parietal layer is usually slightly congested and may shew a few petechial hæmorrhages. On opening the sac a clear straw-coloured fluid, free from flaky material, wells out often in enormous quantity. Milky patches are frequently found present scattered over the surface of the epicardium. These, as well as the tissue along the course of the main coronary vessels are usually infil- trated with fluid and have a swollen, mucoid and translucent appearance. Occasionally the coronary vessels look as if they were embedded in a clear yellowish jelly-like substance. Usually there is no evidence of pericarditis.
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In all cases of dropsical Beri-beri the heart as a whole is enlarged. extent of this enlargement varies within wide limits. Occasionally hearts of enormous size are found like the so-called "bullock's heart.” Coupled with this enlargement one usually finds a considerable increase in the weight of the organ. The amount of fatty infiltration on the heart also varies. In the majority of cases the fatty deposit is in excess. The coronary arteries are usually normal. The auricles, especially the right, are usually dilated. The right ventricle in the majority of cases is markedly dilated and contains a large solid and firm blood clot. Occasionally a certain amount of hypertrophy of the wall of the right ventricle is found, especially in cases of a more chronic nature. AS HAMILTON WRIGHT puts it-dilatation and more or less hypertrophy of the right ventricle is. the rule in cases of beri-beric residual paralysis. The left ventricle is usually only slightly dilated, and its walls are often found in a state of marked hypertrophy, especially when the cases have run a chronic course. In acute cases, on the other hand, dilatation may exist without hypertrophy. The walls of the ventricle are usually pale in colour and greasy and friable to touch. The cardiac muscle is almost always in a state of fatty degeneration, although the degree of this degener- ation varies extremely in each individual case. On opening the heart enormous quantities of extremely dark-red blood escapes which is perfectly fluid. allowing it to stand for a few minutes freely exposed to the air, it becomes of a brighter red colour and begins to clot. As is generally now accepted, this peculi-
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