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arity on the part of Beri-beri blood is accounted for by the fact of the presence of an excess of CO2. The valves of the heart are usually competent. Tricuspid incompetence may however be met with. Scattered over the inner surface of the cavities of the heart numerous small petechia are frequently found.

The aorta, arteries and veins are frequently the seat of extensive atheromatous degeneration. This however has little to do with the disease, and is a common pathological change among the Chinese over 30 years of age.

The upper respiratory passages are in almost all cases normal. Hyperæmia and edema of the epiglottis is found rarely. Occasionally the mucous membrane of the entire larynx is in a similar condition. The trachea may also be found congested, and on its mucous membrane a thick yellowish secretion is frequently found. The bronchi usually contain an appreciable quantity of secretion which may be simply bubbly mucus, or of a purulent or semi-purulent

nature,

The lungs on opening the chest only partially collapse. They are usually crepitant throughout. As a rule these organs are full of oedematous fluid which wells out profusely from the cut surface. Un squeezing the latter a bloody frothy fluid and watery mucus oozes in large quantity. In addition to the presence of cedema, emphysema to a varying degree is usually present and this is occasionally so pronounced as to cause the anterior edges of the lungs to meet over the percardial sac. Hypostatic congestion of varying degree is usually present in the posterior and lower portions of the lung tissue. A considerable proportion of cases of Beri-beri end fatally owing to the supervention of pneumonia,

The pleural cavities are usually normal. Adhesions are frequently present but these are common amongst the Chinese who often suffer from sub-acute and localised pleurisies. Bilateral Hydrothorax is the rule in all well-marked cases of dropsical Beri-beri-both cavities being more or less full of clear yellow-coloured fluid. The bronchial glands are usually normal. In extreme cases of general anasarca they may be slightly enlarged owing to the presence of oedematous infil- tration and cortical congestion. Amongst the Chinese old tubercular deposits are frequently found in these glands.

The thymus gland in young adults may be slightly enlarged owing to oedema and congestion.

The peritoneum is almost always normal. It may be thickened owing to the presence of cedeina. Hydroperitoneum is usually present and may be extreme. The fluid, as in the other cavities, is clear yellowish and viscid in character.

The condition of affairs found in the alimentary canal in Beri-beri, has within recent times been the subject of considerable dispute. Most authorities state definitely that the digestive tract in this disease present nothing of any great patho- logical importance. Other investigators as HAMILTON WRIGHT and his collea- gues in Malaya, however, attach considerable weight to the presence of certain alimentary lesions. They regard the changes present as more or less constant, as typical for Beri-beri, and the point of entrance of the materies morbi of the affect- ion. HAMILTON WRIGHT in his most recent publication on the pathology of Beri- beri describes what he calls the primary lesions, namely, a gastro-duodenitis, and in his conclusions follows up this statement by a considerable amount of weighty evidence in favour of his view. Whether this theory, which up to the present is an isolated one, will be confirmed by subsequent workers, will be awaited with considerable interest. If this conclusion be established that "the premonitory gastro-duodenal syndrome of Beri-beri has as its pathological basis a definite gastro duodenitis", and that this is the primary lesion of the disease, all that remains to be done is to establish the presence of a definite exciting cause of such a lesion. So far no micro-organism has been brought into definite causal relation- ship with the disease and all attempts by HAMILTON WRIGHT and others to isolate a biological cause of Beri-beri have failed up to the present time.