The haemoglobin percentage fell to 26% (3.8 g.%) and the total leucocyte count to 10,600. Death occurred on July 20. Relevant Necropsy Findings.-The skin and all organs were pale, with many petechial haemorrhages. Several tough, pale nodules were present in the scalp, and there was a large haematoma on the extensor surface of the right forearm. The lymph nodes were all enlarged and pale. The spleen was enlarged, weighing 26 oz. (737 g.). On section it was red, soft, and coarsely granular. The liver weighed 92 oz. (2,608 g.), and was pale and firm on section. The right ankle-joint was opened. The synovial membrane, synovial fluid, and articular cartilage looked normal. Report on Histology.-"Sections of liver, spleen, lymph node, scalp nodule, skin haematoma, kidney, and small intestine show, in greater or less degree, infiltration by immature leukaemic cells. A portion of the synovial membrane of the left ankle shows infiltration by leukaemic stem cells. The cells have round or ovoid vesicular nuclei
We have seen in Part I of the present study that information on venereal syphilis has been available for more than a hundred years and that some of the human ecological factors could be assessed in the rise and fall of this adult treponemal disease. In the endemic treponematoses of childhood-on the other hand-knowledge of human ecological factors influencing recrudescence and regression is limited and the morbidity reporting of early and late manifestations of yaws, pinta, and endemic non-venereal syphilis in the rural areas of developing countries is poor. Long-term trends and periodic recurrences can mainly be discerned through prevalence data obtained in campaigns and surveys over the last 40 to 50 years.
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