II. Part 2
The autopsy performed at noon on November 22 showed the following:
A body of strong build but very emaciated; face very gaunt with a strong yellowish tint. The subcutaneous connective tissue of the left calf infiltrated by pus, in some places soft as mush; the suppuration does not go deep anywhere. The right vena saphena is filled over its entire length with deep red clots, which adhere only a little in the upper part and are at the same time very brittle here; vena femoralis clear.
Pericardium almost completely grown together with the heart through a thick layer of newly formed connective tissue in which, in places, small tuberculi are embedded, though only in small numbers. Here and there, especially along the anterior cardiac wall, the two layers that make up the connective tissue have between them crack-shaped gaps filled with hard, dry fibrous material. The heart is not significantly enlarged, the right chamber is slightly enlarged and moderately hypertrophied. The muscle tissue is rather flaccid and dark brown. The aortic valves are thickened, somewhat shortened, two of them grown together over a length of about 1½ Linien (unit of measure); on the chamber wall in the area of the noduli there are a few small, hard outgrowths. The same on the atrial surface of one of the cusps of the mitral valve. Pulmonary artery slightly enlarged, its walls, too, only slightly thickened.
A moderate amount of bloody liquid in the pleural sacks. The lungs, at many places connected with the pleura parictalis, show abundant, bloody fibrous tissue superimpositions at the lower sections, especially on the left. Both inflatable except for the somewhat reduced and deformed lower left lobe, which cannot be fully unfolded. Only two non-extensive areas are emphysematously disfigured, one is found at the anterior edge of the upper left lobe, the other on the lower right lobe. Below the pleura there are numerous and large groups of black spots, distinguished from the usual pigment spots in two respects: first, even in the region of the upper lobes, where the pleura is little thickened or not at all, they do not present themselves sharply contoured; second, they do not appear arranged like usual pigment spots along the course of the intercostal spaces. The transverse section of the lungs appears colored an even dark black, with the exception of a few small areas (which include the emphysematous sections of the usual pale appearance); it is consistently smooth, shiny, and as soft to the touch as that of normal parenchyma. When pressed it gives off everywhere, and in some places a very abundant, foamy, serous, black liquid which stains the fingers like the solution of a bad black ink. Nowhere are there traces of newly formed connective tissue or indurations. The bronchia, to the extent that they were examined with the knife, showed nothing substantially abnormal; because of the decomposition that had already set in, nothing reliable could be said about the nature of the mucous membranes; at any rate, there could not have been any substantial thickenings, since we know from experience that they resist the onset of decomposition. Sparse white phlegm in the trachea. Small, old blood clots in a few branches of the pulmonary arteries. The bronchial glands are enlarged, blackish, in places caseously degenerated.
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