{ 
; 308 
Three days after inoculation the lesion shows specific characters and 
we find an area in which the epithelium presents a pathological change, 
and beneath this the tissue is infiltrated with polynuclear leucocytes. 
The changes in the epithelium consist in degeneration and disintegration 
of the epithelial cells, together with more or less accumulation of fluid 
in and between the cells. This accumulation of fluid occurs not only in 
the degenerating portion of the epithelium but also at the sides of the 
lesion. This process is similar to that seen in a skin inoculation of the 
same duration. 
The degeneration of the epithelium is not uniform, and we find islands 
of comparatively normal cells in the midst of areas where the affinity of 
the nuclei of the epithelial cell for basic stains is lost. Polynuclear leuco- 
cytes are present in large numbers. The epithelium at the edge of the 
lesion is somewhat thickened, apparently as a result of the swelling of 
individual cells. 
After 4 days the lesion shows the same characteristics, save that there 
is considerable loss of substance in the area of degenerated epithelium 
and the lesion is more extensive. At this time the reaction in the tissue 
beneath the lesion is well marked and proliferation and enlargement of 
the endothelial cells of the lymphatics and blood vessels is apparent. 
Many elements of the lymphoid and plasma cell series are present about 
the vessels beneath the lesion. 
Five and 6 days after inoculation the lesions are similar in character 
to those just described, but the necrotic area becomes sharply limited and 
the inflammatory reaction beneath is more intense. 
Lesions of 7 days’ duration show evidence of beginning repair. The 
epithelium at the edge of the lesion is normal and the lesions consist of 
a sharply circumscribed ulceration, in the depths of which repair is active. 
Later lesions show the epithelium growing inward to close the defect, 
and new formed blood vessels and young connective-tissue cells are 
much in evidence in the tissue beneath. 
In the lesions of 3, 4, 5, 6, and 7 days’ duration epithelial cells contain- 
ing cytoplasmic phases of Cytoryctes variole are of frequent occurrence. 
The earlier forms of the parasite occur at the margin of the lesion, the 
later ones nearer the center. Nuclear phases of the parasite are also 
found, but they occur later than the cytoplasmic phases. 
Nose.—The primary lesions in the nose vary in character according to 
the locus of inoculation. When the incision is near the orifice of the 
nostril, on a stratified epithelium, the lesion conforms to the type de- 
scribed on the lip. When the lesion is higher up, upon a columnar 
epithelium, the process in the submucous tissue is most marked. In such 
a situation the bulk of the degenerated epithelial cells seem to be carried 
off almost at once, and we find but little thickening of the mucous layer. 
However, the submucous tissue shows accumulations of lymphoid and 
plasma cells, enlargement and proliferation of the endothelial cells of the 
