6 



hyaline degeneration of the vessel walls, and nowhere are the 

 thrombotic processes clearly and unmistakably described or their 

 frequent occurrence and importance sufficiently emphasized. 



Albrecht and Gohn (Vol. II, p. 540, of their report) describe the 

 kidney changes in plague in the following words : ^ 



In plague, as in many infectious diseases, the kidneys, both niacif> 

 and microscopically, exhibit in a most pronounced manner the signs of 

 parenchymatous and fatty degeneration. Histologically one sees in them 

 not only the changes of cloudy swelling and simple fatty degeneration 

 but also loss of nuclei and necrosis. 



Multiple cortical hemorrhages in the shape of typical glomerular hemor- 

 rhages are very frequent. In many plague kidneys one finds a very 

 striking glomerular change. The individual capillary loops are transformed 

 into cords {striuuje) . which stain well Avith eosin, are still sharply 

 differentiated, and which consist of "beam" or thread-like appearing coagula 

 { gerinseln) . In this manner these glomeruli, deeply stained and well 

 preserved in their shape, contrasting with the remainder of the poorly 

 stained cortex, form a very striking picture. Between such a glomerulus 

 and its capsule there is never any exudate. The vasa afferentia leading 

 to the glomervili often show the same picture of coagulation [gerinnungs- 

 bilder) , and the latter is not only found in the vascular lumen but also 

 involves the vessel wall. (See Table XI, fig. 1.^) In general these 

 pictures are completely identical with those which we observe in multiple 

 splenic foci and in genuine plague pneumonia. 



Here also we are dealing with coagulations in the blood, in the tissue 

 juices, in the elements of the vessel wall itself, ichich can not be stained 

 according to Weigert's fibrin method^ and which when stained by the Van 

 Gieson stain assume a light yellow tint. 



Such glomerular changes are found only in such cases in which very 

 numerous bacilli are circulating in the blood. The bacilli then are found 

 densely crowded in the capillaries and small vessels of the cortex and 

 they can also be seen abundantly between the cord- and net-work of the 

 vascular lumina. 



■ Such is the description of the vascular changes of the kidneys as 

 given by Albrecht and Gohn. In this connection we must point 



^ This quotation has been translated from the original as literally as 

 possible. 



-According to their explanation of the tables, fig. 1. Table XI, a colored 

 drawing, was prepared from material fixed in the Mueller-Orth formalin 

 mixture and then stained with hsemalum and eosin. As stated in another 

 part of the present report, such a method of fixation is absolutely worthless 

 for the microscopic study of the thrombosed vessels. Indeed, after its use 

 one obtains very misleading pictures simulating vessel changes, which are in 

 fact not present. See microscopic desoiption of our case No. 20. 



^ Italics our own. 



