15 



seen anywhere in the renal sections, which, however, show diffuse 

 invasion of the large cylindrical postmortem bacillus mentioned 

 before. A study of the renal sections of this case shows clearly and 

 unmistakably that the fibi'in thrombosis is independent of any 

 demonstrable morphologic vessel-wall changes. If such is found in 

 advanced cases with extensive thrombosis, it is secondary to the 

 primary obliteration. 



There are present in some parts of the sections changes such as 

 an increase of the connective tissue of the capsules of Bowman, 

 fibrosis of the glomerulus, and increase of the interlobular connective 

 tissue in general, Avhich clearly point to an early chronic interstitial 

 nephritis, which was present previous to the pest infection and 

 entirely independent of it. 



Case Xo. 12. Right Hemorrhagic Femoral Bubo. 



(Necropsy Protocol No. 1150. S. H., 35 years old, male Chinese, from 119 La Coste 

 Street, San Nicolas. Died March 24, 1905, 2 o'clock p. m. Postmortem examina- 

 tion made March 25 at 10 o'clock a. m.) 



Anatomic diarinosis. — Right hemorrliagie femoral bubo; acute parenchym- 

 atous nephritis: multiple subserous and submucous hemorrhages; bubonic 

 plague. 



Microscopic examination. — Xo hyaline thrombi in the glomerular capil- 

 laries or in any of the other renal vessels. 



Case X^o. i;*. Right Ixgiixai, Bibo. 



(Necropsy Protocol No. 1183. D. C, male Filipino, 19 years old, from 162 Barce- 

 lona street, San Nicolas. Died May 12, 1905, at 6.30- p. m. Posmortem exami- 

 nation seventeen hours after death.) 



Anatomic diagnosis. — Right inguinal, slightly hemorrhagic, bubo; conges- 

 tion and oedema of the lungs; hemorrhagic jjarenchymatous nephritis; 

 multiple subserous and submucous iicmoirhages : congestion and oedema of 

 the brain. Bubonic plague. 



j\Iirrosco/nr cnnn'mation. — ^lust of the glonicruii exhibit vessels 

 obliterated by hyaline fibrin throml)i. In some of the Malpighian 

 tufts the thrombosis is quite extensive, in others it is moderate, and 

 in still others it is quite insignificant. However, glomeruli entirely 

 free from oljliteration are seen only rarely. Practically all of the 

 thrombi encountered are made up of rcticuhi and bands of fibrin. 

 Completely solid and dense fibrin plugs in the glomerular vessels 

 are not seen in this case. An extension of the thrombi into the 

 afferent and efferent vessels occurs hei-e ;ni(] there. One also 



