16 



occasionally sees a tlirouibus in an interlobular artery or in a vas 

 rectum. The throiwbotic processes are almost exclusively confined 

 to the cortex, but a few thrombi are encountered in the medulla. 

 The vessels of the latter are enormously dilated and engorged. 

 The extreme glomeruli-free, subcapsular zone of the cortex does 

 not contain any thrombi. Bacillar metastatic emboli are not found 

 in the renal sections. 



Case Xo. 14. Right Cervical Bubo. 



(Necropsy Protocol Xo. 928. C. S., Filipino, age 5 years, from 170 Estero San 

 Nicolas. Ill five or six days ; three days in San Lazaro Hospital. Died March 

 18, 1904, at 11 o'clock p. m. Postmortem examination three hours after death.) 



Anatomic diagnosis. — Perforating nicer on the right side of the soft 

 palate : general hypertrophy ; congestion and hemorrhagic oedema of the 

 general lymph glands of the body: oedema and congestion of the lungs; 

 congestion and parenchymatous degeneration of the kidneys; oedema of the 

 gall bladder wall; multiple subserous and submucous hemorrhages; syphilis 

 hereditaria tarda. Bubonic plague. 



Microscopic examination. — A moderate numljer of glomerular 

 vessels show hyaline (fibrin) thrombi. Xowhere is this thrombosis 

 very extensive or at all complete; it affects only a minor part of 

 the vessels of one glomerulus. The renal vessels in general are 

 very much congested, and a very few areas of blood extravasation 

 are found. The few bacilli which are visible are found in connec- 

 tive tissue lymph clefts or in the capsular space of a glomerulus, 

 but not inside of blood vessels. 



Case Xo. 15. Cervical Bubo. 



(Necropsy Protocol No. 910. C. S., a Filipino girl, 9 years of age, from Anda Street, 

 Intramuros, Manila. Postmortem examination five hours after death, on Satur- 

 day, March 5, 1904, at 4 o'clock p. m.) 



Anatomic diagnosis. — Hemorrhagic, acute, parenchymatous nepliritis; 

 congestion and oedema of the lungs; moderate fatty degeneration of the 

 liver; hemorrhagic inflammation, hypertrophy and softening of the cervical 

 glands on both sides; more or less general liypertrophy of most of the 

 lymph glands. Bubonic plague. 



Microscopic examination. — The renal tissue presents a most strik- 

 ing picture. Sections from both kidneys, treated by Weigert's 

 fibrin method, appear as if the vessels had been injected with a 

 violet-stained gelatin. There is not a normal glomerulus to be 

 seen. All the sections show a more or less complete obliteration by 

 hyaline thrombi. In most of the ^ralpighian bodies the hynliin' 



