17 



thrombosis of the capillaries is so perfect that both the main 

 branches of the afferent vessel and the smaller capillaries given off 

 from the larger loops are sharply outlined. Some of the thrombi 

 appear perfectly solid; others are hollow in the center, as can 

 be seen both in transverse and in longitudinal sections; and still 

 others are made up of fibers and filaments. The endothelial lining 

 of the thrombosed vessels is well preserved. Where the thrombi 

 are comparatively thin, one can see, both in transverse and in lon- 

 gitudinal sections, endothelia which are apparently perfectly nor- 

 mal. JiTowhere do the thrombosed vessels show a loss of endothelia 

 to any extent. Therefore, the thrombosis can not be attributed to 

 a denudation of the vessels of their endothelial lining. The cap- 

 sules of Bowman are likewise normal, though a few of them show 

 a very moderate degree of thickening; their lining epithelium ex- 

 hibits no marked changes. In some places the hyaline thrombi are 

 continued not only into the vasa afferentia but even into the inter- 

 lobular arteries. Quite commonly there are seen between the urinif- 

 erous tubules parts of such small vessels filled with hyaline 

 thrombi. However, none are found in tlie larger arteries or veins, 

 in some of which finely granular fibrin and desquamated endothelial 

 cells are present. The vessel walls themselves show no damage 

 aside from a minor degree of denudation of the intima. There is 

 in particular no extension of the fibrin through the vessel walls, 

 nor is there any evidence of mesophlebitic or periphlebitic or 

 arteritic processes. Xowhere do any of the renal blood vessels 

 show a large number of bacilli ; a few are possibly seen inside some 

 vascular lumina, but even these are not definite. A moderate 

 number of bacilli are seen in the lymph clefts between the tubules 

 and around the Malpighian bodies. A few slender, long bacilli, 

 which retain Gram's stain, are occasionally found in the tubules; 

 they represent a postmortem invasion. 



Case No. 16. Right Inguinal Bubo. 



(No necropsy protocol kept. Male Chinese, 26 years old, who died after an illness 



of seven days.) 



Microscopic cxainiiHttiou. — Section? of the kidneys show hyaline 

 fibrin thrombosis of the glomcnihir capillaries, with an extension 

 into the afferent and efferent vessels as well as into the intertubular 

 capillaries and small veins. There is general vascular dilatation 

 and engorgement of the renal vessels. 

 .02.371 2 



