20 



as well as the other vessels. Neither the capsular nor the reflected 

 glomerular cpithelia show any proliferative changes. 



Loose groups of plague bacilli are found here and there in the 

 small renal vessels and also in the uriniferous tubules. 



Case No. 19. Left Hemorrhagic Inguinal Bubo. 



(Necropsy Protocol No. 1132. A. A., male Filipino, 17 years old, from 75 Principe 

 Street, San Nicolas. Died March 7, 1905, p. m. Postmortem examination made 

 on March 8, twelve hours after death.) 



Anatomic diagnosis. — Left hemorrhagic inguinal bubo ; parenchymatous 

 nephritis; multiple subserous and submucous hemorrhages. Bubonic 

 plague; plague septico-pyemia. 



Microscopic examination. — The microscopic examination does not show 

 any hyaline glomerular thrombosis, but metastatic bacterial emboli are 

 found in these structures. Here and there a hyaline cylinder is seen in a 

 tubvile. (These hyaline casts do not give the tinctorial fibrin reaction.) 



Case No. 20. Left Hemorrhagic Inguinal Bubo. 



(Necropsy Protocol No. 1157. T. B., a female Pilipina, 21 years old, wife of a 

 Chinese from Lavazares Street, San Nicolas. Died March 31, 1905. Postmortem 

 examination made April 1, a. m.) 



Anatomic diagnosis. — Left hemorrhagic inguinal bubo; hemorrhagic 

 inflammation of the left pelvic, iliac, and retroperitoneal glands; liemor- 

 rhagic parenchymatous nephritis ; oedema and congestion of the lungs and 

 also of the brain ; uterus gravis, menses I to II ; bubonic plague and plague 

 septico-pyemia. 



Microscopic examination. — This is one of the cases in which 

 very extensive thrombotic processes in the kidneys^ particularly in 

 the glomerular vessels, are present. Here we find perfectly solid, 

 heavy, completely obliterating thrombi, tubular wall thrombi with 

 an open lumen in the center, and also loose fibrin reticula, the latter 

 especially in the vasa efferentia. In the glomerular vessels which 

 are not completely, but only partly, thrombosed, an cedematous or 

 homogeneous swelling of the vessel wall is noticeable. The glomer- 

 ular epithelium shows proliferative changes, the nuclei within the 

 glomeruli are decidedly increased in number, and the Malpighian 

 corpuscles as a whole appear quite solid with little or no open 

 capsular space left. 



Thrombi are comparatively scanty in the subcapsular glomeruli- 

 free zone, in the medulla, and in the medullary rays. In one glo- 

 merulus, in which the capillaries contain both fibrin thrombi and 

 bacterial emboli, a peculiar condition is seen. Watery fluid had 



