21 



evidently forced its way l)et\voen the capsule proper and the epithe- 

 lial lining of the former. The capsular epithelium in a complete 

 intact layer had become desquamated, and a cyst, lined on one side 

 by over one-half of the capsule proper and on the other side by the 

 capsular epithelium, had compressed the Malpighian tuft into one 

 corner of the capsular space. The tuft with its thrombosed capil- 

 laries is seen as a compressed, somewhat crescent-shaped mass in 

 one extremity of the capsule opposite the cyst. 



The kidneys show an extensive infection by metastatic emboli, 

 composed of dense or loose masses of plague bacilli. These are 

 found in the glomerular vessels, in the intertubular capillaries, and 

 in small arteries and veins. Interglomerular vessels sometimes 

 show both hyaline fibrin thrombi and bacterial emboli, but the 

 number of the latter is very much smaller than that of the former. 

 In other words, we see hyaline thrombi in almost all of the glomer- 

 ular capillaries, but bacterial invasion only here and there. Bacilli 

 are also found in the perivascular and in the interlobular lymph 

 spaces. The thrombotic processes are evidently independent of the 

 bacterial invasion, and much of the latter in this case is undoubt- 

 edly due to postmortem growth, since tlie kidneys as well as all 

 organs show numerous large, cylindrical, Gram-staining bacilli, 

 wliich are commonly found in Manila in necropsies which are 

 made a considerable time after death. 



It might also be mentioned liere that in sections fixed by Zenker's 

 lluid and stained according to Weigert's fibrin method, plague 

 bacilli often retain the gentian violet. That tliis is indeed the 

 case may be confirmed by the use of other stains and by comparing 

 alternating sections of short series. In sections from blocks of 

 tissue fixed in the Mueller-Orth mixture the fibrin lias lost its 

 characteristic tinctorial reaction, and when treated by Weigert's 

 method it appears so hazy that it is entirely unrecognizable, neither 

 its homogeneous hyaline appearance nor its fibrous character in 

 other places showing well. If such sections, from material fixed in 

 Mueller formalin, are stained with hematoxylin and eosin, the 

 obliterated glomerular vessels do not furnisli a clear picture. The 

 l)Oundaries of the thrombi arc indistinct and the coagula appear 

 continuous with the vessel walls. The latter themselves create the 

 impression of being in a state of swelling and hyaline degeneration. 

 Sections fixed in corrosive-sublimate solution and colored witli a 

 varictv of stains, includintr carmin-Weigert. eosin-methvlene-blue. 



