with. Groups of plague bacilli are round in the glomerular and 

 intertubular vessels, some of theui auiouuting to fairly dense masses 

 of bacteria. A very few isolated bacilli are scmmi here and there 

 in the uriniferous tubules. 



GROUP III. PRIMARY BUBONIC PLAGUE WITH SECONDARY 

 PLAGUE PNEUMONIA. 



Ca.se No. 24. Ambulatory Plague, terminating by Embolism of tue 

 Pulmonary Artery. Inguinal Bubo. 



(Necropsy Protocol No. 901. FlUpiuo, male, 17 years old. from 185 Misericordia 

 Street. Died February 27, 1904. at 2 o'clock p. m. Postmortem examination 

 thirteen bours after death.) 



Atuttoinic di(i(iiiosis. — Congestion nnd fedema of the lun^s; ])aiencliyni- 

 atous degeneration of the kidneys; embolism of the pulmonary artery; 

 inguinal buboes. Bubonic plague and plague pneumonia. 



Microscopic examination. — No hyaline thrombi in tlie glomerular eajtil- 

 aries or in anj' of the other renal vessels. 



Ca.se No. 2.5. Left Hemorrhagic Femoral Bubo. 



(Necropsy Protocol No. 1141. A. L., male Filipino, 19 years old, from 101 Principe 

 Street, San Nicolas. Died March 16, 1905, p. m. Postmortem examination per- 

 formed March 17, 190.5, twenty hours after death.) 



Anatomic diagnosis. — Left hemorrhagic femoral bubo: small lobular 

 focus in the lower lobe of the right king; general pulmonary congestion 

 and (edema; enlargement and softening of the spleen, ' congestion of the 

 kidneys, and parenchymatous nephritis; bubonic and pneiunonic plague. 

 (Smears from the pulmonary lobular focus show numerous i)!ague bacilli, 

 as do also smears from the bubo and from the spleen.) 



Microscopic examination. — In this case the kidneys do not show any 

 hyaline thrombosis or any metastatic bacterial emboli, but. witliout regu- 

 larity as to distribution, all through the tissues is found the cylindrical 

 postmortem bacillus before mentioned. An interesting pathologic change 

 seen in this case is a proliferation of the glomerular epitlielium. The 

 proliferated capsular e])itheliiuu proper on the inner surface of Bowman's 

 capsule forms crescentic mas.ses, which frequently fill out the capsular 

 space. The reflected epithelium is likewise increased and the glomerular 

 vessels are greatly dilated atul engorged. 



GROUP IV. PRIMARY UNCOMPLICATED PLAGUE 

 PNEUMONIA. 



Case No. 2(1. I'iumahy Unco-MI'Mcati;!) Plague. 



(Necropsy Protocol No. 970. A. Q., Chinese, male, 30 years old, a shopkeeper from 

 f!7 Tetuan Street, Santa Cruz. Ill six days. Died May 18, 1904, at 10.;{0 o'clock 

 p. m. Postmortem examination made thirteen hours after death.) 



Aii'iloniir (li(i(iiinsi.s.- — i'arencliviiialous (icgcnci'at ion of llie Uiiiin-vs; fattv 



