172 DISEASES DUE TO /BACTERIA 



temperature is normal, and abscesses may contain bacilli ten weeks 

 after. 



The chemical pathology is unknown. 



In epidemic pneumonic plague the primary infection is in the 

 bronchi from inhalation, setting up peribronchial inflammation. 



Lobular and lobar pneumonia develop quickly, and then a septi- 

 caemia. 



There is no evidence that it has ever started in the great intestinal 

 tract, though many bacilli must have been swallowed. 



P.M. 



Post-mortem rise of temperature is not uncommon. Decomposition 

 early. 



(i) The skin about buboes shows haemorrhage resulting from 

 toxins acting on endothelial cells of vessels. The ha^mor- 

 rhages are petechial or diffuse and contain bacilli. \'esicles, 

 pustules, so-called carbuncles may be seen. 



(2) Glands. — The primary bubo shows periglandular infiltration. 



Glands matted, greyish, soft centre, numerous ha^morrhagic 

 spots or large haemorrhages. 



The secondary buboes (those infected by drawing from the 

 primary gland) are degenerate glands, no oedema, endo- and 

 peri-glandular haemorrhages. 



The tertiary buboes (those infected after it has become a 

 septicaemia) are hard, hyper^mic and h^emorrhagic. 



(3) Muscles, especiallv those of abdominal walls, are ha?morrhagic. 



(4) Viscera. — Spleen enlarged two to three times the normal size, 



congested, hjemorrhagic, bacilli very numerous, necrotic 

 areas, dotted with pin points. 



Liver enlarged, somewhat mottled, haemorrhagic. cloudy 

 swelling, fatty degeneration. 



Lungs, some bronchitis, and often patches of secondary 

 broncho-pneumonia. 



Efi^usion into pleural sacs common with hccmorrliage. 

 R. heart dilated, fatty degeneration, cloudy swelling, 

 haemorrhage. 



Stomach hypera^mic, haemorrhage, solitary glands and 

 Fever's patches swollen, mesenteric glands markedly so. 

 For sections stain \\ith strong carbol thionin, stop its action with 

 oil of cloves and remove the stain therewith. 

 SYMPTOMATOLOGY. 



Incubation. — Two to ten days, average three days. 

 Frodromal symptoms. — General malaise, headache, gastro- 

 intestinal disturbance, glandular pain, chilliness, giddiness, mental 

 dulness. 



