4 ORIENTAL PLAGUE chap. 



Whether the bubo occurs in the neck, the axilla, the 

 inguinal or femoral region, in all instances the glands show 

 haemorrhage in their substance with partially necrotised 

 foci. A droplet of the gland juice, as also, but to a less 

 degree, of the surrounding inflamed cellular tissue, shows in 

 film specimens a conspicuously large number of B. pestis. 

 The great number of bacilli, possessing the same charac- 

 ters, aspect, staining power, and size, is alone sufficient to 

 make diagnosis of plague highly probable, for there is no 

 other acute disease known except plague which so affects the 

 lymph glands, containing such vast numbers of this kind 

 of bacilli, viz. non-motile, Gram-negative and bipolar in 

 staining, i.e. a vacuole in the centre, or possessing a vacuole 

 at one or both ends, and then appearing as if gnawed out 

 at one or both ends. Unfortunately there are cases of 

 bubonic plague in which a film specimen made of a droplet 

 of the juice of the bubo of the living does not show great 

 numbers of the B. pestis. This is, however, the exception, 

 and is, in most instances, explicable by the fact that the 

 material is not really derived from the interior of the 

 gland, for when such glands after post mortem are dissected 

 out and examined in film specimens, there is no difficulty 

 in ascertaining that the B. pestis are really present in 

 enormous numbers in the gland tissue ; in fact, such film 

 specimens show that the gland tissue is densely packed 

 with them. I have seen several such instances, in which 

 the 1 juice of the bubo, obtained by puncture of the bubo 

 during life, showed in film specimens a comparatively 

 limited number of bacilli — limited, that is, inasmuch as 

 each field of the microscope under a magnifying power of 

 300 did not show more than a dozen or so ; whereas 

 the same bubo, having been removed after post mortem, 



