8 ORIENTAL PLAGUE chap. 



The blood of the peripheral circulation in an acute case 

 of bubonic plague contains very few B. pestis. A few 

 hours before death they can be recognised already in film 

 specimens, though on making a culture (plate or tube) with 

 a drop of the blood at this stage, numerous colonies 

 appear ; but in the early stages they are difficult to find 

 either in films or by culture, unless the blood is derived 

 from the skin over or about the bubo. 



The lungs and kidneys, after post mortem, show the 

 plague bacilli, in proportion to their distribution and 

 presence in the general circulation. 



The liver, and particularly the spleen, are the organs 

 which, next to the bubo, contain B. pestis in great 

 numbers. Sections show that they are chiefly present in 

 the spleen pulp ; in this the blood spaces are distended by 

 blood in stasis with crowds of B. pestis ; in many places 

 these occur in continuous masses, and are arranged more 

 or less in reticulated fashion corresponding to the blood 

 spaces and small veins ; the pulp tissue itself around and 

 between these masses is in a state of necrosis. Fig. 24, 

 taken from a section through a guinea-pig's spleen, gives 

 a good representation of the state and condition of the 

 spleen in bubonic plague in man. 



(B) Septicemic Plague. — Just as in the acute form of 

 plague caused by inoculation of animals — which is almost 

 always of the septicsemic type — so also in the septicsemic 

 plague in man, the B. pestis are copiously distributed 

 throughout all the organs, notably in the blood-vessels. 

 Amongst these organs, the spleen, lungs, kidneys, and 

 suprarenals,as also the liver and intestines, show conspicuous 

 changes. These consist essentially in capillary haemor- 

 rhages with crowds of B. pestis in the capillaries and 



