66 ORIENTAL PLAGUE chap. 



" Post mortem on 9th. On exposing the surface of the abdomen, 

 the lower part was found to be covered with a purpuric eruption, con- 

 sisting of thickly-set pin-point petechiae with larger blotches, some of 

 which were the size of a split pea. The eruption was especially marked, 

 roughly speaking, in a triangular area included between a transverse 

 line drawn through the umbilicus and bounded below by two lines 

 drawn across the front of the thighs parallel to and a few inches 

 below Poupart's ligaments. Two chains of more scattered petechiae 

 extended from the main area of eruption upwards towards the arm- 

 pits. On the arms and lower legs there were purpuric blotches here 

 and there, but the main development of the eruption was in the 

 situation already denned. There were conjunctival haemorrhages 

 and minute petechiae on the pericardium. The pericardial sac con- 

 tained several ounces of fluid. The appearances of the eruption and 

 of the conjunctivae were those characteristic of haemorrhagic small- 

 pox. The lungs had a few petechiae, but otherwise seemed healthy." 



Material was obtained from this body : blood which had been 

 withdrawn aseptically from the right ventricle by means of freshly 

 drawn-out glass capillary pipettes, afterwards sealed ; and pieces of 

 lung and pieces of skin of the abdominal and femoral region, which 

 had been cut out under all necessary precautions. In the laboratory 

 these samples were used for cultivation and experiment, pieces of 

 the lung and of the skin being also placed into Miiller's fluid for 

 hardening. 



The heart's blood was used thus : — 



1. Film specimens were made and stained ; 



2. Agar surface plates were inoculated and incubated at 37° C. ; 



3. Guinea-pigs were subcutaneously injected. 



The above proceedings were undertaken for demonstration of the 

 presence of plague bacilli, the case having, as already mentioned, 

 been notified as possibly plague. 



Examination of specimens of the heart's blood yielded the follow- 

 ing results : — 



Microscopic film specimens, stained, showed numerous capsulated 

 diplococci — each diplococcus consisting of two demilunes closely facing 

 each other and invested in a distinct capsule. They were arranged 

 either as single diplococci or more commonly as short (two diplococci) 

 and longer chains (four diplococci). Fig. 56 shows a specimen of this 

 kind. Not every microscopic field of the specimen contained these 

 capsulated diplococci in such numbers as is shown in Fig. 56 ; never- 





