132 ORIENTAL PLAGUE chap. 



or limited to one or another lobule ; in the latter case haemorrhages 

 into the infundibula and alveoli are not infrequently to be met 

 with. The large and small vessels, i.e. capillaries of the alveolar 

 wall, are distended, much coiled and twisted, and filled with blood. 

 In many instances some lobules and even lobes show consolidation of 

 two kinds : — 



(a) Patches in which all vessels are filled with blood in stasis, 



the central point being a bronchus distended by and 

 filled with debris in which numerous B. pestis in masses 

 are recognisable. 



(b) Irregular patches in which a number of alveoli are filled and 



distended by leucocytes ; plague bacilli are not numerous 

 in this second form of consolidation. 

 In a former report I have described these changes in a more 

 advanced stage of the subacute form. 



4. The liver shows extensive areas in which the capillary blood- 

 vessels of the lobules are distended and filled with blood ; in some 

 parts the blood is in stasis, the central vein being greatly distended 

 and filled with coagulated blood. This is always associated with 

 extensive breaking-down and coagulation-necrosis of the parenchyma. 

 It is for this reason that such parts appear opaque and more or less 

 grey as compared with other neighbouring congested (red) parts. 

 Plague bacilli are numerously present, particularly in the intra- 

 lobular blood capillaries of the infarcted parts, which appear as if 

 injected with plague bacilli. 



5. The kidneys are generally enlarged and much congested. 

 Sections of them show the blood-vessels of the cortex, including the 

 glomeruli, and of the medulla distended and filled with blood ; in 

 some portions of the cortex capillary haemorrhages may also be 

 noticed. B. pestis in groups are found in the glomeruli and 

 particularly in the larger vessels of the cortex and medulla, where 

 they form connected streaks and clumps. The epithelium lining the 

 convoluted tubes is generally in a state of more or less distinct 

 granular degeneration. What is of great interest is that plague 

 bacilli can be found in the space of the Malpighian corpuscles, in 

 some convoluted tubes, and in some uriniferous tubes of the medulla. 

 It is therefore clear that plague bacilli may appear also in the urine 

 of the bladder. 



6. As already mentioned, the small intestine is congested and 

 contains sanguineous mucus. Sections of the gut show that the 



