426 BACTERIA PATHOGENIC TO MAN 



found to be collections of bluish-gray, thick, mucilaginous matter, which 

 is very tenacious and can be drawn out into long threads. The pericar- 

 dium is normal. The valves are normal. In the wall of the right ventricle 

 are several small white areas which look like septic infarctions, and 

 one of larger size in the wall of the left ventricle corresponds with the 

 position of a thrombus, and apparently was the exciting cause of it. 

 Left lung: In the lower part of the upper lobe is an area of consolidation, 

 gray in color and partly resolved. Right lung: There are a few recent 

 pleuritic adhesions. The lower lobe is thickly studded with miliary 

 tubercles, and scattered through the entire lung are suppurating foci. 

 Liver: There is nothing abnormal. The spleen is normal. Pancreas: 

 In and immediately around the gland there are many small abscesses. 

 Kidneys : The description of one applies to both. The surface is every- 

 where and evenly dotted with minute white spots, which suggest septic 

 emboli rather than tubercles. A few prominent white nodules, from 



FIG. 132 FIG. 133 



Streptothrix from bouillon culture. Young streptothrix threads showing 



(From Tuttle.) terminal buds. (From Tuttle.) 



one-quarter inch to one-half inch in diameter, contain thick, tenacious 

 matter (Fig. 134). Section shows that the entire substance of the 

 kidney is densely studded with these minute white granules. 



The gross pathological conditions were interpreted as follows: An 

 old tuberculous nodule in the right lung; acute miliary tuberculosis of 

 the right lung and peritoneum; acute lobar pneumonia, affecting the 

 left lung; septic infarctions and pysemic abscesses of both lungs, heart 

 muscle, both kidneys, pancreas, mesenteric lymph nodes, and subcu- 

 taneous connective tissue. The miliary tubercles of the right lung 

 and peritoneum presented the characteristic appearance of genuine 

 tuberculosis. They were minute, hard, gray, almost translucent nodules, 

 while the granules in the kidneys were of an opaque- white or yellowish- 

 white color. 



Microscopic Examination. Smears from the abscesses beneath the 

 skin and on the surface of the kidneys were stained with methyl-blue, 

 carbol-fuchsin, and by Gram's method. The smears resemble those 

 made of tenacious sputum. There is a large amount of mucoid material 



