19 



beneath the visceral pleura, which on section appear as pea-sized 

 or smaller, circumscribed, grayish-yellow areas of a confluent tu- 

 bercular structure. (See PL III, fig. 3.) None of them are 

 capsulated or caseated, but some are surrounded \)j an irregular, 

 reddish area of pneumonic consolidation. They seem to be limited 

 to the pleura! surface. 



The bronchial glands appear normal on section. The trachea 

 and bronchi are slightly congested and covered by a muco-purulent 

 secretion. The heart muscle is rather pale on section, but other- 

 wise the organ appears normal. The mucous membrane of the 

 esophagus shows hyperplasia of the solitary follicles. 



The liver is of about normal size, soft, and on section its mark- 

 ings are indistinct. The spleen is somewhat enlarged, soft, and 

 on section its pulp is diffluent. The kidneys are slightly enlarged, 

 their capsules strip readily, and on section the cut surface is 

 yellowish-white in color and the corticle and medullary markings 

 are very indistinct. The stomach and intestines were not opened. 

 No further examination was made. 



Bacteriologic examination. Dr. W. E. Brinckerhoff, visiting the 

 case shortly before death, thought that it might be another one of 

 human glanders and brought some of the fluid contents of the vesicle 

 to the laboratory. The cornea of a rabbit was scarified and inoc- 

 ulated with a small quantity of the fluid in order to exclude the 

 existence of the cytoryctes of smallpox. Coverslips of the secretion 

 were stained with Lofiler's methylene blue and examined by Dr. 

 Brinckerhoff. They revealed quite a number of organisms resem- 

 bling those occurring in Case I. (See PI. IV, fig. 2.) Glycerin 

 agar slant cultures showed a number of small, white, discrete colo- 

 nies, after incubation for twenty-four hours at 35-37. In forty- 

 eight hours these had produced a golden-yellow pigment. Micro- 

 scopically they were composed of cocci, which were not studied cul- 

 turally. The twenty-four-hour cultures also showed numerous 

 barely visible, transparent colonies lying between the larger ones. 

 In forty-eight hours the former became quite visible and in pure 

 cultures gave the biochemical reactions which have been described 

 as characteristic of Bacterium mallei. The rabbit whose cornea 

 was scarified died in forty-eight hours. No autopsy was made. 

 It is possible that it died of staphylococcus infection, for the fluid 

 had been collected without precautions against contamination. 



