26 



the kidneys, and bladder, the pericardium, pleura, and peritoneum, and 

 with enlargement of the liver and spleen. In the septicsemic form there 

 is general involvement of nearly all the lymphatic glands and lesions 

 in the other organs similar to those found in the bubonic form. No bubo 

 of the mesenteric glands was ever found. These glands were always 

 examined, and, though changes might be found in them, they were always 

 less marked and less distinct than plague glands found in other parts 

 of the body. In short, there was no necropsy, which went to show that 

 the plague bacillus had reached the stomach or intestines — for example, 

 in food — and thence infected the mesenteric glands. 



In his later contribution Childe describes the pneumonic form of plague 

 as follows: 



"In this form of plague the only marked evidences of disease are found 

 in the lungs. The lymphatic glands and other organs are scarcely affected 

 at all. In the lungs there was general engorgement, with considerable 

 oedema, a reddened condition of the mucous membrane of the bronchi, 

 but no marked evidences of bronchitis, and frothy watery fluid, some- 

 times blood stained, could be squeezed from the bronchi. (Pus in the 

 bronchial tubes was only found on one occasion.) A number of pneumonic 

 patches were found scattered through the lungs, varying in size from 

 a pea to an egg. They were light pink or red gray in color, solid, airless, 

 and sank in water. They were rounded in shape, and usually separated 

 by a distinct ring of engorgement from the crepitant lung around. Some, 

 instead of being pink, were of a deep blood color throughout and less 

 solid, and some of these had a small, greyish, more solid center. Those 

 of the patches which were situated on the surface of the lung were 

 prominent, and projected distinctly from the surface whilst the pleura 

 over them was roughened, and showed signs of early inflammation. These 

 patches had, in fact, the appearance of the first and second stages of 

 lobular pneumonia, but no patches were found which had passed on to 

 the third stage of softening and breaking dowai. In a few cases larger 

 masses of pneumonic lung tlian these were found and once about half 

 the lower lung was found in this condition. Petechial hemorrhages were 

 usually found on the surface of the lung; the bronchial glands were either 

 enlarged, swollen, (edematous, soft, and distinctly engorged, or else they 

 were small, and of the usual appearance, perhaps a little engorged. The 

 remaining lymphatic glands throughout the body showed none of the 

 appearances of either the bubonic or septica;mic form of plague; most 

 of them looked absolutely normal, and the only noticeable change was 

 that the axillary and sometimes the cervical chains were a little engorged." 



Childe found large hemorrhages absent in plague pneumonia, but the 

 usual subserous or submucous petechise and ecchymoses were present. 

 This author describes the microscopy of the pneumonic form as follows: 



"A section of lung tissue, apart from a pneumonic area, shows great 

 engorgement of all large blood vessels, and of the alveolar capillaries as 

 well, and patches of hemorrhage into the alveoli around these engorged 

 vessels are seen scattered about. In a pneumonic area three zones can 

 be made out. At the circumference therQ is intense engorgement of 



