34 



Lymphatic vessels. — In most cases, the lymphatic vessels showed no 

 pathological change, and only in a few were they observed to be congested 

 and swollen, and that only close to the bubo. 



Alimentary system. — The pharynx and the tonsils were greatly congested, 

 the latter being enlarged and occasionally in a state of follicular inflamma- 

 tion. This congestion usually extended down the oesophagus, and in some 

 cases hemorrhages were found in its walls. The stomach was almost 

 invariably engorged with blood, and both minute and considerable hemor- 

 rhages were present in the mucous membrane. These hemorrhages have 

 been classified by Captain James, I. M. S., as follows: 



"A mild form in which, on holding the coats of the stomach up to the 

 light, the course of the^ smaller vessels was found to be picked out by 

 extravasations which also formed small arborescent patches on the mucous 

 surface, or perhaps only reddened the edges of the rugse. 



"A severe form in which there were more or less extensive patches of 

 hemorrhage into the submucous tissues or even into the stomach cavity. 



"Distinct numerous petechise with definite circular outlines and varying 

 in size from that of a pin's head to that of a split pea. In one case the 

 petechife were very numerous and covered nearly the whole of the mucous 

 surface of the stomach. The appearance was so striking that it reminded 

 one of the rash seen on the skin in a severe case of purpura." 



Similar appearances have been observed in the intestines. Congestions 

 and hemorrhagic extravasations were most frequently seen in the large 

 intestine and rectum, and less frequently in the small intestines. Occasion- 

 ally Peyer's patches and the solitary follicles were observed to be swollen. 

 The liver and the spleen were enlarged, the latter being sometimes two 

 or three times the ordinary size. Petechise were frequently present on the 

 surface of the liver, and its substance was engorged with dark blood, and 

 was soft and friable, indicating degenerative change. The spleen also was 

 generally in a state of acute degeneration, soft and pulpy, and in some 

 cases almost diffluent. On section, it was brick red or deep chocolate 

 bro\\'n and always greatly engorged. The gall bladder usually contained 

 bile, and occasionally there were petechise on its mucous lining. The 

 kidneys were also much enlarged and engorged with blood, and presented 

 the characteristics of acute parenchymatous degeneration. Minute hemor- 

 rhages were sometimes observed on the surface, and petechise and coagulated 

 blood in the pelvis and calices. Extensive hemorrhagic extravasation has 

 also been found outside the kidneys, which were then found "lying in a 

 bed of blood." The ureters and bladder were engorged, and petechise were 

 frequently present on their inner surfaces. Besides engorgement, no 

 important change was observed in the supra-renal capsules or thyroid 

 gland, and the genital organs presented a normal appearance. The peri- 

 toneum was considerably engorged, but, above all, hemorrhages, often of 

 large size, were found in many parts, as in the mesentery, in the retro- 

 peritoneal connective tissue, on the luider surface of the diaphragm, and 

 over the spleen, liver, kidneys, and intestines. 



Circulatory system. — The blood was dark and fluid, and gave the impres- 

 sion that it did not coagulate well. The pericardium generally contained 



