45 



in general; multiple subserous and submucous hemorrhages. 

 Bubonic plague. 



Culture tubes inoculated from the inguinal glands developed a 

 typical plague growth. 



Microscopic examination. — Glands : The inguinal glands, the 

 iliac, and the retroperitoneal, all practically show the same changes, 

 which, however, are more profound in the lowermost lymph nodes. 

 All glands contain large tracts of tissue in an advanced state of 

 coagulation necrosis; there is much blood extravasation, which 

 extends into the periglandular loose areolar tissue. The latter 

 also shows much infiltration with leucocytic elements. The cap- 

 sules of the glands are completely loosened by the same type of 

 infiltration. The blood vessels are dilated and engorged, and their 

 walls show hyaline swelling and inflamatory loosening ("Auflock- 

 erimg"). Weigert's method shows both solid and tubular wall 

 thrombi in many of the vessels of the gland substance proper, in 

 the capsule, and in the periglandular areolar tissue. Much fibrin 

 is also found in the shape of reticular deposits throughout the 

 sections. In some places a continuation of an intravascular throm- 

 bus into an extraglandular network is visible. Plague bacilli, freely 

 scattered throughout the sections, are found either in large masses, 

 in small groups, or as single individuals. 



In the spleen the follicles are sharp in outline and the bound- 

 aries of the pulp spaces indistinguishable. The latter are densely 

 crowded with cellular elements among which the erythrocytes much 

 predominate. Besides the common small mononuclears and 

 eosinophilics, a fair number of large mononuclears with hyaline 

 protoplasm, which stains moderately with methylene blue, are foimd. 

 Plague bacilli are seen all throughout the sections ; however, nowhere 

 are they present in large groups, but thinly scattered here and 

 there. A few threads of fibrin are occasionally seen. 



Kidneys : The renal tissue exhibits complete degeneration of the 

 tubular epithelium, with cloudy swelling and fatt)'' degeneration. 

 The degeneration is most marked in the convoluted tubules, while 

 in the straight tubules apparently normal epithelia are found here 

 and there. The uriniferous canaliculi contain a great deal of 

 granular material. The glomeruli show much dilated capillaries; 

 otherwise they present no marked changes. The renal vessels are 

 all much congested. The interstitial connective tissue is quite 

 (Edematous. 



