47 



blood-tinged fluid. The hemorrhagic infiltration of the inguinal 

 region extends through the inguinal canal, into the pelvis, and 

 along the iliac vessels and left ureter upwards. The pericardium 

 contains a normal amount of serous fluid, but it is blood-stained, 

 evidently by post-mortem imbibition. The heart presents a few 

 small subepicardial hemorrhagic areas. The myocardium is soft 

 and flabby, and pink in color. 



The beginning of the aorta presents an atheromatous ulcer, 

 surrounded by a calcareous deposit. Otherwise the heart and the 

 great vessels are normal. The pleural cavities contain a moderate 

 amoimt of blood-tinged fluid. The pleural surfaces of the lungs 

 are dark purple, with some greenish putrefactive areas. The lungs 

 are full of blood and contain but little air. The bronchi, the 

 trachea and, to a lesser extent, the larynx show a congested mucosa. 

 The spleen is enlarged to about twice its normal size. It is steel- 

 gray-purplish on the external surface, and brownish-red on section. 

 The pulp is soft. The Malpighian bodies are fairly distinct. 

 The kidneys are normal in size, purplish-l)lue in color. On section 

 they are dull and decidedly grayish yellow. They are exceedingly 

 soft, a condition probably due to some extent, at least, to post- 

 mortem changes. The mucosa of the left ureter is highly congested 

 and shows some hemorrhagic spots, that of the right ureter is 

 congested, but to a much lesser extent. The mucosa of the bladder 

 shows a minor degree of congestion. The liver is normal in size, 

 rather increased in consistency, and dark purplish in color with 

 some grayish-yellow mottlings. It cuts with increased resistance, 

 and the cut surface is yellow brown in color. The liver lobules 

 are increased in size. The gall bladder and its ducts are normal. 

 The duodenum and the stomach show a highly congested mucosa. 

 The gastric mucous membrane exhibits numerous small pimctate 

 or somewhat larger, irregular hemorrhagic spots. The follicles of 

 both the small and the large intestine are highly swollen and 

 congested. The suprarenals are swollen, soft, and dark yellowish- 

 brown in color. The pancreas is normal. The abdominal glands 

 in general are all more or less swollen, congested, and softened. 



Anatomic diagnosis. — Hemorrhagic left inguinal bubo; general 

 lymphadenitis; multiple hemorrhages into the serous and mucous 

 membranes; congestion and parenchymatous degeneration of the 

 kidneys; congestion and fatty degeneration of the liver; bubonic 

 plague. 



