49 



degree of oedema and even of hyaline degeneration may here and 

 there be observed. No bacilli are seen in the lumina of the vessels, 

 either in those containing thrombi or in those free from them, in 

 the right inguinal glands the most pronounced pathologic change is 

 the increase of connective tissue at the hilum and the great dilatation 

 and engorgement of the vessels. The congestion is greater on the 

 right side than on the left. This is to be attributed to the fact that 

 there are only few bacilli present on the former one, while on the 

 latter they are so numerous as to have a tendency more or less to 

 crowd all of the autochthonous tissue elements. Some few of the 

 vessels in the right inguinal glands show a network of fibrin, how- 

 ever, none complete thrombosis. 



The spleen sections show very numerous plague bacilli. How- 

 ever, they are nowhere found in dense masses as in the primary 

 bubo, but very abundantly as single individuals freely distributed 

 between the cells. The boundaries of the follicles are rather 

 indistinct. The pulp spaces contain numerous crowed red blood 

 corpuscles. In a few small vessels tubular hyaline thrombi are 

 seen. 



The epithelial lining of the uriniferous tubules of the kidneys 

 shows cloudy swelling and fatty degeneration. These changes 

 are most marked in the convoluted tubules, but the epithelia of the 

 straight ones are likewise much affected. Much granular material 

 is found in all of the tubules. The intertubular connective tissue 

 is oedematous. In a number of the glomeruli the capillaries are 

 closed by hyaline fibrin thrombi, while other capillaries are free 

 and non occluded. The thrombi mostly are solid, though some are 

 distinctly tubular with an open lumen in the center. Occasionally 

 one sees a thrombus extending from a Malpighian tuft into an 

 afferent or efferent, or intertubular vessel. Changes of the vascular 

 endothelium of the thrombosed vessels are not demonstrable. All 

 through the renal (and also through the hepatic) tissue, fairly 

 numerous large bacilli, which retain. Gram's stain, are found. 

 These micro-organisms clearly represent a post-mortem invasion 

 found frequently in Manila in bodies, when the post-mortem 

 examination can not be made immediately but has to be postponed 

 for some time. Plague bacilli are not seen in the renal tissue. 



In the liver the parenchyma cells are finely vacuolated ; large, 

 coarse vacuoles are not seen. The capillaries are dilated, par- 

 2.5483 4 



