52 



upper convex surface, where it is somwliat thickened, though not 

 elevated, and opaque and dull grayish-white in appearance. The 

 cut surface of the organ is dark brownish-red; the trabeculse can 

 be seen very well and are distinctly thickened; the pulp is moder- 

 ately soft; and a moderate amount of juice can be scraped off the 

 cut surface. The Malpighian corpuscles are not distinguishable. 

 On the whole the consistency of the spleen is rather increased than 

 decreased. Its weight is 675 grams. The kidneys are normal in 

 size, much congested, and the capsules are rather dull and not very 

 translucent. The outer surface is dark purplish-blue. Here and 

 there a grayish-white mottling is seen. The capsules peel off 

 easily. On the cut surface the vessels appear injected, the tubules 

 decidedly grayish-yellow. The glomeruli are not very distinct, and 

 the pyramids are dark pinkish-purple in appearance. The relation 

 of the cortex to the medulla is normal. The mucosa of the pelvis 

 is smooth and much injected, so that the small vessels are distinctly 

 visible. The suprarenals are normal in size, moderately injected, 

 yellowish-brown in color, and somewhat softened. The liver is of 

 normal size, the capsule very tense, shining, and transparent. The 

 external color is bluish-purple. The cut surface discharges a rather 

 moderate amount of dark, fluid blood. The liver lobules are 

 distinct and of a dark brownish-yellow color. The gall bladder 

 is distended with very dark, turbid, pitchy bile. The mucous 

 membrane is swollen. There are no stones. The ducts are normal. 

 The serosa of the stomach and intestines is injected, that of the 

 latter being of a dull appearance, as before described. The dark 

 spots seen through the intestinal serosa correspond to hemorrhagic 

 spots of the mucosa. The gastric mucosa shows numerous small, 

 punctiform petechige on a dirty grayish background. The pancreas, 

 the prostrate, and the bladder show no particular changes. 



Anatomic diagnosis. — Hypertrophy and hemorrhagic inflamma- 

 tion of the left inguinal and iliac glands; passive congestion and 

 parenchymatous degeneration of the kidneys ; congestion and oedema 

 of the lungs; multiple subserous and submucous hemorrhages; 

 moderate hypertrophy of the heart; old epicardial cicatrices; 

 atheroma of the aorta; splenomegaly. Bubonic plague. 



Smears made from various organs show the following : From the 

 primary bubo, quite a number of very poorly staining oval or round 

 bacilli. Only a very small peripheral rim has taken the dye; the 

 center is entirely unstained. These bacilli appear as empty shells. 



