55 



The trabeculae are fairly well marked. Kidneys : Capsules smooth, 

 surface purplish in color. After removal of the capsules, which 

 peel off easily, the glomeruli stand out as highly injected points, 

 surrounded by a grayish white tissue. On section the glomeruli, 

 the vessels, and the pyramids appear highly congested. The 

 tubules are grayish wdiite. The pelves are smooth and much 

 congested. The surparenals are enlarged, soft, oedematous, and 

 congested. Brownish purple in color. Liver : The liver is some- 

 what swollen, capsules smooth and transparent. Outer surface 

 purplish gray. The cut surface is purplish brown. The vessels 

 discharge a good deal of fluid blood. Boundaries of liver lobules 

 distinct. The gall bladder is of a dark grayish purple color. Its 

 mucous membrane is swollen and congested. The viscus contains 

 a large amount of dark greenish turbid bile. No stones. Stomach 

 and intestines : The serosa is rather dull, showing injected vessels. 

 A number of small hemorrhagic spots are seen on the serosa of 

 the small intestines. The mucous membrane of the stomach is 

 grayish-white and shows a number of small hemorrhagic spots. It 

 is covered with dirty gray, tenacious mucus. The small intestine 

 likewise shows some small hemorrhagic spots in its mucosa. Lymph 

 glands : The inguinal glands of both sides are much swollen, rather 

 soft, oedematous, congested, and purplish in color. These changes 

 are more marked on the right side than on the left. The mesenteric 

 lymph glands show similar changes, though to a less degree. The 

 cervical glands show only a very moderate amount of enlargement 

 and congestion. 



Anatomical diagnosis. — Large granulating ulcer on the right 

 heel. Congestion and oedema of the lungs. Passive congestion 

 of the liver and kidneys. Parenthymatous degeneration of the 

 kidneys, ffidema, general hypertrophy, and congestion of the 

 lymph nodes, particularly of those of the right inguinal region. 

 Multiple subserous and submucous hemorrhages. Bubonic plague. 



Smears are made from the heart's blood, spleen, liver, and left 

 inguinal glands. The smears from the heart's blood show only 

 a few pest bacilli, while those from the spleen and glands show a 

 considerable number. Culture tubes are inoculated from the heart's 

 blood, spleen, and liver. The tube from the spleen developed a 

 pure culture of plague bacilli ; those from the liver and the heart's 

 blood showed a mixed culture of plague bacilli and staphylococcus 

 pyogenes albus. 



