56 



Microscopic examination. — The inguinal lymph glands show 

 an oedematous infiltration and great dilatation and congestion of 

 blood vessels. The perivascular connective tissue at the hilum is 

 much increased. An area of extensive blood extravasation is found 

 near the capsule. The majority of the parenchyma cells of the 

 gland are small mononuclear and ordinary polynuclear cells; 

 plasma cells are fairly numerous, and plasma mast cells are j)\en- 

 tiful. Here and there are seen globular, homogeneous masses of 

 a diameter of 20 to 30 /a and more which have a strong affinity for 

 eosin. Keither the blood vessels nor the other parts of the tissues 

 show any fibrin. Plague bacilli are only sparingly seen in sections 

 of the glands. Sections of splenic tissue show mostly ill-defined 

 Malpighian corpuscles, obliterated pulp spaces, and an overcrowding 

 of the latter with red blood corpuscles. As in the lymph gland 

 tissue, plasma cells and plasma mast cells are numerous. Bacilli 

 are found in small numbers only. The renal tissue shows greatly 

 dilated and engorged vessels, very small areas of blood extravasa- 

 tion between the tubules, an occasional thickening of Bowman's 

 capsule, and most extensive cloudy swelling of the tubular 

 epithelium. While the latter is still found intact here and there, 

 most tubules, both convoluted and straight, are lined by greatly 

 swollen, irregular, hazy cells in which a nucleus is not seen, or if 

 seen at all, it is very poorly stained. 



In the pulmonary tissue one sees enormously engorged interal- 

 veolar capillaries and air spaces partly filled with desquamated- 

 epithelia and erythrocytes. No fibrin is found in the alveoli. 



Case No. 5. Right Inguinal Bubo. 



[Necropsy Protocol No. 977. O. C, Chinese, 25 years, male, from 214 San Jacinto 

 Street. Died after an illness of two days on May 25, 1904, 9.15 p. m. Post- 

 mortem examination fifteen hours after death.] 



Body of a young male Chinese about 25 years old ; rather slender, 

 but well developed. Post-mortem rigidity moderately well marked. 

 The skin as a whole is quite cyanotic, and the post-mortem lividity, 

 which has extended well to the anterior surfaces, is marked. A 

 small amount of dirty-brown foamy fluid exudes from the nares. 

 No wounds or ulcerations are to be found anywhere on the integu- 

 ment. The right inguinal region is somewhat swollen, but the 

 swelling is not high ; it is not well defined but shades off: gradually 

 into the surrounding tissue. The swollen area is markedly cyanotic 

 and cedematous, the skin here pits on pressure. On section the 



