57 



subcutaneous connective tissue discharges a serous, slightly yellowish 

 fluid, and on further dissecting into the tissues an extensive 

 hemorrhagic infiltration is encountered. This hemorrhagic infil- 

 tration surrounds ill-defined, swollen, soft, and hemorrhagic glands. 

 The bloody extravasation extends from Scarpa's triangle through 

 the inguinal canal, into the pelvis along the iliac glands, thence 

 into the abdominal cavity up to the region of the kidney. All 

 lymph glands along this course are swollen, much softened, and 

 hemorrhagic. The same pathologic changes, though to a lesser 

 degree, are shown by the mesenteric, the peritoneal, the mediastinal, 

 and the bronchial glands. The latter are more markedly enlarged, 

 softened, and hemorrhagic than any other glands mentioned except 

 those of the chain beginning with the right inguinal glands. The 

 superficial lymph glands, aside from the right inguinal, are mod- 

 erately swollen, softened, and congested. Subserous hemorrhagic 

 spots are found on the epicardium, on the pleuras, on the external 

 surfaces of the stomach, the small intestines, the kidneys, and on 

 the capsule of the liver at the insertion of the suspensory ligament. 

 The pericardium is smooth, much injected, and contains a moderate 

 amount of fluid. The heart shows a number of subepicardial hemor- 

 rhages, varying in size from a small point to irregular spots several 

 millimeters in diameter. These petechise and ecchymoses are 

 found on both ventricular surfaces and on the sulcus. The myo- 

 cardium is of fair consistency. ISTo further dissection of the heart 

 is made, since it is to be preserved as a museum specimen. The 

 lungs are well expanded, their pleurae smooth, nonadherent, and 

 dark purplish-blue, with a moderate number of small hemorrhagic 

 spots and with some small elevated emphysematous areas on the 

 lower lobes. On section the pulmonary tissue is of dark purplish- 

 brown color, containing very much dark blood and foamy, aqueous 

 fluid. The limgs on the whole are heavy and contain but little 

 air. The bronchial, tracheal, and laryngeal mucosa is somewhat 

 swollen and greatly congested. The epiglottis is of a dark purplish- 

 blue color. The spleen is normal in size, the capsule slightly 

 wrinkled, transparent, and bluish-gray. The organ as a whole is 

 fairly firm. The cut surface is reddish-brown and granular. The 

 amount of juice which can be scraped off the surface is quite mod- 

 erate. The trabeculge and corpuscles are distinct.^ The kidneys 



^ Many plague bacilli were found in the smears from the spleen ; yet 

 it was neither enlarged nor softened. 



