71 



of a dark purplisli-broAvii color. The stomach contains a few 

 ounces of a dark greenish fluid, in which are seen grayish-white 

 flocculi. The mucous membrane is thrown into well-marked rugjB, 

 and is rather pale on the whole, but contains many very small, 

 irregular hemorrhagic spots. The mucous membrane of the 

 duodenum likewise shows numerous small hemorrhagic spots. The 

 pancreas is normal in color and slightly softer than usual. On 

 cutting into the cervical glands of the right side, the tissues are 

 found so highly oedematous that they discharge a considerable 

 amount of clear, slightly yellowish fluid. All the glands of this 

 region are much swollen, almost black in color, and very oedematous. 

 The deepest ones near the angle of the inferior maxilla, the sub- 

 mentals, are the largest of the group, being increased to the size 

 of walnuts. The cervical glands of the left side likewise show a 

 good deal of congestion and oedema; however, they are small when 

 compared with those of the right side. The inguinal glands of 

 both sides are swollen, congested, and oedematous. In fact, all of 

 the glands of the body which are examined during the post-mortem 

 are in this condition. The trachea, larynx, and esophagus are 

 highly congested. On inspection of the mouth it is found that the 

 front teeth are small, irregularly set, and partly decayed. The 

 right side of the soft palate is completely perforated by an ulcer 

 which has destroyed most of the tissues forming the pillars of the 

 fauces. The margins of the ulcer, which is about 2 centimeters in 

 diameter, are irregular and somewhat raised. Contracted cicatricial 

 tissue is found in the neighborhood of the ulcerations. 



Anatomic diagnosis. — Perforating ulcer on the right side of the 

 soft palate; general hypertrophy; congestion and hemorrhagic 

 oedema of the general lymph glands of the body ; oedema and conges- 

 tion of the lungs; congestion and parenchymatous degeneration 

 of the kidneys; oedema of the gall bladder; multiple subserous and 

 submucous hemorrhages; syphilis hereditaria tarda. Bubonic 

 plague. 



Smears from the. different organs show the following : Those from 

 the lungs a moderate number of typical plague bacilli; from the 

 liver a somewhat larger one; and from the spleen an enormous 

 number, these last showing the bipolar staining in a typical manner. 

 In the preparations the common involution forms of the bacilli 

 are also to be observed. Smears from the cervical lymph nodes 

 show a large number of bacilli. 



