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complaining of earache and fever, which did not yield to local treatment. 

 The patient was sent to San Juan de Dios Hospital about March 4, 

 where she died twenty-four hours later, after an illness of nine days. 

 So far as can be ascertained, this child did not handle rats or do anything 

 else to which infection could be ascribed. She slept on a petate on the 

 floor of one of the upstairs rooms, as is the native custom. With the 

 exception of the time from the 7th to the 16th of February, when she 

 attended the public school on the corner of Victoria and Magallanes, she 

 did not associate with children outside her home. The family assert 

 that she was free from vermin when she was sent to the hospital, though 

 it was admitted that Filipino children are generally infected with Pediculi 

 capitis. Five bedbugs found in a crack of the floor upon which she slept 

 and thirteen rats, only one of which was foimd alive, were sent to the 

 Laboratory on March 11 for examination. 



Mr. Chas. B. Hare, assistant bacteriologist in this Laboratory, 

 who examined the rats, did not find any evidence of plague in 

 them. Smears were made from the five crushed bedbugs, which 

 likewise did not show any plague bacilli. It was intended to 

 test the bedbugs by cultural methods, but this was overlooked by 

 mistake. 



Microscopic examination. — Sections from the cervical glands 

 show, even on a superficial examination, a number of most profound 

 changes, namely: (1) Almost complete loss of the normal structure 

 and differentiation of the gland into cortical follicles and medullary 

 cords; (2) advanced coagulation necrosis; (3) extensive extravasa- 

 tion of blood; (4) deposit of granular and fibrillar fibrin; (5) 

 the presence of enormous solid, irregularly distributed masses of 

 bacteria. The deeper portions of the cortex still present some 

 oval compartments outlined by fibrous connective tissue, evidently 

 once the trabeculse; however, the latter do not contain normal 

 lymph follicles, but masses of necrotic tissue and free extravasated 

 blood. Where the dense masses of bacilli are located, there are few 

 tissue elements left. The cells which are still recognizable as such 

 are the mononuclears; their nuclei generally show a marked pyk- 

 notic condition. At the margins of the bacillar masses and clumps 

 are mononuclear cells more normal in character, among which are 

 found quite a few polynuclear eosinophiles. Almost as numerous 

 as the latter are the plasma mast cells. The bacilli are found also 

 in the tissues, next to the large colonies ; here the micro-organisms 

 do not form solid, dense masses, but are freely distributed among 

 the cells. Intimately mixed with the leucocytic cells and the 

 bacilli are numerous red blood corpuscles. The peripheral tissue, 



