85 



in the larger arteries or veins, in some of which finel)^ granular 

 fibrin and desquamated endothelial cells are present. The vessel 

 walls themselves show no damage aside from a minor degree of 

 denudation of the intima. Tliere is in particular no extension 

 of the fibrin through the vessel walls, nor is there any evidence 

 of mesophlebitic or periphlebitic — or arteritic processes. The 

 epithelia lining the convoluted uriniferous tubules are somewhat 

 swollen, with indistinct outlines and a vacuolated protoplasm; but 

 their nuclei are yet quite normal. A granular material partly fills 

 some of the convoluted tubules. The epithelial lining of the 

 straight tubules does not show any marked changes. The capsule 

 of the kidney is normal. Nowhere do any of the renal blood vessels 

 show a large number of plague bacilli ; a few are possibly seen inside 

 some vascular lumina ; but even this is not certain. A moderate 

 number of l)acilli are seen in the lymph clefts between the tubules 

 and around the Malpighian bodies. A few slender, long bacilli, 

 which retain Gram's stain, are occasionally found in the tubules; 

 but they are probably of no significance and represent an agonal 

 or post-mortem invasion. Sections of the liver show a very few 

 small periphlebitic inflammatory foci composed of small, round 

 mononuclears. The liver cells all show a coarse vacuolation, some 

 of the vacuoles being larger than the nuclei. The capillaries are 

 moderately filled. There is no free extravasated blood. A very 

 few plague bacilli are found between the liver cells. 



Case No. 11. Right Inguiival Bubo. 



]S3"o complete necropsy protocol was kept. Body of a male Chinese, 

 20 years old. who died after an illness of seven days. Sections of 

 the kidneys show hyaline fibrin thrombosis of the glomeralar capil- 

 hiries. with an extension into the afferent and efferent vessels as 

 well as into the intertubular capillaries and small veins. There is 

 general vascular dilatation and engorgement and cloudy swelling 

 of the epithelia of the uriniferous tubules. In the spleen, which 

 contains numerous plague bacilli, there is found a liomogeneous, 

 eosin-staining material, which is apparently derived from red 

 blood corpuscles which have become confluent. At the margins of 

 the homogeneous material erythrocytes singly and in groups may 

 be distinguished. Coarse fibrin threads, forming a network, are 

 here and there seen in the homogeneous material. Hyaline fibrin 

 thrombi are likewise encountered in tlie small splenic vessels. 



