88 



bloody infiltration is extensivelj' continued into the surrounding 

 tissue. The whole inguinal region is adherent to the overlying 

 skin. The hemorrhagic condition is continued into the inguinal 

 canal. The whole chain of glands, the right iliac, the retroperi- 

 toneal, the abdominal, the aortic, etc., is in a state of hemorrhagic 

 inflammation. The areolar tissue of the left side of the pelvis and 

 the abdominal cavity is oedematous, gelatinous, and extensively 

 infiltrated with blood. The sheaths of some of the pelvic and 

 abdominal vessels show hemorrhagic infiltration, as does also the 

 loose tissue around the right kidney and the gall bladder. Except 

 where specifically mentioned, the glands are all swollen, softened, 

 and at least highly congested, if not hemorrhagic. Smears from 

 the right inguinal glands show numerous plague bacilli. The 

 organisms are also present in moderate numbers in those from the 

 spleen. 



Anatomic diagnosis. — Congestion and oedema of the lungs ; hem- 

 orrhagic, acute, parenchymatous nephritis; parenchpnatous and 

 fatty degeneration of the liver; hemorrhagic inflammation of the 

 right inguinal and many other hiiiph glands; extensive subserous, 

 submucous, and interstitial hemorrhages. Bubonic ^^lague. 



The cultures inoculated at the post-mortem examination devel- 

 oped a typical growth. 



Microscopic examination. — Upon a general survey, the glands of 

 the right inguinal region show an extensive hemorrhagic infiltra- 

 tion with much necrosis, particularly in those places where the 

 extra vasaton is the greatest. The normal gland structure in general 

 has disappeared, but here and there follicles may still be recognized 

 where the blood extravasation is not so extensive. All vessels are 

 much dilated and engorged. The connective tissue at the hilus 

 is greatly increased. The capsules of the glands are loosened by a 

 hemorrhagic oedema ; and their cells as well as those of the connective 

 tissue reticulum of the glands themselves are swollen and even 

 completely necrotic. The periglandular, loose, areolar tissue is 

 likewise hemorrhagic and in part distinctly necrotic. If the vessel 

 walls are examined with a high power, it is seen that they are 

 rarified by an cedematous infiltration. The cells forming them 

 either show no nucleus at all or a poorly stained or a pyknotic one. 

 The same changes are noticeable in the capsular and periglandular 

 vessels. A number of the parenchyma cells, outside the zone of 

 the dense bacillar zooglea masses, consist of fairly normal, small 



