105 



The tubules are quite markedly yellowish-gray, the surface on the 

 whole being rather dull. The pyramids are purplish. The mucous 

 membrane of the pelves is smooth and somewhat congested. Liver : 

 The capsule is smooth, shining, transparent, and pinkish-gray in 

 color, some areas being decidedly mottled. The cut surface shows 

 the center of the lobules to be grayish-white ; they are distinct in 

 outline. The surface as a whole is dull. The veins contain much 

 dark, fluid blood. The gall bladder contains some turbid, greenish- 

 yellow bile, its mucous membrane being smooth. There are no 

 stones; the ducts are normal. The stomach and intestines appear 

 fairly normal. The suprarenals and the' pancreas are normal. 

 The inguinal glands on both sides are enlarged, swollen, soft, and 

 rather bluish-pink in color. On section they show injected vessels, 

 which stand out prominently on a grayish-yellow background. The 

 substance of the glands is soft. No abscess formation has occurred. 

 An abundant, grayish-white fluid can be scraped from the cut 

 surface. The lower glands of the chains on each side are the 

 largest, showing a central softening quite markedly. There is, 

 however, no abscess formation. These glands are equal in size on 

 both sides and measure 4.8 by 3.7 by 1.7 centimeters. The 

 mesenteric, the cervical, and the other glands examined are all 

 moderately enlarged and more or less congested. Marked congestion 

 exists in the bronchial glands. 



Anatomical diagnosis. — Congestion and oedema of the lungs; 

 parench}Tnatous degeneration of the kidneys; embolism of the 

 pulmonary artery; inguinal buboes. Plague. 



Smears were made during the post-mortem examination from 

 the liver, the spleen, and the glands. In the smears from the 

 spleen and the glands only a very small number of bacilli are 

 found. They are more numerous in those from the liver. Some of 

 the bacilli found in the latter are quite typical in appearance, 

 showing polar staining and rounded ends. Other bacilli are 

 swollen, somewhat irregular, and approaching the type of the invo- 

 lution forms seen on artificial media. Still others are small and 

 look decidedly like diplococci. Others form small chains, the 

 individual members of which appear to be in a state of partial 

 dissolution. The cultures inoculated from the organs developed 

 typical plague bacilli. 



Microscopic examination. — Liver: The liver shows extensive 

 interlobular, inflammatory foci, formed by a cellular exudate. 



