112 



extends as far as the pleura, and posteriorly and below it reaches 

 to within about one centimeter of the pleural surface; but above 

 there are still several centimeters of pulmonary tissue not yet in 

 a state of consolidation. In the consolidated area the tissue is 

 dark brownish-gray with lighter grayish-yellow spots. The cut 

 surface is granular. The juice which is scraped off is turbid, 

 grayish-white, creamy, and purulent. The area of consolidation 

 is sharply defined from the rest of the pulmonary tissue, which is 

 very much congested, dark brownish-red in color, and very oede- 

 matous, containing very little air. The upper lobe of the left side 

 is congested and oedematous and contains much dark, fluid blood. 

 The right side on section is found to be moderately congested and to 

 contain quite a fair amount of air. The bronchial mucosa and that 

 of the trachea and larynx are congested. The bronchial glands are 

 swollen, softened, and dark purplish. The spleen is small and flabby 

 and its surfaces wrinkled and bluish-gray. On section the dark- 

 brown pulp is found to be softened, the trabeculse visible, and the 

 Malpighian corpuscles swollen. Kidneys are greatly congested. On 

 section the vessels stand out very prominently on a very markedly 

 grayish-yellow background. The surface is very dull. Liver : The 

 surface is bluish-purplish-pink with gray mottling. The consist- 

 ency is moderately increased. The cut surface is yellowish-brovra 

 and dull. The vessels are much engorged and the lobules enlarged. 

 The gall bladder and ducts are normal. The gastric and duodenal 

 mucosa shows numerous petechise. The petechise are so numerous 

 and crowded in the mucosa of the stomach at the fundus that they 

 have become more or less confluent at their margins. None of the 

 superficial or deeper l3anph glands, excepting the bronchial ones, 

 show any marked changes. 



Smears from the consolidated area of the lung show innumerable 

 typical plague bacilli ; others only a very few. 



Anatomic diagnosis. — ParenchjTnatous degeneration of the kid- 

 neys and liver; multiple subserous and submucous hemorrhages; 

 pneumonia; acute adhesive fibrinous pleurisy. Plague. 



Microscopic examination. — Sections from the consolidated area 

 of the lung show alveoli filled with mononuclear and poljTiuclear 

 leucocytes, erythrocytes, and alveolar epithelia. The polynuclear 

 leucocytes predominate considerably. Some of the air spaces show 

 a coarse network of fibrin, though such places are not numerous. 

 However, fibrin is found very extensively in the interalveolar capil- 



