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the vessels and subserous, submucous, parenchymatous, and inter- 

 stitial hemorrhages. The most common locations of the latter are 

 the epicardium, the pleura, the peritoneal covering of the stomach 

 and intestines, and the mucosa of the stomach and intestines. There 

 may also be subcapsular renal hemorrhages and blood extravasation 

 into the pelves of the kidneys, the ureters, the bladder, and the male 

 and female genital organs. 



In bubonic plague proper hemorrhages into the buboes are very 

 rarely absent. In only two of our sixteen cases of bubonic plague 

 proper were they not present; in these death was clearly due not 

 solely to the pest infection, but to a complication of circumstances 

 (Case No. 8, Banti's disease; Case No. 16, ambulatory plague, ter- 

 minating by embolism of the pulmonary artery). In fourteen out 

 of sixteen cases the primary bubo showed a hemorrhagic condition. 

 The heart in most of our cases showed subserous hemorrhages. 

 In this organ they were found seventeen times, varying in size 

 from a few small petechise to numerous and not infrequently large 

 ecchymotic spots. The other internal organs, arranged in the order 

 in which hemorrhages occurred in them most frequently are as 

 follows: Stomach, fourteen times; intestines, eight; kidneys, six; 

 bladder, three ; and liver and ureters, each twice.. Other organs in 

 which hemorrhages were occasionally found are the gall bladder, 

 the epiglottis, the esophagus, and the th}T2ius. The most extensive 

 and most widespread hemorrhages were found in Case No. 12 — 

 namely, one of bubonic plague in a male Filipino with secondary 

 septico-pyemia and metastatic dissemination of the bacilli. The 

 primary inguinal bubo itself showed most extensive hemorrhages 

 and an uninterrupted continuation of them from Scarpas' triangle 

 up to the right kidney, involving in the area of blood extravasation 

 all the glands, the periglandular tissue, the sheaths of the large 

 vessels, and the perirenal, loose arolar tissue. The heart, the kid- 

 neys, the ureters, the bladder, the liver, the stomach, the oesophagus, 

 and the small and large intestines, all showed either subserous or 

 submucous hemorrhages, or a combination of both ; blood extravasa- 

 tion was also seen in the anterior mediastinum. On the other hand. 

 Case No. 8, one of the primary inguinal imcomplicated bubonic type, 

 did not show a single hemorrhage. This is the case in which we 

 found a spleen weighing 865 grams and a cirrhotic liver. It is 

 reasonable to suppose that this patient had no resistance to the 



