PATHOLOGY. 217 



The remarkable feature about the tonsils as a whole was their 

 comparative freedom from anatomical changes. Congestion, 

 sometimes oedema, sometimes haemorrhages, occasionally slight 

 lymphoid activity constituted the main features. (See Plate 

 XVIII.) The bacilli were present in small numbers with one 

 exception, and never bore any comparison to the number in the 

 lungs. 



The oesophagus was in every instance normal, no hypersemia 

 of the mucous membrane being observed. 



StomacJi and intestines. — The mucosa of the stomach was fre- 

 quently somewhat swollen and showed numerous, small ecchy- 

 moses. In a few instances small erosions were present. In a 

 few cases the peritoneal surface of the small intestine was red- 

 dened and in a few others haemorrhages were observed on the 

 peritoneal surface of both the large and small intestines. These 

 haemorrhages were of two types — the first dark, almost black in 

 color, measuring from -\ to 1 centimeter in diameter and sug- 

 gesting in their appearance oesophagostomum infection ; and the 

 second appearing as fine, bright-red, linear haemorrhages. The 

 mucous membrane in these cases was reddened and showed 

 a catarrhal condition, with a pinkish mucous layer covering the 

 surface, beneath which were innumerable, bright-red, pin-point- 

 sized areas. 



Lymphatic glands. — The bronchial glands near the bifurca- 

 tion of the trachea always showed more advanced changes than 

 any of the other lymphatics; they were always swollen, rich in 

 blood, and frequently almost black in color from resulting haem- 

 orrhages. The lymphatics along the lower portion of the tra- 

 chea were also usually swollen and sometimes contained haemor- 

 rhages. In a few cases the mesenteric lymphatics showed simple 

 inflammatory swelling, but in the majority of the cases they 

 were normal. The largest ones measured about 2\ centimeters 

 in diameter. On section the surface was pink or of a gray- 

 ish-red or dark-red color, but showed no haemorrhages or nec- 

 rotic areas, although in one case in the veins about them the 

 blood had frequently escaped from the vessel walls. In one 

 instance the glands showed small haemorrhages. In the other 

 lymphatics of the body, no special changes were observed. 



Spleen. — The spleen was distinctly enlarged in 56 per cent 

 of the cases. In bubonic plague the percentage with distinct 

 anatomical enlargement of the spleen is considerably higher, but 

 the spleen is by no means always enlarged in bubonic plague, as 

 has frequently been stated. In the present cases it was usually 



