218 STRONG, CROWELL, AND TEAGUE. 



firmer than the typical, infectious splenic tumor, a condition 

 depending upon the increase of red pulp and blood in the organ. 

 On cut section the red pulp was greatly increased and the folli- 

 cles were usually either small or invisible. In two cases the 

 follicles appeared as white, pin-point areas inclosed by dark-red, 

 pin-head-sized areas, which in turn were surrounded by the 

 lighter red splenic parenchyma. Small, punctiform haemor- 

 rhages occurred beneath the capsule in one instance and scattered 

 through the substance of the spleen in others. The trabeculse 

 were prominent in only one instance in which the age of the 

 subject was apparently between 50 and 60 years. In one case a 

 reddish-white infarct 4 millimeters in its greatest width was en- 

 countered. 



Histological examinatio7i of the spleen. — The chief lesion in 

 the spleen is found in a marked congestion and hyperplasia of 

 the pulp tissue with small haemorrhages occurring beneath the 

 capsule and throughout the pulp in a very large percentage of 

 cases. The degree of the congestion varies. It is frequently 

 especially marked at the immediate periphery of the lymphoid 

 follicles. These lymphoid follicles are for the most part both 

 relatively and absolutely small and seldom show any signs of 

 proliferation. The bacteria in the follicles are very scarce. 

 Some cases show fairly large areas of necrosis of the pulp in 

 the areas of the haemorrhage. The swelling of the endothelial 

 cells of the lymph sinuses is by no means an infrequent occur- 

 rence, although evidence of their multiplication is not seen. 



Kidneys. — Punctiform haemorrhages measuring several milli- 

 meters in diameter were frequently observed in the capsules of 

 the kidneys, which usually stripped easily from the surfaces of 

 the organs. The kidneys were usually rich in blood, and in a 

 number of instances after the removal of the capsule a red, 

 granite-like appearance was observed due to the deeply injected 

 vessels in contrast to the yellowish parenchyma of the organ. 

 The stellate veins were usually deeply injected. Small haem- 

 orrhages about the surface vessels of the kidneys were un- 

 usual, but were observed in three cases. On cut section either 

 parenchymatous or early fatty changes were almost invariably 

 evident. The glomeruli were frequently swollen and often ap- 

 peared as fine, reddish, pin-point-sized areas. Petechias were 

 frequently seen in the pelves and upper portion of the ureters. 



Histological examination of the kidneys. — Extreme degenera- 

 tion of the parenchyma of the kidney is a constant feature. The 

 degeneration is in the form of an extreme cloudy swelling and 



