﻿GANGOSA IN THE PHILIPPINES. 395 



in the loose meshes of which are rows of small, round cells, usually 

 having irregular nuclei and a few adult connective tissue cells. This 

 zone merges at once into the pulp. 



The endothelium of the small arteries is often thickened and irregular, 

 and takes a bright-red hyaline color; the thickening is often uneven, and 

 confined to one-half or less of the circumference of the vessel. This 

 hyaline material appears to be amyloid in the hsematoxylin and eosin 

 stain, but it does not respond with iodine, iodine and sulphuric acid, 

 nor with methyl violet stains. There is no increase in small, round, cells, 

 nor in polymorphonuclear leucocytes. 



Kidney. — The capsule is not thickened; the capillaries and veins are 

 filled with red blood corpuscles; the glomeruli are well preserved, mod- 

 erately congested, the cells not increased, the capsules of Bowman delicate 

 and normal. The convoluted tubules contain a small amount of granular 

 debris and a fine meshwork of coagulated matter; the lining cells are 

 large, granular, bright red and frequently send protoplasmic fringes into 

 the lumen; the nuclei are near the basement membrane and apparently 

 normal. The loops of Henle and the collecting tubules appear normal .• 

 The interstitial tissue is not increased. There are no infiltrating cells. 



Pancreas. — The parenchyma cells have retracted from the stroma pro- 

 ducing distortions. The cells are small, and rather deeply stained. The 

 islands of Langerhans are normal. 



An area is found, miliary in size, having the characteristics of an early 

 tubercle. The nuclei in this area are small, black, fragmenting and 

 irregular; the protoplasm bright-red and hyaline. The area is not 

 sharply marked off from normal pancreas. No karyolysis, no cellular 

 infiltration. 



Cervical lymph gland. — In one section the blood vessels are moderately 

 engorged; the lymph channels are widely distended but nearly empty; 

 the stroma is loose and the strands widely separated; the cell nests are 

 not seen, and the cell columns are less dense than normally. 



Two areas of necrosis over 1 millimeter in diameter are found. In 

 each case the nodule consists of a large, central mass of bright-red de- 

 tritus, granular and lumpy, with a few fragmenting nuclei, surrounded 

 by a narrow and imperfect zone of large epithelioid cells with consider- 

 able dark-red protoplasm, irregular in shape, and much red-staining 

 interstitial tissue. This zone is free from capillaries and passes over 

 suddenly into lymph gland tissue. 



In the peripheral sinus only a few cells are present; several of these 

 are small, with deeply staining nucleus and a narrow band of red proto- 

 plasm, taking much the same shade as the erythrocytes. The cells in the 

 internal sinuses are (1) small round cells and (2) large cells with 

 vesicular nucleus and abundant, bright-red protoplasm, apparently de- 

 squamated endothelial cells. Many of these are cloudy and have only 

 faint traces of the .nucleus remaining. In some cases no nucleus is seen. 



