268 The Philippine Journal of Science 1915 
become hyaline and loose in structure and finally become unrecog- 
nizable. Polymorphonuclear leucocytes may appear in relatively 
large numbers, and these may contain bacteria. This seems 
to be particularly true in cases that have lived for several days. 
In those cases that have shown macroscopic evidence of sup- 
puration the polymorphonuclear leucocytes are especially abun- 
dant. The capsule of the gland becomes infiltrated with red 
blood cells, leucocytes, and bacteria and undergoes a hyaline 
degeneration with eventual necrosis. The entire process thus 
extends to the periglandular tissue, where the adipose tissue 
may be seen to be infiltrated, heemorrhagic, and necrotic, in the 
same manner as is the gland itself. Traces of the capsule of the 
gland can usually be found microscopically. The vessels in the 
periglandular tissue may show the same changes as those within 
the gland, and it is not infrequent to find these occluded by leu- 
cocytic and bacillary thrombi. In the gland and periglandular 
tissue large mononuclear cells, probably derived from the endo- 
thelial cells, may be numerous. These engulf the bacteria and 
fragments of other cells. Groups of plasma cells are not in- 
frequent. The nerves in the neighborhood of the bubo, and 
the walls of the large vessels, may show morphologic changes 
similar to those described in the gland. 
The blood cells which compose the hemorrhagic mass in the 
late stages lose their contour and become a more or less solid 
mass of eosinophilic structureless material. There may be 
visible shadows of individual cells. This process is one of 
hemolysis. 
The number of bacilli appearing in large masses in the glands 
and pefiglandular structures is frequently enormous. In the 
earlier stages these appear to be largely confined to the lymph 
sinuses; but with the breaking up of the structure of the glands, 
the bacterial masses are scattered throughout—within the gland, 
in the surrounding tissue, and in the vessels. In autopsy ma- 
terial, post-mortem proliferation of the bacilli has probably 
occurred. 
In the examination of a bubo in the late stages it may be 
impossible to recognize it as of glandular structure. One may 
see only hemorrhage, cedema, bacterial masses, and necrotic 
material. From such an examination one could not determine 
whether the necrosis or hemorrhage is primary, but it would 
seem in many instances, at least, that the necrosis of the vessel 
walls appears before the massive hemorrhages take place. 
It is not possible to state accurately the chronological order 
in which the various changes in the glands occur, but the changes 
