270 The Philippine Journal of Science 1915 
In three of my cases (2092, 2148, 2150) the pneumococcus and 
the plague bacillus were isolated from the spleen, in another 
(2125) a streptococcus and the plague bacillus, and in a third 
(2267) a streptococcus, Bacillus mucosus capsulatus, and the 
plague bacillus. These cases will be referred to again in the 
description of the lesions in the spleen. 
Excerpts from the autopsy reports of three cases in which 
the primary bubonic lesion was slight will be presented, and 
one typical case showing the widespread, gross, focal plague 
lesions will be reported in full. The following cases illustrate 
the lesions found in cases of early septicemia. 
Case 2125.—Filipino, male, 20 years old. The duration of illness was 
four days. The inguinal glands are somewhat enlarged, firm, dark, but 
no hemorrhages are present in the surrounding tissues. The glands of 
the left side are slightly more prominent than those on the right. Slight 
cedema is present on both sides. On section these glands are dark red 
and present small hemorrhages. The axillary glands are smaller, discrete, 
and red, and show no hemorrhages in or about them. The popliteal glands 
are small and red. Internal glands show no change. Bacillus pestis was 
found in the inguinal glands and spleen. Streptococcus pyogenes was also 
isolated in culture from the spleen. No other focal plague lesions were 
found. 
Case 2295.—Filipino, male, 15 years old. Duration of illness was stated 
as one day. Section over the femoral regions reveals pale, firm, discrete, 
slightly enlarged lymphatic glands. There is no surrounding cdema nor 
hemorrhage. The mesenteric and lumbar glands are small, firm, and pale. 
Section over the axillary lymphatic glands shows them to be slightly 
enlarged, discrete, firm, and somewhat reddened. They, however, present 
no hemorrhages, nor is there surrounding cdema or hemorrhage. The 
faucial tonsils are pale, firm, and not enlarged. The superficial and 
deep cervical glands are not enlarged, but all are deep red; they show 
no surrounding hemorrhage nor cedema. At the bifurcation of the trachea 
is one large hemorrhagic and much softened lymphatic gland. This case 
had numerous cutaneous vesicles and extensive, secondary plague nodules 
in the lungs. 
Case 2878—Filipino, male, 16 years old. The duration of illness was 
three days. The superficial lymphatic glands are not palpably enlarged. 
On section over the right groin the tissues are found very slightly cdem- 
atous; the glands are not enlarged, but are somewhat red. The glands 
in the left groin appear unchanged. The glands in both axille are red, 
but there is no edema surrounding them and they are not softened. The 
peribronchial, mesenteric, lumbar, and cervical glands are not enlarged. 
There were no focal plague lesions. Bacillus pestis was isolated from the 
spleen. 
Case 1969.—Chinese, male, 32 years old. The duration of illness exceeded 
three days. Autopsy was performed one hour after death. The body is 
that of a well-nourished, male Chinese. On the inner surface of the right 
foot there is a very small incised wound, which represents the place from 
which cultures were made of a papule suspected of being the point of 
inoculation. On the left arm, just below the elbow, is a superficial ulcera- 
