x, B,4 Crowell: Pathologic Anatomy of Bubonic Plague 273 
(1) Smears made from the aspirated liquid showed a number of plague- 
like bacilli. 
(2) Cultures made from the said liquid showed pure culture of B. pestis 
bubonice. They were Gram-negative, nonmotile bacilli. Ageglutination 
with antiplague serum was positive. 
(8) Two guinea pigs were inoculated with the liquid. They showed 
considerable swelling at the place of inoculation on the third day; also, 
the enlarged inguinal glands were palpable. One animal died on the third 
day; the other, on the sixth day after inoculation. 
(4) A maculopapulous efflorescence located on the inner part of the 
right planta pedis was incised, and the edges of the wound were scraped; 
the material so obtained was used to inoculate agar tubes. 
(5) Culture obtained therefrom proved to be B. pestis, having all the 
characteristics of B. pestis including agglutination. 
(6) One guinea pig was inoculated with the material subcutaneously. 
In three days considerable swelling was noticeable at the place of inocula- 
tion. The inguinal glands were swollen and tender. The animal died of 
plague on the fifth day after inoculation. 
History of case 1969.—Ting Nu, 82 years, male, barber by occupation. ~ 
This case was admitted to the Philippine General Hospital on August 10, 
1912. Had fever, femoral bubo, evidence of congestion or some pneumonia, 
and bloody sputum. He was transferred to San Lazaro Hospital as highly 
suspicious of plague. While in San Lazaro Hospital he had distinct buboes 
in both femoral regions, some cough, no bloody sputum, but evidence of some 
pulmonary complication, delirium, restlessness, and high fever. The glands 
aspirated on the right side, and organisms morphologically like the plague 
bacillus were found; also, pure culture was obtained. Animals were 
inoculated. 
This patient had, on the left forearm, a vesicle which he claimed came 
from a burn, and on the right foot on the inner surface a small papule 
apparently containing a minute quantity of serum or pus, which it was 
thought might have been a flea bite and possibly the seat. of the primary 
infection. This did not look, however, like a so-called plague pustule. 
Some material was taken from this by the bacteriologist. 
The case died the morning of August 13, having been sick, according 
to the history obtained, about seven or eight days. 
This case received about 30 cubic centimeters of plague serum, and his 
condition after receiving it seemed to be improved. 
This case exemplifies well that class of cases which should be designated 
“DSubonic plague with early septicemia.” The primary bubo was not a 
prominent feature, whereas the evidences of septicemia were predominant 
from both the clinical and anatomic aspects. The secondary focal visceral 
lesions are weil shown in this case (Plates I and II). 
FEMORAL BUBOES 
Femoral buboes occur more frequently than buboes in any 
other situation, this being explained by the Anglo-Indian Com- 
mission by the fact that a much larger area of skin surface is 
drained by these glands than by any others. 
‘Fifty-five femoral buboes were encountered in my series, con- 
