974 The Philippine Journal of Science 1915 
stituting 73.3 per cent of the total. Twenty-four of the buboes 
were on the left side and 31 on the right. In 1 case (2131) there 
was apparently a primary bilateral bubo, and in 4 cases (2072, 
2080, 2085, 2131) the inguinal rather than the femoral glands 
were the seat of the greatest changes. However, as a rule, the 
femoral and inguinal glands were coextensively involved, and 
they have been classed, in general, as femoral buboes. In a 
typical case of femoral bubo there is a visible, rounded promi- 
nence over the site of the glands, which in this case is most 
frequently just below the middle of Poupart’s ligament. This 
swelling may, in some cases, be so slight as not to be readily 
appreciable to the eye, but in these cases palpation of the two 
groins will usually reveal a difference manifested by a greater 
firmness, greater fullness, and greater elasticity over the affected 
glands. It is usually impossible to differentiate the individual 
glands by inspection or palpation or to move the skin over the 
subjacent structures. Punctate hemorrhages may be present in 
the skin overlying the bubo, and in a very few cases definite 
pustules may have formed. (The application of vesicants or 
caustics over the bubo is a frequent practice among the Filipinos 
and Chinese.) The entire extremity of the affected side may 
present an oedematous condition. On section over the glands 
there is encountered the appearance described on page 265 in 
the general description of the lymphatic glands. A single gland 
or all of the femoral and inguinal glands may be involved in 
the change, and the femoral glands are usually more extensively 
involved than the inguinal. The cedema about the glands fre- 
quently extends along the fascial planes well down into Hun- 
ter’s canal. The amount and extent of the periglandular edema 
and hemorrhage varies from scarcely perceptible amounts about 
a single gland to a diffuse, widespread involvement of all the 
neighboring structures. Typically, a mass of enlarged glands 
will be found, usually lying along the femoral vein. These glands 
are enlarged sometimes to as much as 5 centimeters in diameter. 
They are hemorrhagic, as is also the periglandular areolar tissue, 
thus making the outlines of the glands indistinct. In the early 
stages the glands are firm and red; later, they become softened 
and show yellowish areas. 
Posteriorly to the middle portion of Poupart’s ligament is 
usually found a gland, enlarged to 3 or more centimeters in 
diameter, which is well encapsulated but very hemorrhagic and 
sometimes softened. Extending upward from this, the lymphatic 
glands along the iliac vessels are usually enlarged, hemorrhagic, 
