DR The Philippine Journal of Science 1915 
cedema nor infiltration of the tissues surrounding these glands, 
and they were more or less conglomerate and of firm consistence, 
showing numerous yellow foci on the red background. Bacillus 
pestis was found in the iliac glands and spleen in large numbers. 
No other primary focus was found. The duration of illness in 
this case was said to be one day. 
According to Piersol ** the iliac nodes receive afferent vessels 
from the bladder and prostate gland, from the lower part of 
the uterus and the upper part of the vagina, and from the 
glans penis and clitoris. If the portal of entry of the bacillus 
be in any of these parts, the iliac glands may form the primary 
bubo, thus accounting for some of the reported cases in which 
no bubo was recognizable clinically. The possibilities are that 
the femoral or inguinal glands, from which the infection spreads 
to the iliac glands, may never have undergone extensive struc- 
tural changes; or, on the other hand, they may have recovered 
from their more severe changes before death occurred. 
POPLITEAL BUBOES 
In the reports of the German, Austrian, and Anglo-Indian 
Plague Commissions I have been able to find no report of an 
autopsy of a case with popliteal buboes, although it is recognized 
that these occur clinically. The popliteal and cubital glands are 
seldom the seat of the primary bubo, the organisms in this 
disease, as in other acute infections, originating in the extremi- 
ties, passing to the glands in the groin or axilla. 
One case of this series had a primary popliteal bubo, and an 
excerpt from the autopsy record is here presented. These glands 
may be the seat of secondary buboes, which become infected 
through the blood stream, and it is said that they may constitute 
primary buboes of the second order, infected by a retrograde 
passage of the organisms through the lymph stream. 
Case 2081.—There is a considerable bulging in the right popliteal and in 
the right femoral regions, and in the popliteal region there is found con- 
siderable cedema of the tissues. About the deep vessels between the two 
layers of the gastrocnemii are some much enlarged, deep red, softened, 
hemorrhagic glands. The tissues about these are slightly hemorrhagic, 
and the cdema extends up through Hunter’s canal. On section over the 
right femoral region the edema is very great, and there is a large mass 
of edematous fat inclosing enlarged lymphatic glands, one of which meas- 
ures 3.5 centimeters in diameter. This is reddish yellow and soft, and 
there is considerable hemorrhage in the tissues about this gland. The 
*Human Anatomy. J. B. Lippincott Company, Philadelphia and London 
(1907), 984. 
