236 The Philippine Journal of Science 1915 
organisms. The description of the lungs in the following case 
exemplifies the type of lesion encountered in this class of cases. 
Case 2073.—Filipino, 31 years old. This case had a typical right femoral 
primary bubo. 
The lungs. The pleure are deep bluish red throught, and the lungs 
are slightly nodular on palpation. On section, especially in the posterior 
part of the lower lobes, are diffuse, slightly elevated, airless areas which are 
deep red and slightly granular but not redder than the surrounding tissue, 
which is everywhere deep red and somewhat cedematous. The larger bronchi 
contain some mucopus, and the mucosa is much reddened. The pulmonary 
arteries are intact. The peribronchial lymph nodes are red and somewhat 
softened. At the bifurcation of the trachea are one large and two or three 
small, very deep red and slightly softened lymphatic glands. The trachea 
itself has a very much reddened mucosa. The other structures of the neck 
show no change. 
In the infarcted type of pulmonary lesion, also, the changes 
do not essentially differ from the usual pulmonary infarcts. The 
infarcts may be single or multiple. In one of our cases (2073) 
the single infarct was in the upper left lobe; in another (2150) 
there was an infarct in each lower lobe; and in still another 
(3129) there were multiple infarcts in the lower lobes. 
This type of lesion is exemplified in the lungs of the following 
case. 
Case 3129.—Filipino, male, 6 years old. This case had a cervical bubo 
probably originating through tonsillar infection, with a seyere pseudo- 
membranous pharyngitis, tonsillitis, and laryngitis. 
The lungs. The pleure are smooth. On the surface of the left lung 
are found a few small slightly reddened areas, and the tissue beneath 
these is firm. On section these firm areas have a smooth or slightly 
granular, grayish red surface, darker in color than the surrounding lung 
tissue. All are found at the surface and for the most part are more or 
less wedge-shaped with the bases at the surface. They vary from 0.5 to 
3 centimeters in diameter, about 6 being found. The remainder of the 
lung substance is gray, soft, and moist. The bronchi contain a small 
amount of mucus. The right lung is similar to the left. The largest 
nodule is found in the lower lateral edge of the lower lobe. The peribron- 
chial lymph nodes are slightly enlarged and are hyperemic. No hemor- 
rhages are seen in the pleura. 
In the third or metastatic type of pulmonary lesion the char- 
acteristics are exemplified in case 1969 (page 270). The lesions 
vary in size and number from multiple miliary nodules to single 
or multiple larger nodules up to 2 centimeters in diameter. 
These may be very widespread throughout the lungs and occur 
also on the pleural surface where they cause some elevation of 
the pleura. The pleura over them shows injection of the smaller 
vessels, and there may be a delicate layer of fibrin on the pleura 
over the nodule. The color varies from a pale red to gray or 
