x,B,4 Crowell: Pathologic Anatomy of Bubonic Plague 297 
left heart is empty. The mitral ring admits two fingers. The endocardium 
throughout is smooth. The mitral and aortic leaflets are thin and pliable. 
The base of the aorta is free. The muscle of the left ventricle is dark, 
moist, and firm and not hypertrophied. The coronary arteries are intact. 
The lungs are somewhat diminished in volume, the pleura over them 
being smooth but showing numerous petechiz over both lungs. The lungs 
are crepitant, and their elasticity seems diminished. On section of the lungs 
the cut surface shows the same appearance anteriorly and posteriorly in both 
superior and inferior lobes. This consists of a moist, dark red, smooth 
surface which exudes some bloody, frothy fluid on pressure, but this is not 
large in amount. The bronchi have a bluish purple mucosa and are empty. 
The pulmonary vessels are free. The peribronchial lymph nodes are small, 
deeply pigmented, and firm. 
The neck organs. The faucial tonsils are very slightly enlarged, but 
show no gross changes. The lingual follicles are very prominent and 
pale. The tissues of the pharynx have a normal appearance, being perhaps 
slightly congested. The larynx and trachea have a normal appearance. 
The cesophagus is normal. The-cervical lymphatic glands are not enlarged. 
The thyroid is normal in appearance. 
The spleen is very considerably enlarged (to about twice the normal 
size). The capsule is rather tense. On section the organ is of good 
consistence, and the cut surface is of an opaque, grayish red appearance, 
the pulp being rather prominent. The lymphoid and interstitial elements 
are obscured. There are no visible hemorrhages. The cut surface, while 
firm, is not absolutely smooth. 
The adrenals are of normal appearance. 
The kidneys are somewhat enlarged. The capsule strips readily and 
shows no hemorrhages. The surfaces of the kidneys are smooth and very 
deep red. The consistence of the organ is somewhat increased, and it is 
rather resilient. The cut surface shows deep congestion of both cortex 
and pyramids with few rather diffuse, paler areas in the cortex. These 
are rather large and not well circumscribed. The vascular markings are 
rather prominent, but the glomeruli are not readily seen. The pelves and 
ureters are intact. 
The urinary bladder is distended with a clear urine. Its mucosa is pale. 
The prostate is normal. 
The intestines. The small intestine, from the duodenum to the ileocecal 
ring, contains some dark flecks of coagulated blood and a small amount of 
dark, semiformed fecal material. The mucosa throughout shows numerous 
minute petechiz, but there is no suggestion of any membrane and no 
ulceration. The large. intestine from the cecum to the rectum is the seat 
of still more numerous petechial hemorrhages, these all being isolated 
and minute but very closely packed throughout the entire intestine. Here, 
‘also, there is no evidence of any inflammatory reaction. The mesenteric 
and mesocolic lymphatic glands are prominent on account of their color, 
these being deep red, but they are not enlarged and show no evidence of 
necrosis nor surrounding oedema. 
The gall bladder and bile ducts are normal. 
The liver is slightly enlarged; its capsule is thin and smooth and is 
without hemorrhages. On section the cut surface is smooth, brownish red, 
and slightly opaque with fairly distinct lobular markings. 
The pancreas is normal in appearance. 
The stomach contains some blackish flecks of coagulated blood over the 
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