x, B,4 Crowell: Pathologic Anatomy of Bubonic Plague 305 
Scheube ** cites a case of intrauterine infection with plague 
that was reported. by Leumann. 
In my case (2481) of which the uterus contained a 6-month 
foetus no pest bacilli were demonstrable in sections of the pla- 
centa or umbilical cord. 
HISTOPATHOLOGY OF THE TESTES 
In two cases hemorrhages in the testes were noted macro- 
scopically. These appear histologically as diffuse intertubular 
hemorrhages, which widely separate the tubules from one 
another. Much of the blood has undergone hemolysis. The 
cells of the tubules themselves show no recognizable alteration. 
PANCREAS 
No recognizable macroscopic lesion has been seen in the pan- 
creas aside from the occurrence of occasional small hemorrhages 
in its capsule and in the interstitial tissue and some congestion - 
of the organ. 
HISTOPATHOLOGY OF THE PANCREAS 
No marked morphologic change has been found in the pancreas 
in any of the cases. In two cases large vessels within the pan- 
creas showed thrombosis, the vessels being filled with leucocytes 
and a small amount of fibrin with numerous bacilli. No asso- 
ciated change in the surrounding pancreatic tissue was recog- 
nizable. 
ADRENALS 
The adrenals in plague are as a rule swollen and moist and 
often red. Hzemorrhages occur about the capsule of the organs, 
in the cortex, and in the medulla. These are as a rule small and 
punctate, but more diffuse hemorrhages have been seen within 
the medulla. : 
HISTOPATHOLOGY OF THE ADRENALS 
The lesions in the adrenals are not a prominent feature in 
bubonic plague, but there are a variety of lesions which not in~ 
frequently occur. 
A degeneration of the cells especially in the zona fasciculata 
may be present, in which the cytoplasm of the cells appears to 
dissolve away, leaving only a spongelike cytoplasmic reticulum 
surrounding the nucleus. This may involve nearly all of the 
cortex, or may be restricted to a few cells. In a few cases small 
areas were found in which the nuclei also disappeared, constitut- 
ing areas of focal necrosis. There was never seen any evidence 
of exudation of cells into these areas. 
* Krankheiten der warmen Lander. Gustav Fischer, Jena (1910), 267. 
