BACTERIUM DIPHTHERIA 465 



are an extensive local edema, with more or less hyperemia 

 and ecchymoses at the site of inoculation; swollen and red- 

 dened lymphatic glands; increased serous fluid in the peri- 

 toneiun, pleura, and pericardium; enlarged and hemorrhagic 

 adrenal bodies; occasionally slightly swollen spleen; and 

 sometimes fatty degeneration in the liver, kidney, and myo- 

 cardium. In guinea-pigs, especially, the liver often shows 

 numerous macroscopic dots and lines on the surface and 

 penetrating the substance of the organ. They vary in size 

 from a pin-point to a pin-head, and may be even larger. 

 They are white and do not project above the surface of the 

 capsule. 



The bacteria are always to be found at the site of inocu- 

 lation, most abundant in the grayish-white, fibrino-purulent 

 exudate. They become fewer at a distance from this, so 

 that the more remote parts of the edematous tissues do 

 not contain them. They are found not only free, but con- 

 tained in large number in leukocytes, some of which have 

 fragmented nuclei, or have lost their nuclei. The bacteria 

 within leukocytes, as well as some outside, frequently stain 

 very faintly and irregularly, and may appear disintegrated 

 and dead. 



Culture-tubes inoculated from the blood, spleen, liver, 

 kidneys, adrenal bodies, distant lymphatic glands, and 

 serous transudates, generally yield negative results; and 

 negative results are also obtained when these organs are 

 examined microscopically for the bacteria. 



Microscopic examination of the tissues at the site of 

 inoculation, as well as of the liver, spleen, kidneys, lymphatic 

 glands, and elsewhere, reveals the presence of localized foci 

 of cell-death, characterized by a peculiar fragmentation of 

 the nuclei of the cells of these parts. 

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