78 THOMPSON YATES AND JOHNSTON LABOR ATOBIES REPORT 
The lymph glands show generally the same changes as in the first case. The 
majority of the glands are affected, and all stages can be followed out from normal 
gland structure to that of haemo-lymph glands. 
The following is a description of a typical haemo-lymph gland taken from one 
of the enlarged glands of the neck : — 
There is a marked hyperplasia of the connective tissue, the capsule is thin and 
has enlarged vessels running in it. Underneath the capsule is the peripheral sinus, 
which does not extend round the whole gland, since at places the lymphoid tissue 
reaches the capsule. In the sinus are many red blood corpuscles, a few leucocytes 
and phagocytes and coagulated fluid ; from this sinus branches run towards the 
centre. The germ centres are in greater number than normally and are enlarged. 
They show nothing abnormal in their constituents except an infiltration of blood 
cells. The vessels often have an accumulation of red cells around them. The 
arteries inside, and to a less extent outside the glands show endarteritis. In some 
of the glands, chiefly in the periphery, are ill-defined strands of densely packed 
lymph cells. Similar patches, but smaller, are found in the central parts of the 
gland. A good number of phagocytes, a few giant cells, and a varying number of 
eosinophiles are found in the glands. 
The vessels in the adipose tissue about the glands often have small new growths 
of lymphoid tissue around their walls. 
Those lymph glands which appear slightly changed to the naked eye are found 
microscopically to be highly congested. Thick vessels enter at the hilus and divide 
into large branches running towards the periphery. Numerous free red blood cells 
are present among the lymphocytes throughout the glands and also there is a slight 
quantity of blood pigment giving an iron reaction. 
The long-bone marrow in some places has the microscopical appearances of red 
marrow. It is very rich in cells, with but little fat. The vessels are very congested 
and contain a good number of leucocytes and a few nucleated red cells. The cellular 
elements present no abnormality, consisting of giant cells, eosinophiles, and a few 
phagocytes. Blood pigment is present in small quantity. 
Eyes show microscopically nothing abnormal except a little infiltration at the 
corneo-scleral junction and in the cornea. The pial sheath of the optic nerve 
contains more cellular elements than normal, and the vessels of the nerve show 
well-marked small-celled infiltration. 
Suprarenals are very congested. Enlarged vessels run in the capsule and 
between the cells separating them. 
The aorta occasionally shows a little small-celled infiltration around its 
vasa vasorum. 
The central nervous system presents much the same changes as in the case of 
' Kitambo,' but as a rule in a less marked degree. 
