44
17th, patient died at 7-55 A.M. The child was 18 inches in length and
weighed 4 lbs., and although small, it was fully developed. It remained perfectly
well, throve, and after 20 days was sent to a foundling home. When last heard
of ou June 1st, it was still in good health. It never showed the slightest sign of
plague or of any illness whatever.
0Post-mortem examination of the mother was made three hours after death.
Body well nourished, no petechiae on skin, haemorrhages under conjunctivae, rigor
mortis present.
Heart—Petechiae under visceral and parietal pericardium ; heart-muscle
looked firm ; there were post-mortem clots in the cavities and in the aorta.
Vena Gava.—Great engorgement of its coats and many haemorrhages under
the inner coat, giving it a mottled appearance ; these were seen in the abdominal
vena cava as well.
Lungs.—Intense engorgement and oedema ; there was one small round patch
of early pneumonia at the back of the left lung, it was light red and fairly solid,
with recent pleurisy over it. There were small haemorrhages under both pleurae.
Bronchial mucous membrane much engorged, purple and swollen ; the tubes
contained frothy watery fluid, but no pus.
Liver.—A little large, its substance rather pale and soft and much engorge-
ment of vessels.
Spleen.—Eatlier large and soft, of purple colour and engorged ; the Malpi-
ghian bodies were prominent and appeared to be engorged.
Kidney.—Haemorrhages under capsule, engorgement of vessels, the kidney
substance pale and soft. There were haemorrhages in the pelvis and calices and
the whole ureter was purple red with distinct haemorrhages under its inner coat.
The bladder contained urine, and there were haemorrhages into its mucous coat.
Uterus.—Large, as of a woman recently delivered. There was much recent
clot in its cavity of the normal appearance, and a well-marked corpus luteum
in the left ovary. All the generative organs looked normal.
Peritoneum.— Considerable engorgement and large haemorrhages in the
retro-peritoneal tissue, mostly in the lumbarjregions.
Brain.—Haemorrhages under scalp and beneath periosteum on surface of
cranium ; cerebral membranes engorged, with puncta cruenta in brain distinct :
no excess of fluid in ventricles ; brain-substance looked normal.
Lymphatic Glands. Inguinal, on both sides, some as large as beans, and
some smaller, engorged, light red in colour and cedematous, but some of the
upper ones were flatter and more normal-looking.
Iliac right side, the lowest was like an almond, deeply engorged and rather
soft, the upper ones were smaller and paler. Left side, lowest like a large bean,
and the others smaller.
Lumbar, rather large and a little engorged.
Mesentcric, slightly swollen and engorged.
Bronchial, of normal size, slightly engorged.
Axillary, in size from hazel-nuts to peas, dusky red, oedematous and much
engorged.
Cervical, as large as hazel-nuts, deeply engorged and oedematous, and some
with a little haemorrhage into the surrounding connective tissue.
Supra-trochlear, as large as peas and engorged.
Alimentary System.—Tonsils small, slightly engorged, oesophagus rather
engorged but no haemorrhages in its walls ; there were distinct petechiae in the
stomach, a few in the small intestine, and more in the colon and rectum ; all
these parts being likewise engorged. The sub-maxillary and parotid salivary
glands and the pancreas were slightly engorged.
The Breast looked normal and contained good secretion of normal-looking
milk, and its vessels were rather full of blood.
Under the microscope plague-bacilli in large numbers were seen in the
inguinal, cervical and axillary glands : they were also present in the blood to a
considerable extent.