92
[CHAP. II.
but more so in the straight than in the convoluted tubes, and some of the glomeruli are
likewise engorged. The epithelium, of the tubules is swollen and in a condition of parenchy-
inatous degeneration, and the nuclei of the cells stain badly ; but this condition is more
plainly seen in the convoluted than in the straight tubes'. Some specimens show engorged
vessels with hæmorrhage at the pelvis of the kidney.
Ureter.—The vessels of the walls of the ureter are distended with blood, and hæmorrhage
has occurred into the walls, blood-cells being seen in the mucous membrane even as far as
the lumen ; the condition is similar to that found in the walls of veins.
Stomach and Intestines.—The vessels are distended with blood, this condition being best
seen in the sub-mucosa ; at places small hemorrhages have occurred. The epithelium does
not stain well. Nothing abnormal was seen in Peyer's patches.
Brain and Spinal Cord.—The large vessels and capillaries of the pia mater are distended
with blood, but no special changes have been seen in the substance of the brain or spinal
cord.
Muscle.—In specimens of voluntary muscle some fibres are seen well stained and distinctly
striated, but mixed with them are others which are badly stained, with striation faint or
absent, and the muscle-substance is swollen, broken up into irregular lumps and of a shiny
homogeneous appearance. Specimens of the heart-muscle showed this condition also.
Note.—This degeneration of heart-muscle is associated with the dilatation of the heart
and nutmeg condition of the liver found post-mortem ; and also with the fact that plague-
patients are liable to die suddenly of heart-failure.
Blood-vessels.—In the outer coat of largo arteries the blood-vessels are found full of
blood, and the capillaries of the middle coat may also be seen distended ; but the inner
coat is always perfect, distinct and intact, and its elastic tissue plainly visible. The walls of
large veins, however, show much inore engorgement, and in these, large collections of blood
may be seen immediately beneath the inner coat, extending as far as the lumen, and at parts
the inner coat is either extremely thin or cannot be traced over the hemorrhage. This
condition is best seen in vessels incorporated in a bubo, but is also to be found in the vena
cava, iliac veins, &c.
The following organs were also examined, but nothing was observed under the micro-
scope, except some engorgement : The tonsils, salivary glands, thyroid body, breast, male
and female generative organs, cartilage, nerve and thoracic duct. Sections of the skin were
also made, and showed engorged capillaries with small hemorrhages, where petechie were
visible on the surface.
B.—THE SEPTICÆMIC FORM.
Lymphatic Glands.—The areolar tissue around the plague-glands (i. e., the characteristic
glands already described) shows none of the intense engorgement seen in the bubonic form.
The plague-glands themselves are well stained and all their anatomical features are distinct.
All the blood-vessels in the gland are distended with blood-corpuscles, and at parts hæmor-
rhage has occurred into the gland-substance, which is most frequently seen beneath the cap-
sule, but may also be at other parts. The lymphatic vessels and lymph channels in the
gland are wide and distended with lymph-corpuscles. The distension of the blood and lymph
vessels is always most marked at the hilus, and there may be hæmorrhages into the areolar
tissue here. In some glands small areas may be seen, where softening and breaking down is