MEDICAL ASPECTS or PLAGUE.]
95
Lungs.—A little blood-stained fluid in pleural cavities, many sub-pleural hemorrhages
of petechial and larger size. Intense engorgement, with some hæmorrhages into lung-tissue
and some œdema of lungs.
Liver.—All vessels, large and small, both hepatic and portal, gorged with blood ; liver-
substance rather soft; large sub-peritoneal hæœmorrhages on the surface of the liver, specially
along the ligaments.
Tonsils.—Swollen and engorged ; mucous membrane of stomach and intestines
engorged, and small hemorrhages in stomach and large in testine. Hemorrhages under
serous coat of intestinos.
Spleen.—Large, brick-red and somewhat soft, and many small hemorrhages under its
serous coat.
Kidneys.—Large, and all vessels engorged, the kidney-substance itself rather pale and
soft. Many small hemorrhages under the kidney-capsule, and coagula distending the pelvis
of each kidney. Hæœmorrhages into walls of ureters, and bladder distended with urine.
Distribution of the Plague-Bacillus.—In this case the plague-bacillus was found in the
various organs as follows :—It was present in enormous numbers in the glands of the bubo
and in immense but diminished numbers in the blood, as well as the oedema fluid from the left
axilla. The right axillary glands, the supra-trochlear and cervical of both sides showed
a considerable number of plague-bacilli, but far loss than the bubo. The lumbar also
showed them in considerable numbers, but they were rather less in the iliac and inguinal
chains of both sides. A few were seen in the mesenteric glands. A specimen of blood
taken from the left ventricle of the heart and from various large veins in the body showed
many plague-bacilli, but far less than in the blood taken from the bubo. Immense numbers
were found in the spleen and liver, almost as many as in the glands of the bubo ; and some,
but far less, in the lung and kidney.
In point of fact it appeared from these specimens that the bacillus had grown most
abundantly in the glands and blood of the bubo, and next in the spleen and liver ; whereas
in the remaining lymphatic glands and other organs it was present in about the same num-
bers as in the blood of the general circulation, and the bacilli seen in these specimens were
probably those contained in the blood of the respective organs. Possibly it might have
grown to some extent in some of the lymphatic glands, as indicated by the above specimens.
N'ote.—In a case of this nature, where there is extravasated blood around the glands of
the bubo, which extends through all the coats of the large vein (the axillary in this
instance), and where there are enormous numbers of plague-bacilli in this extravasated
blood, there appears to be a direct path for the passage of the plague-bacilli into the lumen
of the vein and so into the blood of the general circulation.
B.—CASK OF A Buno EXTENDING ALONG THE ILIAC VUSSKLS.
M. H. R., Hindu, male, aged 27 years, admitted January 26lh, 1897, says ho has been ill
two days. The left inguinal glands are largo, painful and tender, and the left leg is swollen,
is much exhausted, and died one hour after admission.
Post-mortem examination made three hours after death. Body well-nourished, rigor-
mortis present.
The Left Inguinal Glaivls were as large as almonds, rather soft, red and distinctly
engorged ; the lower ones showed'this condition markedly, but some of the higher to a less
extent. There was no hemorrhage around these glands.