96
[CHAP. II.
The Left Iliac Glands were all dark red, soft, friable and intensely engorged and looked
like soft spleen-tissue; there was great engorgement, extravasation, and œdema around
them and they surrounded the iliac artery and vein, so that the whole mass of coagula,
glands and vessels had to be removed together. There was no rounded bubo as in the
former case, but a chain of swollen glands with hæmorrhage around them extending along
the vessels.
Lumbar Glands.—The lower ones were rather large, soft and engorged, but much less
than the iliac, and there was but little extravásated blood around them. The upper ones
showed even fewer changes, and gome looked normal.
The Right Femoral and Right Iliac Glands were normal. The remaining glands looked
normal, except that the right axillary were engorged, two of them being as large as
almonds, and the right supra-trochlear was likewise engorged to the size of a large pea.
With regard to the remaining organs, the heart showed some dilatation of the right
side, and the lungs a great deal of engorgement and oedema ; there were petechiœ under
the pleura and pericardium. The liver and spleen were both large, dark and full of blood,
and the kidneys large, soft and engorged. There were some petechiæ in the stomach, and
the brain and its membranes were engorged.
Distribution of the Plague-Bacillus.—The enlarged left inguinal glands contained
plague-bacilli in considerable numbers which were found to stain well; specimens of the left
iliac glands showed them in immense numbers, as did those from the lower lumbar glands, but
the higher lumbar showed less. The right inguinal and iliac, the axillary and cervical of both
sides and the bronchial glands showed only a few plague-bacilli, but of this series the right
axillary specimens showed rather more than the others. The lung, liver, spleen and kidneys
similarly contained a few, as did the specimen of blood taken from the heart ; in fact, apart
from the bubo the remaining lymphatic glands and organs merely showed about as many
plague-bacilli as the blood.
C.—THE SEPTICÆMIC POEM.
P. S., Hindu, male, 30 years old, was admitted on the 19th February 1897. Bis friends
said he had been ill with fever for about four clays and had been delirious for one day. He
died immediately after admission. The posl-morfcm examination was made one hour after
death. No petechioc on surface of body.
Lymphatic Glands : Right Inguinal.—The lowest was the largest, of the size of a small
almond, and of the others, some were nearly as large and some smaller ; they were rather
firm and pink and of the characteristic plague appearance.
Left Inguinal.—The lowest was like a small almond, those above quite small, and the
highest as large as beans ; all were slightly firm and pink, but in an earlier stage than on
the right.
night Iliac.—The three lowest were like large almonds, pink and firm, hut the upper
were smaller.
Left Iliac.—The lowest was like a small almond, but red and full of blood and rather
soft, the upper ones were like small beans and less engorged. The Lumbar were like small
peas and beans, all rather red and firm. The Mesenteric were enlarged to the size of small
almonds, beans and peas, and were all dark red, engorged and soft. The Right and Left
Axillary were light red in colour, and rather firm, some being as large as hazelnuts and
some smaller. The
chains showed a similar appearance, whilst the Supra-trochlear
and Popliteal glands were small and pale.