MEDICAL ASPECTS OF PLAGUE,]
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There was no inflammation of lymphatic vessels and no hæmorrhage or œdema round
the glands in this case, so that there was no appearance like the bubo described in former
cases. The condition of the remaining organs was such as has been already described, and
it only remains to notice that there were many small hæmorrhages in the lungs.
Distribution of the Plague-Bacillus.—Specimens taken from the inguinal, iliac and
axillary glands of both sides showed enormous numbers of distinct plague-bacilli which took
the stain well; specimens of the lumbar and mesenteric glands showed the same appearance.
The cervical glands showed them also, but in less numbers, and the bronchial, supra-trochlear
and popliteal glands still less. A large number of specimens to show the bacilli were made
from the glands of each region, and, as a general rule, those glands which were largest and
most distinctly altered showed the greatest number of plague-bacilli. Specimens of the
spleen contained many of the bacilli, but less in number than the plague-glands. The liver
and kidneys showed plenty, but fewer than the spleen, and the lungs still fewer. The
blood contained a fair number, about as many as in the lung.
Note.—In this case the mesenteric glands showed distinct changes and contained many
plague-bacilli, but in some other cases of this type these glands were only slightly altered
and presented a few plague-bacilli : and, as a general rule, the peripheral glands were most
obviously altered and contained the bacilli in the greatest numbers, whereas the visceral
were more normal-looking and showed the bacilli only in small numbers.
D.—THE PNEUMONIC FORM.
R. F., Hindu, male, 23 years old, admitted on January 31st, 1897, complaining of
fever and cough of four days duration. He looked very ill, temperature 102, and he had
dyspnoœa and cough. There were physical signs of pneumonic patches in the lungs. He
complained of no pain whatever, nor was any enlargement of lymphatic glands made out.
He remained very ill and died on February 2nd. Post-mortem examination seven hours
after death. No petechice on surface of body, body well-nourished and plenty of sub-
cutaneous fat.
Heart.—Muscle rather soft and flabby and dilatation of the right side with slightly
coagulated blood in the cavities.
Lungs.—Much general engorgement and œdema of lung-substance, some congestion of
bronchial mucous membrane, with frothy sero-mucous fluid in trachea and bronchi. Distinct
rounded nodules in the early second stage of pneumonia were distributed in the lungs as
follows :—There were five such nodules in the right upper lobe, varying in size from a
hazeluut to an egg, and a few in the rest of this lung, with one mass quite at the base ; also
the left lung contained a few similar pneumonic patches. Those on the surface projected
and there was early pleurisy over them, also petechioo under the parietal pleura generally.
The nodules were surrounded by a ring of engorged lung in the first stage of pneumonia.
The liver, spleen and kidneys were large and engorged, and the bladder full of urine ; the
intestines rather engorged with some petechiæ in the stomach ; the brain and its membranes
engorged.
Condition of Lymphatic Glands.—Bronchial, enlarged and a little swollen and
engorged.
Cervical, normal ; Axillary a little swollen, mostly on the right side.
Supra-trochlear and Popliteal, normal.
Inguinal, slightly enlarged.
Iliac, Lumbar and, Mesenteric, normal.
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