MEDICAL ASPECTS OF PLAGUE.] 101
granular and stained well throughout, but the large were breaking down in parts and
irregularly stained. The small ones were distinctly rounded and no liver-tissue was seen
in them, but some of the large were less regular in shape and contained some distinct
remains of liver-cells: these were probably two or three adjoining masses which had
coalesced. Speaking generally, the small masses were mostly situated near the portal spaces,
but this could not be said of the larger, as some were as big as two or three lobules. Under
higher power the masses were seen to consist of leucocytes, pus-cells, granular dbris and
remains of liver-cells, and there appeared to be an excess of leucocytes in the surrounding
capillaries; in fact, the structure of the masses resembled that of small early abscesses.
Specimens of the liver were also prepared to show the plague-bacilli in situ in the
sections; enormous numbers of them could be seen in the masses and only a few in the
general liver-tissue.
Cultures also were made from the masses, and typical colonies of the plague-bacillus
grew in abundance. Thus these small necrotic masses resulted from the growth of the
plague-bacillus in innumerable definite areas throughout the whole liver, and are compar-
able with the pneumonic patches found in cases of plague-pneumonia due to the same cause.
This condition of the liver was extremely rare, and was only observed in two other cases
during the Bombay epidemic, once by the Austrian and once by the Russian Plague Com-
mission. No similar condition was ever found in the spleen or kidneys to the best of my
belief.
Lung.-Cultures made from the pueumonic patch showed the appearance not of plague
but of Fraenkel's Pneumococcus; and specimens taken from the patch showed the same
pneumococcus under the microscope. Cultures made from the inguinal and axillary glands,
from the spleen and from the heart's blood, all showed the typical growth of plague. These
cultvies were made by Professor Bitter, who has kindly permitted me to make use of his
results.
Note.-This was the only case amongst the autopsies on plague made by myself in
which secondary pneumonia was found, not due to plague.
G.-CASE OF PLAGUE IN A PREGNANT WOMAN. SURVIVAL OF THE FTUS:
DEATH OF THE MOTHER.
D. R., Hindu woman, 25 years old, was admitted to hospital for child-birth on 15th
April 1897 at 11 P.M. She stated that she was five days short of her full term of gestation,
that for the past several days she had had fever preceded by rigors, and that a few hours
before admission she felt some pains in the abdomen of a bearing-down character and
thought she was about to be confined.
On admission she was examined and found not to be in labour, and the pains were
thought to be false. She was quite conscious and able to walk; temperature 102. She
stated that she had two children, and that her previous confinements were normal.
On 16th morning, temperature 102, no pain in abdomen, slight pain and tenderness
over right inguinal region, and some glands could be felt a little enlarged. Patient had a
peculiar drowsy expression of features, with injection of conjunctiv, and looked
very ill. The temperature remained high and at 4 P.M. was 104. At this hour labour
pains commenced. She now complained of some pain in both sides of the neck, and the
cervical glands were tender and slightly enlarged; also the pain in the right inguinal glands
persisted. At 10 P.M. the patient was very restless; temperature 105; labour was progress-
ing normally. At 10-50 P.M. labour was completed normally. There was no unusual
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