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344 ment of the lymphatic glands apparent during life, although after death the glands throughout the body are found to be somewhat enlarged and congested. The high degree of virulence and rapid course of the disease depend on the entry of large numbers of the bacilli into the blood, where they can be readily found during life. The patient is prostrated from the outset ; he is pale and apathetic; there is no, or very little, febrile reaction (100° F.). Great weakness, delirium, picking of the bedclothes, stupor, and coma end in death on the first, second, or third day. Frequently in these cases there are hæmorrhages. Pneumonic plague.— This type of the disease, which was carefully studied by Childe and others, is especially dangerous as well as deadly: dangerous because of the multitude of bacilli which are scattered about in the patient's expectoration,* and because the clinical symptoms are unlike those of typical plague, and are apt to be mistaken for some ordinary form of lung disease. The illness commences with rigor, malaise, intense headache, vomiting, general pains, fever, and intense prostration. Cough and dyspnœa set in, accompanied by a profuse watery blood-tinged sputum. The sputum is not viscid and rusty, as in