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temperature. Bacteria of plague would always be found in the blood within, espe-
cially the blood of the liver and spleen and other similar glandular organs, and thus
indicate completion of the septicæmic state. If taken in by inhalation, this would
lead us to conclude that the pulmonary lymphatic corpuscles would absorb the
microbe, convey it to an organised gland, where a surrounding pneumonic patch
would follow, or, if by the alimentary system in addition to the lymphatics, we have
an analogous composition in Peyer's patches to act as a repository for their recep-
tion and fission.
The disease, therefore, being essentially a lymphatic one in its initial stage,
our theories (or facts) are concentrated in tracing the origins of these microbes
directly into the lymphatic system as a direct source of their future contamination.
Against this we have to consider whether it was found that rats become
affected by inoculation. I observed a very large number without forming that
opinion.
It is inconceivable to suppose that out of the numerons cases of the glandular
form each must have been affected by inoculation. Not more than 10 per cent. of my
374 patients presented such suspicions, and even when the disease first broke out at
Mandvi, and I heard Mr. Hankin propound this view, I was unable to recognise or
appreciate the wound and abrasion cause as being responsible for the ingress of the
propagator of this toxine, and it appears peculiarly strange that such a huge propor-
tion of the population should suddenly have developed open surfaces, without our
having advocated the supply of prophylactics, or aseptic material to protect them
from this known source of contagion.
Again, we have the evidence of Galen and others who have noticed that
those who had wounds and issues did not fall victims to the disease during the epi
demie, and Larrey, who was Surgeon with the French Army in Egypt, expresses a
similar opinion, that the wounded actually escaped being attacked although an
epidemic was raging, but when their wounds healed they were as susceptible to con-
tagion as the others. In consequence of this observation, he thought that the crea-
tion of wounds and discharges would afford immunity—a practice which was adopt-
ed by the surgeons in the great London Plague of 1666 and recorded as a satisfac-
tory protective. And, further, we have writers who emphatically note that "inocula-
tion has never yet been satisfactorily shown to be productive of this disease."
Another theory, however remote, is that the plague bacillus, having some
special idiosyncrasy to be domiciled in a gland and nourished in lymphatic fluid,
gains an entrance through the lungs, enters the general circulation, and finding
the blood-current too rapid, although the material for its propagation is suitable
and nearly of the same composition as lymph, is propelled till it is carried into
one or more glands by entering their hilus, and this may account for two or three
glands being simultaneously engaged.
As a further cause of invasion of the disease into a town, it is stated that
plague may exist in an unappreciable epidemic form for many decades ; then, from
circumstances connected with the season which we do not comprehend, so active
and potent does the disease become, as to produce an epidemic.
As regards infection by personal intercourse, this is partly explained already :
and I believe a person himself uninfected cannot produce the disease in others by
being as it were the bearer of it. So well did this appear to bo understood in past
epidemics of ancient times that people knew no evil consequences resulted from
visiting the sick.