The sun. [volume] (New York [N.Y.]) 1833-1916, 1897-01-15
THE BUBONJC PLAQUE,
why IL IL So Caiied-Its Charaeterist,cs.
Its Origin, aad the Means OF Preventipg II.

III ort&tns n mean ~ y.
Prom Tia London Lancet.
Without entering into tho discussion AZ TO
whether or not all epidemics styled plague"
in Biblical and MEDIEVAL literature were OF
tie nature of tho bubonio plague OF recent
tIme,. thsre can be no doubt that since 1850
the name plague" has been applied to a def
mite train OF symptoms which are considered
to constitute n specific disease. During dit
ferent outbreaks some ono symptom sttains a
fatal pre-eminence. but not 10 the exclusion
OF others. which might at any time assume the
death cad and serve to baptize the disease
rs bubonic." "hemorrhagic." " typhoidal,"
''pneumonic." and so forth.
Tho name plague however. ia not one
which helps us to place the complaint In it's
proper scientific niche in the category OF dis
easc. The word conveys the idea OF an unus-
ual disease, attacking many persons and ut.
tended ty n high mortality, but that gives II
no scientific value any more than the ivan
yik" of the Chinese. Were / to attempt to clas-
slfy plague l would place II among the specl-
fc fevers and particularizc II under the namo
Of "oolyadenitis." and individualize It still
further as malignant polyadenitis." II
may bo objected that Admits is not al ways
present. that many plaguc-strieken patients
die before the glands are even swollen. and
that thei efore the name Is defective: but II Is
needless to point out that In many diseases tho
most typical OF symptoms are at times absent,
and yet the cases can be Classed with their
Kind. To Justify tho prefix poly TO the word
"adenitis" IL Is necessary to remember that al
though one gland alone may, he ci.nicalIy ap,
are found To be ENLARGED at tho post-inortem
examtnatioLs. The most recent report In re.
yard to this subject Ia interesting: Thirty
three cases @: pcr cent wore received with
mt "A proper bubo. In most OF these cases null
tiple adenitis was found. The general sizo Of
The rlnuds heiup that of n lpntn, In the Int
ter STAGES or the discus" other bubOs formed in
different localities and co mnlicated The case;
40 per cent. OF the cases showed swelling OF the
intestinal. bronchial. and mediasiinal glands
in different stages"
20 the disease Is not 80 appropriate ns would Mt
first sight appear. A buho Is essentially the
swelling Of a gland caused 10y the entrance
over which the gland prcstdcs. TINS can
not be said 10 obtain in nlsGuc.f5 II Z 81. called
a sympathetic swcllii &, but merely the out
come OF a blood poison. r. T. is TO be olasscd
to be an "ldiopathir" bubo. n true "buhon dem
blGs." One never speaks Of, the, huhocs OF
tertiary syphilis, or o; scrofnlous hubocs. The
terms may be clinically correct, hut they ire
not in common use they ,hnve. however, as
much right to BIO called bubolic us the CLAN.
siderstions before us ! would venture to name
tho disease 'malignant Dolyadenttis," in tho
hope. that attention may bo drawn to tie
numinl OF tho disease By rorc competent
students than myself.
Plague or malignant polyadcnitls We may de
fine as an acute feDrile disease OF an intensely
fatal nature. characterized by Inflammation
OF the lymphatic glands, marked cerebral and
vascular disturbances, and by the presence u
u specific bacillus.
The cause OF plague Is the advent OF q def
mite bacillus. and.it Is the life history OF this
bacillus which must in future occupy the at
tention OF bacterlologists and clinical observ-
erJ. The proximity OF the bacillus Is AZ the
present day kno wn only by Its effect on human
beings, and, IL may lie. on rats rs well. What
fosters IL appears 10 be bad sanitation; once
established time alone will stay It's ravnges
So far as any given epidemic Is concerned, but
there seems every hope that improved santa
tlon will check it's occurrences.
The prodromdtd OF. plague may be divided
into the remote and the Immediate. but | will
consider them together. Time and again has
IL happened that before nm outbreak OF plague.
during "a period varying from a few months 10
several years, buboes with fever have been OBJ
served in a more or less epidemic form. In
1877 the variety OF plague which infected As
trakhan. previously 10 tho serious outbreak thht
occurred In 1878 some 100 miles higher up the
Volga. was classed as a pests minor" No
one died from the disease per ~. aud but few
people were confined to bed. Should such
another outbreak take place in the neiVhbor-
hood the diagnosis will DO readily cleared up
by an examlnation Of the blood. tho tissues,
and the excretions.