The sun. [volume] (New York [N.Y.]) 1833-1916, 1897-04-04

cSSNOSS ROAaSAh- ROA NV ~ NtRADR - -
period Of Ave months, while London lost
10000 out of an estimated population Of
100000, two-thirds Of whom are supposed
to lave fed to escape c~ontagion. We are
told that since 1850 the disease has never
travelled further north than Astrakan, and
that It has never been known In the West
ern Hemisphere. The present epidemic in
Bombay is believed to have been introduced
from Hong Kong, where there were violent
outbreaks of 1t in 1894 and 1890.
1t was not until 1894 that the cause Of
the disease, the method Of Its propagation,
and the means necessary to prevent Its
spread, became matters Of scientific GER
tainty. The credit for the discovery of the
bubonic plague bacillus Is due to a Japanese
physician, DR.. s. KITAsATo, one of KooH's
disciples, who was despatched to Hong
Kong by the Mikado's Government for the
purpose of making q psychological study
of the disease and reporting upon its clint
cal and pathological characteristics The
cause of the malady was discovered to be
a bacillus somewhat resembling that Of
chicken cholera, a small, short rod, with
rounded ends of the non-spore-bearing
variety, distinguished by the property
of extremely rapid multiplication, and
by the facility with which it enters
the human organism. 1t is found In
large numbers in the pus from the bu.
boes, occasionally in the interior organs,
and on some occasions In the blood. 1t Is
also found In the dust of infected houses
and in the soil. DR.. WYMAN points out
that Notwithstanding the exceptional viru-
lence of this bacillus, 1t is easily destroyed
by all of the ordinary disinfectants, and
dies In q few minutes II subjected to a heat
of 212 degrees Fahrenheit. On the other
hand, 1t develops easily in many culture.
media at the ordinary temperature, and the
length Of its life when exposed to favorable
conditions outside of the human body Is as
yet undetermined, though one experiment
has proved that 1t can live at least thirty
eight days. This question has an obvious
bearing upon the quarantine measures
which may need to be enforced in regard to
merchandise from an infectious port.
Let us now examine in detail the clinical
and pathological account Of this malady
submitted to the Japanese Government
in 1894, and since confirmed by other
European and American investigators.
The black or bubonic plague is defined as
an acute febrile disease Of an intensely
fatal nature, characterized by Inflammation
Of the Emphatic glands, by certain cerebral
and vascular disturbances, and by the pres
ence OF a specific bacillus. One gland alone
may be visibly affected, but most II not all
of the %lymphatic glands are found to be en-
larged at the ~post-mortem examination.
A bubo, Of course, is simply an infiamed
gland, and the name bubonic plague is
given to the disease because of the inflamma-
ton, sometimes followed by suppuration,
Of the various Emphatic glands Of the body.
The glands most commonly affected are those
Of the thigh and groin. The swollen gland
quickly attains the size of a hens egg, but,
unless death intervenes, after five or six
days it softens and is filed with pus, which
may be evacuated. In many cases Of the
severer type the inflamed gland has not
time to form, inc then from the mucous
membranes there are hemorrhages, and be-
meath the skin hemorrhagic extravasations.
1t is probably this phenomenon that inn
parts q dark appearance to portions of the
skin, which has in past times given the
name of "Black Death" to the disease.
With regard to the period of incubation,
DR.. WYMAN says hat usually the disease
makes It's appearance in from three to six
days after exposure to infection. The pa
tient complains Of high fever, a swelling Of
n or more of the Emphatic glands, and
has delirium early in the attack. 1t Is even
possible for large buboes to form in q few
hours after a time when the patient has
felt in the best Of health. In fatal cases
death usually occurs between the second
and eighth day according to DIR. Win,
who investigated the disease for the Ger
man Government, death is generally caused
by paralysis of the heart, though it some
times results from brain complications.
The death rate varies in different epidem-
les; in the case of the outbreak of the NAL
ady in Hong Kong in 1894, the death rate
ranged from 100 per cent. among the Eura-
SLAMS, or half-breeds, and 03.4 per cent.
among the Chinese, to 1872 per cent among
the Europeans. We add that the methods
by which the bubonic bacillus enters the
human body are three. namely, by inocula-
tion through ar external wound or abra-
sion; by respiration and by introduction
into the stomach.
In DIR. WYMAN's opinion, modern science
has provided q thoroughly efacacious REM
edy for this formidable disease. 1t appears
that a French physician, DIR. YERsIN, was
the first to use the serum from an immun.
lied horse upon cases of a severe type. We
are told that in Annoy In 1896 he treated
tw~enty-three sufferers from the plague in
this manner, all of whom recovered except
two, whose cases were desperate from the
outset. The method employed Is similar to
that of the antitoxin treatment of diph-
liberia. According to the Japanese ply
stefan K~ITAsATo, the patient. after appar-
ent recovery, should be isolated a month.
DR.. WYMAN finally arrives at the conclu-
sion that, even should the disease spread to
certain European countries, the modern
sanitation of cities, the knowledge of i'm
proved disinfecting appliances, and the
modern diagnosis of the disease itself,
would enable the health authorities to con-
fine 1t within narrow limits.