The Hawaiian gazette. [volume] (Honolulu [Oahu, Hawaii]) 1865-1918, 1899-12-15


nate constipation. but sometimes diar-
rhoea. and besides there symptoms
there are certain special ones especial
ly Characteristic Of the plague. Buboes
or granular swelling are observed In |
all except rapidly fatal cases. They
occur in a. or 50 per cent OF the cases
in the groin. In IS per cent in the axil-
la, also less frequently In the neck or |
other parts. These swellings may &C.
cur before the fever. simultaneously |
with 1t. or some hours after 1t has set
In. A sudden pain like that of a stab |
Is felt in some region OF the body. The
buboes may suppurate. and free dis
charge of matter from them has at all
times been regarded as a favorable
sign and conducive to recovery. Car
buncles are observed In about or
per cent OF the cases.
Hemorrhagic spots on the skin have
always been regarded as signs OF the
worst omen. Under the name Of to
kens" they are regarded as infallible
signs of approaching death. The &C.
cially the FIRST. in an idiopathic fever
attacking many persons at one time
Is sufYicient to make the diagnosis OF
the plague. The duration of an attack
Of the plague may be from some hours
to a month. Three-fifths Of cases un-
der observation terminated fatally on
the third day. Five-sixths of fatal
cases end by the fifth day. Most OF
those who survive the fifth day get
we'll. In non-fatal cases with suppur-
ating buboes the disease may be pro-
tracted two or three weeks or a month.
The nature OF the soil has little influ-
ence on plague and the temperature
most favorable for the disease is
moderately high one. Where the dis
ease does occur. a temperature Of 80 to
IS degrees or more, combined with alb
sence of moisture. usually stops the
epidemic. When the temperature rises
above Sc degrees 1t gradually dimin-
ishes. and at 113 degrees ceases abrupt
ly. On the other hand. the disease is
usually checked by. the cold of winter.
SANITARY CONDITIONS.
or all the cooperating causes Of the
plague uncleanliness Is the most pow
erful-meaning by this the accumula-
ton OF decaying animal matter around
human bodies and dwellings. The sat
uration of the soil with filth is perhaps
the most important point. Overcrowd-
ed dwellings, especially with deficient
ventilation, greatly favor the spread Of
the disease; but this Is not necessarily
correlative with density Of population,
and plague may flourish in thinly peo-
pied countries.
OF social conditions. poverty has by
far the most powerful influence on the
spread and development of the plague.
The races among which the disease Is
endemic are almost without exception
undernourished. il not destitute. In all
cities the poor are the chief or the
only sufferers. Those of the upper
classes who have been attacked have
been chiefly doctors, clergy. officials
and others whose occupations take
them among the sick.
INCUBATION.
1t Is a very important question what
time may elapse betYeen a person re-
lceiving the poison and showing symp-
toms of the disease. The usual time of
incubation appears to be from three to
five days. but in certain malignant
cases this period may be shortened,
and 1t Is thought reduced to even less
than a day. In rare cases incubation
may be prolonged to eight days. 1t
has been thought that articles contain
mated by contact with plague patients
may retain the power of communicate
ing the disease for weeks, months or
even years. but of this there is no
adequate proof.
i TREATMENT.
No special line of treatment has
proved efficacious In checking the dis
ease, once established. Special symp-
toms are treated in accordance with
the ordinary rules of practice and need
not here be considered. Free ventila-
ton appears to be of the greatest SER
vice in preventing the spread Of the
disease, and probably in promoting re-
covery.
PREVENTION.
There can be no doubt whatever OF
the eflicacy of hygienic measures In
rendering locality unsuitable for the
spread Of the plague. Such measures
not only include personal cleanliness
but especially the removal of all foul
organic matters, good drainage, and
prevention Of overcrowding. and since
, there Is no doubt that the disease may
be carried from places where 1t pre-
, walls epidemically. measures to pre-
} vent such Importation. cannot be neg
, lected. When case has been report
ed. the house should be emptied Of ii
| inhabitants, the sick removed to hos
, pital, the sound placed In an isolated
| building and subjected to observation
for at least week. or, better, ten days
J The clothes of sick persons had betteI
be burnt. their bedding and furnitur.
{ completely disinfected: the house
, should In the meantime be rigid,
4 closed until 1t has been disinfected. Il
these measures are taken in time Their,
, can be no objection to allowing FIRE,
emigration Of the population. Isola
y ton Of the place by q sanitary cor
!, don" would only be possible In yer!
/ exceptional positions. and ~ q rul'
I would aggravate, by 0vercrowding. tn
J, intensity of the disease within.
:. PLAGUE PROPAGATION.
/ DIR. kitazato. described a. one Of tn
IRraafaat authnpitiaa nm In ctlo,,~ AIS