The Pacific commercial advertiser. [volume] (Honolulu, Hawaiian Islands) 1885-1921, 1899-12-13

certain amount of fever; the temDera-
ture is rarely high but has been known
TO be 104 degree Fahrenheit. The dur
alton of the disease is ten to twenty
days usually, but may be eight weeks,
for most of which time the general
health is little impaired and the patient
able 10 go about as usual. 1t rarely,
II ever, causes death and is not OBJ
: viously contagious, but whether or not
it is propagated by infection is not
known.
THE SEVERE PHASE.
AS regards the severe plague, the
early symptoms are sometimes like
| those OF ague (shivers, often long con-
tinued. and pains in the limbs). but
combined with nervous symptoms The
patient becomes distracted, losses
about in constant fear of something he
cannot describe, has a difficulty in an
swering the questions put to him. and
is slow in answering. He is often de-
scribed as staggering like a drunken
man. There is severe headache, in
tense thirst and severe pain in the
epigastrium. The eyes are red and
turbid; the tongue swollen, dry and fis-
sured, sometimes black, sometimes re-
pass into coma even before fever sets
in. In other cases bilious vomiting is
the earliest symptom. The fever which
sets in may last twenty-four to thirty
hours or more. The temperature may
be 104 degrees to 107 degrees Fahren-
heit, or even higher; but in the most
rapidly fatal cases there may be little
or no fever. Generally there is oDsti-
nate constipation, but sometimes diar-
rhoea, and besides these 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 40 or 90 per cent of the cases
in the groin, in 80 per cent in the aXil-
la, also less frequently in the neck or
other parts. These swellings may oc-
cur before the fever, simultaneously
with it, or some hours after it 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 2 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 Oc- |
currence of the above symptoms, espe |
cially the first, in an idiopathic fever |
attacking many persons at one time |
is sufficient to make the diagnosis Of |
the plague. The duration of an attack |
of the plague may be from some hours |
0c
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 |
well. In non-fatal cases with suppur-
ating buboes the disease may be pro-
tracted two or three weeks or month.
The nature of the soil has little inHu-
ence on plague and the temperature
most favorable for the disease is a
high one. Where the dis
ease does occur, a temperature of 80 to
s. degrees or more, combined with alb
Sence of moisture, usually stops the
epidemic. When the temperature rises
above Sc degrees it gradually dimin-
shes, and at 113 degrees ceases abrupt
Iy. On the other hand, the disease is
usually checked by the cold of winter.
SANITARY CONDITIONS. |
OF all the cooperating causes of the |
plague uncleanlinesS is the most pow
by this the accumula-
ton of decaying animal matter around
human bodies and dwellings. The sat
Iration of the soil with filth is perhaps
he most important point. Overcrowd-
ed dwellings, especially with deficient |
greatly favor the spread of
he disease; but this is not necessarily
with density of population,
md plague may flourish in thinly peo-
)led countries.
Of social conditions, poverty has by
ar the most powerful influence on the 6
pread and development of the plague G
The races among which the disease is
ndemic are almost without exception
lndernourished, if not destitute. In all :
titles the poor are the chief or the | g
nly sufferers. Those of the upper :
lasses who have been attacked have 2
een chiefly doctors, clergy, officials
nd others whose occupations take
hem among the sick.
INCUBATION.
1t is a very important question what {
inc may elapse between a person re-
ewing the poison and showing symp-
pms of the disease. The usual time of .
lcubation appears to be from three to q
We days, but in certain malignant q
ases this period may be shortened, {
nd it is thought reduced to even less
IAN a day. In rare cases incubation :
Jay be prolonged to eight days. 1t .
as been thought that articles contain q
lated by contact with plague patients a
lay retain the power of communicate !
lg the disease for weeks, months or =
ven years. but of this there is no y
tequate proof. Il
TREATMENT Leg
No special line of treatment mas
'oved efficacious in checking the dis q
lse, once established. Special symp- Il
ms are treated in accordance with q
e ordinary rules of practice and need 3
Ut here be considered. Free ventila-
On appears to be of the greatest SER y
&c in preventing the spread of the Il