The Seattle post-intelligencer. [volume] (Seattle, Wash. Terr. [Wash.]) 1888-1914, 1900-01-28
low the Sconrge Travels From City to City
Around the Globe.


contact with the sick to be avoided, great
care to be exercised with regard 10 food
ana drink. and. ACCORDING to Kitasato.
after recovery the patient to be kept in
isolation TOR At least one month. II Is
believed that we have valuable aid In
disinfection OF rooms and houses in formal
dohyde gass which has now been eetab-
ifshed a. q reliable agent and which can
BE- used without injury to metals or fab
rics. Il has the disadvantage. however, of
not killing vermin, while sulphur fumiga-
ton does. Tho latter, therefore. Is more
generally desirable. The general and WELL
known administrative precautions In tho
prevention Of the spread Of smallpox-iso-
Iation, guarding Of premises, etc.-are APP
The advice Of Kitasato that the patient
should Be kept isolated one month after
apparent recovery Is significant. Like pre-
cautions are necessary with regard to other
contagious diseases. and too little attention
has heretofore been paid to this very ne
cessary precaution against the spread OF
CONTAGIOUS disease. For example. patients
apparently recovered from cholera may
carry within the intestinal tract the germs
or the disease variable time, In one re-
corded instance 1853 days Patients who
have apparently recovered from diphtheria
may still be found to have the diphtheria
bacillus present in the throat for many days
after recovery.
The means to be adopted when the dis
ease becomes epidemic In q city consist,
first, Of q house-to-house inspection
There should be prohibition OF the use of
dwellings unfit for habitation and abate-
nent OF overcrowding should be required.
Buildings and premises, II infected or sus-
pected. should be vacated for cleansing and
disfnfecting. The sick should be removed
to hospitals or treated in their own homes
and the well who have been exposed should
be removed to refuge camps. Infected bed
ding, clothing. etc, should be destroyed
unless there are proper facilities for disn-
fecticn by steam or boiling. An active cam
pAign should be wased against rats and
vern1in. 1t IL the opinion of some English
writer's that when plague has been thor
oughly mixed and established in given
city its speedy eradication Is impossible,
that the subsidence requires period Of
seven months and seems to depnd upon the
abatement of it's virulence in the due course
Of its evolution.
Plague in Alexandria, Egypt, during the
past summer and fall appears to have
been we'll handled and has apparently dis
appeared. During the summer $1,000 rooms
wers disinfected in scientific manner, and
this suggests and illustrates the import
ance Of this disinfection, not only Of known
infected houses, but Of many others In the
general u6l8nOOInOOQ OF the lnlect1On,
which by reason of the character Of their
inhabitants are liable to infection.
Types of the Disease.
For convenience Of classification, and in
accordance with the clinical symptoms pre-
scented, the disease has been classified as
(a) bubonic, or ganglionic; (b) septicaemic:
(c) pneumonia. OF these forms the bubonic
is the most common. the pneumonia the
most fatal. The method of infection--that
is to say, the point of entrance Of the
specific microbe-is point still under ac-
tive discussion and is different not only
for the various types and forms given, but
also varies In different countries and in
different sections of the same country. For
example. in Hongkong. where the natives
as rule go barefooted. infection in a large
number Of cases has been traced to abras-
ions and wounds OF the lower extremities.
In India some covering or protection for the
foot Is usually worn, but the natives suffer
from the bites of insects and vernlin, con-
sequently the point of entrance OF the in
lection has been largely upon the hands
and arms. Infection through the Intestinal
tract while admitted, Is at yet largely I'M
explained; for, in spite of the assertion Of
Wilm, some breach of continuity would
seem to be necessary for the entrance OF
the microorganism. AS rule, small red
spot marks the point of infection; this be-
ccmes successfully a vesicle and pustuie.
and in the ganglionic form and in large
proportion of cases a general redness or a
series of vescles marks the passage of the
infection along Emphatic tract or cham
mel. These vesicles have been of very fire.
auent occurrence in the Bombay epidemic.
symptoms and Course.
In the bubonic form the victim is seized
with a chill, followed by fever of greater
s,.tAn
degrees to AZ degrees c.; there Is an over
whelming prostration; nausea and vomit-
ing and the rapid formation of a gandular
enlargement, surrounded by an extensive
oedema, forming the bubo which has given
tho most common name to the disease.
The bubo may or may not break down
and go on to suppuration LII 1t does the
gangionic form merges into the septicae-
mic. without any distinct line of demarca-
tion between the two types. Early In the
disease stupor delirium and more or less
profound Inconsistencies mark the ex-
istence OF an intoxication or general sys-
tematic injection.
In the septicaemic form 1t would seem
that the infection has taken place through
the intestinal, digestive or respiratory pas
sages, or has been secondary to the sup
puration of a bubo. These cases are, as
rule, not as violent in their course as the
other types and furnish the larger portion
pneumonia form is at once the most in
sdious in Its onset, the most difficult of
diagnosis and the most fatal i'll its results.
1t is usually ushered in by pain in the
side. which becomes more pronounced as
the disease progresses; the respiration be-
comes more difficult and embarrassed.
and there is cough, with a tenacious,
dark -colored or bloody expectoration 1t
is through the examination Of this expec-
toration that the diagnosis Is most easily
made, as, spread upon slide. stained
and examined under the microscope, the
presence of the plague bacillus in large
numbers may be thus tentatively estab-
lished until cultural and other methods of
studying the organism are concluded. The
baciilus is not in pure culture, but is ac-
companied by diplococci. staphylocci and
streptococci and in making the diagnosis
by this method the property of the plague
bacillus OF completely decolorizing by the
method of Gram must be borne in mind.