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Show . (BuLnIC PLAGUE)" What is Bubonic plngue? Plague is an acute, specific, Infectious, and contagious con-tagious disease by the bacillus pestis. It occurs in widespread epidemics, is characterized by fever, inflammation of various glandular groups, and profound pro-found depression. Tho course of the disease is exceedingly rapid and the mortality extremely high. History and Distribution In ancient times plague occurred in pandemics, spreading over the whole known world. Alost of the Old World epidemics about the beginning of the Christian, era have been described as plague. Hi'rsch dates the first recognizable epidemic in tho second century B. C. Following this, historical descriptions do not satisfactorily sat-isfactorily identify the disease until tho pandemic which persisted for nearly near-ly sixty years, during -which time it ravagod tho whole of Europe (A. D. 542). Following this this epidemic, known In history as the plague of Jus-tlnlnn, Jus-tlnlnn, tho disease appeared from time to time, but only twice to so great a degree. The first of those two extensions exten-sions was during the fourteenth century; cen-tury; the second, known as the great plague of London, began in 16G4 and lasted until 1679. During the first year of this epidemic one-sixth of the total population of London perished. The advance ad-vance of sanitary science since that time has gradually limited the area of its extension. We are now in the presence of what must be considered a 'worldMvide ex tension of the disease. Etiology Plague is caused by a specific spe-cific micro-organism discovered by Kitasato and Yersin in 1S94, during the epidemic In Hong Kong. This organism or-ganism is a short, oval, non-motile, coccobacillus resembling the bacillus of chicken cholera. It occurs singly, joined In pairs, and occasionally in long chains. It is found in large numbers num-bers in the puss of plague buboes and in smaller numbers in the viscera and blood. It has been cultivated from all the accessible tissues of the body during dur-ing life, and from all the excretions except the sweat. It has also been recovered re-covered from the floors and soil in the houses of patients sick with plague. .. Its viability is rather low. If kept moist and cool, It may keep alive and virulent for months, but if dried at the room or body temperature, it dies Jn from three to four days. Exposure to direct sunlight destroys it in a few hours. The bacillus is pathogenic, for nearly all domestic animals. Indeed, most of them are subject to plagup and aid in its dissemination. Sheep, calves, pigs, ducks and fowls readily contract the disease, and tho bacillimay be recovered from their viscera or excretions. excre-tions. The disease also occurs in bats, and the common rat is peculiarly susceptible sus-ceptible to it. The great mortality among rats preceding nnd often signalizing- an epidemic of plague, is an observation that was well known to tho ancients. The Chinese long ago recognized the association between the death of the rats in the house nnd the development of plague a few davs later. lat-er. Finally, the fleas that infes't rats and tho flies in infected houses also servo to carry tho contagion The method of conveyance to man has been established with a fair degree of certainty. Inoculation experiments In man and animals have shown that when virulent bacilli are introduced into the tissues plague develops. For a time it was believed that man -was infected by inhalation of the germ, I by swallowing it on infected food, and by direct inoculation. Thnt infection takes place through the air and food has not been substantiated. The disease dis-ease enters through the sklu, by direct Infection through slight Avounds or abrasions, or through the "bite of sue-torial sue-torial insects. It has been shown that rats suffer more intensely perhaps, ' than any other animal from plague. The rats are infested with fleas, which are also infected, and the disease Is transmitted from rat to rat nnd final- ly from rat to man by the bite of these ' insects. There has been some con-flict con-flict of opinion as to whether the fleas of plague-infected rats would bite ' mnn. To settle this question TldswgU examined the fleaa from a number of rats and found five varieties, of which four were known to attnek man. Direct transmission from pattant to ; patient, while always possible, occurs very rapidly. Lack of personal cleanliness, clean-liness, and deficient light and ventila- i tion In living rooms, are pre-dlsposing causes. Frequency Plague affects nil ages and both sexes equally. Neither geo- i graphical location, character of soil, ! nor elevation have any influence on its spread. It prevails at all seasons o( the year, although, generally speaking it is least active in the seasons, of greatest heat or cold. It sweeps swiftly swift-ly fro mtown to town, following the routes of travel. Its extension from one country to another over sea in due to tho presence of infected rats on Symptoms Clinically plngue maybe m divided into four varieties: ' M 1. Bubonic plague, pestis bvibonica, K malignant adenitis. m 2. Speticaemlc plague, pestis sider-ans. sider-ans. ml 3 Pneumonic plague. 4. Larval plague, pestis minor, pes- m tis nmbulans. M Bubonic Plague This is "by far the commonest type, averaging SO per cent of all cases. The incubation period ' varies from two to eight days, averag- ; ing four days. j The attack begins with fever, lassi- tude, severe headache, and pain in the limbs. Rigors may or muy not be present, pres-ent, but vomiting is usual at this stage. There is drowsiness, vertigo and ox- 2 to 24 hours, fever begins and the tern- M 2 porature rises rather quickly to 103 .1 j to 107. There is now hurried pulse j and respiration. M. Pneumonic Plaguo This form be- li 'c gins suddenly with rigors and all the symptoms of acute pulmonary inflam-j inflam-j mation. Respiration is rapid and labored la-bored and thero is a painful, harassing cough. So far .the symptoms resem- 1 ble an ordinary lobar pneumonia. The sputum, instead of being scanty, tenacious tena-cious and of ; tho usual color, is co pious, watery and spotted and streaked ' with bright blood. Physical examination examina-tion shows -areas of consolidation scattered throughout the lungs. An entire lobe is rarely involved. This , form of the diseaso Is the most fatal , of all, patients rarely surviving after ' tho third clay. . In these cases, too, although it is not clinically ayparent, postmortem examinations exam-inations shpw general involvement of the glandular system. The general measures to be taken for the prevention of plague are, first, j strict attention to sewage, water, ventilation, ven-tilation, and cleanliness of dwellings; S second, the extermination of rats and ; I mice. This has been tried on a large ; scalo by trapping and poisoning. Quar- ; antino has never been an effective B. ' check to tho disease. fi |
