Report on the outbreak of plague at Sydney [1900-1907] / by J. Ashburton Thompson, Chief Medical Officer of the Government and President of the Board of Health.
- New South Wales. Department of Public Health
- Date:
- 1900-1908
Licence: In copyright
Credit: Report on the outbreak of plague at Sydney [1900-1907] / by J. Ashburton Thompson, Chief Medical Officer of the Government and President of the Board of Health. Source: Wellcome Collection.
Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.
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![A second mouse, inoculated with a small piece of the spleen of mouse 1 on 25th January, at lO'SO p.m., was lively on the following day (iGth). On the 27th it became sick, exhibiting the same symptoms as the first mouse. On the 28th, at 9 a.m., it was lying partly upon its left side—the hind quarters being in a normal position ; but the forelegs were tucked away, the left shoulder touching the wire-gauge floor of the cage, and the head stretched out. It remained quiescent in this )50sition till it died at 11 o'clock. The second mouse thus became sick in about forty-eight hours, and died in seventy- two and a half hours after inoculation. The principal ;)o.s<-??io/-i'(')Ji. features were as folloAvs, the animal being examined ten minutes after death: Hajmorr- hagic cedema at the site of inoculation ; enlargement of hccmorrhagic infiltiation round the right inguino-femoral glands ; enlargement of the left inguino-femoral, and right and left axillary glands, but no hemorrhage. Pericardium dusky, but no hemorrhages ; right ventricle of heart contains fluid blood, left ventricle contracted and empty ; lungs redder than normal, but not so much aflbcted as in first mouse ; liver sliglitly swollen, mottled pink and white on surface, section deep red ; gall bladder distended with clear yellow bile ; spleen not visibly altered internally, but section a little thicker than normal, and of a deep red colour ; trobeculre faintly discernible with lens ; stomach normal, small intestines markedly congested, large intestine contains fluid ffeces ; kidneys normal on surface ; section pale ; structure obscure ; bladder empty. Smear f>reparations and cultures were made from various organs gave baxilli as in first mo'ase. A third mouse, inoculated on 2Sth instant with a small piece of the spleen of mouse No. 2, became sick on the 30th instant. During 31st January and 2nd February it had a series of seizures, characterised by very hurried and laboured breathing and prostration, and on each occasion appeared about to die. In the intervals it sat quietly huddled up, rarely moving, and taking very little food. It was found dead at 9 a.m. on the morning of 2nd February, having thus become sick on the second day, and dictl in about four and a half days. The jiosi-mortem ajopearances were very similar to those shown by the other mice ; in particular, the left inguino-femoral glands were swollen and surrounded ]>y hemorihagic cedema, and the spleen enlarged to twice its noimal size. A guinea-pig, inoculated in left thigh on 2nth January with a small piece of the spleen of mouse 1, showed no sign of illness till the 27th, but upon that day became quiet and drowsy, and took food sparingly. On the 2Sth it became very obviously sick, sitting huddled up with the back arched, eyes partly closed, and rarely moving. On the 29th and 30th it remained in very much the same condition, and was found dead at 9 a.m. on the 31st instant. The principal ^)os<-??ior/eTO features were as follow :—Hemorrhagic infiltration at site of inoculation and in left inguino-femoral I'egion ; right gx'oin normal ; enlargement of and hemorrhage round left axillary glands ; right axillary glands enlarged ; heart shows subperi- cardial hemorrhages along auriculo-ventricular and interventricular grooves, and also along the edge of the right ventricle ; lungs dark in colour, especially upper and middle right lobes, in which there is broncho-pneumonic consolidation ; sub- pleural hemorrhages in various places in all lobes ; liver enlarged to about twice normal size, mottled red and white on surface, numerous small subcapsular hemorrhages ; spleen about three times larger than normal, deep violet in colour, showing very numerous white areas on both sides resembling miliary tubercle in appearance, edges rounded, no hemorrhages ; kidneys not enlarged, dusky in colour, hemorrhages under capsule ; suprarenals, especially left, enlarged and hemorrhagic ; bladder distended with clear urine giving albumin ring with nitric acid. No definitely abnormal appearances were detected in stomach or intestines. The blood-vessels found on reflecting the skin were markedly injected, and the blood fluid. The viscera were not sliced as it was desired to preserve tlie specimen with the organs in situ, for microscopical and cultivation purposes small pieces were obtained through areas on the under parts of the organs, previously seared in the usual way with a hot knife-blade. The smear preparations and cultures showed the bacilli already described. A second guinea-pig, inoculated on 30th January with a small piece of the spleeii of guinea-pig No. 1, became sick ou 29th January, was very sick during 31st January and 2nd February, and died at 1'30 p.m. on 2nd February, having thus become sick in two days, and died in about four days. The post-7no)iem appearances were similar to those of guinea-pig No. 1, except that the spleen, though twice tlie normal size, did not show the miliary-tuberele-like appearance. From the foregoing description of the bacteriological examination of material obtained from tlie enlarged femoral gland of A.P., it will be seen that two microbes were isolated—(a) a micrococcus still undetermined, but most likely one of the varieties of staphylococcus pyogenes albus ; and (/)) a bacillus answering positively to all the immediately applicable tests for Bacillus Pestls Buhonka. FRANK TIDSWELL. 3.—Epidemiological Halations. A.P. was a lorry-driver, employed by the Central Wliarf Company. His chief occupation was carting exports from city warehouses to the wharf, and delivering them either at his employer's ware- house or at the sliip's side. Tor several months past he had been thus engaged in carting wool almost exclusively. Occasionally he used a truck to run goods from the warehouse across the wharf. He had not handled goods discharged from any ship since the previous August. He had no business on board ships, th.ough he may occasionally have carried a message to the mates ; and he had not been below on any shij; for three mouths past at all events. Since Christmas he had only visited one other wharf, that of the A.IJ.S.N. Co., on January 9th, when he removed green hides imported from Queensland to a city warehouse. Both steam and sailing vessels from plague-infected ports must by this time (namely, near the end of the sixth year from the date of declaration of the epidemic at Hongkong) have dischai'ged or loaded at every suitable wharf in the harbour ; and, as regards Central Wharf alone, between November 1st and January 20th four .steamships, which all carried Chinese crews, and which had all touched at Hongkong, had lain tliere—one of them from January 9th to 20th. 1'.—Local CoNDiTiONs. A.P. had lived in the house where he was found for eight years (see illustration). It was built of brick, on a sandstone ridge, which sloped rather steeply to a branch of the harbour, within the city limits, and in a neighbourhood containing many large warehouses. It had two stories, four rooms, a small attic, and an unused basement, of which the natural rock formed the floor. It was in average general repair, but the sewerage was seriously defective.* There were no inside fittings, but there was a yard gulley halfway down the small walled yard, and a water-closet at the end of it. These were drained by 0-inch glazed E.W.P., which ran forward under the house in a chase cut in the rock floor of the basement. The drain was in aerial connection with the sewer, and the last length of piping against the front wall of the house had had a considerable hole knocked in it; the interior oi the dwelling was thus brought into direct connection with the interior of the sewer. On the other hand, however, the basement had a large opening at pavement level in its front wall, and a door at the back, both of which were said to be kept constantly open. The drain junctioued with a very old oviform rubble sewer, which discharged on the foreshore at Dalton's Wharf, about 50 feet below the house and about 150 yards away, next to the Central, and which was unprovided with any tide-flap. Very few houses were connected with it, and its chief use seemed to be discharge of storm-waters. In every domestic respect the house was tidy, clean, and well-kept. J. ASHBURTON THOMPSON. This is too generally the case within the city of Sydney, which in this respect is very sharply distinguished from the rest of the Metropolitan area. In the latter sewerage is under exclusive control of the Metropolitan Board of Water Supply and Sewerage ; and the 33,000 houses, containing 182,000 persons, to which the Board's service had been extended down to December 31st, 1899, are in every case connected on the most approved principles.](https://iiif.wellcomecollection.org/image/b21354704_0085.jp2/full/800%2C/0/default.jpg)
