Plague : papers relating to the modern history and recent progress of Levantine plague / prepared from the time to time by direction of the president of the Local Government Board, with other papers ; sented to both House of Parliament by Command of Her Majesty.

  • Radcliffe, Netten.
Date:
1879
Catalogue details

Licence: Public Domain Mark

Credit: Plague : papers relating to the modern history and recent progress of Levantine plague / prepared from the time to time by direction of the president of the Local Government Board, with other papers ; sented to both House of Parliament by Command of Her Majesty. Source: Wellcome Collection.

Provider: This material has been provided by Royal College of Physicians, London. The original may be consulted at Royal College of Physicians, London.

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    seen any dead snake in connexion with an infected house or village. If snakes die from eating the deceased rats, cats could hardly be expected to escape. Yet far from seeing any dead cats, I have on several occasions had some trouble in saving the life of a cat desperately attached to an infected house aboiit to be burnt. [ The villages in which the death of rats in the infected houses was testified to were Bintola, Chani, Kansani, Khajuli, Tailihat, East Dugora, Parsali, Siingarh, and Naukori, and in all these places the history points to an outbreak of plague disease not resulting from infection. They seem to be places in which the disease renewed its active appearance ; and, as the result of careful inquiry and observation, I think it may be true that the death of rats, preceding an outbreak of the disease, points to certain local conditions or pecuKarities as giving rise to the outbreak. In no village, where the history clearly points to infection as the cause of the outbreak could I obtain evidence of the death of rats, and I think it may be true that where rats have not died infection has given rise to the outbreak, p. 94.] I have on several occasions recorded the fact that the people of an infected house, when vacating it for a jungle residence, took with them a supply of the grain they had been eating for many previous days, lived on it in the jungle, and suffered no harm. Indeed that is the usual course of proceeding and frequent result (pp. 87-92). FURTHER APPENDIX, FEBRUARY 1879. F. On the Characters of Epidemic Plague in Mesopotamia in 1876-77.—% E. D. Dickson, M.D., Physician to the British Embassy, Oonstantinople. A Paper communicated to the Local Government Board by the Epidemiological Society of London, February, 1879. The sudden and alarming announcement of an outbreak of plague in Asiatic Russia, the possi- bility of this scourge extending into Europe ; the conflicting opinions that seem to be entertained concerning the nature of the malady and the precautions necessary to ward it off, have prompted the following brief sketch, derived almost entirely from notes taken, and kindly given me, by Dr. Giovanni Cabiadis, as the result of his observations at Hillah and Bagdad, during the outbreaks of plague in 1876-77. History.—Two or three months previous to the manifestation of plague in Mesopotamia glandular swellings free from fever prevailed in that country. They showed themselves in the groin, armpit, or neck, and were not accompanied by other symptoms. They began to appear amongst the inhabitants about the end of autumn, and continued through the winter; but towards the end of it plague broke out and reached its acme of intensity in the spring, and died out suddenly during the summer season when the great heat declared itself, and the thermometer rose to 45 or 50 degrees of centigrade scale (113° or 122° F.). During the prevalence of the plague the thermometer ranged between 5 and 30 degrees; and when it rose to 30° (86° F.) the disease had reached its maxi- mum of intensity. As the temperature increased from 30° to 45° (86° to 113° F.) the epidemic began to diminish, and as soon as the thermometer got up to 45° (113° F.) it ceased abruptly. On the cessation oP plague apyretic glandular swellings reappeared again, precisely similar to those which had preceded the outbreak, and they continued to manifest themselves for about two months longer. These glandular swellings were frequently met with, and were distinct from the chronic adenitic swellings met with in subjects of a scrofulous tendency, and evidently unconnected with any special diathesis. Symptoms.—The symptoms that characterise plague are of two orders, local and general. In severe cases the general symptoms precede the local manifestations. The patient is suddenly seized with high fever, which, in some instances, is ushered in by a prolonged shivering- fit, the pulse beats 130, or even more, and the temperature of the body rises to above 42° (107 6° F.) centigrade. In some cases, however, this febrile condition is hardl}- appreciable, while on the other hand alarming complications indicate the severity of the attack by perturbations connected with the nervous centres, such as convulsive tremor, drowsiness, coma, delirium ; or with the circulating system, such as epistaxis, hsematemesis, htemoptysis, sanguineous diarrhoea, menorrhagia; or with the assimilative organs, such as painful tumefaction of the liver, bilious vomiting, bilious diarrhoea, jaundice, &c, These phenomena appeared to be dependent on some periodic impulse, because at times the bilio- gastric manifestations prevailed; at others the hsemorrhagic, and at others the nervous. The nervous agitation which sometimes ushers in an attack of plague is a very remarkable symptom, and one that Dr. Cabiadis had never met with before. He describes it as a prolonged regular shake lasting from six hours to three days. While the patient is suffering from it he does not complain of cold, nor does the thermometer indicate a lowered temperature. The pulse is smaU, short, and quick, and the temperature of the body remains in nearly its normal state. This tremor is always followed by profound coma, during which the patient rapidly sinks. In some instances of plague Dr. Cabiadis has seen death supervene within a few hours of the attack, and before any of the characteristic indications of the disease, such as buboes and carbuncles, had shown themselves. These severe cases were mostly met with at the commencement and at the termination of an epidemic outbreak.* They were observed in the plague of 1876 at Hillah, as weU as in that of 1877 at Bagdad; and in these instances the glandular swellings either did not appear at all, or were very small and never suppurated ; the patient, moreover, seldom lived more * I have noted a similar circumstance in severe epidemic outbreaks of cholera. The first and the last attacks were mostly fatal.