Report on the outbreak of plague at Sydney, 1900 / by the Chief Medical Officer of the Government and President of the Board of Health.
- New South Wales. Department of Public Health
- Date:
- 1900
Licence: In copyright
Credit: Report on the outbreak of plague at Sydney, 1900 / by the Chief Medical Officer of the Government and President of the Board of Health. Source: Wellcome Collection.
13/112 page 7
![but with thin, colourless, iridescent borders, which were often corrugated. At room temperature on this medium the growth was seldom distinct in less than five or six days, and only reached its maximum development in about three weeks. In beef- broth the growth was usually visible on the second day of incubation, in the form of erumblike spicules attached to the sides, with more or less deposit at the bottom of the tube, the broth itself remaining clear and transparent; but in other cases a moderate uniform turbidity was produced. Growth in broth-flasks containing oil resulted in production of a film, scanty crops of stalactites, and a copious deposit. The stalactites present at any one time never exceeded six or eight, and became detached, and sank to the bottom on the least jar; that more were not found at one time was probably due to unsteadiness of the laboratory shelves. The growth in milk was lessabundant than in broth, and the milk remained unchanged. Inocula- tion of guinea-pigs was usually followed by death in four or five days; the extremes were two to ten days, but six were rarely exceeded. The inoculations were made into the inner side of the knee. Post-mortem there was sometimes hemorrhagic swelling at the site of inoculation, and this extended up the thigh ; there was always swelling, and usually periadenitic effusion and hemorrhage of the corresponding femoral glands, while sometimes the related inguinal, and less often the lumbar, glands showed similar changes. There were petechial hemorrhages under the skin, the serous membranes, and in the viscera. ‘he lungs were almost always more or less inflamed, the liver enlarged (sometimes to twice its normal size), and the latter usually exhibited a fine mottling caused by appearance of white points or by small hemorrhages. The spleen was enlarged to two or three times the normal, marked with white spots on its surface, was dark in colour, and had thick or rounded edges. ‘The kidneys were enlarged, pale, and, as a rule, full of smal] haemorrhages ; the suprarenals were usually congested, and of a deep red colour. Occasionally plague bacilli were limited to the seat of inoculation and the bubo; but usually they were present in all parts of the body, though they were not always recoverable from heart’s blood. They were twice recovered from the urine, and were never found in the bile. A bacillus having precisely the same characteristics and the same patho- genicity wasrecovered from the organs by culture. For a full account of the bacteriological observations made during this epidemic, Appendix A, p. 50, from which the foregoing abstract has been made, should be consulted. Hrom the foregoing account of the usual course of illness, which has beer compiled exclusively from the symptoms recorded of each of the 262 cases which could be clinically observed, from the brief abstract of the post-mortem appearances noted in the twenty-four cases which alone were examined in that way, and from the abstract account of the bacteriology of the disease given above, it will be seen clearly that the epidemic illness now under consideration was plague. On comparing it with the published accounts of plague as it appeared in other parts of the world, it will be seen that it might have been compiled from records made in China, in Portugal, in India, in Mongolia, in Mauritius, or, in short, from the records of plague outbreaks in any part of the world from which such records are forthcoming. Nevertheless, certain minor differences between the disease as seen here and as it has been seen in India and China, for instance, are distinguishable. But they are non-essential; they are differences in degree of severity or of fatality, and are doubtless due to the indirect influence of local conditions of life—of feeding, honsing, cleanliness, and also of race. And of the three recognised forms under which plague exhibits itself—that is to say, the bubonic, the septiczeemic, and the pneumonic, the bubonic form was almost exclusively encountered. The septiczemic form was observed only in 17 cases, of which 15 were fatal; primary plague pneumonia probably not once, although a single case was met with (in a Chinese) which possibly may have been an instance of it, the circumstances having prevented the fact from being ascertained. Bronchitis and inflammatory and suppurative affections of the eye six times (Appendix C), but for an analysis of the whole series of cases reference must be made to Appendix B, p. 58. ! If. ~](https://iiif.wellcomecollection.org/image/b32183021_0013.jp2/full/800%2C/0/default.jpg)
