Licence: In copyright
Credit: Plague : how to recognise, prevent, and treat plague. 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.
27/74 (page 23)
![I PLAGUE. 23 on the power of the infectivity of plague seem to be ahnost nil. Plague may occur m the hottest or m the coldest climates, and develop amongst hill residents and dwellers by the sea. Neither sex nor age seems to avail. Race would appear to exercise a certain influence, but it is doubtful if to race ])er se is to be attributed the difference between the prevalence of the disease amongst the Europeans and the natives in Asia. The Malay race, curiously enough, seem wonderfully exempt from the disease. In Java, Sumatra, and the Malay Peninsula plague has not obtained a hold. This may be ascribable not to race, but to the fact that the equatorial belt has never been known to be deeply, if at all, affected by plague, and the nearer this belt is approached, so the virulence of plague seems to diminish. Plague was styled by Murchison the typhus of the tropics; but although it has crossed the line, it does not seem that the disease finds a favourable soil in the immediate neighbourhood of the equator. VARIETIES OF TYPE. The term bubonic is frequently used to designate true plague, but buboes are by no means an essential sign of plague. In many outbreaks but few cases of a bubonic nature have been met with; so few, in fact, that enlargement of the glands proves the exception rather than the rule. Again, a succession of out- breaks in the same city seldom preserves the same type; pneu- monic symptoms prevailing in one, buboes in another, and yet again, a toxic or septictemic form in the third accession of the disease. So numerous are these divergent forms that the varieties of plague are grouped by several writers as follows :— (1) Buhonic plojjue.—Three-fourths of all plague cases belong to this type. As our experience increases, however, and closer attention is paid to collateral plague ailments, it will be found that many forms of complaint, in addition to the partially recog- nised pneumonic and septic types, will prove to be plague. A mere enlargement of a gland does not constitute a bubo. En- larged glands are met with in the septic and septic-pneumonic types. It is the adenitis and the inflammation in the peri- glandular tissues that combine to form a bubo. The bubonic form is generally stated to be the primary type of the attack, and that in subsequent recurrences a pneumonic type is more commonly met with. The truth of this assertion must be](https://iiif.wellcomecollection.org/image/b24748687_0027.jp2/full/800%2C/0/default.jpg)
