Some practical aspects of the plague at Sydney / by Frank Tidswell.

  • Tidswell, Frank.
Date:
[1900?]
Catalogue details

Licence: In copyright

Credit: Some practical aspects of the plague at Sydney / by Frank Tidswell. Source: Wellcome Collection.

    10/52 page 552
    from one group of glands to anotlier in its neighbourliood. I have already mentioned the association of inguinal and femoral swellings, hut in addition to this it was very common in purely femoral cases to elicit tenderness on pressure above Poupart’s ligament. The indication thus afforded of extension to the iliac glands received confirmation by post mortem and experi- mental observations. But apart from such cases, enlarged glands* were occasionally present in two totally different regions, as groin and axilla, or axilla and neck. They were sometimes on the same, and sometimes on different sides of the body. In a few instances there were bilatual enlargements, always either femoral or inguinal or a mixture of both, but the symmetry was never quite perfect—one side being more advanced than the other. 1 cannot say that the subsequent development of the second swelling, or of either of them, was in any way affected by the existence of the other. As a general rule the buboes appeared quite suddenly, and enlarged rapidly. In the course of twenty-four hours the glands sometimes attained the size of a pigeon’s egg, or even that of a walnut. But on the other hand, occasionally they never became bigger than a marble. It was usual to find several glands of a group enlai'ged, but one much more than the others. The detection of the gland itself, however, de- pended on very early access to the case. If this were obtained it was usually easy enough, by the rounded or oval shape, well-defined limits, &c., to satisfy oneself of the existence of a swollen gland. But it was not many hours before this became impossible, owing to the occurrence of luemorrhagic exudation and oedema round the gland. When this had happened all that could be felt, as a rule, was a diffuse thickening in the region, having no definite shape nor margin. The amount of exudation, like the degree of swelling of the gland itself, was very variable. Sometimes it formed a mass filling up and causing a projection in the groin or axilla, and at others it was so scanty as to be scarcely evident. When the gland itself could be felt it was tense rather than hard, its con- sistence being, to my mind, comparable to that of the testicle. The periadenitic effusion was more or less finn, at all events at first, but later on it sometimes became soft enough to take an imprint of the fingers. The skin over the bubo remained normal in colour for a time, and then became reddened, whilst with the approach of sup- pination it assumed a more violet tint. Sometimes in the later stages it showed discoloration as in a bruise, and in one or two instances there was actual hminorrhage of a petechial character. In nearly all cases the bubo was very tender; in some cases
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