68 POPULAR SCIENCE MONTHLY, 



being taken of their treatment, and yet terminating favorably. 

 It is the benign plague of authors, which is observed when the 

 disease commences and when it is at its end, though it is rarely 

 seen in the middle period, which is entirely devastating, but it is 

 not less plague, and it no less merits the attention of physicians 

 and magistrates." 



In pestis major there is a prodromal stage, accompanied by 

 aching in the limbs, shivering, and a high degree of nervousness. 

 The patient seems to be unable to quickly comprehend questions. 

 There is a staggering gait similar to that of alcoholic intoxication. 

 There is intense headache, with thirst and great pain in the epi- 

 gastrium. The eyes become red ; the tongue dry, swollen, fissured, 

 and sometimes black, and at other times covered with a thick 

 white coat. Coma may set in and death result before there is any 

 marked elevation of temperature. In some cases, however, the 

 temperature may reach 107 F. during the twenty-four hours pre- 

 ceding death. 



In the cases less rapidly fatal there are glandular swellings. 

 These occur in the groin in about fifty per cent of the cases, in 

 the armpits in about thirty-five per cent, and less frequently in 

 the neck and other localities. One peculiarity of the graver form 

 of the disease is the occurrence of stablike pains in various por- 

 tions of the body. This symptom gives rise to the superstition 

 among the ignorant that the victim is wounded by invisible 

 arrows shot from the bow of some demon. Suppuration of the 

 buboes with free discharge has been regarded as a favorable 

 symptom. The skin is sometimes covered with livid petechias, 

 w^hich become very dark after death. This condition gave rise 

 to the term black death, which has been applied to certain epi- 

 demics. Large carbuncles may form in various parts of the body, 

 and these are regarded as a very unfavorable sign. 



A highly fatal form of the disease is accompanied by haemor- 

 rhages from the lungs. This was a noticeable feature of the pan- 

 demic of the sixteenth century, and it was also observed in the 

 recent outbreak along the Volga. Such haemorrhages indicate a 

 grave form of intoxication, and have been observed in the severer 

 forms of other acute infectious diseases, such as smallpox. 



The virulent form of the plague is often very rapid in its 

 action, sometimes destroying life in a few hours, but the majority 

 of fatal cases terminate about the fifth day. During an epidemic 

 at Bagdad it was said that those who lived until the seventh day 

 were safe, but, according to Colvill, four per cent of the fatal cases 

 terminated after the tenth day. 



The mortality from the plague in its virulent form is probably 

 as great as or greater than any other of the acute infectious dis- 

 eases. In many epidemics it may be more than ninety per cent. 



