PLAGUE. 



729 



by returning Russian soldiers to the province 

 of Astrakhan, where the disease broke out in 

 the fall of 1878. The story is that it was con- 

 veyed in a Turkish shawl which a Cossack 

 took homo and gave to his betrothed. It has 

 been suggested that it may have been trans- 

 mitted more directly from the Russian army, 

 where an extraordinary mortality was ac- 

 knowledged from typhus, under which name 

 a worse disease might have been disguised. 

 Against this it is urged that the impartial cor- 

 respondents of neutral nations who were with 

 the Russian armies say nothing of plague, al- 

 though they would not have failed to mention 

 it had there been a suspicion of its existence. 

 A simpler theory is that it was communicated 

 from Resbd, where it raged in 1877 and 1878, 

 and whence there was a regular trade by ves- 

 sels to Zaritzin on the Volga. At Astrakhan, 

 the disease fell under similar conditions to 

 those which favor its propagation in the East. 

 The country is subject to inundations ; the 

 people are poor, badly housed, and filthy in 

 their habits ; and the principal business of the 

 district, the curing of fish, is one which pecu- 

 liarly favors the accumulation of offal and the 

 generation of a poisonous atmosphere. 



A few cases of disease similar to plague were 

 noticed in Astrakhan in May, 1877, but ac- 

 cording to the Russian accounts they soon dis- 

 appeared. The first cases in numbers occurred 

 at the stanitza or village of Wetlianka in the 

 beginning of October, 1878. Wetlianka is 

 situated in the circle of Jenotavsk, 149 versts 

 (about 98 miles) from the city of Astrakhan, 

 and 20 versts (13 miles) from the town of Ni- 

 colskov. It lies on the right bank of the Volga, 

 in a tolerably high, level, and exposed situation, 

 with a loamy soil supporting a scanty vegeta- 

 tion. The town is about a hundred years old, 

 and had one thousand inhabitants, with three 

 hundred houses, all of wood, small and not 

 clean. The only occupation of the people was 

 fishing, in connection with which was a con- 

 siderable curing establishment. The place was 

 considered unhealthly and subject to fevers, 

 and had suffered much from the common epi- 

 demics, cholera, and syphilis. From Novem- 

 ber till the 25th of December, 1878, the weather 

 was moist, cloudy, mild, with only occasional 

 winds, which, blowing lightly from the south- 

 west, brought with them a fine rain. A snow 

 fell on the 12th of December, which soon melt- 

 ed awny. According to the official reports, 

 the cases at first appeared of a mild form. At 

 the beginning of November they were repre- 

 sented as progressing favorably after a dura- 

 tion of from ten to twelve days, although puru- 

 lent swellings were already observed in the 

 armpits of the sick. Dr. Depner, of the Cos- 

 Back corps, visited the place on the 18th of 

 November, and after some days of observa- 

 tion declared the disease to be typhus. Hard- 

 ly had he gone away when it changed its type, 

 with a great increase of mortality, so that by 

 the 27th of November the reports obscurely 



mentioned that 43 per cent, of those attacked 

 died and 14 per cent recovered, without ac- 

 counting for the others. Dr. Depner visited 

 the cases again on December 17th, and gave 

 the opinion that the disease was a very malig- 

 nant typhus, or a new form of disease partak- 

 ing of the characters of typhus and the Indian 

 plague. The marks of the disease were, ac- 

 cording to his account, a palpitation of the 

 heart coming suddenly upon a condition of 

 general good health, irregular pulse, nausea, 

 giddiness, pressure on the breast, spitting blood, 

 thin vomitings, stagnation of the blood, pale- 

 ness of the face, apathetic expression, and 

 dull, sunken eyes, with enlarged pupils. After 

 three or four hours the patient would suffer an 

 extreme exhaustion, which was followed by 

 dry heats, lethargy, some delirium, suppression 

 of urine, and costiveness. To these were added 

 in some cases after the 22d of December spots 

 on the body from the size of a millet-seed up, 

 and a peculiar honey-like odor known as the 

 " plague-smell " ; and death came on during a 

 state of unconsciousness through the rapid de- 

 cay of the vital forces. The corpses did not 

 become stiff, but began to decay in two or three 

 hours. By the 26th of December 100 per 

 cent., or all who were attacked by the disease, 

 died after a sickness of from twelve hours to 

 three days. Among the victims were Dr. Koch, 

 six surgeons, and a number of priests and 

 Cossacks who took care of the sick. Notwith- 

 standing this malignity of the epidemic, and 

 although the symptoms agreed with those of 

 the true plague, the Government took the ut- 

 most care to conceal its real nature, and, con- 

 tradicting all reports to the contrary, declared 

 that it was a typhoid fever. A. second physi- 

 cian sent to visit the infected district, Dr.Kras- 

 soffski, declared that the disease was without 

 doubt a true plague. By the 14th of Janu- 

 ary, 1879, the mortality had reached 368 per- 

 sons, 85 per cent, of those who had been at- 

 tacked, and 40 per cent, of the population of 

 the villages of Wetlianka and Prischiba. 



Measures were first taken by the Govern- 

 ment in January to prevent the further spread 

 of the epidemic. Saratov was put under quar- 

 antine, and a medical inspection of the con- 

 veniences for it was ordered, nnder the direc- 

 tion of the sanitary chief of the district. 

 Pains were still taken to conceal the nature 

 and extent of the infection, but the reports of 

 its spread could not be wholly suppressed. Its 

 outbreak was reported at Zaritzin, Nicolaskov, 

 Kereselitzev (100 versts outside of the limits), 

 Selitrena, Udatschnov, Michaelovskov, and 

 toward the end of January in St. Petersburg 

 itself. The identity of the reputed cases in 

 St. Petersburg was stoutly denied, and is in 

 doubt, but they produced gennine consterna- 

 tion. The efforts of the Government to con- 

 ceal the real condition were not acquiesced in 

 by the physicians. Dr. Botkin, physician to 

 the imperial family, declared unequivocally, at 

 a meeting held January 23d in the rooms of 



