CHAPTER XI. 



BUBONIC PLAGUE. 



Bacillus Pestis Bubonic* (Yersin, 1 Kitasato*). 



Plague, or malignant polyadenitis, is an acute infec- 

 tious febrile disease of an intensely fatal nature, charac- 

 terized by inflammation of the lymphatic glands, marked 

 cerebral and vascular disturbance, and the presence of 

 the specific bacillus in the lymphatic glands and blood. 



The bubonic plague is' an extremely fatal disease, 

 whose ravages in the hospital in which Yersin made his 

 observations carried off 95 per cent, of the cases. The 

 death-rate varies in different epidemics from 50 to 90 per 

 cent. In the epidemic at Hong Kong in 1894 the death- 

 rate was 93.4 per cent, for Chinese ; yy per cent, for 

 Indians ; 60 per cent, for Japanese ; 100 per cent, for 

 Eurasians, and 18.2 percent, for Europeans. It affects 

 both men and animals, and is characterized by sudden 

 onset, high fever, prostration, delirium, and the occur- 

 rence of lymphatic swellings — buboes — affecting chiefly 

 the inguinal glands, though not infrequently the axillary, 

 and sometimes the cervical, glands. Death comes on in 

 severe cases in forty-eight hours. If the case is of longer 

 duration, the prognosis is said to be better. Autopsy in 

 fatal cases reveals the characteristic enlargement of the 

 lymphatic glands, whose contents are soft and sometimes 

 purulent. 



Wyman in his very instructive pamphlet, "The Bu- 



1 Ann. de V 'Inst. Pasteur, 1894, 9. 



1 Preliminary notice of the bacillus of bubonic plague, Hong Kong, July 7, 

 1894. 



551 



