CHAPTER XI 



BUBONIC PLAGUE CHICKEN CHOLERA MOUSE 



SEPTIC^MIA 



Bubonic Plague 



PLAGUE was epidemic throughout Europe during the 

 Middle Ages ; it appeared in England in the fourteenth 

 century as the Black Death, and in the seventeenth 

 century as the Great Plague of London, while numerous 

 lesser visitations have been recorded. Although the 

 disease seems always to have been endemic in certain 

 centres, e.g. in Asia Minor, on the Persian Gulf, in Yunnan, 

 in Uganda, etc., it was unknown in epidemic form from 

 the early part of the nineteenth century until it appeared 

 in Hong Kong in 1894, from whence it spread to India in 

 1896, and subsequently became pandemic. 



Three principal types of the disease are recognised, the 

 bubonic in which the femoral (rarely the inguinal), 

 axillary and other glands become enlarged (whence the 

 disease derives its name), the septicsemic, and the pneu- 

 monic. In India the disease has been mainly bubonic 

 (70 per cent, of the cases). Occasionally the majority of 

 the cases are pneumonic, as for instance in Accra in 1907, 

 in the small outbreak in Suffolk in 1910, and in the great 

 Manchurian epidemic of 1909-10. Septicaemic cases are 

 the exception, but any form tends to become septicsemic 

 on the approach of death. 



At the commencement and at the end of an epidemic 

 the disease may assume an extremely mild type, the 

 so-called " pestis minor," 



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