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THURSDAY, SEPTEMBER 28, 1905. 



A TREATISE OX PLAGUE. 

 -. Treatise on Plague. By Dr. W. J. Simpson. Pp. 

 xxiv + 466. (Cambridge : University Press, 1905.) 

 Price 16.S. net. 



THIS volume deals with the historical, epidemio- 

 logical, clinical, therapeutic, and preventive 

 .ispects of plague, and it marks a distinct and 

 important addition to what has hitherto been written 

 about the subject. It gives a careful and well 

 .arranged summary of many writings, ancient and 

 modern, which deal with oriental plague. Many of 

 the ancient writers, some interesting and basing their 

 statements on carefully observed facts, others less 

 interesting and largely fanciful, are here succinctly 

 placed side by side, and the advances or the reverse 

 evolved out of them for subsequent generations are 

 described in chronological order. What the reader 

 of this volume will at once perceive as a marked 

 difference from other works on plague is the recog- 

 nition of the important bearing of the discovery of 

 the Bacillus pestis as the real cause of the disease, 

 and its influence on our knowledge of the manner 

 of spread of the disease and its prevention. In these 

 respects Dr. .Simpson, as an epidemiologist of recog- 

 nised standing, and by his practical knowledge of 

 the bacteriological aspect, is in a distinctly more 

 favourable position than previous w'riters on plague. 



The subject-matter is dealt with in four parts in 

 twenty-one chapters. Part i. gives an account of the 

 history and distribution of plague from the earliest 

 recorded times down to the end of the nineteenth 

 century — chapter i. — and comprises accounts of 

 plague in Syria, Arabia, Mesopotamia and Persia, 

 Egypt, Lybia, Constantinople, and the west of 

 Europe, including Germany, Italy, and England 

 during the sixteenth and seventeenth centuries. The 

 references to the various writers are everywhere care- 

 fully given, and include writers like Procopias of 

 Cesarea, Evagrius of Antioch, Gregory Bishop of 

 Tours, Paulus Diaconus, A. v. Kremer, Nicophorus 

 Gregoras, Guy de Chauliac, Ed. Maunde Thompson, 

 Patrick Russell, and Dr. C. Creighton's " History 

 of Epidemics in Britain." This chapter i. contains 

 in thirty-nine pages a review of a vast amount of 

 interesting literature not readily accessible to the 

 ordinary student. 



Chapter ii. deals separately with plague in India, 

 which at the present time is of special interest to 

 English readers. Before the seventeenth century, 

 since when more or less accurate records are avail- 

 able, " the history of plague in India is veiled in 

 obscurity. That plague did prevail in India in or 

 before the eleventh or twelfth century is certain, for 

 in some of the Puranas which are at least 800 years 

 old there are references to the disease and instruc- 

 tions to the Hindus as to the precautions to be taken 

 in the event of its appearance. One of these is that 

 whenever a mortality among the rats of a house is 

 observed the inhabitants are to leave " (p. 40). There 

 is evidence of extensive pestilences in India in the 

 NO. 1874, VOL. 72] 



fourteenth, fifteenth, and sixteenth centuries. At the 

 beginning of the seventeenth century plague broke 

 out in the Punjab and spread over different parts 

 of India, the outbreaks in Surat, Bombay, and 

 Bijapur towards the last part of the seventeenth 

 century having been of a particularly virulent 

 character. 



"Nothing more is heard of the disease' (p. 46) 

 on the western side of India until 1S36, when the 

 Pali plague broke out in Marwar in Rajputana and 

 lasted until 1S38 (Dr. Forbes)," and according to the 

 same authority this epidemic was brought from .Asia 

 Minor and Mesopotamia. Next comes the consider- 

 ation of Garwhal and Kumaon (both at the southern 

 slopes of the Himalayas), which are held by all 

 authorities to be an endemic centre; "fortunately 

 this centre is comparatively an inactive one as re- 

 gards its powers of diffusion." Simpson, therefore, 

 does not countenance (see also later) the somewhat 

 sensational suggestion by Hankin that the epidemic 

 in Bombay in 1896 and since was due to importation 

 bv fakeers from Garwhal. Chapter iii. deals in an 

 exhaustive manner with the present pandemic, which 

 is traced from Yunnan by the trade routes into 

 different parts of China, and finally, in 1894, into 

 Canton and Hong Kong. The outbreak and course 

 of the epidemic into these two places are described 

 from personal inquiries, as also the manner and 

 extent to which these localities became centres of 

 distribution of the plague to Bombay in 1896. The 

 course and nature of the epidemic in Bombay Presi- 

 dency, its extension into other presidencies and other 

 countries, are illustrated by carefully executed maps. 



Part ii. deals with the epidemiologv of plague. 

 Having briefly discussed the discovery of the Bacillus 

 pestis by Yersin and Kitasato as the real cause of 

 the disease, the author gives an account of the 

 morphological and cultural characters of the microbe, 

 of its vitality under various adverse conditions (heat, 

 cold, drying on various substances) as asserted by 

 various observers, and finally of its general effect 

 and its pathogenicity after inoculation into rodents 

 (chapter iv.). 



In chapter v. the relationship of epizootics to 

 plague is fully described. That rats and mice are 

 susceptible to natural infection has been observed 

 and mentioned by many writers, ancient and modern 

 (Book of Samuel, vi., Bhajawata Purana, Nicophorus 

 Gregoras, Lodge, Forbes, and many others). Dr. 

 Hunter, of Hong Kong, and the author himself have 

 published charts (reproduced) which give a compre- 

 hensive account of the parallelism of the human 

 plague and rat mortality. While it is universally 

 admitted as proved that in some epidemics the 

 mortality of rats from plague coincides with the 

 appearance of plague in the human being — either pre- 

 ceding it, synchronous with it, or following it — there 

 is, on the other hand, good evidence (collected by the 

 Indian Plague Commission, and discussed by Dr. 

 Bruce Low in his Reports and Papers on bubonic 

 plague, 1902) to show that epidemic outbreaks of 

 plague in the human subject are not necessarily con- 

 nected with plague in the rat. This is a point which 

 ought not to be lightly passed over; it is unfortunate 



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