STUDIES ON PNEUMONIC PLAGUE AND PLAGUE 

 IMMUNIZATION. 



VII. PATHOLOGY. 



By Richard P. Strong, B. C. Crowell, and Oscar Teague. 

 {F)-om the Biological Laboratory, Bureau of Science, Manila, P. I.) 



Although bubonic plague is a disease that has occurred in large 

 and protracted epidemics and has been widely studied, epidemics 

 of pneumonic plague, even of moderate size, have not been 

 frequent and very few contributions to the literature upon the 

 pathological anatomy of primary pneumonic plague have hitherto 

 been made. Moreover, none of these articles has been based 

 upon the study of extensive material during a large epidemic, and 

 some of the cases described in the literature as those of primary 

 pneumonic plague are really instances of secondary infection of 

 the lung. Therefore, the subject of epidemic pneumonic plague 

 is one of particular importance in connection with the Man- 

 churian epidemic. 



Hitherto, our ideas regarding the pathology of pneumonic 

 plague have been based largely upon several cases described 

 by Childe in 1897-1898, and upon three cases reported by 

 Albrecht and Ghon in 1898. The German Plague Commission 

 (Gaffky, Pfeiffer, Dieudonne, Sticker) in the report of their 

 investigations in India, during the same year, described 7 cases 

 of pneumonia in plague, but when one reads the description of 

 these, it is found that but two were cases of primary pneumonic 

 plague, and in both of them the infection was complicated by the 

 presence of other bacteria, in addition to the plague bacillus. 



Childe,^ in 1897 and 1898, describes the post-mortem lesions 

 in two cases of pneumonic plague. In the first case the necropsy 

 was performed seven hours after death and the lesions en- 

 countered are described as follows: 



"The lunp:s showed much {general enfforpement and oedema, with sero- 

 sanguineous frothy fluid in the bronchi, but no pus; the usual appearances 

 of acute bronchitis were absent. There was one small pneumonic patch, 

 the size of a walnut, in the early second stage, situated below the apex 



'BiHt. Med. Jouni. (1897), 1, 1215. 



203 



