544 



Plague 



in 1901 there were 362,000 cases and 278,000 deaths. In the first 

 six months of the epidemic of 1907, the deaths in India were much 

 more numerous, reaching a total of 1,062,908. Where ' sanitary 

 precautions are possible and co-operation between the people and 

 the authorities can be brought about, as in New York, San Fran- 

 cisco, and other North American and European ports, the disease 

 remains confined pretty well within limits and does not spread. 

 An interesting account of "The Present Pandemic of Plague" by 

 J. M. Eager, was published in 1908 in Washington, D. C, by the 

 U. S. Public Health and Marine Hospital Service. 



Plague is an extremely fatal affection, whose ravages in the 

 hospital at Hongkong, in which Yersin made his original observa- 

 tions, 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 



Fig. 224. — Axillary bubo. (Reproduced from Simpson's "A Treatise on Plague," 

 igos, by kind permission of the Cambridge University Press.) 



Hongkong in 1894 the death-rate was 93.4 per cent, for Chinese, 77 

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

 Eurasians, and 18.2 per cent, for Europeans. It affects both men 

 and animals, and is characterized by sudden onset, high fever, pros- 

 tration, delirium, and the occurrence of exceedingly painful lym- 

 phatic swellings — buboes — affecting chiefly the inguinal nodes, 

 though not infrequently the axillary, and sometimes the cervical, 

 nodes. Death comes on in severe cases in forty-eight hours. The 

 pneumonic form is most rapidly fatal. The longer the duration of 

 the disease, the better the prognosis. Autopsy in fatal cases re- 

 veals the characteristic enlargement of the lymphatic nodes, whose 

 contents are soft and sometimes purulent. 



Wyman,* in his very instructive pamphlet, "The Bubonic 



* Government Printing Ofi&ce, Washington, D. C, 1900. 



