THE PLAGUE. 251 



The clothes and coverings of the infected often spread the disease, 

 and yet there are numerous examples of persons who without having^ 

 adopted any method of protection occupied the beds of plague patients- 

 without contracting the malady. 



The plague is transmissible from one country to another 

 by sea. An infected ship becomes an infective centre as readily 

 as an infected house. Once imported, whether by land or sea, the 

 virus from infected persons or merchandise spreads wherever the 

 environment is favourable for its development and extension. 



Old London afforded in every way a suitable environment for 

 the plague. The situation of the city was unhealthy, and the old 

 town ditch was a receptacle for all kinds of filth. The houses 

 projected over the roadway, and the streets were saturated with 

 constant contributions of slops and of excrement from animals and 

 human beings. The houses were often filthy and tinventilated, and 

 the floors strewn with rushes, which were seldom changed. Erasmus 

 goes so far as to say that the rushes were piled the new upon the 

 old for twenty years, and were fouled with spillings of beer, 

 fragments of fish, expectoration, vomit, excrement, and urine. 

 Another very striking insanitary feature of Old London was the 

 overcrowded state of the graveyards, which was well calculated to 

 predispose to pestilence, if not actually to produce it. The burials 

 were so frequent in St. Paul's Churchyard that a new grave could 

 scarcely be dug without bodies being exposed in all stages of 

 putrefaction. 



In 1894 the plague broke out in China, with all the symptoms 

 of the fatal bubonic pest of Old London. The disease was confined 

 to the poorest classes and the most overcrowded and most filthy 

 localities. In Canton the deaths exceeded one hundred thousand, 

 and in Hong-Kong numbered about ten thousand. The disease 

 was contagious, and mainly di£Fused by personal contact. Death 

 occurred, as a rule, in from twenty-four hours to five days. The 

 English and European community escaped, with the exception of a 

 very few out of a large number, mostly soldiers, employed in cleansing 

 the houses. The disease was a specific fever, intensely fatal, accom- 

 panied by high temperature, cerebral congestion, delirium, and the 

 formation of buboes. The buboes consisted of exquisitely painful and 

 swollen lymphatic glands. All the glands, in some cases, were affected. 



According to Cantlie the glandular swelling when first recognised 

 was almond-shaped in the inguinal region, and globular in other 

 regions, with peri-glandular cedema. The swelling rapidly increased 

 in size, becoming softer, less definite in outline, and less tender, until 



