PLAGUE 



were interested in its prevention. Therefore Austrian, German, and Russian 

 Commissions were appointed, and did excellent work. In 1898 the first 

 Plague Commission of India was appointed, and was followed by an Advisory 

 Committee of the India Office, Royal Society, and Lister Institute, appointed 

 in 1904, and, finally, in conjunction with this committee, the Second Indian 

 Commission was appointed in 1907, and has done excellent work in tracing 

 the aetiology to the rat-flea. 



In the meanwhile individual observers had also studied the disease — e.g., 

 Hafikine of India, and Lustig of Florence, had brought forward protective 

 vaccines, while Verjbitski, of St. Petersburg, showed, in 1908, the importance 

 of the bug as a carrier of the disease. 



Of great value have been the researches carried out in various colonies by 

 Professor Simpson. 



According to Nicolas, plague is almost constantly present in New Caledonia, 

 where the bacillus is believed to exist in a latent form. 



During 1909-10 in Manchuria there was a very severe epidemic of pneumonic 

 plague with a few cases of the bubonic type. It was studied by Strong, 

 Kitasato, Teague, Galeotti, and others. 



Fig. 668. — Distribution of Plague in 1914. 



In 1914 plague appeared in Colombo, Ceylon, where the epidemic was 

 studied by Castellani, who isolated the bacillus, PhiHp, and Hirst. Several 

 features of the onset were of interest : — 



1. The human epidemic was certainly not preceded by a diffuse rat epi- 

 zootic, as for years the bacteriological examination of rats had been carried 

 out by the Municipal Health Office with negative results, and it was several 

 weeks after the onset of the human epidemic that the first infected rats were 

 discovered. 



2. Practically all the cases were of the acute septicaemia type, and were 

 associated with an extremely high mortality without distinctive features, either 

 clinically or post-mortem ; and it is interesting to note that when infection 

 was found in the rats it was also of the septicaemic type, and in them also the 

 post-mortem findings were non-characteristic of plague, there being no 

 buboes, no mottled appearance of the liver, no pleural effusion. 



3. The strain of plague bacillus isolated {B. pestis Yersin-Kitasato var. 

 metapestis Castellani) differed in some minor points from the typical one. 



4. The commonest rat flea, as noted by Hirst, was different from that found 

 on rats in the majority of plague-infested areas, such as Bombay, but it is the 

 same as that found in Madras and Rangoon. 



