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Proceedings of Royal Society of Edinburgh. [sess. 
sometimes occur in Turkey. In Asia, epidemics of plague arise in 
Syria, Caucasia, Mesopotamia, and Persia; also in Arabia, on the 
coasts, and inland as far as Mecca. Epidemics have visited 
Hindostan, and tli ere are endemic centres of plague on tbe 
southern slopes of the Himalaya, in the provinces of Kurnaon 
and Gharwal and in Peshawur. It is probably endemic in the 
mountain valleys of Yunnan in China, and in Burmah. 
Description . — In recent outbreaks of plague, three varieties 
have been described — (a) Abortive or larval plague ; ( b ) Plague 
proper ; (c) Fulminant plague. The usual characters of plague may 
be rapidly summed up as follows : — After a day or two’s lassitude, 
shivering, and vomiting of a black material, high fever is experienced, 
with great pain in the axillary and inguinal regions, where buboes 
soon form. Often, too, the body assumes a livid hue, which gave 
plague the name of “black death.” The aspect of the plague 
patient is peculiar ; the face is haggard, the eyes retracted, and the 
conjunctive red. 
Remarks . — In considering the causes of plague, there can be no 
doubt that the influence of the seasons is very marked. The 
disease commences to make its appearance in the winter, and 
cases become more numerous as spring sets in ; but extreme 
heat or extreme cold usually puts an end to an epidemic. It is 
probable that plague has no relation to soil, and with regard to 
altitude, moderately high situations are more prone to be affected 
by the disease than are low-lying places, although from this it must 
not be understood that plains escape. There can be no doubt, 
however, that want, filth, and overcrowding are necessary to the 
production of plague, and it is well known that hygienic measures 
both prevent its appearance and stop its epidemic progress. In con- 
clusion, it may be noted that the closer the association of healthy 
people with the sick the more liable are they to contract the disease; 
hence, persons residing in the same house with plague-stricken 
patients are much more likely to be attacked than others, and cloth- 
ing and bedding may carry the infection. 
