Publisher's Synopsis
Excerpt from The Plague: Bacteriology, Morbid Anatomy, and Histopathology; Including a Consideration of Insects as Plague Carriers
It has been my purpose in the preparation Of this report to furnish a scientific contribution to the subject and to bring out, if possible, some new points, which might be of interest and value. However, another practical Object has never been lost sight of, namely, to provide a guide for those who might be called upon to make a post-mortem diagnosis of the first case of suspected plague in a district. This will always be a matter of great responsibility and sometimes one of considerable difficulty. Unless circumstances compel the contrary, the diagnosis of a plague case, being the first of its kind in a community, on board of a ship, etc., should be confirmed by one well trained in general pathology and bacteriology; or, still better, by one also having experience in the recognition and examination Of plague cases.
The importance Of promptly diagnosing the first case of plague can not be overestimated. This disease does not make its initial appearance as a widespread epidemic, as is Often the case with Asiatic cholera, when caused by a contaminated water supply or from other sources of infection. Rather, it begins very insidiously from one or Several imported cases. It is frequently easy to hold the plague in check, provided it is recognized and properly fought at an early stage. This has been proved by the Observations made in the cities mentioned above and in Manila.
In studying the histopathology of plague a highly interesting change was found in the kidneys, namely, extensive and frequently occurring hyaline fibrin thrombosis of the glomerular capillaries. AS it appears that this change has not been described in the study of the microscopic anatomy of the disease, it has been considered somewhat at length. The histologic examinations in their entirety have led to the conviction that plague in its most common bubonic type should not be looked upon as a hemorrhagic septicaemia, because according to all appearances the infecting bacilli remain practically localized until the agonal stage of the disease is reached.
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