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THE INSPECTION OF CONVENTS.
THE USE OF TOBACCO ON ACTIVE SERVICE.
1365
which had ever been found in the raw water) might we not march ? We believe not, and that the open air will have be doing harm rather than good ? Still this pessimistic saved what might have been the untoward results of smoking view need not trouble us much, for health statistics proved when unfed. that the risk of harm arising either from the presence in the water of so-called pathogenic organisms or from the removal of the harmless ones was so small that it might be calmly MEETING OF THE GENERAL MEDICAL COUNCIL. SUMMONSES have been issued for a meeting of the disregarded." Medical Council on Tuesday, Nov. 27th, at 2 P.M. General These comfortable words of Mr. Mansergh with regard to The Penal Cases Committee will meet on the preceding pathogenic germs were followed by a warning a9 to the and the Executive Committee on Monday, danger which may be apprehended from water derived from Saturday Nov. 26th. " A word of warning sources hitherto considered pure. might, however, be said about water obtained from THE INSPECTION OF CONVENTS. elevated and sparsely-populated moorlands, for," he said, A LETTER which appeared in the Times of Nov. 5th raises "the danger was greater if such water became infected, a most important point. We are not among those who especially if not passed into impounding reservoirs, than consider that convents are dens of iniquity, that the if the supply were taken from a large river." We hope that the members of the Institute of Civil Engineers and the bricking up of recalcitrant nuns is of daily occurrence, or distinguished guests passed a pleasant evening and returned that excavations in the back-gardens of convents would home reassured by the fact that the water of London with reveal facts such as those which horrified the pious inhabiits pathogenic germs which can be calmly disregarded is tants of Cologne when, in 1106, they dug anew the foundastill derived chiefly from the Thames and the Lea, uncon- tions of their walls and came across the bones of the 11,000 taminated with any water from " sparsely-populated virgins and others. But the correspondent to whose letter moorlands"-the "pure nectar from Wales," as it was we refer mentions facts, which so far have not been denied, characterised by Lord Llandaff. which reveal a most dangerous state of things. The doors (of the convent to which the writer refers) into the street are locked at night and the keys are handed over to the reverend THE USE OF TOBACCO ON ACTIVE SERVICE. mother, there being no means of exit until she is comTHE war in South Africa has taught many things of municated with. An outbreak of fire occurred which greater and of less importance. Perhaps nothing that it has fortunately did not end in disaster ; but how easily it might demonstrated has been more marked than the important part have done so. To our minds, as regards sanitary and hygienic which tobacco plays in the soldier’s existence. Whether this the the conditions, ordinary dwelling-house, the conpalace, is to be reckoned as a great fact or a small one there can be vent, and the tenement house should all be under the same no doubt about the truth of it. Yet the Duke of Wellington’s regulations. Epidemics and fire are no respecters of persons armies had no tobacco worth speaking of. If they did not or of religious communities, and though the promise of forbid its use, at any rate the Iron Duke’s officers were angelic protection still holds good, yet it was only given to directed to advise their men strongly against it. What a those in a way —namely, in a definitely marked out path, curious contrast with the campaigning in South Africa, a which the Devil omitted when he quoted the passage point where marches and privations as long and as stern as any for his own purpose. Not to use means which have been suffered by our great-grandfathers were borne by the volunfor our safety is universally recognised as demandprovided teers and soldiers of to-day with a grumble only when their that punishment which is allotted for those who tempt ing " smokes" failed them. We have it from many who took God. True, there must be discipline, but discipline must part in the forced marches leading to Paardeberg, to Bloem- not be such as to combine presumption. fontein, to Pretoria, and beyond, that when rations were but two or three biscuits a-day the only real pbysical THE annual dinner of the Aberdeen University Club, content of each 24 hours came with the pipe smoked by will be held at the Trocadero Restaurant on London, the smouldering embers of a camp fire. This pipe eased the Nov. 21st, at 7 P.M. Sir William McGregor, Wednesday, way to sleep that might otherwise have lingered, delayed by Governor of Lagos, will take the chair, and K.C.M.G., the sheer bodily fatigue and mental restlessness caused by members to dine should communicate with the prolonged and monotonous exertion. It is difficult, then, to honorary intending Mr. J. A. Robson and Dr. James secretaries, believe that tobacco is anything but a real help to men who at 54, Harley-street, W. Galloway, are suffering long labours and receiving little food, and i probably the way in which it helps is by quieting cerebraDR. JOSEPH PRIESTLEY, medical officer of health of tion-for no one doubts its sedative qualities-and thus who was recently selected by the Municipality of Lambeth, is so when more which allowing easily sleep all-important The cases of acute Bombay for the appointment of Executive Health Officer to semi-starvation has to be endured. mental derangement in the course of campaigns such as the the City of Bombay, has not seen his way to accept the present are many. There have indeed been many in South position. The borough of Lambeth is to be congratulated Africa. It would be most profitable and interesting could upon retaining the services of Dr. Priestley. medical officers have taken special note of the capacity for MR. HUTCHINSON, F.R.S., has offered, and his offer has sleep previously evidenced by those who broke down and also of their indulgence or non-indulgence in tobacco. We been accepted, to build and fit out an educational museum in are inclined to believe that, used with due moderation, connexion with the Friends’ School at Ackworth, near tobacco is of value second only to food itself when long Pontefract, Yorkshire. Museums on similar lines have been privations and exertions are to be endured. Two features are provided by Mr. Hutchinson’s generosity at Haslemere, to be noted with regard to the smoking practised on active Surrey, and at his native town, Selby, Yorkshire. service. It is almost entirely in the open air and it is largely on an empty stomach. The former is always an PROFESSOR A. H. YourrG, M.B. Edin., F.R.O.S. Eng., has advantage ; the latter we generally reckon a most unfavour- been appointed Representative of the Victoria University for able condition. Shall we see in the near future patients five years on the General Medical Council in succession to with tobacco amblyopia or smoker’s heart acquired while the late Dr. D. J. Leech. the trusting friend of tobacco thought that he was 1 THE LANCET, Oct. 27th, 1900, p. 1220, enjoying unharmed the well-earned solace of a hard day’s ___
___
1366
PROFESSOR CALMETTE ON PLAGUE.
resulted from the penetration of the microbe into the respiratory channels and it was to this exceedingly grave form that Dr. Muller and his laboratory assistants succumbed PROFESSOR A. CAIMETTE, Director’ of the Pasteur in 1898 at Vienna. Another and still rarer form of plague which Institute at Lille, in the course of ’the first Harben without buboes was plague septicaemia or pesticasmia with extreme rapidity and was caused by the intense developed Lecture of the Royal Institute of Public Health, depullulation of the plague bacillus in the blood and in the livered at the Examination Hall of the Royal Colleges organs. It was not exactly known where the virus first of Physicians of London and Surgeons of England on effected an entrance in these cases ; perhaps the microbe Nov. 7th, said that the recent appearance of plague penetrated by the intestine or directly into the blood through at Glasgow had decided him to choose the study of some little open sore or cut. Post-mortem examinations of severe form this disease as the subject of his lectures. Plague patients who bad succumbed to this particularly mesenteric and retro-peritoneal now menaced all the maritime nations of the globe showed very congested and it had become necessary to take rigorous measures to glands of a characteristic purplish colour like dregs of wine, fact seemed to support the hypothesis of penetration stop its extension. The progress of hygiene and the know- which of the virus by the gastro-intestinal channels. When the the last five on the years etiology, ledge acquired during treatment, and prophylaxis of the affection enabled it to be plague was studied in an epidemic centre all the forms combated very efficaciously and its centres to be rapidly above described were found, but it sometimes happened circumscribed. It was .known that the plague bacillus was that the first cases did not present clear characteristics found in the buboes and sputa of the patient, that it was and it was thus possible that they might be incorrectly also frequently found in the blood, that it had the form diagnosed. At Calcutta Dr. Simpson and Dr. Cobb reported the of a short bacterium, slightly ovoid, that it was easy to stain presence of the plague bacillus in cases of inguinal glandular by the ordinary laboratory methods, and that it could be congestion which had been noticed with extraordinary cultivated on the usual media. frequency among the men of a certain regiment stationed An From a clinical point of view the plague assumed two at Hong Kong during the epidemic of 1894. clinical forms-bubonic plague and plague without buboes, official Commission appointed to investigate the evidence the former being more commonly observed. Persons attacked of Dr. Simpson and Dr. Cobb declared that they were by bubonic plague ordinarily suffered at the commencement cases of simple non-venereal buboes. In reality the comof the illness from a sensation of great weakness with heavi- mission was wrong. It was dealing with an exhausted nonness of the head and painful pricking or tingling at the malignant form of plague that ancient writers had already place where the buboes would appear. The patient was recorded under the name of pestis mitior, as frequent suddenly taken with repeated shivering, of short dura- at the commencement and the end of great epidemics. Such tion at first but getting longer and longer. Intense facts proved how little the best clinical examination pain, great thirst, alimentary or bilious vomiting, and alone could suffice to make a diagnosis of plague. diarrheea afterwards occurred. Glandular congestion, ordi- Such diagnosis could only be determined when the narily limited to a single group of glands, appeared on bacteriological examination demonstrated the presence of the same day or on the day after. A bubo appeared with the microbe of Yersin in the glandular fluid in the little delay; it was accompanied by a painful tumefaction, blood or in the sputum. At the commencement of a case the least pressure on which caused the patient to cry out. of bubonic plague, in order to ascertain whether the The temperature rose very quickly, the pulse was rapid, full, plague :microbe was present or not, it might be feared often dicrotic, but regular, and the breathing was quickened. that to make a puncture with Pravaz’s syringe right into The facies was typical: red, haggard, weeping eyes with an the lymphatic tissues to extract therefrom some drops of expression of agony and terror, and the tongue dried, furred, fluid to be fertilised in the usual manner and examined and red at the edges and point. Sometimes at the com- immediately after colouration would spread the infectious mencement the patients, after a short period of excitation germs beyond the glands in which they had been localised. and mad terror, were smitten suddenly with an overpowering But to-day with the aid of sero-therapy there was no somnolence and collapse ; they then resembled subjects foundation for that fear, because to put the patient beyond struck with serious adynamic typhoid fever. The head was the danger of any possible reinfection it was only necessary, thrown back, the eyelids were half closed, the mouth was directly after the puncture with Pravaz’s syringe, to slightly open. When they were spoken to in a loud voice they inject a small quantity (about five cubic centimetres) of looked around with a stupefied expression, replied with much anti-plague serum into the middle of the gland or at a short difficulty, and dragged their words like intoxicated persons. distance from it. The extracted fluid should be placed When exciting phenomena dominated them the patientsimmediately in tubes of nutritive gelose and in tubes of suffered from hallucinations of sight or hearing, believingbouillon of beef or of veal at a temperature of from 25° themselves to be surrounded by extraordinary animals, asito 30° C. for a period of 24 hours. At the same time a in alcoholic delirium. Sometimes they showed very clearsmall quantity should be spread out on glass slides coloured symptoms of meningitis, opisthotonos, converging strabismus, with methylene blue or thionin. On gelose the appearance dilatation of the pupils, delirium, cramp of the arms, of the microbe colonies did not present any very specific chaflexion of the legs, and fibrillary movements ofracteristies, but their number indicated the degree of gravity The localisation of theof the infection. In the meat bouillon the specific characterthe muscles of the face. glandular lesions determined the special attitudeisties were more precise. The bouillon remained clear and of the patients. The least movement caused them toI transparent and contained some slight whitish clots shriek ; the skin was frequently covered with petechise;; floating on the surface, which sank to the bottom of in grave cases turbid sero-sanguineous pustules formed. the tube at the least movement. If the bouillon was or even actual carbuncles, which latter characterised theturbid it was evident that some microbe other than to which ancient authors gave the name ofthe plague bacillus, perhaps of a mixed infection, was special type " black plague." On auscultation signs were constantlypresent. In such circumstances the diagnosis should found after the third or fourth day of broncho-pneumonia. be made more precise by inoculating susceptible animals The cough was dry and painful, terminated by the expectora- with the culture. The mouse especially took the plague tion of frothy sputa, slightly viscid, yet streaked with bloodand it was only necessary to prick this little animal in and containing the plague bacilli in great quantities. Inthe thigh with a needle dipped in the culture on gelose in grave cases the heart presented signs of an alteration ofE order to give it the disease and cause its death in from 36 the myocardium, with prolongation of the first sound andL to 48 hours. When the inoculated animals succumbed very other cardiac symptoms. In these grave cases thecharacteristic lesions were found on the bodies and the patients scarcely micturated at all and the urine, attplague bacilli were in great quantities in all the organs, times containing blood, was very acid and albuminous. especially in the glands, the spleen, and the liver. To Except in entirely benign cases, suppuration of the buboes; diagnose a case of suspected pneumonic plague it was was the rule and was generally of good augury, as it indinecessary to collect as much as possible of the rusty cated that the system was defending itself against the sputum, to dilute it with a small quantity of boiled water, plague infection and that the infection remained localised. and to fertilise several tubes of gelose with platinum wire, Convalescence was always long. The forms of plague withoutt the temperature not exceeding from 20° to 23° C. At this buboes and without apparent glandular congestion were relatively low temperature the pneumococci did not germimuch rarer than the forms of classical bubonic plague which1 nate, the streptococci germinated badly and very slowly, he had just described, The primary pneumonic plague. while the plague bacilli developed rapidly. At the end
PROFESSOR CALMETTE ON PLAGUE.
,
.
.
.
-
.
’
1365
which had ever been found in the raw water) might we not march ? We believe not, and that the open air will have be doing harm rather than good ? Still this pessimistic saved what might have been the untoward results of smoking view need not trouble us much, for health statistics proved when unfed. that the risk of harm arising either from the presence in the water of so-called pathogenic organisms or from the removal of the harmless ones was so small that it might be calmly MEETING OF THE GENERAL MEDICAL COUNCIL. SUMMONSES have been issued for a meeting of the disregarded." Medical Council on Tuesday, Nov. 27th, at 2 P.M. General These comfortable words of Mr. Mansergh with regard to The Penal Cases Committee will meet on the preceding pathogenic germs were followed by a warning a9 to the and the Executive Committee on Monday, danger which may be apprehended from water derived from Saturday Nov. 26th. " A word of warning sources hitherto considered pure. might, however, be said about water obtained from THE INSPECTION OF CONVENTS. elevated and sparsely-populated moorlands, for," he said, A LETTER which appeared in the Times of Nov. 5th raises "the danger was greater if such water became infected, a most important point. We are not among those who especially if not passed into impounding reservoirs, than consider that convents are dens of iniquity, that the if the supply were taken from a large river." We hope that the members of the Institute of Civil Engineers and the bricking up of recalcitrant nuns is of daily occurrence, or distinguished guests passed a pleasant evening and returned that excavations in the back-gardens of convents would home reassured by the fact that the water of London with reveal facts such as those which horrified the pious inhabiits pathogenic germs which can be calmly disregarded is tants of Cologne when, in 1106, they dug anew the foundastill derived chiefly from the Thames and the Lea, uncon- tions of their walls and came across the bones of the 11,000 taminated with any water from " sparsely-populated virgins and others. But the correspondent to whose letter moorlands"-the "pure nectar from Wales," as it was we refer mentions facts, which so far have not been denied, characterised by Lord Llandaff. which reveal a most dangerous state of things. The doors (of the convent to which the writer refers) into the street are locked at night and the keys are handed over to the reverend THE USE OF TOBACCO ON ACTIVE SERVICE. mother, there being no means of exit until she is comTHE war in South Africa has taught many things of municated with. An outbreak of fire occurred which greater and of less importance. Perhaps nothing that it has fortunately did not end in disaster ; but how easily it might demonstrated has been more marked than the important part have done so. To our minds, as regards sanitary and hygienic which tobacco plays in the soldier’s existence. Whether this the the conditions, ordinary dwelling-house, the conpalace, is to be reckoned as a great fact or a small one there can be vent, and the tenement house should all be under the same no doubt about the truth of it. Yet the Duke of Wellington’s regulations. Epidemics and fire are no respecters of persons armies had no tobacco worth speaking of. If they did not or of religious communities, and though the promise of forbid its use, at any rate the Iron Duke’s officers were angelic protection still holds good, yet it was only given to directed to advise their men strongly against it. What a those in a way —namely, in a definitely marked out path, curious contrast with the campaigning in South Africa, a which the Devil omitted when he quoted the passage point where marches and privations as long and as stern as any for his own purpose. Not to use means which have been suffered by our great-grandfathers were borne by the volunfor our safety is universally recognised as demandprovided teers and soldiers of to-day with a grumble only when their that punishment which is allotted for those who tempt ing " smokes" failed them. We have it from many who took God. True, there must be discipline, but discipline must part in the forced marches leading to Paardeberg, to Bloem- not be such as to combine presumption. fontein, to Pretoria, and beyond, that when rations were but two or three biscuits a-day the only real pbysical THE annual dinner of the Aberdeen University Club, content of each 24 hours came with the pipe smoked by will be held at the Trocadero Restaurant on London, the smouldering embers of a camp fire. This pipe eased the Nov. 21st, at 7 P.M. Sir William McGregor, Wednesday, way to sleep that might otherwise have lingered, delayed by Governor of Lagos, will take the chair, and K.C.M.G., the sheer bodily fatigue and mental restlessness caused by members to dine should communicate with the prolonged and monotonous exertion. It is difficult, then, to honorary intending Mr. J. A. Robson and Dr. James secretaries, believe that tobacco is anything but a real help to men who at 54, Harley-street, W. Galloway, are suffering long labours and receiving little food, and i probably the way in which it helps is by quieting cerebraDR. JOSEPH PRIESTLEY, medical officer of health of tion-for no one doubts its sedative qualities-and thus who was recently selected by the Municipality of Lambeth, is so when more which allowing easily sleep all-important The cases of acute Bombay for the appointment of Executive Health Officer to semi-starvation has to be endured. mental derangement in the course of campaigns such as the the City of Bombay, has not seen his way to accept the present are many. There have indeed been many in South position. The borough of Lambeth is to be congratulated Africa. It would be most profitable and interesting could upon retaining the services of Dr. Priestley. medical officers have taken special note of the capacity for MR. HUTCHINSON, F.R.S., has offered, and his offer has sleep previously evidenced by those who broke down and also of their indulgence or non-indulgence in tobacco. We been accepted, to build and fit out an educational museum in are inclined to believe that, used with due moderation, connexion with the Friends’ School at Ackworth, near tobacco is of value second only to food itself when long Pontefract, Yorkshire. Museums on similar lines have been privations and exertions are to be endured. Two features are provided by Mr. Hutchinson’s generosity at Haslemere, to be noted with regard to the smoking practised on active Surrey, and at his native town, Selby, Yorkshire. service. It is almost entirely in the open air and it is largely on an empty stomach. The former is always an PROFESSOR A. H. YourrG, M.B. Edin., F.R.O.S. Eng., has advantage ; the latter we generally reckon a most unfavour- been appointed Representative of the Victoria University for able condition. Shall we see in the near future patients five years on the General Medical Council in succession to with tobacco amblyopia or smoker’s heart acquired while the late Dr. D. J. Leech. the trusting friend of tobacco thought that he was 1 THE LANCET, Oct. 27th, 1900, p. 1220, enjoying unharmed the well-earned solace of a hard day’s ___
___
1366
PROFESSOR CALMETTE ON PLAGUE.
resulted from the penetration of the microbe into the respiratory channels and it was to this exceedingly grave form that Dr. Muller and his laboratory assistants succumbed PROFESSOR A. CAIMETTE, Director’ of the Pasteur in 1898 at Vienna. Another and still rarer form of plague which Institute at Lille, in the course of ’the first Harben without buboes was plague septicaemia or pesticasmia with extreme rapidity and was caused by the intense developed Lecture of the Royal Institute of Public Health, depullulation of the plague bacillus in the blood and in the livered at the Examination Hall of the Royal Colleges organs. It was not exactly known where the virus first of Physicians of London and Surgeons of England on effected an entrance in these cases ; perhaps the microbe Nov. 7th, said that the recent appearance of plague penetrated by the intestine or directly into the blood through at Glasgow had decided him to choose the study of some little open sore or cut. Post-mortem examinations of severe form this disease as the subject of his lectures. Plague patients who bad succumbed to this particularly mesenteric and retro-peritoneal now menaced all the maritime nations of the globe showed very congested and it had become necessary to take rigorous measures to glands of a characteristic purplish colour like dregs of wine, fact seemed to support the hypothesis of penetration stop its extension. The progress of hygiene and the know- which of the virus by the gastro-intestinal channels. When the the last five on the years etiology, ledge acquired during treatment, and prophylaxis of the affection enabled it to be plague was studied in an epidemic centre all the forms combated very efficaciously and its centres to be rapidly above described were found, but it sometimes happened circumscribed. It was .known that the plague bacillus was that the first cases did not present clear characteristics found in the buboes and sputa of the patient, that it was and it was thus possible that they might be incorrectly also frequently found in the blood, that it had the form diagnosed. At Calcutta Dr. Simpson and Dr. Cobb reported the of a short bacterium, slightly ovoid, that it was easy to stain presence of the plague bacillus in cases of inguinal glandular by the ordinary laboratory methods, and that it could be congestion which had been noticed with extraordinary cultivated on the usual media. frequency among the men of a certain regiment stationed An From a clinical point of view the plague assumed two at Hong Kong during the epidemic of 1894. clinical forms-bubonic plague and plague without buboes, official Commission appointed to investigate the evidence the former being more commonly observed. Persons attacked of Dr. Simpson and Dr. Cobb declared that they were by bubonic plague ordinarily suffered at the commencement cases of simple non-venereal buboes. In reality the comof the illness from a sensation of great weakness with heavi- mission was wrong. It was dealing with an exhausted nonness of the head and painful pricking or tingling at the malignant form of plague that ancient writers had already place where the buboes would appear. The patient was recorded under the name of pestis mitior, as frequent suddenly taken with repeated shivering, of short dura- at the commencement and the end of great epidemics. Such tion at first but getting longer and longer. Intense facts proved how little the best clinical examination pain, great thirst, alimentary or bilious vomiting, and alone could suffice to make a diagnosis of plague. diarrheea afterwards occurred. Glandular congestion, ordi- Such diagnosis could only be determined when the narily limited to a single group of glands, appeared on bacteriological examination demonstrated the presence of the same day or on the day after. A bubo appeared with the microbe of Yersin in the glandular fluid in the little delay; it was accompanied by a painful tumefaction, blood or in the sputum. At the commencement of a case the least pressure on which caused the patient to cry out. of bubonic plague, in order to ascertain whether the The temperature rose very quickly, the pulse was rapid, full, plague :microbe was present or not, it might be feared often dicrotic, but regular, and the breathing was quickened. that to make a puncture with Pravaz’s syringe right into The facies was typical: red, haggard, weeping eyes with an the lymphatic tissues to extract therefrom some drops of expression of agony and terror, and the tongue dried, furred, fluid to be fertilised in the usual manner and examined and red at the edges and point. Sometimes at the com- immediately after colouration would spread the infectious mencement the patients, after a short period of excitation germs beyond the glands in which they had been localised. and mad terror, were smitten suddenly with an overpowering But to-day with the aid of sero-therapy there was no somnolence and collapse ; they then resembled subjects foundation for that fear, because to put the patient beyond struck with serious adynamic typhoid fever. The head was the danger of any possible reinfection it was only necessary, thrown back, the eyelids were half closed, the mouth was directly after the puncture with Pravaz’s syringe, to slightly open. When they were spoken to in a loud voice they inject a small quantity (about five cubic centimetres) of looked around with a stupefied expression, replied with much anti-plague serum into the middle of the gland or at a short difficulty, and dragged their words like intoxicated persons. distance from it. The extracted fluid should be placed When exciting phenomena dominated them the patientsimmediately in tubes of nutritive gelose and in tubes of suffered from hallucinations of sight or hearing, believingbouillon of beef or of veal at a temperature of from 25° themselves to be surrounded by extraordinary animals, asito 30° C. for a period of 24 hours. At the same time a in alcoholic delirium. Sometimes they showed very clearsmall quantity should be spread out on glass slides coloured symptoms of meningitis, opisthotonos, converging strabismus, with methylene blue or thionin. On gelose the appearance dilatation of the pupils, delirium, cramp of the arms, of the microbe colonies did not present any very specific chaflexion of the legs, and fibrillary movements ofracteristies, but their number indicated the degree of gravity The localisation of theof the infection. In the meat bouillon the specific characterthe muscles of the face. glandular lesions determined the special attitudeisties were more precise. The bouillon remained clear and of the patients. The least movement caused them toI transparent and contained some slight whitish clots shriek ; the skin was frequently covered with petechise;; floating on the surface, which sank to the bottom of in grave cases turbid sero-sanguineous pustules formed. the tube at the least movement. If the bouillon was or even actual carbuncles, which latter characterised theturbid it was evident that some microbe other than to which ancient authors gave the name ofthe plague bacillus, perhaps of a mixed infection, was special type " black plague." On auscultation signs were constantlypresent. In such circumstances the diagnosis should found after the third or fourth day of broncho-pneumonia. be made more precise by inoculating susceptible animals The cough was dry and painful, terminated by the expectora- with the culture. The mouse especially took the plague tion of frothy sputa, slightly viscid, yet streaked with bloodand it was only necessary to prick this little animal in and containing the plague bacilli in great quantities. Inthe thigh with a needle dipped in the culture on gelose in grave cases the heart presented signs of an alteration ofE order to give it the disease and cause its death in from 36 the myocardium, with prolongation of the first sound andL to 48 hours. When the inoculated animals succumbed very other cardiac symptoms. In these grave cases thecharacteristic lesions were found on the bodies and the patients scarcely micturated at all and the urine, attplague bacilli were in great quantities in all the organs, times containing blood, was very acid and albuminous. especially in the glands, the spleen, and the liver. To Except in entirely benign cases, suppuration of the buboes; diagnose a case of suspected pneumonic plague it was was the rule and was generally of good augury, as it indinecessary to collect as much as possible of the rusty cated that the system was defending itself against the sputum, to dilute it with a small quantity of boiled water, plague infection and that the infection remained localised. and to fertilise several tubes of gelose with platinum wire, Convalescence was always long. The forms of plague withoutt the temperature not exceeding from 20° to 23° C. At this buboes and without apparent glandular congestion were relatively low temperature the pneumococci did not germimuch rarer than the forms of classical bubonic plague which1 nate, the streptococci germinated badly and very slowly, he had just described, The primary pneumonic plague. while the plague bacilli developed rapidly. At the end
PROFESSOR CALMETTE ON PLAGUE.
,
.
.
.
-
.
’