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in limited amount to the Medical Officers of Health of districts
actually invaded by Plague, for the protection therein of doctors,
nurses, and other persons that are, under the conditions of the invaded
area, being subjected to sustained exposure to Plague infection.
(2) Symptoms of Plague.
An ordinary attack of Plague usually begins some three to five
days after exposure to infection. Such attack may develop gradually,
but, as commonly met with, there is sudden onset with much fever, as
indicated by a high temperature, rapid pulse, headache, hot skin,
and thirst. The eyes are injected as if inflamed: the expression, at
first anxious and frightened, becomes subsequently vacant and dull;
the utterance is thick, and the gait unsteady as in one under the
influence of drink. There is at times a distinct tendency to faint.
The tongue is at first covered with a. moist white fur except at the
edges, which are red, but later on it becomes dry and of a mahogany
colour.
The most distinctive sign of Plague is the presence of swellings,
or "buboes" as they are called, in the groin, armpit, or neck. These
"buboes." which led to the disease being called "Bubonic Plague," and
which have no relation to venereal complaints, appear, as a rule, about
the second or third day of the disease. They are usually painful and
tender on pressure, and in size they vary from that of an almond to
that of an orange. Later 011 they may "gather" and burst like an
ordinary abscess. There may, too, appear about the body purple
spots, and what are known as "carbuncles."
But "buboes" are not an essential feature of Plague. Cases
occur in which these manifestations of the disease are greatly delayed
or even absent, as for instance in "Pneumonic," "Gastric," and
"Septicæmic" Plague; forms of the malady which may be mistaken
for, respectively, inflammation of the lungs. Typhoid Fever, and acute
blood poisoning. Plague in these forms is always grave; not only
because of the fatality of the cases, but for the reason that they,
especially the "Pneumonic," are highly infectious to other persons.