An address on the general pathology and serum treatment of plague : delivered at a meeting of the medical profession of Bombay, held under the auspices of the Bombay Medical Union, on March 18th, 1908 : Sir Bhalchandra Krishna, Kt., the president of the Union in the chair / by Khan Bahadur N.H. Choksy, M.D.

  • Choksy, Khan Bahadur N. H.
Date:
1908
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Licence: In copyright

Credit: An address on the general pathology and serum treatment of plague : delivered at a meeting of the medical profession of Bombay, held under the auspices of the Bombay Medical Union, on March 18th, 1908 : Sir Bhalchandra Krishna, Kt., the president of the Union in the chair / by Khan Bahadur N.H. Choksy, M.D. Source: Wellcome Collection.

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    the infection, is the rat flea, has been conclusively demonstrated by the extensive series of most elaborate, ingenious and painstaking experiments conducted by the Plague Research Commission. I would refer you to their published reports in the Journal of Hygiene5. The actual process by which infection is brought about is thus summarised by Lamb — “ After careful consideration of all the available evidence bearing on the subject, the Commission were of opinion that it pointed to the conclusion that the bacilli after multiplying in the stomach of the rat flea—Pulex Cheopis—leave its body with the faeces, and then become injected into the healthy animal either by being carried in by the pricker or by being rubbed into the pricker wounds.” The flea while sucking has the habit of squirting blood per anum. Wounds made by the pricker afford a sufficient avenue for the entrance of the bacilli even when no rubbing is resorted to. It is also possible for infection to take place by contaminated mouth parts or by regurgitation from the stomach. Infection by the eating of infected fleas and by infected saliva can be almost certainly excluded. “ The chances of an animal contracting plague after being bitten by a single infected flea are remote.” The method of invasion in plague in the case of the bubonic and cellulo-cutaneous types is thus explained. It has been assumed that in septicaemic plague there is direct infection of the blood. There is however just the pos¬ sibility, that it might not be always so, as in some instances, whilst the most careful search during life has failed to elicit any evidence of glandular enlargement, the autopsy has re¬ vealed bunches of very tiny buboes too deep-seated to be felt, in the axilla and other parts. That can only occur when the lymphatic glands having through some inexplicable cause, failed to arrest the bacilli in their progress, the latter gain an easy entrance into the blood and produce septicaemia. Under such circumstances errors are liable in diagnosis ; a case of the bubonic type with secondary septicaemia is thus likely to be mistaken for primary septicaemic plague. Many observers have noted the pre¬ sence of very minute buboes in some of the most virulent and fatal cases of plague, and such undoubtedly are of this nature. Infection in pneumonic plague is contracted by inhalation— especially of the fine spray of the sputum teeming with the bacilli. I would however venture to ask whether it is the only possible channel ? The apparent primary pneumonia might be but a