The clinical varieties of plague / by A.K. Chalmers, M.D., D.P.H.(Camb.), Medical Officer of Health, Glasgow.

  • Chalmers, A. K. (Archibald Kerr), 1856-1942.
Date:
1900
Catalogue details

Licence: In copyright

Credit: The clinical varieties of plague / by A.K. Chalmers, M.D., D.P.H.(Camb.), Medical Officer of Health, Glasgow. Source: Wellcome Collection.

Provider: This material has been provided by The University of Glasgow Library. The original may be consulted at The University of Glasgow Library.

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    lymphatics become infected. The bubo varies in size, and is, as a rule, extremely tender and exquisitely painful. In cases which prove fatal early the glands may remain hard and painful, but in the majority, owing to the matting together of glands by a serous and sanguinolent infiltration, and by a mass of extravasated blood, the bubo enlarges and forms a doughy and bulky swelling. At times, owing to pressure on veins, a considerable amount of cedema of the tissues in the neighbourhood of the bubo occurs. The size of the bubo is not of so much importance as its position. When situated in the axilla or in the cervical region it is particularly dangerous when the exudation is extensive, because the effusion is apt to become organised and con- verted into a hard mass, which may press on some vital part, or may form a large slough. If the patient lives for seven or eight days the bubo either begins to resolve, or shows signs of softening and goes on to suppuration or to suppuration and slougliing. Examination of the lymph and blood of the glands and buboes show large numbers of the plague bacilli. A gland or bubo may be punctured, and a small quantity of the contents drawn off by suction with a sterilised pipette, closed at one end to protect the operator against accidental infection. * (3) The Septicaemic form :— The septic variety of plague is a virulent type in which the lymphatic glands show no special enlargement during life, and consequently the bubo is absent, but after death the glands are found to be generally affected, being some- what enlarged and much congested. In this form of plague the bacilli early invade the blood in large numbers, and are easily detected. The chief characteristic is its rapidity. The patient is profoundly affected by the amount and strength of the poison received. Usually ushered in with high fever, there is at times no power in the patient for reaction, and the temperature does not reach 100° F. The