PLAGUE, a very malignant kind of contagious fever prevailing at. certain times and places epidemically, characterized by buboes, or swellings of the lymphatic glands, by carbuncles and petechire. and not apparently furnishing any security against its recur rence in the same individual. For a history of the origin of the plague in the far east (China), and its gradual spread, under the name of the black death (q.v.), through Asia and Europe, in the 14th c., the reader is referred to Recker's Epidemics of the ;Male Ages (1844, published by the Sydenham society). Its trne and permanent home seems to be iu the regions bordering upon the eastern extremity of the Mediterranean. At differ ent periods of the 13th, 16th, and 17th centuries, it visited western Europe. It last attacked London and almost all England in the years 1663-65; while so late as 1720, it destroyed nearly half the population of 3Iarseilles; and seventy years afterwards, pre vailed in Russia and Poland, since which time it has been almost unknown iu western Europe. It is umv limited chiefly to Egypt, Syria, Anatolia, Greece, and Turkey, occa sionally extending northward towards Russia, and westward as far as Malta.
The disease usually commences with a sensation of intense weariness and fatigue, slight shivering, nausea and sickness, confusion of ideas, giddiness, and pain in the loins. These symptoms are rapidly followed by increased mental disturbance, with occasional stupor and delirium, by alternate pallor and flushing of the face, by suffusion of the eyes, and it feeling of intense constriction in the region of the heart. Dotting pains are felt in the groins, armpits, and other parts of the body, which are soon fol lowed by enlargements of the lymphatic glands, or buboes (which sometimes appear on the first and second day, sometimes not till near the close of the disease, and sometimes are altogether absent), and by the formation of carbuncles on various parts of the body. As the disease advances, the tongue becomes dry and brown, while the gums, teeth, and lips are covered with it fur; the bowels, at first constipated, become relaxed, the stools being dark, offensive, and sometimes bloody. The power of the will on the muscles is much impaired; and altogether the patient resembles a person under the influence of intoxication. Throughout the disease, there is more or less tendency to faintness; and usually about the second or third day, peteehial spots, livid patches like bruises, and dark stripes (called vibices), appear upon the skin, especially iu severe cases. These discolorations are owing to the extra•asatiou of blood, and are often accompanied with hemorrhagic discharges from the mucous membranes cases, the pulse gradually sinks, the surface becomes cold and clammy, blood oozes from the mucous surfaces, there is coma, or low delirium: and death occurs usually in five or six days, either with out a struggle, or preceded by convulsions.
Great difference of opinion exists as to the cause of plague. Some maintain that it is propagated exclusively by a peculiar contagion; others, while admitting its contagious nature, maintain that it may also be spontaneously engendered by endemic or epidemic influences; while others, again, reject the contagion view altogether, and assert that it originates exclusively in local causes or epidemic influences. Of these three views, the great mass of evidence goes to show that the second is the correct one. Whatever may be the cause of the disease, temperature appears to exert a considerable influence over it, In tropical climates, the disease is unknown, and the cold weather of northern climates has been observed to check its ravages. In Europe, it has always been most fatal in the summer and autumn, especially in September. Thus, in the plague of London in 1665, the deaths from the plague were, in June, 590; in July, 4,129; in August, 20,046; in September, 26,230; in October, 14,373; in November, 3,449; while in December, they were less than 1000.
The exact nature of the disease is unknown. A poison whose characters evade all chemical and microscopical examination is absorbed and alters at once, or after a short stage of incubation, the composition of the blood and the condition of the tissues.
With respect to treatment, little can lie done to arrest the progress of the disease in any individual case. The patient should, if possible, be removed at once from the source of the disease; lie should be exposed freely to fresh air: his secretions should be duly regulated, and his strength supported as far as possible. Friction with olive oil has been strongly recommended, but subsequent experience has not confirmed the first reports in its favor. But although treatment is comparatively valueless, much may be done toward guarding against the attacks of the disease. There can be little doubt that it is in consequence of the free external use of cold water, perfect cleanliness, moderate habits of life, and superior ventilation that European (especially English) residents in the infected cities of the Levant are comparatively exempt from this disease. It is very possible that inunction of the body with olive oil may be (as has been asserted) a useful prophylactic agent, although it fails to cure the disease. It is almost needless to add that all unnecessary communication with the sick, or contact with clothes or other matter that may have been infected with the poison, should be as much as possible avoided.