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plague, disease, usually, swellings, epidemic, europe and skin

PINE-NEEDLE BATH.—Bath prepared by adding an extract of pine needles (4 to 16 ounces of pine-needles to I or 2 quarts of hot water) to a full body-bath. Instead of this, 15 to 20 drops of pine-oil may he added to the bath, or a decoction of fresh fir and pine twigs may he used. The oil irritates the skin more than does the extract, and is not well endured by persons with sensitive skin. The temperature of the bath should be about 95° F., and its duration from to to 3o minutes.

PINWORMS.—See Worms.

PLAGUE.—In the days of antiquity, and the Middle Ages, the word " plague " was used as a designation for many malignant diseass occurring in epidemics. Within more recent years, however, the term has been used solely to designate one certain malady—namely, the bubonic plague. This is a very acute, contagious disease, and is characterised by a severe general infection, accompanied with high fever and, in the majority of cases, with inflammation of the lymph-glands of the groins, the arms, or the neck. It is usually rapidly fatal. Endemic in certain parts of the interior of Asia and Africa, the disease occasionally spreads from its perma nent homes, involving smaller or larger portions of the population of the globe. The " emerods (or tumours) in their secret parts," mentioned in I. Sam. v. 9, were undoubtedly the results of plague in Canaan. The first epidemic more exactly known historically was the pandemic which, during the sixth century, spread over almost the entire Europe. It is usually referred to as the " Justinian Plague," as it occurred during the reign of Emperor Justinian.

The most terrible pandemic of the subsequent centuries was the " Black Death," which invaded Europe in 1348, and from which it has been estimated that no less than 25,000,000 human beings perished. This epidemic was transmitted to Europe from China, Constantinople being the first point infected. Thence the plague travelled westward in a circle, reaching Russia three years later. Some cities and countries lost one-half their populations ; and ships manned by dead crews drifted aimlessly about on the high seas, the putrid corpses scattered on their decks carrying contagion to the lands to which wind and tide chose to bear the vessels. At least 41 epidemics are

known to have occurred since then. In 1896 an epidemic broke out in Bombay which threatened the world.

The cause of plague is a micro-organism, which usually enters the body of man through small wounds of the skin. The disease is spread by human intercourse, and also by animals, especially by rats. These animals may also be affected by plague. In fact, it is possible that the malady is, originally, a disease of rats or of other rodents. Unfavourable hygienic conditions, such as dark, musty and dirty dwellings, over-crowding, misery and famine, are important factors in developing and disseminating the disease.

The most frequent type of bubonic plague is characterised by swellings of lymph-glands in various parts of the body, most frequently in the groins and armpits, more rarely on the neck. These swellings, which have given the malady its name, are more or less extensive and painful. They often break down and suppurate. In many patients the disease runs so rapid a course that the glandular swellings have little time to develop. The bacteria causing the disease enter the blood, and the patient dies under symptoms of severe blood-poisoning. In the so-called " pneumonic " form of plague, the infection is located chiefly in the lungs, where it causes an inflammation which is characterised chiefly by the coughing of bloody sputum, marked shortness of breath, and high fever.

Measures to prevent the disease consist primarily in the speedy isolation of affected persons, and strict surveillance of suspected individuals. These safeguards must be combined with extensive disinfection, including all objects used by patients, their excreta (sputum, urine and traces), the sickroom, and the infected houses. It is also of great importance to institute campaigns of extermination against rats, in houses as well as on shipboard ; to prohibit the gathering of throngs ; to supervise traffic, by water as well as by land ; and to aim at improving general sanitary conditions. For the individual person, the most scrupulous cleanliness is imperative.


PLEURA.—For anatomy and physiology, sec INTRODUCTORY CHAPTERS (P• •