558
Cases have been reported where the bubo or buboes did not appear until the 8th, 9th or 10th day of the disease. The majority, however, are well marked before the 4th or 5th day of the illness.
The Growths. This is usually slowly progressive. In a few cases this would appear to be absent for some days, and followed by a sudden and rapid increase in dimensions. This is frequently observed in buboes which have been late in appear- ing. According to Lowson, the prognosis is grave in such cases.
The Size. They are variable in size. Buboes as large as pigeon's eggs, a man's fist, or even larger, are most frequently found. In a few cases the swelling may never reach a size larger than a bazel nut.
The Distribution.--The results of the post mortem examinations of 788 cases of plague in which bubonic swellings were found, are as follows:-
1. Single Buboes :—
Right femoral bubo,
Left femoral bubo,
238
234
Right axillary bubo,
129
Left axillary bubo,...
91
Right inguinal bubo,
26
Left inguinal bubo,
18
Right cervical hubo,
18
16
2
Left cervical bubo,.
Left parotid bubo,
Left subinaxillary bubo,
1. Double Buboes :-
-
Right and left femoral buboes,
Right and left axillary buboes,
Right femoral and left cervical buboes,
Left axillary and left cervical buboes,
4
2
1
1
III. Multiple Buboes, Case No. I.--Chinese female, æt. 30. Large buboes were found in the following situations :-
(1.) Below and inside Poupart's ligament on the left side.
(2.) At the junction of int, and ext. iliac vessels on the right side.
(3.) In the mesentery.
(4.) In the superior mediastinum.
There was no pneumonia.
The woman was pregnant.
A six months' fœtus was extracted. Plague
bacilli were found in the maternal placenta. The results of bacterio- logical exainination of the fetus were negative.
Case No. II.-Chinese male, æt. 35. The following buboes were found :-
(1.) In the right inguinal region.
(2.) Around the left external iliae glands,
(3.) In the right axilla.
In addition to this the whole of the subcutaneous tissue of the right inguinal, and lower parts of the right and left lumbar and umbelical regions of the anterior abdominal wall was cedematous and densely infiltrated with blood. Numerous plague bacilli were found in this tissue. There was no evidence of injury. The infiltrated area did not appear to have any connection with the buboes present.
Case No. III-A Chinese male, æt. 52. The following buboes were found :-
(1.) Immediately below the left ear.
(2.) Just above the left clavicle.
(3.) In the right axilla.
(4.) In the left axilla.