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Although it has not been generally denied that other channels of infection may occasionally be concerned in the development of the disease, the views of the Indian Plague Commissioners have met with general acceptance, and most observers are of the opinion that the chief channel of infection in plague is the skin system.
The Government Bacteriologist of this colony, Dr. HUNTER, has, however, in 1904 written a report entitled a "Research into Epidemic and Epizootic Plague" in which he states that, in his opinion, the importance of the skin infection theory, has been grossly exaggerate, and in which he very strongly emphasizes the relative much greater importance of the gastro-intestinal tract as a channel of plague in- fection.
As one who is concerned with Public Health work, i.e., the prevention and mitigation of disease in communities, I have had to carefully consider this question in the light of Dr. HUNTER'S conclusions and in order that a somewhat different point of view may be taken of this subject generally and of the food question particularly, I venture to submit this report for consideration.
To begin with, although it may be superfluous matter for some readers it may not be out of place to briefly consider the anatomy and physiology of the lymphatic system.
The blood in its circulation does not come into sufficiently intimate relation with the cells of the body to supply directly all necessary nutriment to them. It is held that the supply of proteid material to the cells is conditioned by the trans- udation of such material from the capillary blood vessels into the spaces about the cells of the tissues. The lymph is a fluid derived from the blood plasma through the very fine walls of the capillaries and which bathes the cells of the tissues with a nutrient fluid.
This lymph may not stagnate but must circulate. After fulfilling its functions of supplying certain nutriment to the cells it has to flow on and ultimately gets back into the blood circulation by means of a system of lymph vessels which receive tributaries from the different tissues of the body on their way to pour their contents into the large veins near the heart.
The lymphatic vessels begin in a network of fine capillaries in the organs and tissues of the body. These capillaries by joining with one another give rise to larger vessels in the same way that the venous capillaries join to form larger veins.
The lymphatic vessels, however, are peculiar in that during their course they pass through certain tissues known as lymphatic glands. While passing through these glands the lymph is brought into close relation with their tissues and in its passage receives into its stream from the glands certain cells called lymphocytes which flow onward with the lymph and get into the blood stream and there con- stitute one kind of leucocytes or white corpuscles of the blood.
The lymphatic vessels bringing lymph to the glands are called their afferent vessels and those leaving the glands their efferent vessels.
The situation of the lymphatic glands and their relations to the different organs and tissues which are drained by the lymphatic vessels passing througli them are described as follows in QUAIN's Anatomy, 9th edition, (it will suffice to quote the description of the lymphatics of the lower limb, pelvis, abdomen and the upper limb):-
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Lymphatics of the Lower Limb.”
"THE LYMPHATICS OF THE LOWER LIMB are arranged in a superficial and a "deep series. Those of the superficial series, together with the superficial lympha- "tics of the lower half of the trunk, converge to the superficial inguinal glands, "with the exception of a few which dip into the popliteal space. Those of the
deep series enter the deep inguinal glands.
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"THE POPLITEAL LYMPHATIC GLANDS, usually very small, and four or five in number, surround the popliteal vessels, and are imbedded in a quantity of loose "fat. They receive from below the deep lymphatics of the leg, and a few super- "ficial ones which accompany the short saphenous vein; their efferent vessels "ascend with the femoral vein to the groin.