Sessional_Paper_1904 — Page 654

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(3.) The epidemic finished with septicamic plague.

(4.) The bubonic variety of the disease only became pronounced at the

height of the epidemic.

(5.) The pneumonic variety followed the course of the bubonic type. From this epidemic, the experience in regard to the prevalence of the different types of the disense, is almost identical with that found during 1902.

The start and finish of the epidemic with uncomplicated septicemic cases of the disease. and the appearance of bubonic swellings and lung complications, during the height of the epidemic, would appear to be of considerable importance in regard to the exact nature of the infection. The course of these epidemics is, in my opinion, additional evidence in favour of the view which I have put forward, namely, that plague is, ab initio, a disease of a septicemic nature.

In both epidemics, septicemic plague is first in the field, increases proportion- ately during the course of the epidemic, and closes up the rear. The bubonic and pneumonic manifestations are met with in considerable numbers, only after the establishment of uncomplicated cases of plague septicemia.

Sex Incidence in Plague.

Both sexes would appear to be equally affected.

Age Incidence in Plague.

The disease is most frequently found between the ages of 20 and 40,

Infants and children would appear to suffer more frequently from plague, than is generally supposed. According to LowSON, AOYAMA, and others, infantile plague is rare. My results show that during plague epidemics, the disease figures largely as a cause of death in children under à years of age.

The following figures may be of interest, representing the results obtained after performing 812 post-mortem examinatious on children under 5 years of age:

-

Septicæmic Plague,

Bubonic Plague,

Pneumonic Plague,

Luder 2 years.

1

Over 2 years and under 5 years of age.

31

4

50 27

14.

39

91

These figures permit of the following conclusions :-

(1.) Children under two years of age, most frequently contract plague

in the uncomplicated septicamic form.

(2.) The bubonic and pneumonic varieties of the disease are rare in

children under 2 years of age.

(3.) All types of plague are more frequent in children over two and

under five years of age.

(4.) Lung forms of plague are more common in children over 2 and under five years of age. In fact my figures show that over 40% of the total number of pneumonic varieties of plague, occurred in childen under five years of age.

Occupation Incidence in Plague.

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In past epidemics, it has been extremely difficult to obtain any accurate information in regard to this subject. The dumping of dead bodies has a great deal to do with this difficulty.

It is known that medical men, nurses, attendants on plague patients, and members of different plague staffs, rarely contract the disease.

Coolies, cooks, hawkers, married women, mill workers, and domestic servants account for a large number of the cases.