"مذكرات الحرب. مقر قيادة الجيش، الهند. [...] قوة المشاة الهندية «د». المجلد ٣٢. الجزء II. (من ١٦ إلى ٣١ مارس ١٩١٧)." [و‎‎١‎٠‎٨] (٢٩٤/٢٢٤)

(in) For rat destruction the liberal and systematic use of poison baits is
probably the best means of bringing about a rapid reduction in the rat popula
tion.
(iv) That infection amongst the rats will probably Lave spread consider
ably beyond the area in which plague rats and human cases have already been
found.
(v) That infection amongst the rats persists for several weeks (in the off
season perhaps for 2 or 3 months) after the last plague rats or human cases
have occurred. In carrying out rat destruction operations with the view of
eradicating infection, it is all important that these points and particularly the
latter (iv) and (v) should always be borne in mind.
POST MOETEM SIGNS OE PLAGUE IN A EAT.
(The following are the most characteristic signs.)
1. Cutaneous.
Sub-cutaneous congestion (pink skin and toes), Oedema, sub-cutaneous
haemorrhages of various sizes, sometimes quite minute (?-flea bites).
2. Lymphatic system.
Buboes. —hard caseouscentre, matted, surrounded by haemorrhages and
oedema. Situations : sub-maxillary and cervical, inguinal, axillary, posterior-
axillary, pelvic.
3. Abdominal.
Spleen. —enlarged, moulded, conjested, covered with minute white necrotic
specks. If rat dies in later stage, or if recently recovered from acute attack,
there may be small splenic abscesses (with virulent B. pestis in pus),, also signs
of recent perisplenites; and adhesions of spleen to vicera and abdominal wall.
Liver. —Hard moulded, waxy surface (as if covered with thin film of oil
or grease, not water), very friable, granular, covered with minute necrotic
specks. (Very characteristic.)
4. Thoracic.
Lungs.—pleural effusion (very common and very suggestive), minute
pulmonary abscesses (very rare). -Heartf-Pericardial effusion, congestion.
5. Bacteriological test.
B. Testis. —Present in spleen, liver, heart blood, bubo, etc. If much
decomposition, heart blood and bubo may remain free from putrefactive organ
isms longest. B. Pestis must be distinguished from pseudotubercle, chicken-
cholera, hog-cholera, and a few others.
On Agar growth is slow and is translucent, slimy and sticky to touch.
On Broth when grown for about a w r eek and not disturbed by the slightest
vibration, shews stalactities. This is almost diagnostic of plague.
6. Biological test.
The most certain test for the presence of B. Pestis in a putrid rat, in which
plague could otherwise not be recognized, is by rubbing a little of the rat tissue
(spleen or blood or bubo, etc.), into a small roughly shaved and bleeding surface
of the abdomen of a guinea-pig. The guinea-pig dies of plague in 3 or 4 days.
Note. —The above is a classical 'picture and all signs are rarely present simultaneously. As a rule
only 2 or 3 of the above signs are distinctly present at the same time, but when present they are a more
certain means of diagnosis than a mere microscopic examination, especially in a semi-putrid rat With a
little practice, it should be possible to detect a pl gue infected rat when the appliances of a laboratory are
not available.
In Mesopotamia. —Typical buboes and necrotic specks on liver and spleen,
and sub-cutanecus oedema, so commonly seen in India, apjpear to be rarely
present—on the other hand, sub-cutaneous congestion and pleural effusion are
marked and usually present.
Negative signs, —The only signs that may contraindicate the presence of
plague are :—
1. A small, tough, flabby spleen,
2. A small, tough, flabby liver.
3. ♦Healthy appearance of pleura and pericardium,
where these are present, the rat has probably not died of plague.