Pestis, pestilentia), in medicine, a term given to any epidemic disease causing a great mortality, and used in this sense by Galen and the a ncient medical writers, but now confined to a special disease, otherwise called Oriental, Levantine, or Bubonic Plague, which may be shortly defined a specific infectious fever, one variety being characterized by buboes (glandular swellings) and carbuncles.
(2) Rufus speaks of the buboes called pestilential as being specially fatal, and as being found chiefly in Libya, Egypt and Syria, He refers to the testimony of a physician Dionysius, who lived probably in the 3rd century B.C. or earlier, as and to Dioscorides and Posidonius, who fully described these buboes in a work on the plague which prevailed in Libya in their time.
It appeared in Gaul in 546, where it is described by Gregory of Tours with the same symptoms as lues inguinaria (from the frequent seat of buboes in the groin).
At the end of November 3 the disease became suddenly more severe, and most of those attacked died; and from the 21st of December it became still more malignant, death occurring in some cases in a few hours, and without any buboes being formed.
In the second of these, which occurred in the Ahmedabad district of the Bombay Presidency in 1683-89, buboes ale distinctly described.
It is found in the buboes in ordinary cases, in the blood in the so-called " septicaemic " cases, and in the sputum of pneumonic cases.
The Bombay Plague Research Committee, whose experience is unequalled, say: " In a number of instances points of inoculation were found on the extremities of patients, from which plague cultures were obtained, and in these cases buboes were found above the point of inoculation.
The really pathognomonic sign is the appearance of buboes or inflamed glands, which happens early in the illness, usually on the second day; sometimes they are present from the outset, sometimes they cannot be detected before the third day, or even later.
Sometimes the buboes are multiple and on both sides, but more commonly they are unilateral.
Petechiae occur over buboes or on the abdomen, but they are not very common, except in fatal cases, when they appear shortly before death.
Buboes should be treated on ordinary surgical principles.