Few greater calamities from a public health point of view could befall a community than an outbreak of Bubonic Plague. Until the disease broke out in Sydney in 1900, the possibility of New Zealand becoming infected does not seem to have been seriously considered. With Oriental Plague raging within three and a half days’ sail of the country, public opinion was sufficiently aroused to justify the Government in formulating legislation to deal with the question. It was also shown that vigorous sanitary reform was necessary more especially with regard to the chief centres of population.

Auckland, as being the nearest port to Sydney, San Francisco, Calcutta, and other centres of infection, naturally was looked upon as the most likely point of entrance. During the past seven years sporadic cases have occurred in Auckland, all strange to say, with one exception, within a short radius of the last focus of infection, Lower Queen Street, at a short distance from the chief wharf of the harbour.

The last outbreak—in which two young women died within three days with symptoms clinically similar, and post mortem appearances identical—typical cases of Bubonic Plague of the Septicaemic type—came like a thunder-clap on the community. The fact that both patients were employed in the same building, one occupying a position on the floor almost immediately above the other, the finding of a rat which had died from Plague in the same building, the grossly filthy condition of the cellars, and the uncountable accumulation of dirt and rags under the floors of the topmost room, combined with the regrettable mishap of the second victim dying in the ambulance unattended, the prompt and drastic measures taken to curtail the outbreak entailing considerable hardship on a large number of citizens, all combined to arouse public interest to fever pitch.

The experience of all centres where Plague has broken out is that the first great difficulty has been to convince the public that the disease was really and truly one of Oriental Bubonic Plague. Fortunately, as far as diagnosis was concerned, there was not a vestige of doubt in either of these cases, the presence of the Bacillus Pestis being easily demonstrated in each of the numerous specimens examined, combined with the cultural and biological tests being positive. Smears of blood from the heart, spleen and kidneys all showed the typical cocco-bacillus with bipolar staining.

A guinea pig innoculated in the first case with gland tissue died within 50 hours, the B. Pestis being found in the blood. As in the first case, a second guinea pig innoculated with cultures taken from the first guinea pig died of Plague; so in the second case a guinea pig similarly innoculated also died of Plague. I am greatly indebted to my chief (Dr. Mason), Dr. Makgill (Government Bacteriologist) and Dr. Frost (Bacteriologist to the Auckland Hospital) for their great assistance in completing the chain of evidence, and confirming the diagnosis.

Both cases occurred in residents of Parnell, Dr. Ferguson being the medical attendant in each case. That he should together with Dr. Lindsay, who was called in consultation in the first case but arrived just after death—have suggested Bubonic Plague as the cause of death, more especially in the first case, shows considerable clinical acumen. The following are Dr. Ferguson’s notes on the cases.