Medicine: The Plague

The plague—in earlier times called also the Black Death or the Pestilence—has been one of the great wholesale man-killers of history. Ancient Greece and Rome were helpless against it. In the 14th Century it killed 25 million in Europe, probably another 25 million in China and India. Boccaccio used the plague in Florence as a backdrop and excuse for his Decameron; 300 years later Pepys noted in his Diary many a detail of London’s famed plague of 1665. One or two cases a year still show up in the U.S.

Contrary to popular opinion, the plague has not been stamped out. But Dr. Robert H. Pollitzer, 63, who has spent 27 years fighting plague in China, is quite cheerful about getting it under control, even there. Said he: “There are optimists and pessimists in this plague-fighting business. I am an optimist … It is not any more a question of looking for effective methods. It’s just a case of applying them.” Dr. Pollitzer, who works for U.N.’s World Health Organization, last week started work in the University of California’s George Williams Hooper Foundation in San Francisco, where he will spend his three months’ leave from China. The foundation developed many of the modern techniques used against the plague, is trying to find still better ones.

What are the effective new methods? The plague is spread in a double bacillus play from rats to fleas to man; men usually catch it not from flea bites, but from rubbing flea vomit or feces into the skin. Science tries to kill the rats by new, powerful poisons like “1080,” the fleas with DDT (see above), attack the disease itself with modern medicines and vaccines.

Sulfa drugs, used with streptomycin, a combination discovered within the past few years, protect against the two most common forms of the plague: bubonic, which attacks the lymph glands, and pneumonic, which attacks the lungs. Sulfa drugs alone work too, in most cases after bubonic plague has struck. In one district in rural China, said Dr. Pollitzer, his WHO teams found 44 cases, saved 41. For the pneumonic form, there is rabbit serum, developed two years ago at the Hooper Foundation’s animal building, known to laboratory workers and San Francisco newspapers as “Mousetown”; rabbits, like man but unlike horses (usual source for serums), can catch the plague. There are also new vaccines that can be given to ward off attacks; they are made from live bacilli that, says Pollitzer, have become “friendly,” lost their ability to cause the disease.

This new combination of tools old & new has not yet been completely tried out in the field against epidemic plague. There was little plague in China last year. Said Dr. Pollitzer: “It grieves us that we could not try out our new tools more, but it is gratifying that we had so few patients.”