6
A shop, where rats presumably dead of plague were found, was closed
for a day or so as being infected by plague. It was then opened, the floors
dug up and the interior whitewashed. One of the workmen, a youth of 15
years, who had assisted in scrubbing walls and removing the floor, became
ill, exactly four days after leaving the shop, and on the fifth was admitted
to the plague hospital with a well-marked axillary bubo and other symptoms
of plague. After this the shop was again closed and again was limewashed
and scrubbed down; another workman, who previously had been quite
well, became ill with plague four days after finishing his share of the work,
developed a femoral bubo, and died in 36 hours. Here, then, was also
evidence of direct inoculation from an infected house—in one case an
axillary bubo, where the lad had been engaged in " scrubbing tables " as he
said, a possible direct inoculation through the hand, and in the other case
a femoral bubo, a possible inoculation through the bare feet.
Cases of plague occurring during segregation cannot be taken to show the
period of inoculation individually, but from them only a general idea can be gained.
In the Government Segregation Camp of Poona, most cases were found on the
fourth day of detention, 9 out of 41, the third and sixth came next with 6 each,
and five occurred on the second day. There are possibilities of incurring the
disease in the best conducted camp ; and again in cases occurring in the earlier
days, it is impossible to say how long they had been incubating previous to their
admission to camp. It does not follow that other members of a family are
attacked from the occurrence of the case nor that the disease was taken from it.
Those segregated were as far as possible taken to camp at once, but frequently
for potent reasons this was delayed, and although one can say that so many
days have elapsed from admission into camp or from the date of a case occurring
in their homes, yet one can only with difficulty reach an accurate period of
incubation, not being able to follow the movements of the people previously.
The Medical Inspection of the Dead.
The value of this system cannot be over-estimated, as by this means the
earliest intimation is conveyed as to :—
(a) The infection of a town.
(b) The re-infection of a previously infected town.
(c) The actual number of plague cases in an infected district.
It also enables the immediate disinfection of the house where the case
occurred and the segregation of the inmates.
This system was commenced in Poona immediately the Search Parties ceased
their work, when the disease had almost been stamped out, and it is at this
period that the system is so specially valuable, as the information which the
Search Parties conveyed would be no longer forthcoming. The system has
worked most admirably in Poona and with no opposition from the people. When
from any cause an objection to the examination was made, the death was con-
sidered as due to plague and the house disinfected and occupants segregated,
With regard to the recognition of a plague corpse, anyone who has had
much experience among plague would have little difficulty from the general
appearance combined with a diagnosis by exclusion.
Those having a bubo developed externally present no difficulty at the present
time in Poona ; those reported as having died from pneumonia must be treated
with suspicion and carefully inquired into, as these cases are frequently plague.
Abortion and premature labour must also be looked upon with misgiving, and
while dealing with this an exemplification may be instanced.
A child was certified by a Native medical man as having died from natural
causes at birth and that the mother was ill but free from plague ; regarding this
with suspicion, I visited the case and found the mother, a girl of about 17 or 18
years, with all the signs of a septic disease with high temperature ; the child
born was one of about six months. As she was too ill to move she was left in the