15
CASES ILLUSTRATING THE COURSE OF PLAGUE IN THE
INOCULATED.
Kondabai, a female, aged 11 years, came from a compound in which four
other servants were attacked by plague, three of whom had died. Kondabai and
the other servant who recovered were inoculated with M. Haffkine's prophylactic
lymph nine days before she was attacked.
When first seen on the 21st February 1897, at the Arthur Road Hospital,
she was delirious, her expression was frightened, the eyes were not red nor
injected. The pulse was frequent, 126 per minute and rather wiry, respiration
35 per minute, temperature 103° F. Her tongue was moist and somewhat
swollen and thickly coated white except at the tip and edges ; the bowels were
confined. Her father stated that she had had slight fever after inoculation, and
that previous to the onset of plague symptoms she had been in good health. She
was attacked on the previous night by shivering, vomiting and headache, and at
the same time a very painful bubo appeared in the cervical region at the angle
of the lower jaw on the right side. There was a good deal of infiltration into
the cellular tissue around the gland, giving rise to a painful swelling which pre-
vented her opening her mouth freely. She had slight cough with tough and
scanty expectoration. On examining the lungs the bases were slightly
congested, particularly the right. The heart sounds were normal. The liver and
spleen did not appear to be enlarged, but it was very difficult to examine her,
as she was delirious and could hardly be kept in bed. Vomiting had ceased.
The urine was passed involuntarily, and was not examined. There was no skin
eruption. On the evening of the 21st her temperature had run up to 106° E.
(vide Chart VIII),* pulse was frequent and fair in volume, there was a doughy
swelling filling up the interval between the lower jaw and the neck and extend-
ing for a short distance downwards ; the corresponding cervical gland on the left
side was also inflamed and tender. She was very delirious, the cough continued,
but no examination of her lungs was possible. On the morning of the 22nd she
was still delirious, but became conscious towards the evening, her temperature
falling to 102.4° E. Next morning a painful gland appeared in the right axilla.
All these glands eventually suppurated; otherwise the course of the disease
presented no features of special interest.
Noronha, a clerk in the office of the E. B. and C. I. Railway, left his
house in Girgaurm and went to live in the Fort on the 1st April 1897. He had
been inoculated with M. Haffkine's prophylactic against plague on the 1st, and on
the 3rd March, having been given 3 c. c. on the 1st and 3½ c. c* on the 2nd
occasion. He was attacked by plague on the 9th April. The disease set in with
a chill, followed by fever, severe headache and acute pain in the left groin. He
stated that on the 1st April a mouse was found dead under his cot, and on the
2nd April a dead rat was discovered in the house. On the 12th April the fever
and headache diminished considerably. On the 13th February he was seen by
Dr. Bhalchandra Krishna, who found he had a temperature of 100° E. and a left
femoral bubo, and diagnosed the disease plague. On the 14th he had no fever
and afterwards attended Dr. Bhalchundra's dispensary for medicine, and made an
uninterrupted recovery.
A. CASE OF MARKED GENERAL INCO-ORDINATION"
AND PARESIS AFTER PLAGUE.
Kallian Vishram, aged 19, a Hindu, by occupation a clerk, was admitted into
the Jamsetji Jijibhoy Hospital on the 27th September 1897 for inability to walk.
Towards the middle of April 1897 he was attacked with plague at Musjid
Bunder (Mandvi) and removed to the Jain Hospital. His wife had died from
plague. On the day after admission he became unconscious, and on recovering
* Chart XVI shows the course of the temperature, pulso and respiration in an attack
plague occurring three days after inoculation with M. Haffkine's prophylactic«