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This morning, after a restless night without delirium, he took some light refresh-
ment consisting of tea, milk, and eggs with a little bread, and his temperature was
103° F. At 2 p.m. M. Haffkine saw the hoy and found his temperature 102° F., and
advised his father to take him to hospital. At this time he had no appetite, was
prostrate, and stayed in bed till he was conveyed to Parel Hospital, where he
complained of headache, pain in the left groin and thirst. The swelling in the left
groin was very hot and tender.
Present State.—A slim, fairly well-nourished Parsee boy, quite conscious and
intelligent. No characteristic facies present. Eyes not injected, pupils normal. Skin
warm and perspiring, with prickly heat, eruption, and sudamina.
Tongue thickly coated with white fur, tip and edges clean, fungiform papillæ
prominent, especially near the tip. Gums spongy and slightly swollen. Peculiar foetid
odour from the breath. Veins of neck pulsating. Cardiac sounds strong, loud, and
healthy; chest normal, lungs healthy. Liver and spleen not felt. A bubo, the size of a
bean, just below the level of Poupart's ligament, near its middle on the left side,
very tender, and, being well defined, plainly visible. The skin over the inflamed
gland is hot and tender. The bubo can be moved a little and the skin is not adherent
to it, nor is there any oedema surrounding it. There is a small, tender, shot-like
gland in the left axilla close to the pectoral wall.
Remains of a speckled rash, like mosquito bites and prickly heat scratchings, can
be seen on both sides of the ankles and legs of both lower extremities ; but there are
no apparent wounds. Temperature 102 ; Pulse 132, soft and compressible, but
regular ; Respiration 36. Chiefly complains of headache, thirst, anorexia, and pain in
the groin.
May 1.—Temperature 100° ; Pulse 20; Respiration 36. Slept well during
the night. Bowels moved four times—thin, greenish-yellow in color, and bad smell-
ing, following a purgo consisting of calomel 5 grs. and pulv. jalap, co. 30 grs. at 6 p.m;
bubo very tender. No delirium or incoherence in speech. Headache less, and he says he
feels better. Given large doses of perchloride of mercury and stimulants since admis-
sion; 2 drs. of liq. hydrargyri every two hours and stimulant mixture (equal parts rum
and water) one ounce every three hours. Blood examined for plague bacilli, but none
discovered. Urine slightly cloudy with albumen, by heat test; bile pigments present
At 5 p.m. Temperature 101° F., Pulse 124 ; Respiration 30. He vomited three
times since morning, but was otherwise well.
May 2, 8 a.m.—Temperature 99.6° F.; Pulse 100; Respiration 36. Pulse full, soft,
forcible, and large. Tongue clean, except towards the posterior part on each side of the
central line. No headache, slept from 2 till 6 with the aid of a draught containing
morphine and bromide ; skin warm and clanny. Appears drowsy. Bubo in left axilla
not detected. Bubo in left groin longer, more standing out in relief from its sur-
roundings, no œdema over or around it. Sudamina present, rash-like eruption faded.
May 3, 8 a.m.—Temperature 99° F.; Pulse 96; Respiration 20. Patient slept well.
Tongue has two patches of yellow dry fur at the back. Bowels confined, urine passed
naturally, normal in appearance, and to clinical test. Feels thirsty and tired. Quiet,
conscious, and intelligent. At the evening visit his temperature was norma], bubo less
in size and no longer painful. Skin dry. Tongue dry and clean. No headache.
Pulse and respiration normal. Convalescent.
May 4.—The bubo was absorbed and the patient practically well, having made
α rapid recovery from a mild attack of plague. He was allowed to go home on.
7th May 1897.