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As the one died and the other recovered, it may be reasonably inferred that the
former had already contracted the disease before arrival.
Dr. Yersin.—Three cases were also treated with Dr. Yersin's serum—one male
and two females. The male alone recovered.
Recurrence.—Here the patient's first attack was in February. He developed
the usual symptoms of high fever (T. 105°) and an enlargement of the gland (left
femoral).
The case, however, proved a mild one. He was convalescent in a week and
made a rapid recovery.
Two months later he again fell a victim, presumably through domicile with a
patient on whom he was in close attendance at Matunga.
On this occasion the gland suppurated and was removed by operation.
He made a very tardy recovery, after remaining two months in the hospital.
The Signs of Plague after Death.
The signs of plague after death are of particular importance in deciding how the
corpse should be disposed of, and whether measures should be taken for disinfecting or
destroying the house and articles of furniture and clothing ; which must be done if the
person has died of plague.
In the absence of any history, or the refusal of relatives and neighbours to give
any information, there are certain external evidences of the cause of death, particularly
the enlargement of the glands which are to some extent reliable. The discovery of
the plague bacillus under the microscope in specimens of the blood and juices or in
cultures from the same would of course finally decide the question in most cases, but
still in some it is necessary to perform a complete internal post mortem examination
also in order to be quite certain. If the position of the body has not been altered
after death, it will invariably be found lying on either side with the knees flexed and
the head leaning towards the chest ; rigor mortis is delayed ; there is softness and
want of cohesion of the fibres of the muscles ; the thumbs point towards the palms of
the hands ; the features have a fixed anxious expression ; the eyes are sunken and
muddy in aspect with a peculiar lustre of the cornea, the pupils being dilated and the
lids half closed ; the tongue is swollen and coated with fur of a glistening appearance
and is clean at the tip and edges ; the fur is dry, white or yellowish-brown, cleft clown
the centre, and horny. The complexion is opaque and dingy, the skin is dry, and, if
death has been recent, the forehead and hands are cold and clammy ; and enlargement
of the glands in one or other locality would decide the opinion that death had been
due to plague.
If death occur during delirium or convulsions, there may be distortion of the
features, in which, if the patient dies while on his back, the head is thrown to either
side and the legs are separated. Petechial spots may also be noted, although in the
epidemic in Bombay they have been comparatively few. In death from pneumonic
plague the body and face have a dusky bluish livid hue, sputum hangs round the
lips, and the body seems shrunken and collapsed.
(1) From the attached statement it appears that the 33 hospitals, which have
sent in returns, have
Admitted in all
Of whom
... 2,538 patients.
... 1,438 died.
This gives a mean mortality of 56.6 per cent.