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attack of plague. Plague concurrent with malaria. Concurrent attacks of plague
and malaria [as shown by the discovery of Laverans body (Amœboid)] have been noted
in which the malaria confers a distinct periodicity on the temperature of plague (vide
Temperature Chart).
Trognosis.
All cases complicated with (1) primary pneumonia, (2) extensive cedematous
condition of skin over seat of buboes, (3) all cases in which the attack centralises
itself from the first in the nervous system end fatally, whilst rapid suppuration of
buboes is looked upon as a favourable symptom.
Of five cases of abortion from plague, not one has recovered.
The prognosis is better in children than men and in men than women ; of 260
deaths in the Brahmapuri Hospital (Hindoos) there have been—
Males ...
Females ...
Children under (10)
...
...
...
89
146
25
whilst from deaths, 3,516, from all hospitals, there have been—
Males ...
Females ...
Children ...
1,226
1,727
563
The high rate of mortality among females may be partially accounted for, first, by
the fact that large numbers of the Hindoo men inhabiting the city are merchants and
extensive travellers by sea, second, a much larger number with the chivalry common to
the native mind, on the outbreak of the epidemic, fled the city, panic-stricken, leaving
their wives, children, and belongings to forage for themselves. The healthy and
robust appear not only to prove to contract the disease, but to suffer from the most viru-
lent forms and die in as great a proportion as those of weaklier frame and weaker
constitution.
Mortality,
The mortality appears to have differed among the various castes and at different
phases of the epidemic.
Of the first 100 recorded cases in the Brahmapuri
Hospital (Hindoo), the mortality was
...
... 90 per cent.
Of 100 cases recorded from the same source a month
Amongst the Borah community from 7th April to 11th
June (Hajira Hospital), the mortality was...
... 45 ,,
Khatri and Mahomedan Hospital
...
...
... 36 „
Khoja Hospital
...
...
...
...
... 13 „
From the above statistics, it will be seen that the Hindus suffered by far
the worst ; but considering the ghastly conditions of their existence, the terrible over-
crowding in low, badly-built, badly-ventilated and worse-lighted houses, the total
absence of drainage, and the most degrading personal filth, the only marvel is that the
whole population has not been annihilated.
That the mortality has been seriously aggravated by the lamentable ignorance
and obstinacy of all castes in refusing to bring their sick early to hospital, no one can
for a moment doubt ; large numbers of cases have been admitted moribund, or have
died within a few hours. Many have been admitted in the most loathsome condition,
one poor wretch having suffered such frightful neglect that the whole of an enormous
cervical bubo extending from the left ear to the sterno-clavicular joint was found on
admission to be filled with living maggots. Children brought in with perforated
corneal ulcers. Men with enormous sloughing glands, and all the horrors of the later
stages indicated their set resolution that no patient, however ill, should be brought to
hospital until his condition was thought by his relatives to be hopeless if kept at home.
57