80
April, 29th at 9 a.m.—Temperature 101° F. ; pulse 142 ; respiration 24.
Bubo much larger, measuring 3"X 3", with much surrounding œdema, and very
tender ; and the front part of the neck below the left side of the lower jaw is swollen,
and infiltrated by soft œdematous inflammation. Tongue covered with brownish
fur, very dry, and rough, Pulse small, weak, and running. Slept two hours after
20 ms. liq morphinse and grs. 30 ammon. brom. Bowels moved once, urine passed,
very thirsty. Swelling, tenderness, and hardness over upper part of right sterno-
mastoid where a fresh bubo has developed. Patient is conscious, but stupid and
drowsy. Headache less, cannot swallow food or stimulant, asks for water and again
rejects it. All attempts at swallowing, cause regurgitation through the
nostrils.
Skin hot and dry, abdomen distended. Nothing abnormal in chest or abdomen is
detectable. Feeding by nutrient enemata resorted to.
In the evening eyes sunken, tongue increasedly furred, voice weak, very
irritable, skin very hot, thirst excessive, looks sinking, and gasps for breath at times,
At 6 p.m. temperature 105.2° F. ; pulse 144, weak and anacrotic ; respiration 60.
sighing and irregular. Buboes very tender. Byes half open. Patient semi-comatose.
Bowels moved once ; yellowish, thin, and very fœtid. Urine passed naturally in bed-
pan. Fed regularly by enema.
April 30.—Temperature 102° F. ; pulse 144 ; respiration 36. Buboes have
appeared in each groin, and that beneath the right sterno-mastoid is larger and œdema
extends from if to the angle of the jaw. Swelling of neck—collar-like, soft, and boggy.
Tongue furred, slightly moist. Respirations laboured, short and stertorous. Bubo at
left side of neck larger, and skin over it hot and œdematous, with browny hardness
in deep parts. Eyes sunken. Bowels and bladder evacuated last night, but not
since 10 p.m. Thirst present ; very irritable and prostrate. Fed by enema as before.
At 6 p.m.—Temperature 104.8 °F.; pulse 144 ; respiration 60. Skin very hot,
cries out, is restless, irritable, slept a little during the day. Bubo on left side of neck
much larger and more indurated ; two buboes can be felt beneath the margin of the
right sterno-mastoid. The buboes in right groin are pea-like, in left groin shot-like,
having diminished since morning a little. Refuses stimulants and water by the mouth,
as swallowing is impossible, the liquid visibly regurgitating. Enemata continued
and stomach tube resorted to by the nurse.
May 1.—Temperature 103.4° F. ; pulse 120 ; respiration 24. Patient is very
drowsy, unconscious, comatose, swelling of neck enormous, respirations stertorous,
patient evidently sinking. Died of syncope at 8 a.m. on 2nd May 1897, having
remained in the same state of coma for 24 hours.
Analysis of M. Yersin's Cases.
In all, 27 persons were injected at Parel Hospital with M. Yersin's serum. One
is excluded from the tabular statement as it certainly was not a plague case. Injected
at his own urgent request ; he died of remittent fever two days afterwards.
One patient sent specially to be injected from Clive Road Hospital may be
excluded, but was reported as recovered and is shewn in the table.
One
person was injected prophylactically, and did not develop plague during 41
days under observation in a separate ward. It is to be noted that this woman's
child remained in the ward with her and did not develope plague, although not
prophylactically injected.
Case No. 3 in the series had cerebro-spinal meningitis, and an osseous tumor
was found compressing the medulla and spinal cord against the basilar slope of the
occipital bone and margins of the foramen magnum, to which death was due.