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the epidemic in its earlier stages, has been to sacrifice these ail important needs to the
fear of the risks connected with removal of the patients, which are reduced to a minimum
if carefully and scientifically carried out. There is now no doubt that it is criminal to
allow a plague patient to remain in a close, ill-ventilated, confined room, which is sure
to be to his disadvantage, as well as a danger to others, and all classes of natives are now
well aware of this from their personal experiences during the epidemic. The hygiene
of the patient must also be thoroughly seen to, and immediately on admission he
should be washed with hot water and sponged with antiseptic solution.
Diet.
Rice gruel with milk in small quantities and given frequently was found a good
staple diet for all plague patients ; it relieves thirst and is easily digested. Milk with
equal parts of soda-water also answers well. The diet should always be principally
milk and farinaceous food, The special food preparations of Mellin, Benger, Savory
and Moor, or Carnrick Frame Food, corn flour, barley flour, sago are most useful.
If there is no caste objection to animal food, soups and broths can be also given, and
no doubt help to support the strength. The greater mortality and liability to attack
amongst the vegetarian Hindus indicates that amongst them the constitution was
vulnerable to the disease to a much more marked degree, than amongst non-vege-
tarians. Special preparations of meat essence given iced are very useful and virol has
been extolled as being very efficacious. A teaspoonful of virol with two teaspoonfuls
of brandy and an ounce of water was given frequently and with advantage in some
cases. Liebig's extract, Valentine's meat juice and jelly are also useful. Care should
be taken not to overload the stomach, as it is likely to hamper the action of the heart.
There is a marked instance of this in case No. 1 (a ward orderly, p. 94), in the
Grant Road Hospital report. The food should be liquid, given in measured quantities
at regular intervals, and in the earlier stages of pyrexia it should be iced. On account
of the difficulty of supplying good fresh milk and the liability to fraud, condensed milk
was used in some of the hospitals. It is less palpable than fresh milk and not so
satisfactory, but- it is a good stand-by in an emergency, Peptonised foods, milk
especially, are of great service, and in certain cases where the atony of the intestinal
tract is marked they are indispensable, and should also be used in all cases where
there are signs of much impairment of the digestive functions.
Medical Treatment.
Calomel.—Having purgative and antiseptic properties, a full dose may be adminis-
tered at the outset, and, if necessary, be followed by a saline purge. If the condition
of the patient renders the administration of medicines difficult, repeated small doses of
calomel may be placed on the tongue and washed down with brandy and milk.
Liquid hydrarg. perchlor. in fairly large doses 3ii (two drachms) every two hours
for a few doses and 3i (one drachm) to be continued afterwards. The effect of the
mercury on the gums in cases of true plague seems tardy while in other fevers its
speedy action renders its abandonment necessary. It certainly mitigates delirium and
reduces the fever. It is noticeable that syphilised patients inured to mercury suffer
less severely than others when attacked by plague and this result amongst the public
prostitutes has been a matter of general comment. The experience of the Parel
Government House Medical Officer shows that large doses can be administered with
benefit.
Other drugs have been used for their antiseptic properties, e.g., salol, jinacol,
carbolic acid, sulphocarbolate of soda, thymol. The nervous symptoms require skilful