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5. The supply of water was drawn mainly from the service pipes of the
hospital building, but the supply not being constant, we were obliged to get water
from outside.
6. The floors of the wards were sprinkled every morning with strong solution
of carbolic acid or mercury, and lirnewashed twice a week, the whole building, in-
cluding the walls, windows, ceilings, &c., was disinfected twice during the year.
The clothings of the patients were generally burnt either after recovery or death, and
therefore there was no necessity for sending the same to the disinfecting Station.
7. As soon as a patient died, the body was covered or wrapped with a sheet
saturated with a strong solution of mercury or carbolic acid, and then removed
immediately to the Khoja Cemetery which is not far off. The body was not allowed
to remain in the hospital for more than an hour or two. Pauper patients were also
treated in the same manner and the expenses for the disposal of the body were paid
by the founder of the hospital.
8. A list giving full particulars of cases inoculated with Professor Haffkine's
serum is herewith attached.
9. There was no sickness amongst the staff of the hospital.
10. Attached please find eight tables, giving full particulars as regards the
admissions, deaths, recoveries, situation of buboes, percentage of mortality, &c.
11. During the week ending 18th March 1899, there were 24 admissions
which is the highest number admitted, 7 patients admitted in one day only, which
was the 14th March last.
12. The total number of deaths during the year is 100, of whom 97 died of
Plague; the average percentage of deaths is 50. There were 6 deaths in one day
only, which was the 22nd March last.
13. Incubation:—The statements made by the patients and their relations are
generally unreliable, and therefore it is impossible to state with accuracy the period of
incubation, but from a few reliable cases which I know of, the period of incubation
appears to be from a few hours to 8 or 10 days.
14. Symptoms.—Fever:—It lasts for about six days, unless there are complica-
tions. It varies from 100 to 108°, but nothing depends upon temperature as regards
the prognosis, unless the temperature is above 106°. I have seen almost all patients
die when the temperature rises above 106°; we had only one case recovered in
January 1898, whose temperature had gone above 306°. Sudden subsidence of the
fever during the first 5 days is a very dangerous sign, almost fatal.
Pulse.—Is always frequent and full in the beginning, its beat ranging from 100
to 106 or sometimes more; as the disease advances it becomes weak, irregular,
intermittent, &c. The pulse is the only sign which I think shows whether the
patient is progressing favourably or not. If the pulse is weak, notwithstanding
the symptoms appearing favourable, the case generally proves fatal.
Respirations.—Are always increased, sometimes as far as 60 or even 80 per
minute; if the respirations increase without any lung complications, it is a bad sign;
sometimes the respirations become irregular.
Tongue.—In the beginning it becomes white, coated, with the edges red; as the
case advances, it becomes dry, brownish or sometimes black in bad cases; moist and
cleaner in favourable cases. The only characteristic sign of plague in its characteristic
tongue.