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for a long time and gave better results than the above mentioned drugs, but it
was always combined with Strychnia, Digitalis, and Rum, so it is difficult to
credit some recoveries to these drugs only. Other germicides such as Tetra Chlor.
lodi and Amber emulsion as recommended by some persons were tried in half a
dozen cases, but the result was in no way encouraging.
Pneumonic cases were treated on general principles. They were as a rule
isolated from other plague patients; that is, they were kept in a separate ward built
for pneumonic cases only.
The chief factors in the treatment of plague cases are judicious nnrsing and
stimulants. Acute cases are kept on milk diet only. When the patient is delirious
or is not able to take his nourishment owing to the swelling of the tongue or epiglotis,
he is fed through .the nose by the Esophageal tube. This process, though difficult,
is very effective. When there is some constriction in the pharynx and the patient
could not be fed by the Esophageal tube or when there is constant vomiting and the
patient is not able to retain anything, nutrient enemas are given every four hours.
These are generally retained and the patient's strength is sustained until he is able
to take his food by mouth.
Sero-theurapy.—Professor Lustig's serum was tried by Dr. Galliotti in 13 cases
in this hospital, out of which three recovered. All these cases were early cases and
were selected by Dr. Galliotti himself. It was observed that about two hours after the
injection the patient felt sudden depression of spirits and was revived after a dose of
stimulants. In one case a patient died an hour after injection. All the patients who
died, died after the third or fourth injection of sudden failure of the heart. In one
case there was diarrhoea and in another secondary pneumonia.
Native system of treatment.—699 cases underwent native treatment, out of
which 573 died, giving 82·1 percentage of mortality. All these cases were early cases
and were conscious enough to prefer the treatment they wanted to undergo. The
nostrums prescribed to the patients were in the form of decoctions, the prescription of
which is a secret known to the Vaidya only and which he is loath to divulge.
Bath treatment.—About the beginning of January 1899, Mr. A. Leslie got
permission from the Special Medical Officer in charge Plague Operations, to try the
vapour bath treatment on plague patients in the Maratha Hospital. A shed on the
north of the hospital was built and fitted for that purpose. At first work Was begun
with primus stoves with four burners, but later a small engine was fitted outside the
shed and galvanised iron pipe fitting was made into the shed. There was room for
two patients at a time. Mr. E. H. Hate was placed in charge of the bath and
Lieut. H. I. E. Twigg, I.M.S., was appointed supervisor. During four months that
the bath treatment was tried, 565 cases were taken. Each case had one, two or as
many more baths as were found necessary. The largest number of baths given to one
patient was eight, including the hot and cold baths. The total mortality amongst
these patients was 80 per cent.
Making allowance for moribund cases and for undue proportion of males treated,
female cases were more fatal than male. All the cases under bath treatment were
also treated with drugs usually prescribed for other plague cases. On the whole it
seems that bath treatment had very little or no effect in reducing the mortality of
plague, but at times the symptoms were aggravated and the patient's life was found
in imminent danger (vide Appendix).
Diagnosis.—The diagnosis of plague when well developed is not difficult, but
it may be mistaken for relapsing fever, remittent fever or typhus fever in their early
stages, There was only one case of mumps admitted in this hospital and was diag-
nosed as that of mumps and not mistaken for plague.