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the patients were found dead in the ambulances, and it was said that the bedding was
saturated with a deadly poison which killed a person no sooner he slept upon it. But
the people have now learnt that there was no truth in these rumours, and the patient
gets confidence after a stay of a day or two in the hospital.
GENERAL SIGNS AND SYMPTOMS OF PLAGUE PATIENTS.
The onset of the disease is very sudden, a person apparently well, perhaps on
work feels a sudden chill or rigor, complains of severe headache, accompanied with or
without vomiting. The skin becomes hot, but the patient does not think of going to
bed, he thinks that there has been nothing serious with him, but a little indispo-
sition, especially a bilious attack. He tries to work as usual, the temperature rises
to 104°—105° F., the patient feels some pain in the groin or armpit or the neck and
finds that he is unable to work or do anything else but take to bed. When removed
to the hospital the temperature varies. The maximum temperature noted on admission
is 105° F. and the minimum 98° F. which has tendency to rise to 102° F. or 103° F.
after a few hours.
Gait.—The gait of a plague patient is, as a rule, tottering when the patient is
able to walk.
Aspect.—The aspect of the patient is always very characteristic and when once
seen is never forgotten. The features appear as if depicted with fear and anxiety as if
from fear of impending death. In some cases the patient has a maniacal look with
blood shot eyes. In the comatose condition he has a dull or drowsy look with eyelids
half closed and the face more or less cynotic.
Speech.—The speech of a plague patient is no doubt characteristic. It is of
two kinds—(1) the words thick and broken up into syllables and articulated with
difficulty in a more or less husky tone, and (2) the words are uttered as it were in a
irritable or an angry tone.
Temperature.—Rise of temperature attracts early attention of the patient or
his friends. It varies from 100 to 107° F., but the usual range of temperature is
between 102—105° F. No regularity could be seen in the chart of any two cases.
Generally there is a continuous rise for three or four days, and then there is a sudden
fall indicating collapse or sudden death, or the temperature becomes intermittent
with a remission of 1—2° F. every day, but the remission does not occur always in
morning as in other inflammatory fevers, but in some cases the remission is in the
evening. The fall of temperature by lysis may go on up to 7 or 8 days in cases
which are likely to recover, while in other cases it again rises and after two or three
days remission to 105 or 106° F. the case ends fatally. In some cases, it is observed
that the temperature comes down to normal on the second, third or fourth day, rises
suddenly the next day and again falls below normal, the case ending fatally. In a
case of septiiemia the temperature chart is very characteristic, the rise in the evening
and the fall in the morning are well marked. In cases where suppuration of the
bubo or sloughing is extensive or deep-seated, the temperature rises and falls day
after day until the patient improves.
Buboes.—The appearance of a bubo with rise of temperature is considered
to be a sure symptom of plague, and the patient complains more about it when it
was tender and painful. It appears along with the rise of temperature or after two
or three days and in some cases it appears even after six or seven days. The appear-
ance of a bubo is usually characterized by pain and tenderness, but in a few cases
neither of them are present and the patient feels no discomfort even if the bubo be
pressed hard. The size of a bubo varies from that of a small pebble to that of a big
orange, but smaller the bubo, more excruciating is the pain and more danger to the
patient. Swelling in and around the bubo is well marked. It is due to infiltration