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Strychnia has been found to keep up the tone of the pulse and the system
generally by acting as a stimulant in many cases. But after a certain stage of thd
disease was reached, when circulation and respiration show signs of gradual failing,
it is observed in some cases that the strychnia injections do not prevent further
failure of the heart though repeated almost every 4th hour.
Another symptom which required special attention was fever. The rise of tem-
perature in plague cases was looked upon not as the disease itself, but as a sign of the
intensity of the activities of the infective agent, and so. the reduction of temperature by
means of depressing antipyretics such as antipyrine, phenacetine, &c., under which
the temperature is lowered down several degrees for a few hours only to rise again,
was not attempted. When the temperature was below 103°, nothing special was
done to lower the temperature except ice to the head, sponging the body with tepid
water, and the use of antiseptics and stimulant diaphoretics internally.
But when the temperature rose and kept above 104° F. with but very slight
remissions and the ordinary treatment by antiseptics, as mentioned above, failed in
effecting a reduction, other means were employed to reduce the byperpyrexia.
They usually consisted of the application of cold to the body in various ways,
such as ice bag to the head, sponging and wet pack. These measures were useful
not only for reducing hyperpyrexia, but also the nervous excitement and exhaustion
attendant on it.
The fatigue attending these operations was not to be overlooked, and so brandy
and milk were given before and after the operation.
Another symptom which required prompt treatment was vomiting. When it
was persistent and severe it was generally looked upon as an unfavourable sign, as
loss of strength ensued owing to the rejection of food and medicines. Mustard plaster
to the epigastrium, ice to suck, and an effervescing draught with liquor morphinæ
hydrochloratis were generally found sufficient to check it.
The last symptom which required to be attended to was the glands. When
the gland was inflamed and painful, belladonna with glycerine or unguentum
laydrargyri or strong liniment iodi was applied, and to relieve pain it was fomented
with warm linseed poultice. When the gland was ripe and formed into an abscess, it
was opened and dressed daily with iodoform ' boric acid' and carbolic oil.
Sleeplessness.—It was combated by potas : bromide and hyocyamus. But in many
cases morphia with atropine was used hypodermically at bed time, and it generally
succeeded in bringing on sleep and making the patient quiet. In some cases when the
patient was very violent and had no rest for hours together the injection was repeated
every eighth hour, and it was attended with good results.
For delirium attended with red eyes, blister to the nape of the neck was found
very useful in restoring consciousness.
Hygienic Treatment.
Attention to the laws of hygiene is necessary and important not only for the
welfare of the sick and the convalescent, but also for the welfare of those who are as
yet in the enjoyment of good health. When we know that persons suffering from
diseases much less virulent and infectious than the plague, require to be placed in good
hygienic conditions for their recovery, it cannot be doubted for a moment that these
conditions are essentially necessary in cases of plague, for it is almost certain that its