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Bearing in mind this nature of the plague, the rational indication for treatment
to eliminate the toxin, or to neutralize in whatever way we can, the morbid
activities of the special microbe with which the organism has been infected. This
was tried to be achieved by means of antiseptics or germicides.
The chief germicide used was Liqr. Hydrargyri Perchloride given in 3.—3i.
dose, six or eight times during twenty-four hours. It was generally combined with
stimulant diaphoretics and cardiac tonics.
Another germicide that was much used this time was a combination of Iodine
and Chlorine in certain proportions. Every one admits that Iodine and Chlorine
stand very high in the list of drugs possessed with germicidal power. The chief diffi-
culty was, how to give them in a suitable form in a quantity sufficient to neutralize
all the-toxines and germs in the blood, without the least chance of doing any injury
to the tissues and organs, through which they were introduced into the system.
Ultimately a combination in the form of Terchloride of Iodine was prepared with
varying proportions of Chlorine, added to it to make it stable, and was tried in good
many cases in the hospital. That this preparation has a marked effect in destroying
the germs of Typhoid fever, Cholera and other diseases, and that it is not poisonous
has already been shown by Trangott and Professor Behring by experiments made on
hospital patients. First it was administered in 10 to 20 minim dose frequently
repeated, but later on it was given from 3s. 3i per dose largely diluted with
water.
Some patients could bear it very well, while others vomited as soon as it was
given. No evil effect was seen in a single case. The results obtained are no doubt
hopeful and beneficial to the extent of 50 per cent., but they cannot yet be declared
as conclusive as other drugs were also given to the patients to whom Iodine Terchlo-
ride was administered.
A germicide can possibly be of use only when it is given from the very com-
mencement of the disease. It is of no use expecting any marvellous result from it
when the disease is sufficiently advanced. It cannot be expected to repair the mis-
chief already done to the system by the bacteria and their products.
I must here express my sincere thanks to Professor T. K. Gujjar, for suggesting
to me this drug as powerful germicide, and supplying it to the hospital at his own
expense.
On admission the.patient was undressed, the personal clothing was removed,
and the body was carefully sponged over with warm water containing Condy's fluid.
He was then given new clothes and put into a fresh bed in the acute ward.
When the admitted patient was first examined in the hospital, the foul state of
the tongue, and the foul breath usually present in plague cases, suggested the use
of a purgative, and this was done by means of calomel in 5- grain doses at bed time,
and followed by a saline purge, if the bowels did not move freely by it. I think
calomel is best suited for this purpose on account of its antiseptic and purgative
property, as it sweeps the intestines clean of decomposing injesta and of putrifactive
bacte'ria that may be present there. Free action of the bowels was necessary to
expel poison from the system, and this was seen to do some good as it frequently
stopped the vomiting and enabled the patient to take his nourishment with better
relish than previously.
Another chief indication is to maintain the patient's strength and to support
the constitutional vigour so as to help the system to resist the toxic influence of the
infective products of the plague bacillus. It is of the greatest importance that the