227
TABLE VIII.
Showing cases of Secondary Plague-Pneumonia complicated with Buboes.
Males-
Females
Children
Admitted.
Nil
Died.
Nil.
Recovered.
Nil
Percentage of Deaths.
Nil.
Notes on the Symptoms, Character and Treatment
of the Disease.
From personal experience at the hospital, it; has been found that the period of
Incubation varies from a day to a week. (Certain patients having been segregated,
went for a single night to sleep in infected houses and caught the disease.)
Symptoms.
Among the external and most prominent symptoms of plague are a visible
expression of complete prostration, an anxious and pinched expression of the face with
a peculiar 'risus sardonicus' over it, and the appearance of buboes on the surface of
the body. This enlargement of the glands may be either a mere tenderness without
swelling, or a huge tumour. Injected blood-shot eyes form another external symptom
of the disease, but this symptom is generally accompanied with several others affect-
ing as well the circulatory system of the human body. The pulse is in all cases
frequent and soft, but in acute cases even irregular and intermittent from the very
onset; and the circulatory system in acute cases is even so far damaged as to bring-
on a marked lividity of the countenance, or a general cyanosis of the whole body or,
in cases of abnormal distension of the portal venous system, grumous vomiting; there
are likewise hcemorrhagic petechial or blackish patches on the body as well as the
extremities due to failing circulation. The mischief wrought by plague on the res-
piratory system is, however, not less remarkable than on the circulatory one; the
breathing, which is from the very onset of the attack, frequent and shallow, soon turns
dyspnoeal with the development of the disease, and this difficulty of breathing is more
commonly inspiratory than expiratory. Dyspnœal breathing is always an essential
symptom of extreme cases except when it originates in the mere distension of the
abdomen so common in plague. But by far the most alarming symptom of the damage
done by plague to the system is the vomiting of blood. By the time, however, the
plague presents such alarming symptoms, the nervous system is entirely shattered.
Purely nervous affections commence either with a marked stupor or a restless and
sleepless condition accompanied with severe headache; and these symptoms gradually
give place to coma, or delirium (either low muttering or violent) or hyperpyrexia ac-
cording to the precise character of the plague development. The last symptom hyper-
pyrexia is invariably accompanied with intense thirst. Turning next to the effects of
plague on the alimentary system, we must note a dry and brown-furred tongue,
occasional retching and vomiting, abdominal distension with a stubborn constipation
consequent upon it, or even, as in certain cases, diarrhoea as its commonest symptom,
whilst the only affection common to the urinary organs in plague is the retention of
urine, with Hæmaturia in rare instances.
Malaria and Bronchitis have been observed to complicate plague cases; but no
such complications have been known to accompany the disease after the patients have
been brought to the hospital, because of their summary prevention: likewise there
have been no sequælæ marked after recovery in this hospital. The period of convales-
cence is from three to nine weeks. Eighty-one cases were kept under observation, and
nearly all of them were found to be simple fever cases, and only three were those of
Phthisis. Mumps have never been mistaken for plague in this Hospital.