2
large numbers and give a characteristic appearance to the specimen which enables the pneumonic
type of plague to be detected readily by microscopical examination. There is in sputum, however,
always the possibility--
(1) That it is not derived from the lungs at all, but only from throat or even the mouth.
(2) That plague organisms are scanty and cannot with certainty be detected on account of
the multitude of other organisms.
(3) That bacilli bearing a close resemblance to plague may be present and. so render a
guarded opinion necessary.
" 3. Microscopical examination of a bubo prior to suppuration gives almost certain evidence
as to plague. The only error likely to occur is that fluid supposed to be from the gland is really
from the tissues around it or even blood from the skin sucked in when the needle is withdrawn.
" It is on account of the uncertainty attaching to puncture that cutting down upon the gland
is so much to be preferred when a great deal turns upon the diagnosis.
"Old buboes which have become purulent may or may not show the plague bacillus since this
organisms is apt to be killed off."
4. Water samples. —The sending of water samples also promises to be carried
out in a connected manner. The systematic use of such examinations by the
Sanitary Engineer to Government has been largely responsible for the results given
in the separate article upon this subject embodied in the report.
Samples are forwarded in sterile bottles specially designed to prevent con-
tamination of the sample due to want of technical knowledge on the part of the
person who collects it. A matter which has unfortunately no remedy is the delay
in receipt of the sample which often has to come a long journey by rail before it is
received at the Institute. To minimise the effects of this delay in important cases,
the sample has been sent packed in sufficient ice to keep it cool until it reaches the
laboratory, and this procedure is eminently desirable.
5. Tissues and tumours.—No less than 123 tissues, chiefly tumours, have been
sectioned and reported upon. As in many cases it is very advisable that both
clinical and pathological evidence be combined, and to increase the value of the
report, a mounted section is always forwarded along with the report. In the great
majority of cases the specimens are found to be of the ordinary types well known
in Europe such as epitheliomas, mammary cancers, adenomas, sarcomas and so on,
but the possibility of undescribed conditions is kept constantly in mind. In the
present year secondary foci of the fungus of Madura foot were . detected in the
femoral glands, a condition so far as I am aware not previously recorded, A piece
of tissue containing Rhinosporidium Kinleayi, a new sporidian parasite of man, has
.also been received and will form the subject of investigation as opportunity offers.
The specimens referred to have been as follows :—
Plague—
(a) Human sources
...
...
(b) Rat plague ...
...
...
Malaria
...
...
...
...
...
Leishman Donovan body ...
...
...
Widal reactions
...
...
...
Tumours ...
...
...
...
...
...
. . .
. . . . .
...
...
...
...
...
...
...
...
...
...
...
121
275
217
12
134
123
Sputum for tubercle
...
...
..
...
57
Water samples
•••
,..
95
Rabid material
...
...
_ .
...
...
..
...
10
Cholera
8
Various, including examinations for leprosy, amoeba coli, gonococcus
and for various clinical purposes
25
Mosquitoes and other biting flies
•••
•••
6
Total ... 1,083
•
(ii) RESEARCH.
1. The number of workers is limited and research has of necessity to be
restricted in scope. But as far as possible it has been made to embrace both
matters of pure science, and such as have a direct application to the needs of the
' Presidency. It has also been devised so as to keep at the same time bacteriological
and protozoological work equally in progress. Since, however, recent advances
in medicine have been in the main protozoological, research on these lines has