155
Sickness and Mortality among Staff.
(a) Plague.—3 ward boys were attacked with plague of whom 2 recovered
and 1 died.
(b) Relapsing Fever.—1 ward boy and 1 sweeper contracted this disease,
but both recovered.
(c) Cholera.—1 ward boy was attacked and died.
Special Treatment.—Iodine Terchloride was used in 62 cases of plague, Of
these 40 died, and 22 recovered. A series of experiments was again tried with
Professor Lustig's Anti-plague Serum, every alternate one of 206 consecutive
admissions being placed in the serum group, the results among the remainder,
treated on general principles, serving for comparison. Out of the serum group
(of 104) there were 23 recoveries and 81 deaths, and out of the control group (of
102) there were 21 recoveries and 81 deaths. This gives a percentage in favour of
the serum treatment of 1·53. This is less than the advantage obtained in previous
years, but the type of plague was much more severe this year (a large proportion of
the cases being septicœmic in character on admission and over 60 per cent. having
multiple buboes against an average of about 13 per cent. in previous epidemics),
and it was found that at least 3 times the quantity of serum as was found to be
sufficient for each case last year was required this year before any visible result
was obtained.
Clinical Observations.—In his report Dr. Choksey, draws attention to the fact
that views expressed by him in a previous report, regarding the unfavourable
influence of prophylactic inoculation during the incubation stage of plague, have
received further confirmation in a report on plague measures at Ahmadnagar
drawn up by Major Sarkies, I. M. S., from which he quotes as follows :—"The
mortality from plague among persons inoculated during the incubation stage is
higher the sooner after inoculation the disease shows itself. In persons attacked
one or two days after inoculation, the chances of recovery are less than those
attacked later."
During the year Dr. Choksey, with a view of attempting to confer immediate
immunity, injected into about 20 persons, belonging to families of plague patients,
20 C. C. each of Curative Serum, and in not one of these did plague subsequently
appear.
He reports having made close observations regarding the alleged association
of relapsing fever with buboes and gives, as his opinion, that the association is not so
common as to classify buboes even among the occasional symptoms of relapsing fever.
He has observed a hyperaesthetic condition of the skin which causes patients to
wince when pressed in the groins and axillse, giving the impression of tenderness
over glands, but does not associate this condition with the glands. He admits that
parotitis complicates relapsing fever in about 2 or 3 per cent. of the cases, but is of
opinion that other glands which are sometimes found inflamed and suppurating, in
relapsing fever patients, are merely chronically enlarged glands undergoing such a
change in consequence of secondary infection (Streptococens or staphylococeus)
following upon a lowered state of vitality.
Post Mortem Examinations.—Several of these were performed during the
year, and in cases in which the buboes had been multiple, it was found that the
intra abdominal and intra thoracic glands were largely involved, a phenomenon not
commonly observed in past epidemics.
Statistics.—The following tables furnish statistical information regarding the
cases admitted.