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APPENDIX No; V.
Bacteriological Examination of Hospital Cases.
From the 6th December 1899 to the 16th of June 1900, 149 examinations were
made into the cases of 105 patients. Of these examinations 36 were from plague-
oases, 63 for relapsing fever, 14 for malaria, 8 capsules wore taken for serum
diagnosis, 4 samples for leprosy and 24 for various other diseases. Those exami-
nations were carried out at the Plague Research Laboratory, Parel.
Plague.
36 examinations were made in plague cases, of which 12 were cultures from
plague buboes, 13 were samples of pneumonic expectoration in plague, 4 were agar
cultures of blood (taken by puncture of the skin), 5 were from plague carbuncles
and sores and 2 cultures were from a small-pox case with buboes.
Of the 12 cultures from buboes, in 8 the plague bacilli were found, usually
associated with organisms from the surface of the skin, or the cooci of commencing
suppuration. One of those in which the bacilli were found was a case of pestis
ambulans with hardly any symptoms besides the buboes. In 4 of the cultures the
bacilli were not found ; in 3 of these this was due to the pus organisms being.
present in great numbers; and in the other case I probably missed the gland, which
was small. 2 cultures were made from a small-pox case which had buboes before-
and at the commencement of the small-pox eruption (A.R. 1539), but the plague
bacillus was not present. The question, therefore, remained whether (or not) the
bacilli had been present and had been killed by the presence of the small-pox
virus.
In the 13 examinations of pneumonic expectoration, the pneumonococcus was
found in all but the plague bacilli in only 3. This was probably due to the other
organisms present killing the plague bacilli in the agar culture, as in " smear "
preparations made from the same expectorations a bacillus was seen resembling
the plague bacillus. The 4 cultures from blood were only attempted in very severe
cases and in only one case was the bacillus found (A.R. 480) in a little girl with a;
temperature of 105.2, who died in a few hours. The blood was taken from the lobe
of the ear.
Relapsing Fever.
Of the 63 examinations made from known or suspected cases of Relapsing
Fever, 47 were blood samples, 8 were samples of blood and mucus from stools;
and 8 were cultures from relapsing fever buboes.
Results :—Of the 47 blood samples the spirillum was found in 25 cases and
not found in 22. In the cases in" which the spirillum was not found 11 were
doubtful cases and were probably not relapsing fever, but with the rest the blood was
taken when the temperature was rising at the Beginning of a relapse. These cases
show the uncertainty of finding the spirillum even when most expected and in some
cases in which it may have been found in a previous examination. The spirilla were
found to bo fairly numerous in the blood of epistaxis of relapsing fever. In 4 of
the case3 clumping of the spirilla was observed ; this occurred just before the crisis.
In cases where the spirilla were found in large numbers (say 8 to 10 or more in a
field) a fatal issue has followed. The number of spirilla has, as a rule, no relation to
the temperature observed, e.g., in one case (A.R. 1318) a very few spirilla were
found with a temperature of 106°.4. Another case which illustrates well the want of
relation between the temperature and the presence of spirilla was (A.R. 2817) where