152
rounded at the ends and joined together in pairs, so as to form what
M. Haffkine calls a " diplo-bacterium." The division may appear
complete or only an indication of it may be seen, and the poles staining
more easily than the rest of the organism, a most characteristic appear-
ance is obtained by which it may be easily diagnosed. The appearance
of a cultivation in agar, is also very characteristic. Almost no growth
is seen for two days, then a peculiar dotted or ground-glass appearance
is to be noticed spreading out from the inoculated spot, which once seen
is easily recognised. It has been compared to the appearance of the
back of a mirror when the growth is viewed from behind, and when
looked at from the side with the light reflected from its surface it has a
peculiar varnished look, not easily mistaken. Specimens taken from
cultures in agar and broth present many and various appearances under
the microscope; thus, in the early days of agar culture threads of
varying diameter and without divisions may be seen, and in broth
cultures, chaplets or chains may be found. In the tissues involution
forms are found which it is difficult to recognise, unless a careful study
of the transition forms is made.
The treatment pursued in Bombay differs little from that laid down
by Dr. Cantlie in his paper in the British Medical Journal of 30th
January 1897, i.e., stimulants, good nursing and the treatment of symp-
toms as they arise, special care being taken of the heart, which is so apt
to fail suddenly even during convalescence. At the Parel Hospital,
Surgeon-Captain Thomson appears to have achieved a considerable
amount of success by treating his patients with large doses of per-
chloride of mercury with the object of acting on the bacteria in the
intestines. He gives two drachms of the liq. hydrarg. perchlor. on admis-
sion and a drachm every two hours thereafter for the first 24 hours, and
then every three hours till canvalescence sets in. His death-rate in cases
that survive for 24 hours after admission is 36 27 per cent., and as no
salivation is produced, the plan seems worth trying. The glands at this
hospital are treated with glycerine and belladonna and hot fomentations
when inflamed, with the result that only about 2 per cent. suppurate,
which is a great matter as when opened the incisions take a very long
time to heal. At the Arthur Road Hospital under the care of Dr.
Ohowksey, no perchloride is used, but injections of liquor iodi are made
into the affected glands, with the result that nearly all the glands
suppurate and tedious sores remain open for weeks, retarding convale-
scence. Dr. Chowksey maintains that the temperature falls after the
injection, and that the practice is an endeavour to imitate Nature's
mode of care which he alleges is brought about by suppuration, but this
contention is not borne out by the experience of the Parel Hospital
noted above. The cases admitted here are probably of a more acute
type than those sent to Parel, for the mortality up to the end of
February was 54 71 per cent. of the admissions."
(G.O., No. 887-M., dated 13th April 1897).
3. Extract from the Report of Major Baunerman, M.D., B.Sc.,
dated 13th October 1897.
" As regards treatment, I need only repeat what was contained in the
former report submitted to Grovernment, viz., good feeding and nursing,
the patient being kept in the recumbent position till four days at least
after temperature has come to normal as heart failure is so much to be