Evening bulletin. [volume] (Honolulu [Oahu, Hawaii]) 1895-1912, 1899-12-23

diately adjacent should be removed
and the houses disinfected. The CON
facts" as the exposed persons are
termed, are TO be quartered in camps"
specially laid out for their accommo-
dalton. Here they are medically ex-
amined once or twice a day, and de-
tanned for at least seven days. Should
any of the contacts" in the isolation
camp develop plague, the building
or tent must be evacuated. disinfected
or destroyed according to the material
of which it is built. A further obser-
walton period is then necessary before
those remaining can be released.
Should, however, the contacts" con-
sent to vaccination by Haffkine's pro-
phylactic the example set by the In
dian Government may be wisely and
safely followed-namely, granting in
oculation certificates emitting the
holder to exemption from plague rules
for period of six months.
When plague breaks out in city the
Town must be apportioned into SAM
tary districts, over which an officer in
authority is placed in charge. An un-
limited supply of workers must be at
his disposal for searching out the sick,
carrying the patients to hospital dis
Quarters must be provided for these
men, so that they do not go back to
their homes to eat or sleep, otherwise
they may carry plague to their fami-
lies. The officer in charge must have
ample powers given him of advancing
or Furnishing all those working under
him, and complete power must be as
signed to him to deal with refractory
friends and relations of patients.
MEDICINAL TREATMENT.
Even after several years experience
of epdemics of plague in different
parts of the world, but little advance
has been made in the medicinal or sur
gical treatment of plague.
symptomatic lne of treatment is
all that we have to guide us. Initial
constipation, associated with slight ic-
teric tint of conjuctivae and skin, Is
combated ny a five grain dose of cal
omel. Free purgation, should the va
riety develop into one of intestinal
type, is not, however. without danger.
AS rule, however, II seems to do good.
The buboes may be poulticed chiefly
with the idea of relieving pain. The
substance of the gland may be inject
ed with a minim or two of carbolic
acid or solution of hydrargyri per-
chloridum and iodide of potassium
The capsule of the gland may be in
cised simultaneously or the gland may
be laid open and treated antiseptically,
in the hopes of staying the process of
gland necrosis. None of these modes
of treatment have yielded any such
measure of success as to highly recon-
mend themselves. Pus when formed
should, of course, be allowed free
evacuation, but the early incision of
the gland meets with disfavor in the
opinion of several practitioners. To
combat the tendency to heart failure
the usual drugs are indicated; digi-
tails, strophanthus, musk, camphor,
carbonate of ammonia, and alcohol,
have each their advocates, and each is
useful. High temperature Is to be
treated by phenacetin in preference to
either antifebrin or antinvrip DoH-
rum is to be relieved by sponglng the
body with warm water, coid appnca-
tons to the head, and hyoscine admin
istered hypodermically.
A curative serum, originally intro
duced by Yersin in China, and now
prepared at the Pasteur Institute,
Paris, has been tried in China, India,
and Oporto. Except In Oporto, the
treatment seems to have met with but
little success; but, according to Cal
mette, the serum has reduced the NOR
tality in Oporto to nil
e.