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a long low cellar, without any window opening, and with the air entering only by a square open shaft from the level of the roof three or four stories high. Down one side of the shaft ran a broken earthenware drain pipe, leaking freely, the contents streaming down the wall of the air shaft to a shallow pool of filth which crossed the undrained floor of earth. Although it was broad daylight outside a lantern was necessary to see one's way. On a miserable sodden matting soaked with abominations there were four forms stretched out. One was dead, the tongue black and protruding. The next had the muscular twitchings and semi-comatose con- dition heralding dissolution. In searching for a bubo we found a huge mass of glands extending from Poupart's ligament to the knee joint. This patient was be- yond the stage of wild delirium. Sordes cover the teeth and were visible between the parted and blackened lips. Another sufferer, a female child about 10 years old, lay in the accumulated filth of apparently two or three days, unable to speak owing to the presence of enlarged cervical glands. The fourth was wildly delirious (the conjunctivæ intensely congested) and was constantly vomiting. The attendant (sic)-the grandmother of the child- had a temperature of 103° F. and could only crawl from one end of the cellar to the other. She was wet through, and was herself doomed. This is no fancy sketch but a true picture of how we found some of our patients at the outbreak of the scourge in Hongkong. No one, unfamiliar with the horrors of some coolie accommodation in China, could credit "how the poor live" in Hongkong, or could imagine how the horrors of their everyday life were intensified by the plague.
The terrors of the disease itself were rendered greater by the fear the poor wretches often had of falling into the hands of the "foreign doctors."
It is no great credit to our boasted civilisation or to our vaunted mission work that the average intelligent Chinaman of to-day prefers the fetish tricks of the native practitioner to the more enlightened methods of graduates of the western schools; but the fact remains that the horror of western medicine is by no means confined to, though almost universal among, the members of the coolie class. So evident was this fact that it was deemed prudent to allow such sufferers as preferred their own native doctors to be attended by them, in hospitals under European super- vision.
Face to face with a hundred difficulties, accentuated by the natural suspicion and ignorance of the Chinese, whom as far as possible we wished to appease, natur- ally short handed as far as medical men were concerned (for the visitation gave us little warning and spread with alarming rapidity), the difficulties the executive had to combat were grave in the extreme.
Wisdom after the event is a proverbially cheap attribute, and doubtless there are many people who possess it. We hear, now that the immediate strain and danger have passed, how very much more satisfactorily things might have been done, principally from people who did little or nothing to help us in the hour of our extremity. We hear of wiseacres who knew that the plague was here inany weeks before it arrived, but who kept such valuable information strictly to themselves, in the interests, doubtless, of the community. Rash and inaccurate "first thoughts have found their way into the British journals, and crude guesses have appeared in print under the false guise of "methodised experience." It will be prudent for plague students to accept very guardedly such early lucubrations. No man who really saw the plague in its early days had time for recording in a trustworthy way its often varying phases, and at that time sound clinical record was almost impossible. Later on in the light of a quieter time, and a more leisurely observa-. tion there was time to expunge as error that which at first was not unreasonably recorded as fact. We constantly laboured under the difficulty of not being able to speak the language of our patients, and such a condition of affairs was not only more or less alarming to them, but greatly against our treatment throughout. Of course, we had attendants who were able to interpret, but an interpreter is an. unsatisfactory necessity by the sick bedside, and often helps to confuse a sufferer, whose intelligence ab initio is none too clear, and whose approaching delirium dissipates coherency.
The sick person may be said roughly speaking to present upon first being seen many varying aspects. Sometimes the patient is brought in, in a condition to demand very careful diagnosis before committing him to a plague ward. There may be only general malaise with a temperature of say 102° F., a tongue somewhat coated, an anxious, sometimes terrified, expression, a quick small pulse (more or less the result of shock and fear), and a general feeling of aching over the body. Such symptoms of course may be the result of a dozen different pathological con- ditions and caution is ne ded. Another case may have the injected conjunctivae and high fever which forerun the stage of delirium and here the bubo is as a rule