228
50
Case XVII--Chinese. Et. 6.
Admitted 1st August, 1894, at 4 a. m. with convulsion, and temperature of 105° F. On admission had grs. iv. of phenacetin. I was called to see her at 8 a.m. and found her comatose with a temperature of 103.8° F. Recognized her as an out-patient seen two days before, who had com-. plained of slight fever with a few blotches of what I took to be urticaria on her face, and for which small doses of quinine and magnesia were ordered. She was immediately put into a cold bath (75° F. at that time of year) which was cooled down to 55° F. by the use of ice. When the temperature had come down, on examination it was found that the right pupil was dilated and there was internal strabismus of the left eye. The head was turned over to the right side all the time. On pressure in the left groin, the left leg was drawn up slightly but as the child was unconscious nothing else could be elicited. As there was the possibility that it was a case of plague, the blood was examined by Dr. TAKAKI as well as myself without definite result ;--but on some blood being withdrawn from the spleen by a hypodermic syringe numerous bacilli were found. A hæmorrhage in the brain was diagnosed but its situation could not be fixed. The child remained unconscious all day in almost the same condition, never moving at all, and died at 8.40 p.m.
AUGUST, 1894.
M
1
E
2
109-
108-
167-
106-
103-
104-
193-
102-
101-
100-
99-
98-
97.
Pulse
Resp.
The post mortem examination was made the following morning.
The left femoral region was first cut down on through about half an inch of fat, and a solitary dark blue enlarged gland about the size of a cracknut was found. There were no glands enlarged in the right femoral region. There were numerous mesenteric glands inflamed and slightly cularged the spleen enlarged and follicles swollen. The meninges were intensely congested as was also the superficial brain matter in proximity, especially the Pons Varolii and Medulla. No hemorrhage was found after exceedingly careful examination,
Case XVIII--Chinese. Et, 53:
Admitted 12th May, 1894. Died on the 13th after having been five days sick. This was the first case we saw which had a hemorrhagic bleb. The bubo was in the right femoral region and the bleb was situated on the outer side of the right ankle. It was about the size of a dollar and the epidermis rose gradually over the sanguineum fluid until the swelling seemed to have a height of about half an inch. From the time of his admission until the time of his death twenty-eight hours