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So far, however, little can be said in regard to occupation incidence. The Indian Plague Commission of 1901 came to the conclusion, that the incidence of plague is not dependent on trade or occupation.
WILLIAM HUNTER.
Pathological Anatomy.
During the past two years, nearly 1,500 post-mortem examinations have been held upon plague corpses. In almost every case, the body was thoroughly examined for lesions due to the action of the B. pestis. By this routine method, a number of interesting facts regarding the pathology of plague has been ascertained. All types of the disease have been examined; a goodly number of children were also dissected and the lesions in them compared with those met with in adults. Many of the females examined were pregnant, others had aborted just before death. In such cases, the contents of the uterus was inspected for the presence of charac- teristic plague lesious.
In the majority of cases, a history of the cases brought for post-mortem examination was not ascertainable. This was due to the fact that most of the bodies were found, either in deserted honses, streets, the harbour, or the hill sides. Most plague bodies show a considerable amount of bluish discolouration, This develops to its greatest degree from 6 to 12 hours after death. It is well marked on all dependent parts, but occasionally is found more or less all over the body, and especially on the face, scalp, neck and shoulders. This discolouration of the skin is a marked condition in plague, and in plague infected areas; sucli an appearance of a body ought to raise suspicion as to the existence of the disease. The appearance is by no means confined to plague. It may be met with in malaria, beri-beri, etc., but is never so pronounced. It is one of the signs relied upon by the advocates of simple corpse inspection and is of use to those who are engaged in superficially examining cases of uncertified death, and who have in many instances to give what must be regarded from a professional point of view an unscientific opinion. The determination of the cause of death by such corpse inspection is in many cases directly opposed to the principles and practice of medicine. The only thing which can be allowed for corpse inspection, is the hint occasionally given by such a “viewing of the body as to the advisability of order- ing a necropsy in order to place the diagnosis of plague upon an irrefutable positive or negative basis. In Western countries, corpse inspection ought to be completely supplanted by post-mortem examination. In the Orient, on the other hand, a certain amount of licence must be allowed in medicine owing to native prejudice.
Rigor mortis does not set in early in plague. In may be completely absent. The majority of cases of plague occur in well nourished individuals. Emaciation is not a characteristic post-mortem appearance. Opinious appear to vary as to the rate of decomposition of plague corpses. WILM notes in his Report that "there was no marked tendency to decomposition. This is not my experience. Changes rapidly set in amongst the abdominal viscera, and the body quickly becomes discoloured. A good deal, however, depends upon the time of the year when the necropsy is performed. During the hotter seasons in Hongkong, post-mortems on plague bodies have to be held within 12 hours, if reliable results are to be obtained in regard to the pathological appearances of the organs and tissues. Other factors of importance are the conditions of the body as to nourishment, fat, etc., the age of the individual, the presence of certain micro-organisms which produce rapid putrefaction. The condition known as "foaming organs" is one which I have found frequently at the Public Mortuary. This condition is caused by the Bacillus ærogenes capsniatus of WELCH. During the hot seasons of the year, this organism plays great havoc with much of the interesting pathological material at the Mortuary. So rapid is its effects on the organs and tissues, that the delay of 6 to 10 hours in per- forming the autopsy may render a correct diagnosis almost impossible. I have known of bodies, still warm, having been brought to the Public Mortuary from the Tung Wah Hospital for examination at 10 a.m. and by 5 p.m. the corpse was