216
or over.
"The symptoms are as follows:- With or with-
out premonitory warning in the shape of malaise or chill, there is a sudden onset of fever rising to 105°
There is much headache and cerebral dis- turbance, accompanied by stupor. In from 12 to 24 hours a glandular swelling occurs in the neck, arm- pit or groin, rapidly enlarging to the size of a fowl's egg; it is hard and exceedingly tender. With or without a decline of the fever, the patient sinks deeper into a condition of coma and dies usually at
the end of 48 hours or sooner. If six days are
reached recovery is hopeful. The glandular swelling shows no signs of suppuration. In some cases epis- taxis or vomiting of blood occurs; petechic appear in a few cases, but no regular eruption.
Such are,
brief-
ly the symptoms at the beginning of the disease. It
was then extremely fatal, over 30 deaths having occurred
in the small street we visited. The mortality was
high, being over 65 per cent of the patients attacked.
These houses are occupied by labourers and artisans,
they are small and badly ventilated with damp earthen
floors. linderneath the flag stones in front of the
houses in question is the usual drainage arrangement,
which at the period of our visit, was in a very in-
sanitary condition on account of the lack of water and in consequence of the prolonged drought. The people stated that at first many dead rats were found about the houses, but that after a few days these ani- mals entirely disappeared. On the 17th April we had
again
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