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membranes were generally bright red all over the brain, and occasionally the grey matter underneath was rosy red showing a condition of acute cerebritis. The longitudinal and lateral sinuses were generally full of the dark fluid watery blood. At the base the congestion of meinbranes, and even the Pons and Medulla them- selves, was most marked. Hæmorrhages were rare in the substance of the brain itself, only on three occasions did I see a hemorrhage in the Pons Varolii, others had been diagnosed during life but not found post mortem.

As regards the glands which are affected one met possibly with only one markedly enlarged, or many lymphatic glands in the body enlarged either slightly or to a very great extent. In the early cases, as I have already mentioned, the enlargement in one special region seemed to swamp the interest taken in the rest of the glandular system. The enlarged glands principally affectel were generally surrounded by a sero-sanguineous exudation, in the midst of which a hæmorrhagic gland, or glands, was situated. Only in two or three instances was pus actually met with in these on the post mortem table. The periglandular effusion was in a few cases very great round a small gland, and sometimes the œdema would extend round this further still; whilst often a chain of glands would be greatly enlarged without any surrounding exudation at all. As the epidemic went on the extravasated fluid became gradually less, and at the end of the epidemic it was seldom seen, the slightly enlarged gland or glands being generally clearly seen as a dark blue body distinctly outlined in the surrounding fatty or subcutaneous tissues (referring to the femoral glands which were generally first cut down on).

Sometimes a very great amount of cedema was present in the neighbourhood of the bubo.

MORTALITY.

Taking the total number of deaths and recoveries amongst the Chinese (as far as official figures go) the death-rate was 93.4 %. Amongst Indians it was 77 %; Japanese, 60%; Eurasians, 100%; Europeaus, 18.2 %.

I have no doubt that one cause of the heavy mortality amongst Chinese was the want of efficient medical attention and nursing in the early days of their illness. Many died in their houses without the slightest attendance. The Chinese admitted to European Hospitals only came in after having been several days sick, when the most favourable opportunity for treatment had passed. The cases which lived longest, or which recovered, were usually under treatment from almost the beginning of their illness. All the Europeans were under treatment at an early date as were several of the Japanese who recovered; and although some of the European cases were not severe I think that early and suitable treatment had a great deal to do with the diminished mortality. I regret to say, that with the Eurasians this was not so. Two of these were under treatment early but both died, whilst another case which was not diagnosed early died on the seventh (?) day. There is no doubt that European blood and stamina had a good deal to do with recovery, and I say this notwithstanding the fact that they were necessarily more carefully nursed and looked after than some of the Chinese. It must always be borne in mind that an intelligent European had every chance in his favour; he was in the first instance very jealous of his earliest departure from health, and lost no time in placing himself in communication with experienced help; then he was able to explain his own symptoms in his own tongue to a medical man who spoke and understood the same language. Again he had confidence in the power of western medicine to help him, and he was untroubled by the constant dread of the "foreign doctor" which environs not only every ignorant coolie, but the vast majority of the more or less cultured classes of the Chinese nation.

CONVALESCENCE AND AFTER EFFECTS.

When a bubo was opened I found that iodoform was the best application for insufflating purposes. After a couple of days' treatment by plugging with lint soaked in carbolic oil and smeared over with iodoform the bacilli usually disappeared from the discharge. This was due, I think, to the antiseptics employed and not to any possible death of the bacilli by the growth of staphylococcus in the pus. In some lymphatic abscesses (in the case of Professor AoYAMA,) which had been present for several days before opening, the bacilli were found in numbers. Hot corrosive sublimate fomentations were the best external applications in most cases, being cleanly and easily applied. Where the bubo was large, dirty, and discharging freely, poultices of linseed, either alone, or with charcoal and dusted over with iodoform, were preferable. Suppuration was sometimes prolonged for a month or more, and where this was so a careful examination sometiines revealed a large