41
degrees of temperature after two five-grain doses of phenacetin, one example of what I have noted elsewhere in this report that in a severe case when the temperature is affected readily to this extent by antipyretics it is not a favourable sigu. It shows, I think, that the circulatory system is in a condition where it cannot stand much depressing influence.
Case VII.--English.
Et. 28.
This man was on the whitewashing party for twenty days before becoming ill. Felt sick with slight shivering on 8th June. On the 10th June admitted to the Hygeia, with vomiting, tempe rature 105° F. no headache, small femoral bubo in left groin, yellow furred tongne, pulse full and bounding, but yet easily compressible.
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JUNE, 1894.
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Pulse
Resp.
Between the 10th and the 13th the bubo increased very much in size, having a boggy feeling and with a good deal of surrounding redness. It was also very painful. Treated by lead and opium the inflamatory appearance disappeared in four days. On the 21st the bubo was opened and there was a considerable amount of pus evacuatol. Treatment :--tepid sponging, quinine grs. v. three times a day. Bromide of potash grs. XL. and hydrate of chloral grs. xx. every night during the period of delirium with plenty of iced beer and usual nourishment. Discharged on the 27th July.
When examined in the beginning of December this patient is found to have very tumultuous action of the heart which is most irregular at times. There is no bruit to be discovered. The apex beat is just outside the nipple line. The pulse is 122 when sitting at rest, and irregular. He appears very nervous and shaky. He frequently suffers from headache, but evidently of not so severe a character as his fellow soldiers. The spleen shows no enlargement. There is an occasional cramp of the muscles of the front of the left thigh, evidently due to some implication of the anterior crural nerve in the cicatrix. He frequently suffers from shortness of breath and palpitation, more especially when marching up a hill,
Remarks. This case was one which showed a great amount of after-change in the nervous mechanism of the vascular system and led one to suspect that the enervation of the heart had been permanently affected by the disease.
Case VIII--Chinese. Æt. 38.
Was admitted to the Government Civil Hospital on the evening of the 8th June, suffering from incised wound of the scalp about six inches long with severe hæmorrhage. The woman fainted whilst in the receiving room. The wound was caused by her falling down stairs. On the 9th she was very stupid but did not have the appearance or symptoms of a patient with compression or concussion of the brain. On the evening of the 9th plague was diagnosed and she was removed on the following morning to Kennedytown where she died the same evening from plague. It was remarkable how very few similar accidents occurred, Here there was no fracture of the vertex and
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