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Remarks.—As already mentioned, the temperature on the second day was somewhat peculiar and no other case during the epidemic showed a practically normal temperature for almost the second twenty-four hours of the disease. He was seen by Dr. HORDER. of Pakhoi on admission, who concurred in our diagnosis, and he was also somewhat surprised to note this temperature.

Had we not seen this man on the 2nd when his temperature was 101° F. it is quite possible that this case might have been put down as one where the bubo was apparent forty-eight hours before the fever began. It is to be noted also that when the temperature again went up on the 4th, the onset of delirium was particularly rapid. The want of sleep during the first two nights, I think, was caused by the anxiety on the part of the patient which necessarily was present in every European case, and which was more than usually well marked in this man. The other soldiers who suffered from the disease were examined at the same time as the two Cases VII. and XIII. One suffered from occasional occipito-cervical pain and shortness of breath whilst another had a tumultuous action of the heart with irregular pulse and frequent vertical headache. The urine of all was normal, no albumen. Although these men were discharged from the Hygeia on the 27th July some of them had to remain a considerable time in the Military Hospital on account of the indolent character of the ulcers left after the buboes.

Case XIV-Eurasian. Æt. 49.

On August 3rd some blood was sent for examination and as plague bacilli were found in it the patient was removed to Kennedytown. History :-Was at the Alice Memorial Brauch nursing on Saturday, 21st July. She has had fever for eight days. Temperature chart affixed. Her tongue showed the typical advanced condition of plague. Dyspnoea was considerable and the pulse very feeble and slightly intermittent. There was no bubo to be seen. She complained of considerable abdominal pain about the umbilicus. She died the same evening.

JULY, 1894.

27 28 29 30 31 1

AUGUST.

2

3 4

106-

105-

104-1

103-

102-

101-

100

99

98-

Post mortem examination on the following morning was partial; the spleen was soft and slightly enlarged, there were no externally visible swollen glands in the femoral, axillary or cervical regions, but there was a considerably enlarged and congested mesenteric gland almost directly situated at the seat of pain; in addition there were several other glands which were enlarged but not to such a considerable extent as the one before mentioned. There were no hæmorrhages in the abdomen. Bacilli were numerous in the glands and spleen. There was no inflammation of the intestines or stomach and no hæmorrhages on the mucous surface of the latter organ.

town.

Case XV.--Chinese. E. 21.

Was admitted on August 7th. This patient was sent by Surgeon-Major JAMES from the Tung Wah Hospital. On arriving at the Government Civil Hospital for bacteriological examination of the blood, he had a convulsion. Bacilli were found in the blood, so he was sent down to Kennedy- He had never had fits before. Had been sick for three days. On examination it was found that he protruded the tongue to the left side-the left leg and left arm were paralysed; pupils equal; left side of palate also paralysed; the left facial nerve apparently not affected. After the convulsions he was immediately conscious, and before they occurred he could sometimes tell that they were coming on. During the last two days he has had numerous fits. There was no involuntary urination. "He says a fit is now coming on and he thinks so because of a feeling in his chest. During the fit, the eyes are turned to the left. The muscles of the paralysed left limbs jerk somewhat but not enough to raise the limbs off the bed as they do on the opposite and sound side. The mouth is drawn over to the left side and the head jerks over to the left side also. During the fit the pulse is rather weak and remains so for a short time after." On the 8th the paralysis of the previous day had become only