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It would be impossible to detail in this report, the notes of all the cases which are of interest in regard to this question. I shall limit myself to the histories of the following four cases, these being representative of the question at present under consideration :-

Case No. I.-F. A., admitted to the Government Civil Hospital on the 17th March, 1903, complaining of severe diarrhoea. Tempera- ture on admission, normal. The blood was examined with nega- tive results. The character of the stool was loose, bile stained and foul smelling. Nothing characteristic was found in the stool when examined microscopically. The number of stools on the day of admission was 6, On the 18th 4 stools, on the 19th 4 stools, and on the 20th he had 2 stools. All the stools were of the same character as described. The temperature was still nor- mal on the 20th. In the evening of the 20th it suddenly rose to 102° F. The diarrhoea was still present. On the 21st the even- ing temperature was 103° F., diarrhoea still present. On the 22nd the temperature was 103° F, diarrhea small in amount. The blood was examined by the method recommended by Ross for malaria, and a number of oval, bipolar shaped micro-organisms was found, These were regarded as plague bacilli, and the patient was remov- ed to Kennedy Town Hospital. Here, he complained of severe headache, and sleepiness. The tongue was thickly furred, and in general, the patient presented all the signs of severe plague infec- tion. No bubo developed. He went through an extremely severe attack of plaque of the septicamic type.

Case No. II.-S. S., a police constable, was admitted to the Government Civil Hospital on 3rd June, 1903, complaining of vomiting and diarrhoea of a day's duration. On admission, the dejecta were found to be watery, bile stained, and foul smelling. The tongue was furred. The teinperature was 100° F. The blood was exa- mined by Ross's method, and large numbers of bacilli identical with the B. pestis were found. On the strength of this, the patient was removed to the Infectious Diseases Hospital, where a severe and typical bubonic plague developed.

Case No. III.-T. K., a Chinese police constable, was admitted to the Government Civil on the 4th March, 1903, complaining of severe

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'colic," vomiting and constant watery diarrhoea. The bowels opened twice soon after admission, and the dejecta were watery and brownish yellow in colour. Nothing abnormal was found in the stools. The patient looked very pinched, ill, and somnolent.. The temperature was 99° F.

On the 5th the temperature was still 99° F. The patient was very sleepy and dull. He complained of severe headache. The tongue had become thickly coated. The diarrhoea was still profuse and of the same character. The blood was examined as in other cases. Bacteria morphologically identical with the B. pestis were found. He was removed at once to Kennedy Town Hospital where he passed through a typical attack of plague of the bubonic type.

Case No. IV.-H. T., a Chinese coolie, was admitted to the Government Civil Hospital on the 16th March, 1903, complaining of cramps in the abdomen, headache, vomiting and diarrhea. On admission, the temperature was 100.8° F.. the tongue was fonl, headache was constantly complained of, and vomiting and diarrhea continued severe. Nothing abnormal was found microscopically in the stools. They had the usual naked eye appearance. During the first 24 hours after admission, the patient had 22 stools. The blood was examined as in other cases and organisms identical with plague bacilli found. He was transferred to Kennedy Town Hospital and developed into a typical case of septicæmic plague with no bubonic formation.

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