Sessional_Paper_1905 — Page 351

289

Recovery-rate.-Of the cases of Bubonic Plague, 3 males and 6 females re- covered, and of the Septic variety 4 males and no females. This gives a total of 13, a percentage of nearly 17, on the cases admitted. Analysing them still further we arrive at these percentages :-

Bubonic Plague,

Septic Plague,.

Males 8%

..Males 25%

Females 29°/

Females Nil.

These percentages depend upon numbers too small to generalise from.

Death rate. This amounted to 82% of the cases admitted and gives per- centages with reference to the Bubonic and Septic variety as follows:--

Bubonic Plague, Septic Plague,

Males 91.6. Females 71.

Females 100.

... Males 73.

Here too these percentages should not be used too implicitly; for instance, only two females suffering from Septic Plague were under treatment, and both died, giving this enormous percentage. It is quite probable that with a large

number under treatment the results would not have been the same.

It will be noticed that the death-rate among those under treatment amounts to 82°。 whereas in all cases notified it amounts to 97 %- This may be held to demonstrate what is evident, that the care and attention a patient receives in Hospital give him a better chance of recovery--with reference to the number we are dealing with we have a difference of 15 per cent. On the other hand, however, I am inclined to the opinion from the cases which I have had the opportunity of observing both in this Hospital and in the Tung Wah Hospital that the heavy mortality on the total cases notified indicates that the disease appeared in a more virulent form, and that no treatment at present known was likely to have had any beneficial result.

Does early treatment on the onset of the disease tend to direct it to a successful issue?-I have drawn up a table shewing the duration in days of the illness previous to admission. It will be seen that on the third day after the onset 12 cases of Bubonic Plague were admitted of whom one recovered, and two cases of Septic Plague of whom also one recovered. On the 4th day of illness 16 cases of Bubonic Plague were admitted of whom 2 recovered, and two cases of Septic Plague which succumbed. The history could not be definitely obtained from 20 cases of Bubonic Plague, and 9 cases of Septic Plague. These cases were admitted practically in extremis, and I am strongly of opinion that the disease was of very recent onset--certainly not more than four days. It will thus be seen that 61 of the 77 cases were admitted comparatively early, and that active treatment had no effect on them, for only 4 recovered, or a little over 6 per cent.

Hence I con- clude that the disease was of a much more severe type than in 1903: that in spite of cases have been brought in early general poisoning of the system by the Plague organism was developed so early, and was of so intense a character that no treatment could have prevented a fatal issue.

As a corollary I append another table (No. V) shewing the length of resid ence in Hospital of patients who died. It will be observed that 8 died within 6 hours of admission, 13 within 12 hours, 16 within 18 hours, 4 within 24 hours, 11, within 2 days, and 4 within 3 days. Only 7 cases lived for a longer period. Thus 41 cases died within the first 24 hours-they were in a hopeless condition, and no treatment however energetic could have availed them.

Until a serum is

discovered which is as efficient in its action as the antitoxin of Diptheria we must rely upon the natural immunity of the human body to antagonise the poison of the Plague bacillus, and in our present state of knowledge we are unable to say how long the bacillus, remains in the blood before this immunising action becomes of sufficient potency to neutralise the poison and its action.

The Distribution of the Bubo in Bobonic Plague. The number of cases of Bubonic Plague amounted to 76.5 per cent. as compared with .23.5 per cent. of cases of Septic Plague, that is, a ratio of 3 to: 1. As it has been asserted lately that one of the principal avenues of infection is by means of the alimentary tract (through the medium of food), this preponderant