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quickly passed away. Repeated examinations of sputum shewed no tubercle and no Plague, and latterly there were no Plague organisms in the blood. When this was ascertained to be the case she was transferred on the 32nd day of her illness to the Tung Wah Hospital. She had three injections of Yersin's serum, and was taking iodide of iron and cod liver oil. At the Tung Wah the evidence of bron- chitis was persistent, and she lost ground steadily, becoming gradually more emaciated and weaker. She died about three months after she contracted Plague.
The following is the report of the post-mortem examination :-The body was extremely emaciated-I have never seen a more emaciated body. There was a dema of the lower extremities, and small bedsores over the trochanters and ischia. The heart was soft and flabby-fatty degeneration. Lungs-in both there was marked evidence of chronic bronchitis. There was slight evidence of tubercle, one or two nodules the size of a bean in the slight apex in which tubercle baciili were present. No pleurisy. About 4 ozs. of clear yellow flud in each pleural cavity. The Liver was diminished in size and weight-about 40 oz.; it was very anæmic. There. was fine cirrhosis and marked iron pigmentation. Gall bladder was not distended the bile was very thick. Spleen small in size, weight 4 oz., capsule thickened : anæmic diffuse armyloid-marked malarial pigmentation, but miscroscopi- cally, no parasites. Stomach and intestines normal. Mesenteric glands normal. Kidneys pale and fatty. Pelvic organs normal.
organs normal. Brain normal-Glands all nor mal. No plague bacilli found. This case is interesting as demonstrating a condition of progressive atrophy combined with chronic bronchitis and malarial cachexia. The tubercular process was not active.
The Formation of fibrin in Plague Blood.—The blood of convalescent Plague patients as I observed in three cases is very thin and watery. The percentage of hæmoglobin is diminished and the number of leucocytes increased. Fibrin for- mation is delayed. In ten instances which I observed it took almost five minutes to form. The percentage of fibrin seems lower than normal. These points how- ever I was not able to investigate very thoroughly.
THE HOSPITAL BUILDING.
The building was colour washed and painted during the year. A large beam in one of the wards which had been destroyed by white ants was replaced by a steel girder. An extra kitchen has been contrived out of a spare store room. Sundry minor alterations and repairs were effected. The building is in a satisfac- tory condition at present.
THE HOSPITAL HULK "HYGEIA"
During the typhoon season the Hygeia was moored under the shelter of Stone Cutters' Island and a case of small-pox on board was attended by the Port Medi- cal Officers. On the termination of this case, sundry minor repairs were effected and she was painted. A new gig was supplied to replace one that had get broken in dirty weather. Many alterations and repairs still remain to be done.
ADMISSIONS TO THE "HYGEIA."
Only cases of small-pox are treated on board and a Table of statistics is appended. The cases admitted call for no special remark. As usual in all sırall- pox hospitals fine points in diagnosis sometimes arise, but where there is any doubt I consider the wisest and most judicious plan is to treat the case with all the consideration a small-pox case deserves.
I append a number of Tables and statistical returns.
In concluding I must express my cordial thanks to Dr. HUNTER, the Govern- ment Bacteriologist, for many hints and much kind assistance.
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I have, &c.,
W. V. M. KOCH. Medical Officer in charge.
The Honourable the Principal Civil Medical Officer,
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