Sessional_Paper_1906 — Page 461

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Significance of the Maturation of the Bubo.

As far as I have had an opportunity of observing, maturation of the bubo and early incision and evacuation is a favourable element in prognosis, should Plague bacilli be absent from the discharge. In five cases of Bubonic Plagne the bubo matured, in two of these there were no Plague bacilli in the pas-they recovered: in two Plague bacilli were present -they died.

This occurred in one case-a the patient ultimately recovered.

Resolution of the Bubo.

male with a left axillary bubo. The bubo resolved and The import of such resolution of a bubo seems favourable.

Treatment of Plague.

It must be confessed with regret that no advance has up to now been made in the treatment of Plague. No drug has yet been put forward which could act as a specific, no serum has been elaborated which can act as a preventive or a curative agent. We are driven back to allowing Nature to initiate her own defences and can only assist her by measures tending to keep up the strength of the patient. How weak are these measures the heavy mortality shews. Judging from analogy a serum would seem to afford the most rational means of combating the disease, and for this, we have to look to the Laboratory worker. During the year I have been able to put Yersin's serum again to the test. A fresh supply was obtained and used extensively. Twenty-two cases were treated, and three recovered. Auxiliary means of treatment were also employed in order to enhance the chances of recovery and they must share in the credit of the recoveries. Through the kindness of Dr. WOOLLEY, Director of the Serum Laboratory in Manila, Dr. RUEDIGER of that institution sent me some serum prepared by himself. I used it in four cases at the end of the season. The cases were in a desperate condition and did not recover. The utility of the serum, therefore, has not had a fair test. Appended is a list of the cases treated by Yersin's serum, number of doses injected and the result :---

Male.-R.F.B. 1 injection, 20 c.c. 14 hours before death-Died. Male. Septic. 1 injection, 20 c.c. 2 hours before death – Died,

Male.-R.F.B. 2 injection, 10 c.c. each time, 5 hours and 2 hours before death—Died. Female.-L.F.B. I injection, 20 c.c. 5 hours before death-Diel.

Male.-Rs and L.F.B. 3 injections, three successive days. 20, 20, 25 c.c.-Died. Male.-Septic. 4 injections on successive days, 20, 25, 20, 20 c.c.--Recovered, Male.-R.A.B. 4 injections on successive days, 20, 25, 20, 20 e.c.--Recovered. Male.-L.F.B. 1 injection, 20 c.c. 9 hours before death-- Died.

Male.-Septic 4 injection, on successive days 20 c.c. each time-Recovered. Male.-L.F.B. 2 injections on successive days 20 cc. each-Died. Male. Septic. 4 injections on successive days, 20 c.c. each time—Died. Male-R, and L.F.B. 1 injection, 20 e c. the day before death—Died. Female. Septic. I injection, 20 c.c. 24 hours before death- Died. Female.-L.F.B. 1 injection, 20 c.c. 11 hours before death-Died. Male.-R.F.B. 1 injection, 20 c.c. 18 hours before death-Died. Male.-R.F.B. 2 injections, 20 c.c. each time on successive days-Died. Male.--R. A.B. 3 injections, in two days, 20 c.c. each time-Died.

Male.-L.F.B. 7 injections, 20 e.e. each time, first and last day, 40 c.c.-Died. Female.-R.F.B. 3 injections. 20 c.c. each time within 36 hours-Died.

Female. Septic. injections, 20 c.c. each time--Died.

Male.-L.F.B 3 injections, 20 c.c. each time-Died. Male.-R.F.B. 1 injection, 20 c.c.-Died.

In all 52 injections were given.

Bubonic cases-Recovered, Male 1; Female 0

Died,

12

12

Died,

Septic cases-Recovered,

י

31

NC WO

It will be seen that the results this year confirm those of last year as regards the use of serum (Yersin's), and that an efficient and effective curative serum remains to be discov- ered.