Sessional_Paper_1906 — Page 463

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Number of Vaccination Marks in Patients who died.

European Males.......Confluent Small-Pox. No. of Marks, 1

Do. Do.

Hæmorrhagic Small-Pox.

European Female ...Confluent Small-Pox.

Chinese Male

Chinese Female

***

Do.

Do.

...Death,

1

2

2

19

1

"

0

1

>>

I

*

1

7:

Treatment.

All severe cases are kept under the influence of red light, and large doses of carbolic acid have been used. By this means pustulation seems to be modified, and pitting is not so severe. In addition, symptomatic treatment is resorted to.

RELAPSING FEVER.

Notes on Cases.

On the 10th January, 1905, eight patients were sent to the Hospital Hulk" Hygeia from the emigrant steamer Cranley" which was en route to South Africa with coolies from Chin-Wan-Tao for the Gold Fields. Five of these cases were suffering from small- pox unmistakeably. The other three had a high temperature, a quick pulse, intense back- ache, headache and general aching over the bones and joints. The respiration was quick- ened, the tongue was dirty. It was thought that these cases were cases of incipient small- pox, and this opinion gained strength from the occurrence of undoubted cases of that disease. As however the illness had lasted seven days and there was no definite evidence of the existence or onset of small-pox I thought it advisable to examine the blood microscopically. Numerous spirilla were found, and there was no evidence of any malarial infection. These cases ran a characteristic course and the spirilla were found every day in the blood during the persistence of the high temperature.

Course of the Cuses:-

First Case Fever 7 days, Remission 5 days, Fever 4 days,-Recovery. Second Case-Fever 12 days, No remission,--Recovery.

Third Case Fever 12 days, Remission 3 days,-Sudden deathı.

I am unable to state exactly that the duration of the primary attack of fever was in each case accurate, because no information was supplied me by the ship's authorities, and I had to rely upon the statements of the patients,

The temperature in no case rose above 105° F. It was steady, was practically unin- fluenced by antipyretics and quinine, and was only slightly modified by cold sponging and that but temporarily.

The treatment adopted was the administration of ordinary diaphoretics: antipyretics and quinine were tried, but without effect and digitalis and strychnine were given when- ever the heart shewed signs of flagging.

The case that succumbed suffered slightly from chronic bronchitis. He had passe l through 12 days of fever, and was in the third day of his remission. He seemed to be doing well, was quite cheerful and lively. He ate a hearty breakfast and fell back dead in his bed. Owing to the interesting nature of the case I detail the record of the post-mortem examination which was made about 6 hours after death.

No. post-

Post-mortem examination. -Body well nourished. Vaccinuation positive. mortem rigidity and very little lividity. Small chronic ulcer over Right Trochanter about the size of a twenty-cent piece, with a necrotic base and a slightly inflamed area around it. A small quantity-one drachm-of clear straw coloured serum in pericardial sac. Blood very fluid and watery-straw coloured except in mass. Heart-no epicardial petechia, slight amount of epicardial fat. Weight 10 oz. Heart muscle pale. Aortic valves normal, also mitral valves. No atheroma. Dilatation of right ventricle--walls thin-valves normal. Left ventricle, walls thin. Pulmonary valves normal. Lungs- Left Lung, 12 oz.--some chronic bronchitis, no consolidation, no pleurisy. Right Lung