Sessional_Paper_1907 — Page 847

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4. Chinese M. Left Femoral Bubo.

Small vesicle on inflamed base at apex of

Scarpa's triangle containing Plague Bacilli.

5. Chinese M. Left Femoral Bubo. Small pustule on back of calf swarming with

Plague Bacilli.

6. Chinese M. Right Femoral and light Inguinal Buboes. Remains of pustule

on thigh containing Plague Bacilli.

7. Chinese M. Left Cervical Bubo.

Left Cervical Bubo. Left Tonsil ulcerated, Sinears from ulcer were swarming with Plague Bacilli.

Treatment of Plague..

In the earlier part of the season I relied altogether on symptomatic and stimulant treatment but in April Dr. HEANLEY, Government Assistant Bacteriologist, suggested the trial of injections of Cyllim, intravenously and into the buboes. The injection of antiseptics

is of course no new idea, Formalin and others have been tried but found more or less useless. Cyllin, however, possesses the following qualifications:-

(1.) It is staple or nearly so in the presence of organic matter.

(2.) It possesses a specific toxicity for vegetable as opposed to animal protoplasm. (3.) The Carbolic Acid coefficient for the Bacillus Pestis is given as 340. The fact

that it is practically non-poisonous in moderate doses has been shown by Dr. SOMERVILLE in a series of experiments on animals which he published in the Journal of Tropical Medicine for July 1st, 1905.

Theoretically, therefore, it would seem to be an ideal disinfectant for intravenous and subcutaneous injection.

We, therefore, prepared a solution of Cyllin Medical" 1 in 30 in distilled water. The emulsion was filtered through ordinary filter paper and on microscopical examination the individual globules were found to be much smaller in diameter than a red blood corpuscle.

I treated 13 cases of Bubonic Plague with injections of from 10 c.c. to 30 c.c. into the diseased glands and surrounding infiltrated tissue. Out of the 13 cases 5 recovered. In three of these cases I also gave intravenous injections as follows :-

1. Chinese M.

of 20 c.c. of Cyllin

1

Left Femoral Bubo.. Plague Bacilli in blood. Intravenous injection in 1,000. Died three hours later.

2. Chinese F. Left Femoral Bubo. Bubo infected. but on fifth day Broncho- Pneumonia developed and sputum was found to be crowded with Plague Bacilli. Con- sidering the case to be hopeless I gave 30 c.c. of Cyllin 1 in 30 intravenously. The temderature fell but as it was rising again the following day, I repeated the injection. About 15 minutes after the second intravenous injection the patient had a rigor. This patient made a slow recovery.

3. Indian M. Left Femoral Bubo.

Left Femoral Bubo. Injection intravenously of 30. c.c. of Cyllin 1 in 30. Died two days later.

Many of the cases treated in this way were in a dying condition and the intravenous injection were only given as a last resort. The post-mortem showed that in some the buboes had not been sufficiently infiltrated with the solution and in others the deeper glands which were out of reach were also infected and consequently the obstruction of the superficial bubo was unavailing.

In all cases the injections caused a fail of temperature and beyond the rigor meo- tioned above, no symptoms of any kind were produced. These results seem to justify a more extended trial and I hope next season to have a supply of Cyliiu, specially prepared. by Mr. AINSLIE WALKER of London, for intravenous injection.

Pathology.

In the majority of cases nothing unusual was noted, but in two the lungs were the seat of multiple peripheral infarctions, one of these cases developed double hypopyon two days before death. In another case pericarditis was present and the fluid was swarming with Plague Bacilli. Extensive sub-peritoneal hæmorrhages were also noted in two other

cases.