16 Comatose or semicomatose state of patient. Voice weak, speech incoherent. 2. The most prominent of these symptoms is the affection of superficial glands ; cases, when this symptom is absent, if there are any, appear quite exceptionally. 3. In a case of plague a microscopic preparation, made with the contents of the- affected gland, will show numerous diplobacteria of characteristic shape and size, described for the first time by Kitasato in Hongkong. 4. To obtain the microbes with certainty a patient is to be selected at the height of the symptoms, with glands largely increased, and before any injections had been made into the glands. At the commencement of the swelling, or in a convalescent patient, a drop withdrawn from the gland may fail to show the microbes. 5. For making a preparation, an ordinary or a grooved needle, a spirit lamp, a microscopic slide and 5 per cent. carbolic lotion is to be prepared. Then proceed as follows : Wash the skin just over the swollen gland with carbolic lotion. Allow the lotion to dry in situ ; pass the needle in the flame of a spirit lamp and leave it to cool down. Steady the gland with the fingers of left hand, so as to make it quite prominent, with the skin tightly drawn over it, and prick the gland through the skin. Press out a drop of the whitish contents of the gland, withdraw the needle and burn the part of it which has been introduced under the skin of the patient till it is red hot. Apply the slide to the drop of lymph pressed out of the gland, and spread it as uniformly as possible over about a half of the surface of the slide, avoiding any contact between the infective material and the fingers or any other object. 6. Keep the slide in the hand till it is dry, and while holding it in the hand by its free end, pass it rapidly in the flame five or six times, with the preparation upwards, till the lower surface of the slide felt by a finger is too hot to be left in contact with the finger without pain. Excessive heating or charring will make the preparation unrecognisable. Disinfect the skin over the gland and apply a suitable dressing if necessary. 7. In a certain number of cases, pricking the gland through the skin fails to bring to the surface the characteristic material. A more certain proceeding is to incise, with aseptic precautions, the skin over the gland, and the gland itself, and to take directly from the gland a drop of lymph on the point of a scalpel, spreading it over a slide as directed above. * Messrs. Kemp & Co., Bombay, have been instructed how to pre- pare such pipettes, and have pro- mised to sell boxes containing a dozen and half dozen of pipettes at the cost price of a few annas a box. 8. Another way consists in sucking up a drop from the gland by means of a sterile Pasteur pipette, protected by a cotton plug.* For this cauterise a small spot of the skin just over the gland. Break the fine end of the pipette and pass the thin part of it rapidly through the flame several times. Allow it to cool down and insert the pipette into the cauterised part of skin, steadying the gland with the fingers of left hand. By a boring motion introduce the tip of the pipette into the gland. The moment when this is reached will be felt by the tissues offering less resistance to the penetration of the pipette. Apply the mouth to the open end of pipette, and while constantly moving the pipette to and fro, suck up a small quantity of fluid. The best is the thick whitish contents of the gland, blood to be avoided by changing slightly the direction of the pipette or putting it deeper or more superficially. Withdraw the pipette and blow out a drop of it on the slide, spreading as above. The pipette is to be burnt immediately after this, and all objects used disinfected. 9. The use of a syringe is not advisable. 10. The slide is stained by any of the aniline dyes and examined with an oil immersion lens, or sent for staining and examination to the Bubonic Plague Research Committee, Petit Laboratory, Bombay. 11. Any operation should be avoided with glands situated on the abdomen above Poupart's ligament. 10. The Sanitary Commissioner reported on October 24th that he had issued the necessary advice to the authorities at Ahmedabad, Dhulia and Surat. The outlying municipalities were, he reported, fully alive to the importance of checking the disease at its outset. SECTION 7. General remarks. The position at the beginning of December when Government arrived in Bombay from Mahabaleshwar was briefly that extensive measures had been taken for the protection of Aden, Sind and the Mofussil districts of the Presidency from infection, and in Bombay City the Municipal Commissioner had been provided with powers of the most drastic kind for dealing with the epidemic. He bad found it inexpedient, however, for reasons which appeared very forcible at the time, to make full use of those powers as regards the segregation of the sick: but had adopted extensive measures for improving the sanitary condition of the city and for disinfecting infected localities, and those measures appeared to have had the effect of keeping the disease in check in the city.