121
wool and the following stimulant and expectorant mixture was pre-
scribed:-
R./
Ammon. Carb. grs. V.
Sp. Aetheris Sulph. m. XX.
Liq. Strychni in. V.
Sp. Chloroform m. X.
Aqu Camphoris ad. oz. I.
every four hours.
Later, as the pulse became weak, hypodermic injections of
Strychnia and Aether were given every four hours.
Course of the illness.-The bubo rapidly increased in size until
it was as large as a turkey's egg; a large and deep slough formed in-
volving the whole depth and breadth of the bubo, and when this
separated (on March 12th) a large, deep, irregular cavity was left, which
at no time showed much tendency to heal. On March 12th, there was
slight hmoptysis; pain was complained of in the left side and a dry
pleuritic rale was heard over the left base in the axilla. The temperature,
which had throughout been very irregular, dropping on many occasions
to normal and on others rising to 103 or 104, rose on the 13th to 1048
and the sputum was for the first time rusty in character. On the 14th
the breath sounds on the left side were distant; friction was absent;
expiration was prolonged. On the 15th, the pneumonic signs were more
pronounced; these were dulness, tubular breathing, and profuse fine
and medium crepitations. The pulse was at this time very weak. On
the 16th, the patient became delirious; there was profuse rusty sputum;
the pulse became extremely weak and in spite of treatment death occurred
at 8 p.m.
CASE IV.-BUBONIC PLAGUE.-MULTIPLE SUPPURATING- BUBOES; INTER-CURRENT
ERYSIPELAS; EXHAUSTION AND DEATH ON THE 30TH DAY.
Joseph A. Dennis, Christian male, aged 25; cook; admitted to
Hospital February 21, 1898, with a history of three days' illness.
State on admission.- Temperature 1006; pulse 98, intermittent;
respirations 30. The tongue is moist and highly coated with greyish-
white fur; there is nausea, but no vomiting; the bowels are confined.
There is a tender bubo, the size of a walnut, in the left axilla; there
is also pain and tenderness in the left neck, but no swelling can be felt
there. There is no cough and the chest is normal. The spleen is not
enlarged.