14 Description of Plague : [ CHAP. II,
A circumstance tending to increase the mortality in plague
hospitals is that the severe cases are the more likely to be brought
there. Many patients were admitted in a moribund condition.
Mortality in
Hong-kong.
The following extract from a report by Sir William Robinson, the
Governor of Hong-kong, on the Hong-kong epidemic of 1896 shows
that the rate of mortality during the Hong-kong plague was higher
than the rate has been in India :-
"The mortality generally, as compared with 1894, shows a slight
improvement. The total number of Chinese cases up to noon on the
4th instant was 675, and the number of deaths 602, or a little more
than 89 per cent., whereas in 1894 the mortality among the Chinese
who were treated in hospitals was 93 per cent.; and it must also
be borne in mind that in the latter calculation no account is taken of
dead bodies found in the streets and sent at once to the burial-
ground, while the returns for the current year include all deaths from
the plague. "
Mortality in
different types
of plague.
In the account given by Dr. Bitter, reproduced in the first section
of this chapter, it is said that the simple bubonic cases usually end in
recovery, and that the septicmic cases are invariably fatal. The
reports of the Bombay hospitals show that this last statement is
somewhat too emphatic, though no doubt recovery in both septicmic
and pneumonic cases is comparatively rare. Surgeon-Captain Thomson
gives the following account of the results observed at the Parel
Hospital, Bombay:-
" Cases without palpable buboes were most fatal, averaging 78.6
per cent. Many of such cases died early of convulsions, coma, and
syncope, overwhelmed by toxic products suddenly attacking the
great nerve centres, as it were, before there was time for an inflamed
gland to arise.
" The next most fatal were left axilliary and right cervical in the
same proportions, then right axilliary and right parotid in nearly the
same ratio; next came inguinal, and next femoral; and multiple
seemed to be least fatal.
Buboes on the right side had
66.7 per cent. mortality.
left
58.3
in the upper part of the body
69.3
lower
57.2
" The nearer the head the more fatal the case, and those with
buboes in the neck, and especially in its anterior aspect were very
fatal. "
Influence of race,
sex and age.
Comparing the experience of the different hospitals, race does
not seem to have any marked effect on the rate of mortality. The