.?e?SES OF PLAGUE AT CHAUSA.
following brief notes of three cases of plague occurring recently at the Chausa Plague Observation Camp illustrate very forcibly the difficulty there is in detecting dangerous people travelling from infected areas. The cases show The
how sudden the onset may be. In all three the progress was rapid, and a fatal result quickly ensued. The late appearance of the bubo is noteworthy in cases (1) and (2). These cases also illustrate, we consider, the very great care and attention which the slightest cases of fever occurring among passengers require, and evidently receive, from the medical officers in charge of the Plague Observation Camps. The detention of a passenger on account of a temperature of only 99?, case (2), is evidence of the accuracy with which the inspection of travellers is carried out. Case (1).?A Hindu female child, aged 10 years, was removed from an up-passenger train on June 11th, with a temperature of 104?. She had been living in Calcutta in Jaun Bazar Street. Her face was flushed, conjunctive were injected, and her tongue was coated uniformly with a thick greyish-white fur. She was semi-conscious. She was stated to have been perfectly well the
340
THE INDIAN MEDICAL GAZETTE.
and to have been attacked by fever while in the train, not having been in contact She had no bubo with any case of plague. The same evening when found in the train. her temperature remained at 10 i?, pulse 115, and she was still semi-conscious, and much Next morning her temperature was weaker. 104"2?, pulse 120, and she complained of tenderness and pain in the left groin, where a small hard swelling about the size of a pigeon's egg, with some infiltration round it, was found. She had passed one normal stool during the night. Her pulse became irregular and more feeble, and Streak cultures she died soon after 10 a.m. from the gland gave a negative result, probably owing to dryness of the media. Case (2).?A Mahomedan male, aged 50, travelling from How rah to Buxar, was overcarried, and found at Chausa to have a temperaHe I ture of 99? on the afternoon of July 16th. Next was therefore detained for observation. morning his temperature was lO-i'50, and his pulse 130. He was delirious, talking much and crying out for opium. Conjunctivae much injected. Tongue and arms tremulous. No signs of any bubo anywhere. Much thirst and severe headache. Later in the evening he seemed quieter and better, but about 8 P.M., he escaped from his hut and hid near some railings. When taken back his delirium increased, and he was very violent. He died next morning at 6 a.m., when a large hard bubo was found in the left groin the vertical set of femoral O affecting glauds. This O bubo was not there the night before. Streak cultures from it failed. Case (3).?A Hindu adult male was removed from an uptrain on July 16th. The reason for his being detained was that the Police reported he had alighted at Buxar from Calcutta, and re-booked for Mirzapore, his action in doing so raising the suspicion that he wished to escape observation. On the 17th he was quite well. It was ascertained that he came from Bara Bazar, but he denied that there was any plague near his dwelling. That afternoon he developed fever, 104-8?, with a pulse 112; his face was flushed, and his tongue was furred. No glands were swollen, and he was quite conscious. Next
day before,
o
o
morning (18th) Surgeon-Captain Gwyther found an intensely painful doughy glandular enlargement in the right groin affecting mainly the vertical set of glands. His temperature had fallen to 102,? and his pulse was 108. In the afternoon he became weaker, in spite of active stimulant treatment; his temperature fell to 101-2?, pulse 108, and he complained of acute pain in the bubo with much thirst. Later on he slept about an hour and passed a loose watery stool. During the night his temperature continued to fall, his pulse rate to rise, and he was
He passed two more thin stools. very restless. He became gradually weaker and died at 10-30 A.M. on the 19th.
I
[Sett.
1898.
following brief notes of three cases of plague occurring recently at the Chausa Plague Observation Camp illustrate very forcibly the difficulty there is in detecting dangerous people travelling from infected areas. The cases show The
how sudden the onset may be. In all three the progress was rapid, and a fatal result quickly ensued. The late appearance of the bubo is noteworthy in cases (1) and (2). These cases also illustrate, we consider, the very great care and attention which the slightest cases of fever occurring among passengers require, and evidently receive, from the medical officers in charge of the Plague Observation Camps. The detention of a passenger on account of a temperature of only 99?, case (2), is evidence of the accuracy with which the inspection of travellers is carried out. Case (1).?A Hindu female child, aged 10 years, was removed from an up-passenger train on June 11th, with a temperature of 104?. She had been living in Calcutta in Jaun Bazar Street. Her face was flushed, conjunctive were injected, and her tongue was coated uniformly with a thick greyish-white fur. She was semi-conscious. She was stated to have been perfectly well the
340
THE INDIAN MEDICAL GAZETTE.
and to have been attacked by fever while in the train, not having been in contact She had no bubo with any case of plague. The same evening when found in the train. her temperature remained at 10 i?, pulse 115, and she was still semi-conscious, and much Next morning her temperature was weaker. 104"2?, pulse 120, and she complained of tenderness and pain in the left groin, where a small hard swelling about the size of a pigeon's egg, with some infiltration round it, was found. She had passed one normal stool during the night. Her pulse became irregular and more feeble, and Streak cultures she died soon after 10 a.m. from the gland gave a negative result, probably owing to dryness of the media. Case (2).?A Mahomedan male, aged 50, travelling from How rah to Buxar, was overcarried, and found at Chausa to have a temperaHe I ture of 99? on the afternoon of July 16th. Next was therefore detained for observation. morning his temperature was lO-i'50, and his pulse 130. He was delirious, talking much and crying out for opium. Conjunctivae much injected. Tongue and arms tremulous. No signs of any bubo anywhere. Much thirst and severe headache. Later in the evening he seemed quieter and better, but about 8 P.M., he escaped from his hut and hid near some railings. When taken back his delirium increased, and he was very violent. He died next morning at 6 a.m., when a large hard bubo was found in the left groin the vertical set of femoral O affecting glauds. This O bubo was not there the night before. Streak cultures from it failed. Case (3).?A Hindu adult male was removed from an uptrain on July 16th. The reason for his being detained was that the Police reported he had alighted at Buxar from Calcutta, and re-booked for Mirzapore, his action in doing so raising the suspicion that he wished to escape observation. On the 17th he was quite well. It was ascertained that he came from Bara Bazar, but he denied that there was any plague near his dwelling. That afternoon he developed fever, 104-8?, with a pulse 112; his face was flushed, and his tongue was furred. No glands were swollen, and he was quite conscious. Next
day before,
o
o
morning (18th) Surgeon-Captain Gwyther found an intensely painful doughy glandular enlargement in the right groin affecting mainly the vertical set of glands. His temperature had fallen to 102,? and his pulse was 108. In the afternoon he became weaker, in spite of active stimulant treatment; his temperature fell to 101-2?, pulse 108, and he complained of acute pain in the bubo with much thirst. Later on he slept about an hour and passed a loose watery stool. During the night his temperature continued to fall, his pulse rate to rise, and he was
He passed two more thin stools. very restless. He became gradually weaker and died at 10-30 A.M. on the 19th.
I
[Sett.
1898.
