174 DISEASES DUE TO BACTERIA 



VARIETIES. 



(i) Ambulatory Type, the mildest form. — The symptoms can be 

 looked upon as the prodromal symptoms, aggravated some- 

 what. 



(2) Bubonic Type. — The bubo is usually in the groin. The fever 



maximum is reached on the fourth or fifth day, and lasts till 

 the seventh or tenth day, falling by lysis, and rising again if 

 suppuration sets in. 



(3) Septica?mic Tvpe. Onset sudden, temperature high, very 



rapid pulse, marked prostration, severe vomiting, diarrhoea, 

 hc-emorrhage, death in one to three days. 



Children may be playing in the street in the morning, 

 haemorrhage in the afternoon, and dead next morning. 



(4) Pneumonic Type. 



(i) Primary pneumonia. 



No prodromata ; incubation two to five days. 



Cough and dyspnoea within twenty-four hours; bloody 

 expectoration with bacteria second to third day. 



Conjunctiva injected, respiration rapid, dyspnoea, cyanosis. 



Spleen not usually palpable. 



Very fatal. 

 (2) Secondary pneumonia (after buboes). 



As general symptoms. 



MORTALITY varies. Apart from mild attacks it is 60-95 P^^' cent. 

 Chinese 93*4 per cent. 

 Japanese 60 per cent. 

 European i8"2 per cent. 



Of known and controllable cases in hospitals, jails, &c., 35-45 per 

 cent. 



TREATMENT. 



Bed, good nursing, fresh air. 

 Fever with sponging and cold applications. 

 Heart by digitalis, struphanthus and strychnine. 

 Restlessness; opiates, chloral, potassium bromide. 

 Haemorrhage; calcium chloride or lactate. 

 Constipation ; calomel and saline. 

 Pneumonia; the ordinary treatment. 

 Kidneys, much fluid to keep them flushed. 

 Diet; broths, milk, stimulants usually. 

 Diarrhoea; ice pills and morphia, hyclroc}'anic acid, salol. 

 Buboes. Glycerine and belladonna, when suppurating incise and 

 drain. 



