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The best form of isolation hospital — and the cheapest— is a shed 
of ataps, bound to iron supports, the floor should be cemented if 
possible, and the “ whole show ” burnt when the epidemic is at an 
end. 
Chicken-pox. 
The rash comes out on the first day of the fever, all the symptoms 
are less severe than small-pox, and the eruption comes out in crops. 
The feel of the pimples is not so hard as those of small-pox. Suppu- 
ration occurs in the pimples just as in small-pox, but the two diseases 
are really unlikely to be confused. 
Plague. 
Perhaps the first remark to be made upon this disease to the 
layman is, that there need not necessarily be any buboes, and indeed 
the most serious cases show no external sign of the terrible affection, 
as is now well known the form from which the disease obtained its 
name was the bubonic form, in \rhich swellings of the glands in various 
parts of the body do exist (groins, neck, armpits) this form of the 
disease — given the fact that cases have been occurring in the neighbour- 
hood — is at least easy to suspect, and the extreme depression and very 
acute fever, lead one to isolate the case promptly, but the cases which 
I wish to put you on your guard against are, the pneumonic and 
the septicemic forms, these occur with some frequency in all 
epidemics, and I think that perhaps the safest dictum I can give you 
as a working and standing order is -this, “isolate all cases of high 
“fever which is accompanied by marked depression, or giddiness, or 
“constant cough,” and try not to mistake a plague case for a drunken 
coolie, the symptoms frequently resemble each other, but the severe 
fever must settle the diagnosis for you. 
The diagnosis should be confirmed microscopically by Dr. Bell’s 
method (Hong-Kong). 
The incubation is laid down, at three to eight days, but instances in 
which infection has occurred from clothing, and after months, have 
been observed. Initial symptoms are shivering followed by severe fever, 
headache, vbmiting, unsteady gait, depression, enlargement of some of 
the glands (if of the bubonic type). 
Little children usually succumb. 
Plague patients are infectious for about one month after recover}'. 
Rats are known to disseminate plague. 
Infection may take place through wounds and scratches, and also 
through the bites of insects, e.g., rat-fleas, bugs, and perhaps 
mosquitos. 
The excreta and sputum are infective. 
Attendants upon plague cases should wear shoes. 
