Plague. 
Two cases of Plague were detected in the course of ordinary Post¬ 
mortem examinations. Both the patients had been picked up dead or d) ing 
tn the street and taken to the hospital. 
In neither case were there any visible buboes nor were the lungs 
affected. In both there were subserous haemorrhages, and in one there 
was a large perirenal haemorrhage and in the other there were haemorrhages 
into the substance of and on the surface of the left inginual glands which, 
however, were not appreciably enlarged. 
In both cases the diagnosis was made from smears and confirmed by 
cultural methods. 
Another case occurred in hospital at Kwala Lumpur, a definite bubonic 
case, also confirmed bacteriologically. The detection of these cases led to 
the location of the centre of the disease at Kwala Kubu and some 14 
cases all confirmed bacteriologically subsequently occurred. Strict 
isolation of contacts, etc., was enforced, and the epidemic did not assume 
formidable dimensions. No other cases occured in Kwala Lumpur. There 
was a history of mortality amongst rats at Kwala Kubu pre\ ious to the 
detection of" the epidemic, and in previous small epidemics rats as well as 
men have been found to be infected, so that conditions here are such that 
the disease does spread amongst both man and rats and yet has ne\er 
spread to any great extent and has always been suppressed shortly after 
the discovery of each outbreak with very small loss or expenditure. T. he 
disease is very virulent and in every known case death has occurred. 
Cholera. 
There was one small outbreak of Cholera near Kwala Kubu. The 
diagnosis was confirmed bacteriologically. The water from seyeral wells 
was examined and one in particular was found to be infected and closed. 
There was no further spread of the epidemic. 
No cases of Cholera have occurred at Kwala Lumpur. One case was 
suspected on account of the symptoms and the character of the stools. 
The post-mortem appearances were not incompatible with that diagnosis. 
Bacteriological examinations and cultures of scrapings and of the “ rice 
water” intestinal contents showed the complete absence of vibrios. Almost 
pure cultures were obtained of an organism indistinguishable from the 
B. Coli communis. Similar suspicious cases seem to occur from time to 
time. Samples sent either of excreta or intestinal contents in such cases 
are free from Koch’s Cholera organism. In no instance ha\e other cases 
occurred in relation w r ith them, and the disease appears to be neither infectious 
nor communicable to any important extent. 
Sepsis. 
The deaths from sepsis, exclusive of extensive and gangrenous bed 
sores in Beri-Beri cases,include two cases of gangrene of legs ; Necrosis, two; 
Suppurative Nephritis, tw r o, one of them associated with suppuration in the 
Prostate and the other with renal calculi. In one case there was a large 
perineal abscess and fistula with ulceration of the duodenum. 
