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Hospital. On the 22nd a native was taken dead from the s.s. Egypt into the hospital. the had
no enlarged glands, and was thought at the time to have died from septica?mia. On the 26th
another Goanese was removed from the s.s. Egypt to the Port Sanitary Hospital with enlarged
glands and fever. On the 29th the plague bacillus was demonstrated in material from the gland.
These patients, who had evidently suffered from plague, had formed part of the crew of the
s.s. Rome, which had been transferred to the s.s. Egypt. The s.s. Rome had left on the 2Gth
for Australia, but no further cases occurred on board that vessel or on board the Egypt. Special
precautions were taken to destroy rats on board the Egypt. A suspected case of bubonic plague
was sent to the branch hospital from the shore quarters on the 18th August, but bacteriological
examination gave negative results. On the 26th October the s.s. Ben Lomond arrived at
Gravesend from the Philippines. An engineer was found to be suffering from an enlarged suppurating
gland in the groin, and on the 29th Dr. Klein reported that the case was " of the nature
of plague."
In August, 1900, it was recognised that cases of plague had occurred in the population of
Glasgow. Dr. Chalmers, medical officer of health of Glasgow, states in a report on this subject—
" When plague was recognised to exist, it had already invaded several parishes, and had been
present for at least a fortnight, almost certainly for three weeks. It was suspected to exist on
25th August. On the 27th a man was found who had sickened on the 12th, while his wife was
already dead on the 9th, and a grandchild, a baby of two months, living with them, on the 7th of
that month." During August and September 35 cases occurred in Glasgow, 15 of which died,
another death from the same cause occurring in Govan. Of the 16 deaths, 7 occurred in the
houses of the patients, the deaths being attributed at the time to such diseases as acute gastric
enteritis, zymotic enteritis, pneumonia and typhus. With trifling exceptions all the persons
attacked were found to have been associated with each other, a number of them having been present
at " wakes " associated with earlier deaths from the disease; in one case, that of the wife of a man
employed in the sanitary department as clothes collector, the husband probably conveyed infection
to her. In addition to the usual administrative measures of the removal of the sick to hospital,
and the disinfection of their homes and the contents of their homes, persons who had been in
contact with the sick were removed to the corporation's reception house. The course adopted with
these people was to bathe them, to supply them with clean clothes in substitution for their own,
to house and feed them, but not to confine them to the building.
During the outbreak a number of persons—70 in all—received injections of from 10 to
20 c.c. of Yersin's serum. Of these, five were "contacts," of whom two subsequently
developed the disease in a mild form. Pour other contacts, however, who did not receive
injections, also suffered from the disease in a mild form. Of the staff, one person sickened
with plague, a ward maid who sickened ten days after receiving injections of 10 c.c. of the serum.
The mother of one of the patients also sickened seven days after receiving 10 c.c. of Yersin's
serum. Of the patients ten received injections of Yersin's serum and four died, one of these did
not come under treatment until the fourth week of the illness. Dr. John Brownlee, whose
report is appended to that of Dr. Chalmers, referring to the results of the prophylactic use of
Yersin's serum, and to the attack of two persons who had previously received injections, writes—
" These two cases prove that a dose of 10 c.c. of Yersin's serum administered subcutaneously does
not afford complete protection; yet it is a fair presumption that a certain degree of immunity is
afforded, as the symptoms in both cases were of great mildness." Writing of the curative action
of Yersin serum, he expresses the opinion that "subcutaneous injection is not of any great
curative value," and that " intravenous injection of the serum seems, in most cases, to produce a
most marked therapeutic effect, even when given late in the disease." He states, moreover, that
" it is probable that the doses given were, in general, too small, and should an opportunity again
arise of using this remedy, large initial doses of 60 c.c. and upwards would be given intravenously.
Probably it would be advisable, if using the serum subcutaneously at all, to inject it only into the
area drained by the lymphatic system which leads directly to the bubo."
The occurrence of plague in Glasgow led to consideration of the steps which should be
taken in London should the disease appear in the population.
On the 19th September the Local Government Board issued an order requiring the immediate
notification of all cases of plague to the sanitary authorities and to the Board, and the
Chairman of the Public Health Committee sanctioned arrangements being made1 with Mr. James
Cantlie, M.B., F.R.C.S., formerly medical officer in one of the plague hospitals in Hong Kong, to
prepare an account of the signs and symptoms of plague for issue to medical men practising in
London. (See appendix II.) Enquiry had been made in July by the Council's officers in all
common lodging-houses and seamen's lodging-houses for cases of illness which might in any way
raise question of plague, and this enquiry was repeated in September, and subsequently maintained
throughout the year. No such cases were found.
On the 20th September the Public Health Committee of the Council met to consider a
letter from the Local Government Board referring to the appearance of cases of plague in
Glasgow, and to the importance, not only of the early isolation of cases of plague, but to the
prompt removal of all persons who have been in contact with the patient to a place of reifuge.
Under section 13 of the London County Council (General Powers) Act, 1893, the Local Government
Board may assign to the Council any powers and duties under epidemic regulations made in
pursuance of the Public Health Act, 1875, which they may deem it desirable should be exercised
and performed by the Council. It was not proposed at once to issue such regulations, but the
Board desired to know what arrangements the Council could make for the accommodation of
1,000 persons in 200 families. The Public Health Committee expressed the opinion that the
Council should undertake this duty, and gave instructions for the necessary arrangements to be
made for the various premises in the possession of the Council to be thus utilised. The
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