(1). High temperature may be reduced by antipyretics, such as antipyrin, phenacetin, antifebrine, &c. These drugs produce profuse perspiration and a certain amount of depression; it is, therefore, advisable to restrict their use during the first few hours only, and if not found responding, they should be dropped altogether. Pyrexia is but a sign of the intensity of the activities of the infective agent, and by artificially reducing the body heat we really do not lessen the virulence of the poison, as shown by the rise of the temperature again as soon as the action of the antipyretic subsides. Hyperpyrexia itself is, however, an injurious symptom, and when there is long continued high temperature it is necessary to reduce it, either by an antipyretic, quinine or cold bath, or cold sponging. Cold bath is not suitable in plague patients on account of the movement of the body which it entails, and also on account of the serious cardiac depression which accompanies the disease. Two grains of phenacetin with 1 grain of hydrobromate of quinine is a safe antipyretic. Brandy and tepid sponging are also very useful.

(2). Brain symptoms.—For headache a mustard plaster behind the upper part of the neck and over the occiput. Ice cap or Lieter’s tube or plain water should be applied over the temples and scalp. Nervine sedatives, such as Potassium Bromide, may be given for insomnia when there is not much depression. Otherwise full doses of alcohol may be tried. Opium should not be used, but in mild cases, without great depression, 10 to 20 minims of Liquor Opii sedativus with 30 minims of Sal Volatile in an ounce of camphor water may be given to soothe nervous unrest. For insomnia Lowson speaks highly of MorpinÆ gr. 1/8 to gr. ½. Hyoscine gr. 1/200 to gr. 1/75 may be tried. Meningites should be treated by cold to the scalp and counter-irritation to the nape of the neck and occiput.

(3). HÆmorrhages may be treated by Ergot or Ergotin internally or hypodermically. When there is much hÆmorrhage, use of alcohol should be partly suspended.

(4). If there is constipation, a dose of calomel may be given. In the beginning there is almost always constipation, which should be removed by a dose of calomel followed by a saline. Diarrhoea may be checked by an enema of opium. Two grains of Dover’s powder and 10 grains of tannin mixed with an ounce of gum mucilage and with two or three ounces of warm water, arrowroot or starch may be used for injection. Salol in 10-grain doses every 4 hours may be given for diarrhoea. For vomiting and hiccough sinapism over the epigastrium, sucking of ice, and for thirst acidulated water with syrup of lemon are recommended. Coma must be promptly met by cold effusion if there is pyrexia or by rectal injection of strong coffee. The bladder of the patient should be carefully watched. Pneumonia and other complications should be treated under general principles.

When temperature falls and convalescence begins, the stimulants should be lessened, and afterwards a tonic with quinine, acid nitromuriatic dil., tincture calumba or quassia may be given with infusion aurantii.

Serum treatment.—The whole system of serum therapeutics is due to the genius of Pasteur. Diphtheria and tetanus are diseases that are caused by specific germs and are now successfully treated by immunised serum. Tetanus can be prevented and even cured by the injection of serum of other animals vaccinated against this disease: this process has been applied by Yersin for producing a plague serum, for which a prophylactic and curative power is claimed, and this serum may be called plague antitoxin. Yersin treated his first case in Canton. At Amoy, the people were less averse to treatment, and in 10 days he was able to treat 23 with two deaths only. As yet Yersin’s serum has been tried in the declared diseases, but Yersin also proposes to use it as a preventive. Haffkine also proposes to make use of his serum for curative purpose. Yersin’s serum is older than Haffkine’s, otherwise bacteriologically they are identical. The subject is in far too unsettled a condition at present, but it has no doubt a hopeful future before it.