467 
In Japan the cost of preventive measures and quarantine has reached 
an enormous figure. During the first outbreak the city of Osaka 
expended more than 352,500 yen; during the second, Tokyo city spent 
320,000 yen, although the number of patients there only numbered 15— 
1. €., 21,333 yen for every victim. These figures show the expense of 
plague outbreaks even when they are considered apart from their dread- 
ful effect upon human lives. From the facts already given it will not be 
difficult to infer how much the present epidemic, which is raging in Kobe 
and Osaka with unparalleled vigor, will burden the financial resources 
of the country. Already the city of Kobe has given out 310,000 yen 
and Osaka city 470,000 yen for its prevention; and it is apparent from 
the present conditions that we will have to spend considerably more 
money to keep the plague at bay. 
Such is the direct burden of plague upon the frees of a country, 
but this is not all; for the indirect detrimental effects must also a 
considered. This loss, indeed, can not be estimated, because it is a wide 
and far-reaching one, affecting both domestic and foreign affairs and 
one which can not be compared with that of an epidemic of any other 
kind which involves only its direct damage upon a limited community. 
Plague, indeed, is a fearful enemy to mankind. 
Two methods of invasion are apparent from the studies of the epidem- 
ics in Japan: One is contagion from imported plague patients and the 
other by contact with the disease germ mingled with the freight brought 
in from some infected region. The nature of the preventive measures 
to be employed depends upon the source of the epidemic. If the invasion 
be by means of a plague patient, discovery is made easier and prevention 
or quarantine, as the case may be, can promptly be applied, so that the 
depredations of the disease may be confined within a small radius. On 
the other hand, if the organism is being propagated through the medium 
of rats, preventive measures are difficult; for, by the time infected 
rats are discovered, human beings have already become victims. More- 
over, as a rule, by the time man receives the contagion from rats, the 
ravages of an epidemic have already reached serious proportions among 
these animals, so that the outbreak soon assumes a character which 
renders control difficult; the infection therefore spreads far and wide, 
affecting both men and animals. Such a result is illustrated by the 
first outbreak and by the present one in which Nagasaki and Kobe are 
the chief sufferers. he results at Chiba and Kagawa can be taken as 
an example of a case where the source of the epidemic was in human 
patients. In this outbreak we were able to keep the epidemic confined 
within a small locality by promptly applying the usual preventive meas- 
ures—that is to say, before the rat was attacked by the germ. We can 
thus see that the same preventive measures may give different results in 
different cases. 
In every epidemic it is difficult to ascertain the exact circumstances 
