473 
an epidemic period this source of information reveals only about one- 
tenth of the whole number of cases actually existing. In the localities 
which have never before been visited by plague, the physicians them- 
selves are ignorant of the nature of the disease and they may thus permit 
an outbreak to spread rapidly. This unfortunate condition was illus- 
trated in Kagawa during the past year. 
As a means of promptly seeking out patients in places which are fre- 
quently in danger of an outbreak of pest, the physicians attached to the 
police are given authority to examine the bodies of all persons dead from 
acute, febrile diseases. During epidemic periods such examinations give 
results parallel to those obtained by the investigation of the rats which 
are caught, and that such precautions can not be neglected is shown by 
the experience obtained in the past. The following table gives the 
number of plague patients discovered during the outbreak in Osaka and 
Kobe during the past year: 
Osaka, Kobe, 
Physicians’ reports 49 30 
Inspection of dead 27 26 
Inspection of houses 34 33 
Among the isolated suspects 20 0 
Miscellaneous 4 1 
134 90 
The value of the inspection of the dead is apparent, for the foregoing 
table renders it evident that in Osaka 27 and in Kobe 26 instances would 
have occurred in which bodies which really were infected with plague 
would have been regarded as being dead of other diseases and thus the 
number of foci of the epidemic would have been increased. 
The inspection of apparently healthy persons living in an infected 
locality or its vicinity is not an easy task, though a very necessary one. 
Kpidemics are most liable to prevail in places where ignorant people 
reside and this fact alone greatly hinders the work of the health in- 
spectors. Only by reason of their devotion to duty and work can their 
efforts be successful. The value of their work was illustrated during 
the outbreak of the second epidemic in Tokyo. In the latter city, with 
the exception of three early cases out of a total of 13, a suggestion and 
warning was given by the diagnosis of plague in persons apparently 
healthy and these persons were removed and isolated. During the 
present epidemic in Osaka not a few of the dangerous patients were 
discovered by the general inspection of healthy persons. However, the 
task of finding plague cases by such a method becomes more difficult in 
proportion as the epidemic spreads and the patients are found scattered 
over a wider area. As aforesaid, plague in a patient must frequently 
be diagnosed by both a clinical and a bacteriological examination and 
the application of such tests must be undertaken as speedily as circum- 
stances will permit. ‘The absolute diagnosis is usually effected within 
