REVIEW — TROPICAL MEDICINE, ETC. 93 



2. Bed-bngs. Anthrax ? cerebro-spinal meningitis ? endemic gastric catarrh of Austria- Insects- 

 Hungary ? epidemic dropsy ? intermittent fever ? (Russia), leprosy ? Leishmaniosis? mouse continued 

 septiciemia? plague? skin diseases ? spirochustosis? tuberculosis (Dewcvre's case), typhus 



fever, yaws '? 



3. Cnckroache.i. Plague? 



4. Fleas. Miliary fever ? plague, taenia cucumerina, typhus fever ? 



5. Flies (non-biting). Anthrax, conjunctival diseases, cholera, diarrhcEa, dysentery, 

 enteric fever, myiasis of various kinds, metazoan parasites (by transporting their eggs and 

 depositing them on food) ; leprosy ? ophthalmia, skin diseases, staphylococcic infections, 

 trypanosomiasis? tuberculosis, yaws? (Castellani). 



6. Fill's (biting, apart from mosquitoes). Anthrax (as in Cyprus). Septic and 

 septicaemic infections, trypanosomiasis. 



7. Itch Insect. Leprosy? skin diseases. 



8. Lice. Skin diseases. Spirochaetosis. 



9. Mosqidtocs. Dengue ? distomiasis ? filariasis, leprosy ? malaria, Malta fever ? seven 

 days' fever? Weil's disease ? yellow fever. 



10. Ticks. Black-water fever? filariasis (F. persfans) '? plague? (Skinner). Japanese 

 Eiver Fever ? skin diseases, spirochaetosis, spotted fever of Rocky mountains ? trypanoso- 

 miasis? (Manson's suggestion). Typhus fever? yaws? 



One may also mention as of less importance certain Coleopterous and Lepidopterous 

 larvae which produce cutaneous irritation and inliammation, while spiders, scorpions and 

 centipedes must also be kept in mind. 



As regards the Bed-bug, the following is quoted from the Indian Medical Gazette of 

 June, 1906:— 



There is .a definite tradition in Russi.i, fi'equently repeated by Professor MetehuikofF, in his lectures .at the 

 Pasteur Institute, that the bed-bug forms an intermediate host or is at least an agent for conveying intermittent 

 fever, so common in certain districts of that country. Its possibilities in the rule of intermediary in cerebro-spinal 

 meningitis arc still the subject of investigation. 



In these circumstances, all possible information with regard to the pest is interesting, and consequently a 

 leaflet issued by the Department of Agriculture should attract attention. This pamphlet is written by Dr. Qirault, 

 who has carefully followed the life-history of eimex or clinocoris, as the insect is variously called in scientitic 

 nomenclature, and has found important new material with regard to its feeding habits. The adult insect feeds 

 about once in from thirty-sLx to forty-eight hours, taking nearly fifteen minutes to get its till of blood. At earlier 

 ages, the feeding period is much shorter. Except in susceptible human beings who have a decided idiosyncrasy, 

 no local effect at all is produced by the feeding process. Some individuals, however, suffer from almost intolerable 

 itching and have a series of urticaria-like lesions. The parasite is so jirevaleut in certain parts of the country, 

 however, that it is evident that those with an idiosyncrasy are comparatively rare. The insect may live from five 

 to ten weeks or even longer without any food. This is especially true during the winter, when, if they have no 

 food, they go into a short comatose condition. While each insect seems to live not longer than about 100 days at 

 the outside, some have been known to exist as long as eight months ; and it is these that enable the species to 

 continue its existence even under unfavourable circumstances, so that they live from season to season in lumber 

 eamps, summer residences, empty apartments and the like. 



Another interesting phase of investigation with regard to the bed-bug and its connection with disease was 

 carried out by Drs. Qirault and Strauss, as to whether or not the insect had other host relations besides those with 

 the human race. As is easily understood, the host relations of this insect are greatly increased in importance 

 because of their scope in the potential transmission of disease if they attack other animals than man. It has 

 been found experimentally that at least mice, both living and dead, are attacked by bed-bugs and that young mice 

 particularly seem to provide an excellent supply of food for them. This observation has been confirmed by 

 observations made by Drs. Qirault and Strauss, and, as it seems not unlikely that other small animals, including 

 even rats, may also be hosts, the spread of such affections as pest, mouse septicaemia and the like by means of this 

 parasite must be taken into account. In a word, a new departure of disease etiology seems to be opened up by 

 these observations. 



Cimcx lectularius measures 4-5 mm. in length, 3 mm. in breadth, and has eight abdominal segments. The 

 females deposit fifty whitish eggs at a time, three or four times a year, and eimex becomes mature in about 

 eleven months. Bed-bugs live in cracks and fissures, under carpets, behind pictures, in furniture, bedsteads, etc. 

 Hidden by day, at night they attack persons to suck their blood. An alkaline secretion of their salivary glands 

 forms the so-called " wheal." Bed-bugs can migrate from house to house and may leave a house if it becomes 

 uninhabited. The characteristic nasty odour of bugs is due to a clear, oily, volatile liquid secreted." 



Patton deals with the distribution of the bed-bug, of which the two common species are 

 Gimex lectularius, Linn., and 0. rotnndatns, Sign., as Patton has named C. macrocephalns. In a 

 private conmiunication, Patton informs me that the bed-bug from Angola is C. rotundatns, and 

 suggests that it is probably the carrier of Leishmaniosis in the Sudan. The Khartoum bug 

 is C. lectularius. Patton also points out that the bug lives on blood alone, not on moist 



