156 BBVIBW — TROPICAL MEDICINE, ETC. 



Plague— This is all very woll, but Klein's prophylactic had, at the time this was written, only 



continued been tested on animals, and it has yet to stand the severe trials from which the older 

 prophylactic has triumphantly emerged. This leads us to speak of Haffkine's views on 

 plague and his preventive method, and, where much is confused and contradictory, one is 

 glad to find a paper at onco so clear and free from dubiety. Hatfkine' first of all enumerates 

 the measures which have been suggested for stamping out the plague or preventing its 

 importation. The first category of measures comprises : — 



1. Discovery and uotification of persons attacked with the disease. 



2. Isolation of the attacked. 



3. Certain precautious with regard to the disposal of the dead. 



4. Segregation of those who have come in contact with the sick or dead. 



5. Institution of cordons round infected areas. 



6. A less drastic and less thorough plan than the last mentioned, viz., placing in quarantine arrivals from 

 infected places, detaining the sick and suspected, and letting the rest free after a time of observation ; or 



7. A still less rigorous measure, which is merely to examine travellers, isolate the sick and suspected, and let 

 the others free under a system of surveillance. 



He deals with these in detail and concludes that all the evidence goes to show that 

 (<() plague is what has been termed in a general sense a disease of locality ; (&) it is contracted 

 principally at night ; and (c) that the part which man plays as a direct agent in its propagation 

 is a more or less subordinate one. Hence the futility of the above measures, which are 

 always diflBcult, often impracticable, and can achieve little of value. 



The second list of measures is directed against places and fomites within an infected area, and comprises 

 destruction or disinfection of houses, furniture, clothing, bedding, carriages, goods, warehouses, grain and other 

 stores, garbage, drains and streets. Outside the infected area the measures consist in the refusal to admit carts 

 trains and ships with goods from infected places ; or in the refusal to admit only certain goods ; or in mere 

 inspection of trains, carts and ships, and some procedure by which these, and the goods they convey, as well as 

 the belongings of travellers, are sought to be rendered harmless. 



All these measures are intended for the avoidance or destruction of plague germs which may possibly exist in 

 the objects concerned. 



He notes, however, that the expense and difficulty of such operations are enormous and 

 that the ascertained facts regarding plague bacilli do not appear to justify their adoption. 



The third category of measures relates to the lower animals, and includes : — 



1. Destruction or keeping away of rats by poisoning, trapping, tar and sulphuric acid mixture, or through the 

 agency of the domestic oat. 



2. Improvements in towns and villages, with a view of reducing or keeping out the rat population, viz., 

 structural alterations of dwellings, warehouses and grain stores, demolition of insanitary buildings, introduction or 

 improvement of conservancy arrangements, prompt disposal of garbage, periodical inspection of stores, paving and 

 draining of streets, and certain other measures. 



3. Destruction and dispersion of fleas by petroleum or other insecticides. 



4. Fumigation of houses as a temporary protection against rats and fleas. 



5. Obligation on ships from infected regions to anchor away from the shore ; or 



6. Provision of mechanical arrangements for preventing the landing of rats along mooring cables and 

 gangways ; and 



7. Fumigation of ships arriving with plague patients or plague rats on board. 



The measures have, therefore, for their object, and, I believe, rightly so, the rat and the flea, described by 

 Rothschild under the name of Pule.c chcnpis : but epizootics of plague break out also among squirrels, tarbagans, 

 guinea pigs, mice, monkeys, kangaroos in Australia, and some other animals, which contribute to keeping the 

 disease alive. 



Haffkine, however, cites the experiences in rat destruction at Sydney, New South 

 Wales and in Japan, where the results of well-organised campaigns against these rodents 

 were far from being encouraging. He goes on to say that though the measures against 

 rats, either extermination or by change in the construction of cities and villages, are a most 

 important item in an anti-plague campaign, the question whether any noticeable impression 

 can be made on the epidemic by these measures within the length of a generation, or even in 

 a longer period, is a matter of great uncertainty. Even the destruction of rats on ships 

 alone, if imposed as a general measure, would cause a dislocation of traffic and an outcry 

 formidable to face. The result is that every day, plague is imported, though fortunately it 

 need not spread, into one part or other of the marine countries of the world. 



1 Haffkine, W. M. (February, 19081, "On the Present Slcthods of Combating the Plague." Journal of the 

 Royal Institute of Public Ucalih, Vol. XVI. 



