Review of Reviews, lliJlS. 



LEADING ARTICLES. 



183 



gress has yet attained. It is only within the 

 past fifty years that we have got any true 

 idea of the elements which compose it or of 

 its microscopic structure ; and as yet our 

 knowledge of it is most imperfect. As to its 

 exact niodes of working, in some ways we 

 are still groping towards the light. But 

 we are now able to demonstrate as mucli 

 of its structure and working as enables us 

 to realise scientifically the general and par- 

 ticular nature of its place in life. In the 

 minds of all those who have considered brain 

 problems there is now a firm assurance, at- 

 tained by the process of induction from fact, 

 that there is nothing connected with human 

 disease or conduct or emotion or volition 

 with which it has not to do. 



RATS AND FLEAS AND THE 

 BUBONIC PLAGUE. 



Among the secondary results of the 

 Spanish-American war none is perhaps 

 of greater importance than the progress 

 in sanitation on the Island of Cuba, 

 more especially in the city of Havana. 

 A description of the conditions at the 

 close of the war reads : " The American 

 authorties found the city (Havana) in a 

 woefully unsanitary condition. The 

 streets were unswept, garbage was piled 

 in heaps, and the pavements were in a 

 miserable condition. The existing 

 sewers were in some places completely 

 clogged, and all of them leaked, con- 

 taminating the surrounding soil." How 

 remarkably sanitar)^ conditions have ad- 

 vanced since then is evident from a 

 perusal of Samdnd y Bcneficencia, the 

 official bulletin issued monthly at 

 Havana by the Health Department of 

 the Cuban Republic. In this volume 

 of more than 200 pages, large octavo, 

 are given, besides the ordinary vital 

 statistics, reports on analyses of milk, 

 inspection of mosquito larvae, bacterio- 

 logical work, h\-gienic examination of 

 pupils in the public schools, the exter- 

 mination of rats, and the destruction of 

 condemned foodstuffs. From yellow 

 fever, that former scourge of Havana, 

 not a single death has been recorded 

 since 1908. That the De])artmcnt is 

 thoroughly alive to the importance of 

 its duties is shown by an article on La 

 Pestc Bubonica (The Bubonic Plague) 

 from the pen of Dr. Juan Guiteras, the 

 energetic Director of Health in Havana, 

 who describes the vigorous measures 

 taken by his department. The plague 



was introduced into Cuba during the 

 past summer from Porto Rico, in conse- 

 quence, as Dr. Guiteras believes, of " the 

 delay of the United States authorities 

 in recognising the disease there." The 

 presence of the plague in Havana was 

 first conclusively noted on July 4th, in 

 a patient at No. I Hospital ; and writ- 

 ing on August 3rd, Dr. Guiteras states 

 that " the disease has been confined to 

 three individuals and three cit\' blocks, 

 and he has every reason to hope that it 

 will end there." He bases this anticipa- 

 tion on the fact of the " early commence- 

 ment of the campaign of ' deratization ' 

 (' desratizacion ') and fumigation of 

 buildings known to be infested with 

 rats." That rats are frequent media of 

 the transmission of the plague infection 

 has long been known. In the present 

 case Dr. Guiteras was informed " by an 

 anonymous letter of the existence of an 

 unusual mortality among the rats in a 

 certain district of Havana" about the 

 same time as the appearance of the 

 bubonic plague. Investigation showed 

 " that this mortality was not due to any 

 organised attempt to destroy the rats ; 

 and it was also learned that two cases 

 of ' \ iolent sickness ' had occurred 

 among the employees of the provision 

 warehouses in which the dead rats had 

 been found." These two cases died at 

 the hospital witliin a few da\'s of ad- 

 mission. The mortality amongst the 

 rats soon afterward ceased. 



Rats are not the onh* sources or media 

 of infection of the bubonic plague ; 



I'llK HUHONIC FI,K.\! 



