io6 INFECTION AND IMMUNITY 



reason to believe that they play an important part 

 in the propagation of the malady. It has been sug- 

 gested that infection may be carried from rats to man 

 through the agency of fleas which swarm upon these 

 rodents and desert them when they die. 



The Japanese physician, Aoyoma, who was associ- 

 ated with Kitasato, and who contracted the disease 

 but recovered, is of the opinion that in a great major- 

 ity of the cases, and perhaps in all, infection occurs 

 through an external wound. He calls attention to 

 the fact that physicians and nurses in attendance 

 upon cases of the disease rarely become infected, and 

 states that during the epidemic of 1894 in Hong Kong 

 only three Japanese and one Chinese physician be- 

 came infected, while all of the nurses escaped ; also to 

 the fact that of three hundred English soldiers who 

 volunteered to clean and disinfect the Chinese pest- 

 houses during the prevalence of the epidemic, only 

 ten contracted the disease. The greater liability of 

 the lower class of natives to contract the disease, he 

 ascribes not only to the insanitary surroundings in 

 which they live, but also to the fact that they seldom 

 wear shoes and stockings, and thus are very liable to 

 infection through insignificant wounds, scratches, or 

 abrasions, both of the feet and hands. In this con- 

 nection it is well to call attention to the fact that in 

 former epidemics physicians have suffered severely, 



