NON-SPORING BACILLI 263 



Removal of rat food, by frequent scavenging and 



attention to the feeding of fowls, pigs, etc. 

 Slaughter-houses require special attention. 

 General campaign of cleanliness, avoidance of 



fatigue of body or mind, and temperance in all 



things. 

 Haffkine's prophylactic inoculation, at least to all 



those on the staff or otherwise specially exposed 



to infection. 



Nursing. Bubonic plague requires no special pre- 

 cautions, as it is not infectious. The liberal use of iodoform 

 as a dusting powder, on the person and clothing, is strongly 

 recommended to prevent the attacks of fleas. 



Pneumonic plague is acutely infectious, hence both 

 doctor and nurse should wear a cotton-wool respirator, 

 as should also the attendants. 



Summary. Plague is a rat disease. It is conveyed 

 from rat to rat, and from rat to man, by the rat flea. The 

 human flea is not involved to any extent in the matter. 

 Bubonic plague is not an infectious disease, as this phrase 

 is commonly understood. Pneumonic plague is most 

 infectious, apart altogether from the question of fleas. 

 Plague pneumonias breed true, i.e., give rise to other 

 cases of pneumonic plague. The B. pestis blood-count 

 is low in man, high in the rat. This affords an explana- 

 tion of the high degree of infectivity of the rat flea 

 as compared with the human flea. Insanitary conditions 

 apart from the presence of rats play a secondary part. 

 In Suffolk, Mus rattus is rare, Mus decumanus is common ; 

 therefore close contact with plague-stricken rats is unlikely, 

 and hence the small epidemic. (Pringle, " The Outbreak 

 of Rat Plague in Suffolk," Public Health, January, 1911.) 



For an important article on the " Spread of .Plague," by 

 C. J. Martin, and the subsequent discussion, see Brit. Med. 

 Jour., 1911, vol. ii, p. 1249. 



Summary of the " Lancet " Reports on the Plague in 

 China, 1910-1911. 



The outbreak of plague in China, beginning in Manchuria 

 on October 12th, 1910, and extending rapidly until it had 



