108 geo(;raphic distribution of bubonic plaoue 



awe-inspiring in plague which seems to appall the onlooker. Cholera and small- 

 pox show external evidences which make a spectator aware of the existence of 

 u severe disease, but to witness rows of plague patients dying off in a hospital 

 has, I am sure, a much more depressing effect on bystanders than the two diseases 

 I have mentioned." 



Three attendants in the various hospitals contracted the diseasfe 

 and died, but that attendants in a well conducted hospital run but 

 little danger of infection is shown by the following statement b}'' Dr 

 Lowson : '• It is to me a source of keen gratification that none of the 

 attendants in the government hos})itals were attacked." In this re- 

 spect bubonic plague resembles cholera, typhoid fever, and yellow 

 fever. In none of these diseases are the attendants upon the sick a])t 

 to contract the disease when proper precautions are taken as regards 

 cleanliness of the patient and disinfection of excreta. 



The plague bacillus is very easily destroyed l)y disinfectants. Dr 

 Lowson reports that a one-})er-cent solution of carbolic acid kills the 

 bacilli within an hour, and a two-i)er-cent solution almost immedi- 

 ately. Quicklime was almost as ])rompt in its action. Exposure to 

 fresh air for three or four days usually destroyed the vitality of the 

 bacillus, and exposure to direct sunlight destroyed it in three or four 

 hours. 



Kitasato and Yersin both arrived at the conclusion that the disease 

 may he contracted by inoculation through a wound or abrasion, 1)y 

 w-ay of the respiratory tract when the bacillus is present in dust car- 

 ried by the inspired air, or by way of the stomach when food or drink 

 taken contains the bacillus. P^xperiments on rats and other animals 

 show that they become infected when cultures of the plague bacillus 

 are deposited upon the mucous membrane of the nose. 



The Ja))anese ph3'sician, Aoyoma, who was a.ssociated with Kita- 

 sato, and who contracted the disease, but recovered, is of the opinion 

 that in a great majority of the cases, and i)erhaps in all, infection oc- 

 curs through an external wound. He calls attention to tlie fact that 

 phy.sicians and nurses in attendance upon cases of the disease rarely 

 become infected, and states that during the epidemic of 1894 in Hong- 

 kong onl}' three Japanese and one Chinese phA-sician l)ecame infected, 

 while all the nurses escaped ; also to the fact that of 300 English sol- 

 diers w'ho 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 dis- 

 ease he ascribes not only to the insanitary surroundings in which 



