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dating some doubtful points will occur later on, Going upon recent experience here we have as yet no definite proof that, during this epidemic, pigs, cattle and dogs were infected. KITASATO's observations were unfortunately limited to what may be termed "Toy" animals, and it would have been more satisfactory if animals which are generally used for human consumption had been utilised also for experi- ment, and the direct connection of the disease between human beings and these animals had been definitely proved, so much depending on the food supply of certain communities in the Far East at the present moment,
It is satisfactory to know that the causa causans of the plague has been dis- covered, and some of us must regret that our time, being entirely taken up by practical work in connection with the treatment of the plague-for which no fame is secured-we had so little time to look to the more purely scientific side of the question.
In the following pages stress has been laid on the paucity of medical men who could be found to help in our extremity. It may be thought that we surely had enough time to make some efforts in the direction of discovering bacilli. I can only say that after a day of from twelve to eighteen hours hard and exciting work in the trying heat of a Hongkong summer none of the men who had to bear the brunt of medical supervision, and who had to look forward to a prolonged mental strain, were much inclined to start work with the microscope by gaslight,--more espe cially as they were generally completely tired out and ready to sleep immediately; or were too exhausted to secure the repose necessary to enable them to start afresh next day. It may not be out of place to mention that in the Egyptian epidemic in 1843 half of the French physicians in Cairo perished from the plague; and in the Russian epidermic in 1879 (where Vetlianka was the principal seat of disease with about five hundred cases), the first thres medical men who were in attendance on the sick died, as did numerous attendants. These were somewhat appalling figures when the epidemic broke out, and the outlook was not much improved when our numbers went up to four by the addition of Surgeon-Major JAMES, A.M.S., and Surgeon PENNY, R.N., the European nursing staff being reinforced by two Police Constables. It is noticeable that none of those who were in active attendance on, or engaged in removing, the sick during the whole period were attack- ed. This I put down to the instructions that were given at the beginning of the epidemic. On the second or third day after the epidemic was discovered it was proved that the disease could be propagated through the blood by inoculation. The fæces were also suspected as an additional mode of conveyance of infection. Cultures were made from these, but unfortunately this method of infection was not proved until KITASATO arrived, time being wanting to make frequent observations of our culture tubes. In the meanwhile, notwithstanding want of proof, the faces were always looked upon as the most prolific source of infection carbolic acid or quicklime being added to them before disposal in the sea, and it was a satisfaction to us when KITASATO confirmed our suspicions. The question as to whether infection from the contents of buboes could occur was answered in the affirmative early, and every precaution as regards antiseptics was taken in opening these swell- ings. With our present knowledge of the nature of the epidemic it may be said (and has been said) that our precautions at the beginning were excessive, but here again it is the same old story of "wisdom after the event." By the knowledge gained in Hongkong during 1894, plague has been divested of a great deal of its terrors if care be taken by the people engaged in fighting it. Not only this, but if proper sanitary precautions are taken, no civilised country should ever be the seat of an epidemic of plague. I am bound to admit that, if ever any place was ripe for such an epidemic, certain parts of Hongkong in May 1894 were in a condition for it to spread like wildfire. Full details as to the condition of the City of Victoria are given later, and it is satisfactory to know at the present time that attempts are being made by those in authority to remedy faults which have been accumulating for years, and which have been pointed out before but without result.
In these times of scientific research it is not too much to expect that some << serum " treatment will be found to neutralize the toxines produced by the Pest Bacilli, and when the further researches of KITASATO and YERSIN are published I hope we shall have some remedy suggested which will enable us to reduce the very high mortality due to Plague, should it ever unfortunately come to these shores again.
In the following pages I have avoided theorizing as far as possible, what follows being more a report on the epidemic than a treatise on the disease.
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