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theory which has been so freely canvassed in connection with the outbreak of this disease in Bombay, that infection is contracted, in the great majority of the cases, by inoculation through small abrasions of the skin. These reasons were that the inguinal and femoral buboes have been found to occur just as frequently among the European cases of the disease, who are carefully shod as among the natives who habitually go barefooted; the Europeans employed in house to house visitation and cleansing work during the Plague epidemics in this Colony of 1894 and 1896, who contracted the disease, all had femoral or inguinal buboes, although it can hardly be denied that their bare hands and arms were, by the nature of the work in which they were employed, far more exposed to any infection by inocu- lation than were their feet and legs; secondly, that only in very rare cases is there any evidence of wound, of any local inflammation, or of lymphangitis, although in cases of experimental inoculation of animals these latter have always occurred, except (it is said) in a few cases in which a pure culture of the bacillus has been used, and in view of the fact that pus, blood, sputum and intestinal excreta are the natural media of transmission of the disease, it would be unreasonable to suppose, as is necessary to render this theory of infection by inoculation tenable, that contact of the supposed wound with a pure culture, is in the human subject the almost invariable rule. Another objection to this theory is that none of the diseases which are unquestionably transmitted by inoculation (e.g., rabies, tetanus, charbon, etc.) have hitherto been known to occur in widespread epidemics, and the theory therefore commits us to an entirely new phase in the aetiology of the communicable diseases, and one which certainly ought therefore to be fully substantiated by facts before its advocates can expect it to ineet with general acceptance.

It is difficult, I admit, to explain, with any other theory, why the inguinal and femoral glands should be so frequently the first to betray the disease, but I must confess that I still adhere to the explanation of this fact given by me in my Annual Report for 18 95, namely, that the disease is essen- tially one of the lymphatic system generally, and that, as can be seen at any post-mortem examination, most of lymphatic glands of the body are in a more or less inflamed and irritable condition, while the special enlargement of any particular group of superficial glands (which does not by any means always occur) is due to purely accidental circumstances, such as by the carrying of heavy weights upon one's shoulder (as is invariably done by Asiatics) during the initial period of the discase, great strain being thus thrown upon one leg, by climbing up and down narrow flights of stairs as was done by the Europeans employed in house to house visitation and cleansing (most of the arduous manual labour was performed by coolies acting under the direction of these Europeans) or in fact by any of the ordinary daily avocations of life which happen to be of a laborious nature.

Murchison's opinion, although not perhaps scientifically accurate in the light of modern bacterio- logical research, yet indicates the close resemblance of Typhus Fever and Bubonic Fever, for he wrote : Plague is perhaps the Typhus of warm climates, the two diseases being generated from similar causes and differing only in intensity from the effects of climate and other collateral circumstances."

The marked recurrence of cases in houses previously infected, even after an interval of more than twelve months, has convinced me that only the most thorough disinfection, and even in some cases the removal of all existing unsound woodwork, will era licate the disease from an infected dwelling, and I have decided to abolish the processes of disinfection by burning sulphur and by washing the floors with some coal tar preparation, which have hitherto been in vogue in this Colony, and to adopt the system of disinfection, which has proved so successful in Paris, of spraying floors, walls, etc. with a 1 in 1,000 solution of Perchloride of Mercury; the rooms will subsequently be exposed as far as it is practicable in the ill-ventilated and mostly back to back dwellings in which these cases occur, to a free current of air by opening all doors, windows and ventilators as fully as possible, and keeping the premises unoccupied for a few days. There is, however, but one course for the Government to adopt, if this Colony is to be kept free from this and other filth diseases, and that is the absolute prohibition of back to back houses, and the compulsory provision of an adequate amount of light and ventilation in all the Chinese dwellings in the Colony."

I have the honour to be,

Sir,

Your obedient Servant,

FRANCIS W. CLARK,

Medical Officer of Health.