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Latency in plague does occur, There is no reason why it should not. It is now a well recognised fact that pathogenic micro-organisms may be present on the external and internal surfaces of the body, as well as in the internal organs without calling forth manifest symptons of disease.

According to GoTSCHLICH, such cases of latency may be divided into three categories:-

(1.) Latency during convalescence.

(2.) Latency in healthy individuals.

(3.) Latency with accompanying trivial symptoms, such as one finds in

the initial stages of many infectious diseases.

It has now been proved that individuals convalescent from plague may be sources of great danger to public health. Plague bacilli may be discharged from their bodies for some considerable time after their recovery from the disease, and the bacilli discharged are alive and virulent, and capable of setting up the disease in other individuals or animals. Dating from the commencement of the disease, GOTSCHLICH and others have found plague bacilli in the excretions for 70-80 days or even longer. The sputum is also known to harbour plague bacilli for a long time even after recovery.

So far as I know quarantine regulations take no cognisance of such cases of latency. Success in the extermination of rats on board ship is a much wished for victory.

At the present time no absolute guarantee of their having been got rid of in any ship can be given with the most inodern means at our disposal for their destruction.

Within the past few years there exists plenty of proof of the introduction of plague into a sea-port by plague infected ship rats. Added to these questions, namely, the occurrence of latency in plague, and the role played by rats, must be added another, equally important, the difficulty or even impossibility of locating sufficiently early the boundary of the plague infected area or what is known as the "circonscription territorialle contaminée."

Summing up this criticism of the present day quarantine efforts at prophy- laxis, it may be said that such regulations have not come up to what we expected of them, and that the frequently one-sided and rigorous measures adopted stand in no relation to the damage inflicted on commerce and international relations.

A reform of the present quarantine measures would appear to be necessary. The system requires to be limited. As GOTSCHLICH has it, the system should apply, in ordinary international commerce, to actual infected and suspected ships. There should be no rigid rules and regulations or standing orders for the Public Health Officer. Competent officers should be left to a certain extent to the gui- dance of their own initiative, according to the nature of the circumstances which may be before them.

All this becomes evident to those who have had much experience of epidemics of plague. To them, it is of the greatest importance to know the partienlar variety of the disease before them. They must apply the measures at their disposal according to whether simple septic cases are prevalent or whether they have to deal with the deadly primary pneumonic type of the disorder.

It is of interest to note that measures in regard to these various points have been recommended by the members of the recent Conference in Venice. The detailed examination of all incoming ships during plague epidemics is a most im- portant duty and a further excellent plan would be the continual supervision of all ships in the port as recommended by GAFFKY.

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Again, the control of the health of the ship during voyage is necessary. connection with this two recommedations might be male. Firstly there is urgent need for better trained ship doctors, and secondly the authority exercise l by ship doctors ought to be strengthened.

Further, the medical examination of passengers and crews of out-going ships and the control over cargo and merchandise ought to be rigorously prosecuted.