is shown by such facts as these : when a case of plague breaks out in a house the other inmates are extremely likely to take the disease ; and even in severe forms the plague does not cease till it has affected all or nearly all the household. This is indisputably an almost universal law. In the plague of London in 1603 it was said the disease entered .hardly any house but it seized all that lived in it. And in 1879, on the Volga, in one village, as was ascertained by Mr Colvill and the present writer, the plague attacked five houses containing thirty-three persons all of whom except two took the disease and died. In this respect plague resembles typhus. In the next place the disease will spread from an infected house to persons who have close relations with it. Thus in the villages on the Volga it was noticed that after one family was affected cousins and relations by marriage were the next to be attacked. Doctors and those visiting the house are also exposed to the risk, though in a less degree. In Vetlanka on the Volga three physicians and six surgical assistants died. On the other hand, doctors in some instances have singularly escaped from being attacked by the disease. In Egypt, in 1835, out of ten French physicians engaged one only died, nor was this immunity secured by any precautions. These experiences do not prove that the disease is not contagious, but they modify the ex aggerated notions which have been held on the subject. The facts appear to be expressed by saying that it may undoubtedly be communicated from one person to another, but chiefly by breathing the air of the sick room, and this generally from prolonged not from momentary exposure, so that the possibility of communication by chance meet ings and similar contingencies may be disregarded. This view is that of Dr Cabiadis and others who have studied plague in Irak where no doctor or assistant, with one exception, suffered from the disease. It is not inconsist ent with the experience recorded in Egypt. But it is clear that the intensity of contagion varies greatly in different epidemics. Modern experience contradicts the belief formerly entertained that contact with plague patients was the only or even the chief means of acquiring the disease. Everything tends to show that the atmo sphere immediately surrounding the patient is the most effectual conveyer of contagion, and more effectual in pro portion as the poison is concentrated. Precisely the same relations are observed with regard to typhus. It has been disputed whether dead bodies convey infec tion of plague. Formerly the contagion from this source was greatly dreaded, and the task of burying thought to be specially dangerous. But the French in Egypt made more than a hundred post-mortem examinations without precautions and without harm. In Mesopotamia and in Russia no autopsies were made, but in the latter country some striking instances were noted of those engaged in burying the dead themselves dying of the plague. On the whole both facts and analogy lead to the belief that the disease may be derived from touching or being near a dead body, but not that there is any special danger of infection from this source. 2. It is a very momentous question whether the con tagion is capable of being conveyed by clothes and other objects which have been in contact with the sick. The very general belief that this is so has been controverted only by the French physicians in Egypt, one of whom, Bulard, himself wore a shirt, taken direct from the body of a plague patient, for two days. They also state that in Egypt it was customary, when a plague epidemic was over, to sell the clothes and effects of those who had died of plague, without, as is affirmed, communicating the dis ease. In Constantinople they were customarily sold at once ; and it is alleged that the dealers in old clothes did not specially suffer. In 1835 the hospital at Cairo, where 3000 plague patients had been treated, was used, without even changing the bed coverings, immediately after the epidemic for other patients, without harm. Negative instances of this kind might be multiplied, but their im portance is diminished by the consideration that the communicability of plague, by whatever means, is always found to become spontaneously weak at the decline of the epidemic, till it is extinct altogether. While the epidemic influence lasts there is abundant evidence that infected clothes, &c., are among the means by which the disease spreads. In Egypt, in 1835, two criminals con demned to death were for the sake of experiment placed in the clothes and beds of those who had died of plague, and both took the disease, one dying. Instances are given by White (Treatise on the Playue, p. 161, London, 1847) of the disease spreading " like wildfire " through the dis tribution of infected garments, and of those engaged in disinfecting clothes and other objects being suddenly seized with the complaint, e.c/., on opening a box containing infected garments. While the reality of this mode of com munication cannot reasonably be doubted, it admits of some question whether the plague has ever been thus con veyed over great distances, or from one country to another. The best known instance in England is the alleged trans mission of plague from London to the village of Eyam in Derbyshire in 1665 by an infected parcel of clothes, a story which cannot be criticized at this distance of time, but which presents some weak points. 1 Dr Cabiadis states that he has seen plague thus conveyed in Irak to places outside the existing focus of infection, but gives no details. On the whole we must consider the exportation of plague by clothes over great distances, and into countries not subject to the same epidemic conditions as the infected country, " not proven." The communication of plague by merchandise or objects not personal, coming from an infected country, rests upon still more defective evidence, though at one time generally believed. In virtue of this belief all goods, especially those regarded as susceptible (as wool, furs, raw cotton, itc.), were, when coming from an infected or suspected country, subjected to disinfection under special regula tions. But there is really no evidence that plague was ever thus transmitted or that these regulations kept it out. On the contrary there are numberless instances of this supposed cause having failed to operate when it might have been most expected to do so. During the plague at Alexandria in 1835, which destroyed 9000 persons in that city, the exportation of cotton from the Government warehouses was never inter rupted, though the plague was most destructive in those very buildings. It was loaded on English and other ships without any precautions whatever. Twenty-five ships, eight of which were infected with plague, conveyed cotton amounting to 31,000 bales to England. Nevertheless no case of plague is known to have occurred among the quarantine officers or others engaged in unloading these ships or disinfecting their cargoes in quarantine. Equally large quantities were exported to Marseilles and Trieste, and smaller quantities to other ports, with the same result. Further, no case of infection has occurred among quaran tine officers or persons employed to disinfect goods, from this cause alone, either at Marseilles since 1720, or at any European lazaretto. 2 The conclusion is that the fear of importation of plague by merchandise coming from an infected country rests on no solid foundation. By whatever -means, there is no doubt that plague is 1 See W. Wood, History of Eyam, London, 1848.
- Laidlav,-, quoted in Prus, J{aj>j>wt, p. 479.