The termination of an epidemic in the pre-sanitary period depended to a considerable extent upon the fact that those who suffered a mild attack acquired thereby an immunity; and that when the more susceptible individuals in a community had succumbed to the prevailing disease there was a necessary termination of the epidemic for want of material.
Another factor which no doubt has an important bearing upon the termination of epidemics is a change in the virulence of the germ as a result of various natural agencies. Time will not permit me to discuss this subject in its scientific and practical aspects, but the general fact may be stated that all known disease germs may vary greatly in their pathogenic virulence, and that in every infectious disease mild cases may occur, not only because of the slight susceptibility of the individual, but also because of the 'attenuated' virulence of the specific germ. In the eighteenth century, the beginning of sanitary science, isolation of the sick and seaboard quarantines came to the aid of these natural agencies, and did much in the way of arresting the progress of this pestilential disease. At the present day these measures, together with disinfection by heat or chemical agents, are relied upon by sanitarians with great confidence as being entirely adequate for the exclusion of this disease or for stamping it out if it should effect a lodgment in localities where an enlightened public sentiment permits the thorough execution of these preventive measures; but when the disease prevails among an ignorant population which strenuously objects to the carrying out of these measures, the contest between the sanitary officer and the deadly germ is an unequal one, and the stamping out of an epidemic becomes a task of great magnitude, if not entirely hopeless. This is illustrated by the experience of the English in their encounter with bubonic plague in their Indian Empire.
Plague seemed to be almost a thing of the past and no longer gave any uneasiness in the countries of Europe which had formerly suffered from its ravages, when in February, 1894, it made its appearance in the city of Canton-) China, and three months later in Hong Kong. The disease is known to have been epidemic in the province of Yunnan, which is about 900 miles distant from Canton, since the year 1873, but it attracted little attention until the lives of Europeans living in the city of Hong Kong were threatened by the outbreak of an epidemic among the Chinese residents of that place. Many thousands of deaths occurred in Canton during the three months which elapsed after its introduction to that city before it effected a lodgment in Hong Kong.
Fortunately this outbreak gave the opportunity for competent bacteriologists to make scientific investigations relating to the specific cause of this scourge of the human race and to the demonstration that it is due to a minute bacillus. This discovery was first made by the
