THE MARMOT THE CAUSE OF THE PLAGUE

The plague began with the marmot, a rodent known to the Mongols by the name of tarbagan, which exists in immense numbers in the country traversed by the Manchurian Railway. Records existing for 60 years past show that this rodent is subject to a form of plague associated with the respiratory tract. Marmots yield a fur which in skilled hands in Europe is converted into imitation marten and sable. The value of the skin on the spot varies from 1s. to 2s. Russian houses have a monopoly of the trade, the chief centre of the industry being Manchouli, the first station on the railway on the Chinese side of the border. Some two million skins are now exported annually by the Russian railway to Moscow, whence they are distributed along two main routes ending the one in Leipzig, the other in London.

The tarbagan hibernates from October until April. It is attacked with plague in September and October. Those that die perish in their burrows, and there infect — how it is not known — the succeeding generation that resorts to the same burrows in the next hibernating season. It is hunted in April, May, and June: it breeds in July and August, and it is again hunted in the weeks preceding its hibernation. For years plague has been endemic among these rodents; Mongols and Buriats, who formerly hunted them for Russian dealers, could tell what animals were infected, and these they left severely alone. But when the trade assumed increasing importance and demand for skins increased in Europe, then Chinese were attracted to the chase. They came in hundreds and then in thousands, they had no experience, they were ignorant

of the plague, they handled the plague-stricken, and were infected.

How they were infected is still undetermined, but evidence points to direct infection from the breath or accidental inoculation in the process of skinning. There is no evidence yet available that the marmot had bubonic plague, nor is there evidence that it was the host of a flea or other blood-sucking parasite. Hunters live upon the flesh, but direct intestinal infection is believed not to occur. While the hunters are in the field they do not suffer from plague: the disease only manifests itself when they come back for the winter.

OVERCROWDING.

Manchouli, the chief centre of the trade, has, apart from a Russian garrison of 8,500, a permanent Chinese population of 4,500, who, with several hundred Russians engaged in the trade, live together near the railway station. Caravanserais are not numerous, and they are in ordinary times overcrowded. Imagine then the conditions when 4,000 or 5,000 ‘hunters return from camp and cram themselves into squalid rooms already overfilled with onefourth the number. But there is still greater overcrowding at this season. Chinese in Manchuria are mainly natives of the three northern provinces of China proper, Shantung, Chibli, and Shansi. À considerable proportion of these come to seek work in Manchuria in the spring, returning in the winter, when the soil is frozen. Harvesters and labourers, fishermen and boatmen crowd the inns in October, when their season’s work is done, October then is the month of greatest overcrowding, it is the month when plague would be most likely to declare itself, and as a matter of fact it is in October when the plague does manifest itself. Special arrangements are made for the movement of this floating population to Manchuria and back again. Steamers ply then from Niuchwang to the coast of Shantung; the northern Chinese railways alone carry not less than 80,000 coolies per annum at cheap rates to Tientsin in Chihli. Thus, October and November are the best months for facilitating the extension of the disease.

At the season of overcrowding coolies in the inns lie close packed, naked, side by side along a raised earthen platform or kang, warmed by heated air, or they may lie in tiers in bunks rising from floor to roof in an atmosphere that is simply awful. Infection could fine no more fertile field.

In the recent epidemic the first cases occurred in the railway area at Manchouli. After rapidly claiming 600 deaths its progress was stayed by the Russian authorities, who moved the whole Chinese community bodily into quarantine. Russians speak with praise of the docility of the Chinese under these conditions carried out in extreme winter. They praise their patience under suffering. No credence need be given to stories of Chinese spitting in the faces of the Russian doctors in order intentionally to infect them. There

is no reason to credit the poor coolie with any such knowledge of the infec-

tivity of his secretions. From Manchouli plague spread to other stations on the railway, and in each case was dealt with severely but effectively. Finally, it reached Kharbin in the first week of November, and here it remained until the last week in February. Faced with an onslaught of such unexpected virulence the local Chinese authorities not only failed to make any reasonable attempt to avert the danger—they obstructed the efforts of those who realized the peril. They showed deplorable ignorance, vacillation, and mendacity.

CHINESE OBSTRUCTIVE TACTICS.

The chief Chinese official of Kharbin and the chief obstructive was the acting Taotai, Yü Ssu-hsing, who lives in the Russian town; the second was a prefect who lived in the Chinese town, where, dozing over his opium pipe, he outdid even the Taotai in the concoction of lying reports for the bewilderment of the authorities in Peking. These two men are directly responsible for the deaths of thousand$ of their countrymen. Moreover, to their obstruction, to their refusal to co-operate with the Russians in an effort to prevent the spread of infection, may be attributed the exhaustion of Russian patience and the presentation of the Russian Note of February 17, threatening retaliatory measures unless China displayed a less unfriendly attitude towards Russia. Yet, while the prefect has been cashiered, the Taotai has received only nominal suspension, still enjoys official recognition, and is daily expecting promotion.

When the plague broke out in the Chinese town Russia offered to render medical assistance, but the offer was refused “in deference to the popular wish.” It was an interference with China’s sovereign rights, rights in this case including the right to die of plague without foreign meddling. Better to lose life than to lose face, argued this amiable mandarin, who, when plague was running unchecked, not a single case of recovery after attack being recorded, was gravely telegraphing to Peking that 500 cases had been cured by Chinese doctors by means of Chinese medicines and acupuncture.

The first case of plague was discovered on November 8. The first Westerntrained Chinese doctors arrived on December 6, but were prevented from working. À fortnight later the Director of the Army Medical College at Tientsin, Dr. Wu Lien-tèh, a Cantonese from Singapore, who had a brilliant career at Cambridge, arrived here with a number of assistants, only to encounter heart-breaking opposition. But then the Chinese Governor of Kirin came here himself. A Cantonese also, he had had personal experience of the advantage of Western medicine, for his own son had been treated by Dr. Wu Lien-téh and had recovered from a severe attack of typhoid. The Governor realized the importance of giving support to the doctors. Dr. Gibb was sent from Peking

to assist Dr. Wu in organizing preventive measures. Soldiers were provided to

form a cordon round the infected town. Sanitary measures were devised, police and à corps of stretcher-bearers were organized, and system introduced. The Russian authorities supplied 100 railway cars fors a quarantine station, an excellent arrangement, for they are easily aired and easily warmed. As I write 1.200 “contacts” are living there more comfortably than in their own houses, - Their period of detention expires to-morrow. The town was divided into four sections, the occupants of each section being distinguished by a different coloured badge. Disinfecting stations and laboratories were created. There was daily house-to-house visitation. The cry “Bring out your dead” was heard as in the

Plague of London.

THE Work oF ENGLISH AND CHINESE DocToRs.

À few days after the departure of the Governor, Dr. Stenhouse and Dr. Graham Aspland arrived from Peking, and the lastnamed has remained on duty until to-day. Too much praise cannot be given to these three English doctors for their courage and devotion, their skill and humanity. And all honour is also due to Dr. Wu Lien-tèh who has borne the brunt of the work, has faced constant danger, and has shown administrative gifts of a high order. He ïs the chief of the Chinese Sanitary Commission. His energy has been untiring, his good humour unfailing. With him have been 20 Chinese doctors trained in Western medicine and nearly all speaking good English; with him also have been 30 Chinese medical students and dressers. They have all deserved well of their country. The experience they have gained will be invaluable in the future. Conspicuous on the staff was a young doctor, Dr. Chuan, whose experiences have included à two years’ residence with the Chinese Amban in Tibet and a visit to Simla.

Success attended organized effort. À I have said, plague declared itself on November 8, but it was not until January 14, after the visit of the Governor, that any effective measures could be instituted. The death-roll reached its height on January 28, when there were 173 fatal cases One month later, on February 28, no death was recorded in the Chinese town.

Infection was by direct contact. Rats and fleas played no known part in the infection. The attack was fulminant, there was no authentic case of recovery. Old persons and young children fared better than the strong and middleaged. In one family, out of 14 persons there were only two survivors, a woman Of 71 and her great-crandchild of two. Among all the bodies cremated there was only one child. Evidence as to the value of inoculation is inconclusive, but evidence is overwhelming that nearly.every case of death among the Europeans was preventible, and there have only been 50 deaths among a European population in the infected areas of North Manchuria of not less than 60,000.

Astonishing indifference was manifested in the face of danger.