"(19) Fleas found on dogs and cats bite both human beings and rats.
"(20) Human fleas and fleas found on cats and dogs can live on rats as casual parasites, and therefore can under certain conditions play a part in the transmission of plague from rats to human beings, and vice versa."
RESULTS OF VARIOUS INVESTIGATIONS
Various other plague commissions from other countries as well as many individuals have investigated the same subject, and the results all point conclusively to the fact that the rats and the fleas are at least the most important factors in the spread of the disease. The evidence from many sources and from many experiments may be briefly summed up as follows: The disease is caused by the presence in the system of minute bacteria, Bacillus pestis. It is probable that plague is primarily a disease of rats and only secondarily and accidentally, as it were, a disease of man.
Rats are subject to the plague and are often killed by it in great numbers. An outbreak of plague among men is often preceded by a very noticeable outbreak among rats.
Rats dying of the plague have their blood filled with the plague bacillus. Fleas or other suctorial insects feeding on such rats take myriads of these bacilli into their stomach and get many on their proboscis.
The fleas usually leave a rat as soon as it dies and of course seek some other source of food. When such infected fleas are permitted to bite other rats or guinea-pigs these animals often develop the disease. Several of the species of fleas that infest rats will bite man also, and in the cases of many plague patients it can be definitely shown that they had recently been bitten by fleas.
STRUCTURE AND HABITS OF FLEAS
A study of the structure and habits of fleas shows that in many respects they are particularly adapted for spreading such a disease as bubonic plague. The piercing proboscis consists of three long needle-like organs, the epipharynx and mandibles, and a lower lip or labium. The mandibles have the sides serrate like a two-edged saw. The labium is divided close to its base so that it really consists of two slender four-segmented organs which lie close together and form a groove in which the piercing organs lie. When the flea is feeding, the epipharynx and mandibles are thrust into the skin of the victim, the labium serving as a guide. As the sharp cutting organs are thrust deeper and deeper the labium doubles back like a bow and does not enter the skin. Saliva is then poured into the wound through minute grooves in the mandibles, and the blood is sucked up into the mouth by the sucking organ which lies in the head at the base of the mouth-parts. Just above this piercing proboscis is a pair of flat, obtuse, somewhat triangular pieces, the maxillary blades or maxillæ. When the proboscis is fully inserted into the skin the tips of these maxillæ may also be embedded in the tissue and perhaps help to make the wound larger. Attached to these maxillæ is a pair of rather stout, four-jointed appendages, the palpi. They probably act as feelers.
If the flea chances to be feeding on a plague-infected rat or person many of the plague bacilli will get on the mouth-parts and myriads of them are of course sucked up into the stomach with the blood. Those on the proboscis may be transferred directly to the next victim that it is thrust into, and those in the stomach may be carried for some time and finally liberated when the flea is feeding again or when it is crushed by the annoyed host. The latter is probably the most common method of infection, for the bacilli that are liberated when the flea is crushed may readily be rubbed into the wound made by the flea bite or into abrasions of the skin due to the scratching. Kill the flea, but don't "rub it in."