It is natural to suppose that an insect which throughout its whole life is in such intimate relationship with man should play an important rôle in the transmission of disease. Yet comparatively little is definitely known regarding the importance of the bed-bug in this respect. It has been shown that it is capable of transmitting the bubonic plague, and South American trypanosomiasis. Nuttall succeeded in transmitting European relapsing fever from mouse to mouse by its bite. It has been claimed that Oriental sore, tuberculosis, and even syphilis may be so carried. These phases of the subject will be considered later.

The sources of infestation are many, and the invasion of a house is not necessarily due to neglect, though the continued presence of the pests is quite another matter. In apartments and closely placed houses they are known to invade new quarters by migration. They are frequently to be met with in boat and sleeper berths, and even the plush seats of day coaches, whence a nucleus may be carried in baggage to residences. They may be brought in the laundry or in clothes of servants.

Usually they are a great scourge in frontier settlements and it is generally believed that they live in nature under the bark of trees, in lumber, and under similar conditions. This belief is founded upon the common occurrence of bugs resembling the bed-bug, in such places. As a matter of fact, they are no relation to bed-bugs but belong to plant-feeding forms alone ([fig. 19] c, d).

It is also often stated that bed-bugs live in poultry houses, in swallows nests, and on bats, and that it is from these sources that they gain access to dwellings. These bugs are specifically distinct from the true bed-bug, but any of them may, rarely, invade houses. Moreover, chicken houses are sometimes thoroughly infested with the true Cimex lectularius.

Control measures consist in the use of iron bedsteads and the reduction of hiding places for the bugs. If the infestation is slight they may be exterminated by a vigilant and systematic hunt, and by squirting gasoline or alcohol into cracks and crevices of the beds, and furniture. Fumigation must be resorted to in more general infestations.

The simplest and safest method of fumigation is by the use of flowers of sulphur at the rate of two pounds to each one thousand cubic feet of room space. The sulphur should be placed in a pan, a well made in the top of the pile and a little alcohol poured in, to facilitate burning. The whole should be placed in a larger pan and surrounded by water so as to avoid all danger of fire. Windows should be tightly closed, beds, closets and drawers opened, and bedding spread out over chairs in order to expose them fully to the fumes. As metal is tarnished by the sulphur fumes, ornaments, clocks, instruments, and the like should be removed. When all is ready the sulphur should be fired, the room tightly closed and left for twelve to twenty-four hours. Still more efficient in large houses, or where many hiding places favor the bugs, is fumigation with hydrocyanic acid gas. This is a deadly poison and must be used under rigid precautions. Through the courtesy of Professor Herrick, who has had much experience with this method, we give in the Appendix, the clear and detailed directions taken from his bulletin on "Household Insects."

Fumigation with formaldehyde gas, either from the liquid or "solid" formalin, so efficient in the case of contagious diseases, is useless against bed-bugs and most other insects.

Other Bed-bugsCimex hemipterus (= C. rotundatus) is a tropical and subtropical species, occurring in both the old and new world. Patton and Cragg state that it is distributed throughout India, Burma, Assam, the Malay Peninsula, Aden, the Island of Mauritius, Reunion, St. Vincent and Porto Rico. "It is widely distributed in Africa, and is probably the common species associated there with man." Brumpt also records it for Cuba, the Antilles, Brazil, and Venezuela.

This species, which is sometimes called the Indian bed-bug, differs from C. lectularius in being darker and in having a more elongate abdomen. The head also is shorter and narrower, and the prothorax has rounded borders.

It has the same habits and practically the same life cycle as Cimex lectularius. Mackie, in India, has found that it is capable of transmitting the Asiatic type of recurrent fever. Roger suggested that it was also capable of transmitting Kala-azar and Patton has described in detail the developmental stages of Leishmania, the causative organism of Kala-azar, in the stomach of this bug, but Brumpt declares that the forms described are those of a common, non-pathogenic flagellate to be found in the bug, and have nothing to do with the human disease. Brumpt has shown experimentally that Cimex hemipterus may transmit Trypanosoma cruzi in its excrement.