In the old descriptions of the disease it was frequently mentioned that large numbers of dead rats were found when it was prevalent, and the most striking fact of the recent investigations is the demonstration that the infection in man is due to transference of the bacillus from infected rats. There are endemic foci of the disease where it exists in animals, the present epidemic having started from such a focus in Northern China, in which region the _Tarabagan_, a small fur-bearing animal of the squirrel species, was infected. Rats are easily infected, the close social habits of the animal, the vermin which they harbor, and the habits of devouring their dead fellows favor the extension of infection. The disease extends from the rat to man chiefly by means of the fleas which contain the bacilli, and in cases of pneumonic plague from man to man by means of sputum infection. The disease once established in animals tends to remain, the virus being kept alive by transmission from animal to animal, and the persistence of the infection is favored by mild and chronic cases. CHAPTER IX DISEASE CARRIERS.--THE RELATION BETWEEN SPORADIC CASES OF INFECTIOUS DISEASE AND EPIDEMICS.--SMALLPOX.--CEREBRO-SPINAL MENINGITIS.--POLIOMYELITIS.--VARIATION IN THE SUSCEPTIBILITY OF INDIVIDUALS.--CONDITIONS WHICH MAY INFLUENCE SUSCEPTIBILITY.--RACIAL SUSCEPTIBILITY.--INFLUENCE OF AGE AND SEX.--OCCUPATION AND ENVIRONMENT.--THE AGE PERIOD OF INFECTIOUS DISEASES. We have seen that insects serve as carriers of disease in two ways: in one, by becoming contaminated with organisms they serve as passive carriers, and in the other they undergo infection and form a link in the disease. The more recent investigations of modes of transmission of infectious diseases have shown that man, in addition to serving while sick as a source of infection, may serve as a passive carrier in two ways. For infection to take place not only must the pathogenic organism be present, but it must be able to overcome the passive and active defences of the body and produce injury. Pathogenic organisms may find conditions favorable for growth on the surfaces of the body, and may live there, but be unable to produce infection, and the individual who simply harbors the organisms can transmit them to others. Such an individual may be a greater source of infection than one with the disease, because there is no suspicion of danger. The organisms which thus grow on the surfaces have in some cases been shown to be of diminished virulence, but in others have full pathogenic power. Such passive carriers of infection have been found for a number of diseases, as cerebro-spinal meningitis, diphtheria, poliomyelitis and cholera. In all these cases the organisms are most frequently found in those individuals who have been exposed to infection as members of a family in which there have been cases of disease. The other sort of carrier has had and overcome the disease,