r^^ '^^ / v_/ v/ '-> , — — — — \7/v^/cr, /^ /Zw^.. :2W..jv/^ >^P ^ ^^^a^t /^4.ti^r>^ ^ cure a^ , ^Tk /'^^rC . /^^ ^^<^^rz^ l^^l y^n^ - - ^' "INFECTION." BY SIR J. CLARKE JERVOISE, BART. WITH REMAEKS BY MISS NIGHTINGALE SECON D EDITION. ITonbon; PRINTED BY YACHER & SONS, 29, PARLIAMENT STREET, AND 62, MILLBANK STREET, S.W, 1882. PREFACE. IDS^YORTH, HORNDEAK, HiXTS, Feb. U(ft, 1882. In com])]iaucc with the suggestion that I should repnhlish the pamphlet "Infection," (which I \vi'ote anonymously in the year 1867) with my name and address, and in consideration of "how many things have ha2:)pened since then," I do so in the hope that the cause of truth and science may be promoted thereby. J. CLARKE JERYOISE, Magistrate and D.L. for the County, and Ude M.P. for the Southern Division of the County of Southampton. A 2 INFECTION. Some Members of Parliament and others having said that if I would write out my observations on the subject of infection they would read them, I have determined on putting them into print ; and I am the more encouraged to do so by the following extract from ''The Lancet" in a county paper for May 18th, 1867 :— THE LOQUACIOUS HAMPSHIHE MEMBER ON INFECTIOUS AND CONTAGIOUS DISEASES. " When Chloroform was first introduced into the practice of medicine, objection to its use in obstetrical and other cases was taken, on the plea that suffering was not only natural, but was even ordained to be the lot of mankind. This argument, fallacious as it is, has some ground, however uncertain, to rest upon. The objectors to the use of chloroform do not deny the fact that it relieves pain, but they deny that it is right that that relief should be given. Sir C. Jervoise has not even this shallow foundation on which to base the arguments he adduced the other night in the House of Commons against taking precautionary measures to limit the spread of infectious (ind coiitdijious diseases.* The bon. baronet did not 'believe' in infection or contagion, and characterised as 'cruel' and costly the efforts which have been made to stop their progress. Lord R. ilontague disposed of the 'belief of Sir C. Jervoise in a few trenchant and common- sense remarks. It would be a matter of very little moment what were the articles of belief of the worthy baronet upon a subject which he certainly does not understand, were the influence they exert not most injurious to a large class of the ignorant and unthinking." — Lfnici't. I have never seen a number of the " Lancet," but the A\'ord reminds one of letting hlood at spring and fall ^ and other practice, done in good faith, but against common sense. I am much indebted to the Editor of the ''Lancet" for his "trenchant" criticism. For my own part, I have only to say, that I never doubted the benefits conferred on suffering Immanity by the discovery of chloroform, and its predecessor (ether) ; but, if it had been prescribed, without effect, for * Contagions diseases are expressly cxckuled, unless to define the difference between the meaning of tlie term, as distinguished from In/eclious diseases thus con- founded with them by " The Lancet." 6 stamping out a disease wliicli subsequently raged for two yearSj and then recommenced, I should doubt tlic quality of the physic or tlic qualification of the physician. WJien Gil Bias, in good faith, was practising the system of his ]\Iaster Sangrado, his patient said, '' Hold, Gil Bias, for though I " have not a drop of blood left in my body, 1 don't feel better. " I see clearly that I must die, but do let me die quietly." On the 3rd May I moved an address to the Crown (Xo. 1, in the orders of the day), but in consequence of the superior claims to attention of the supposed cases of hardship and cruelty to the Fenian prisoners in Mountjoy prison, I did not rise till between 9 and 10 o'clock, " impransus," to address an audience, indifferent, or hostile, as I believed, with two successive governments opposed to me, as well as foregone conclusions, popular belief, or perhaps superstition, tlie old faith, Avhich is known to survive even the language of a country ; and to move a resolution which, if carried, would be an admission of the unnecessary loss, groundless alarm^ and loanton injustice^ which had been inflicted on the country in consequence of action being taken on hypothesis, unsupported by demonstration.* I have no complaint to make of the report of my speech, and no regret at having brought the subject forward. Neither have I any fault to find witJi the answer I received from the Vice-President of the Committee of Council on Education. Motion and Answer : — CONTAGIOUS AND INFECTIOUS DISEASES. '•'Sir J. C. Jervoisk rose, according to notice, to muvo 'that an humlilc address be presented to Her Majesty praving tlint Her Majesty will be graciously pleased to cause such iiKpiiry to he instituted as may lead to the better distinction l)etween contai^ious diseases and such as are termed infectious, so as to obviate, as far as possible, the loss, alarm, and injustice consequent on the theory of the infectious nature of certain diseases when unsiij)ported by demonstation.' The subject of the conveyance of disorders by some mysterious a'^ency from one person to another in our state of society must, he thouglit, be regarded as one of the most important matters • " It was one thing to say a few words there surrounded by kind friends, and quite another to pet up in tlie House of Commons where every one wislicd you to sit down." (Lord G. Cavendish," Timc.»." Oct. 6th, U\'H.\ which could engage their attention. It affected people in every position in life, every association, and every meeting of persons in every capacity, whether at home, abroad, or in the colonies ; and it might be viewed in its bearing not only on persons who were at liberty, but on a class of persons whose case had been under discussion that evening — viz., those who were placed in confinement. Nothing could be more shocking, if the theory alluded to in his notice of motion were true, than the idea that persons locked up in gaols should find themselves subject to the influence of infectious disorders. The hon. member referred to a tale written by a French author about a poor leper and his sister, who were shut up in a tower and condemned to a miserable life of seclusion on account of their fearful malady. Their only companion was a little cur dog, and the sister having died, the brother was left alone with the pet dog, which, however, the authorities ordered to be destroyed, in order to prevent the infection from being carried elsewhere ; and the wretched man at last committed suicide to relieve himself from an insupportable existence. That tale was founded so much upon fact that it might be said to be almost a true representation of the state of things in certain eastern countries. The infectious nature of leprosy was believed in in many parts of India, where great cruelties were inflicted in connection with the precautions adopted in regard to those who suffered from that malady. The hon. baronet who aiidressed the House a considerable time, and was almost inaudible, avowed himself a disbeliever in infection, and was understood to depreciate specifics pre- scribed and recommended to protect persons supposed to be especially exposed to it. He derided precautions that were too complicated or costly for general adoption by those upon whom they were urged, and asked, for instance, what was the use of urging that no water should be drunk that had not been boiled if people were destitute of the means of boiling it. He also referred to the outbreaks of scarlet fever at Southampton, Aldershot Camp, and elsewhere, with the view of showing that medical men, trained nurses, and others in immediate contact with patients, escaped the com- munication of the disease ; and noticing the supposition that medical men carried it to their own children, remarked that if such communication were probable the patients of medical men were exposed to danger quite as much as the members of their own families. " Lord R. Montagu said that a commissioner had been sent to Russia to inquire into ' the black disease,' and this gentleman reported that the disease was not infectious, so that it did come und^r the motion of the hon. member. It was true that in the other House, Earl Granville said a great many persons had died from it ; but this was a mistake. Earl Granville was alluding to another disease which also existed in Russia, and which was highly infectious. This disease broke out among cattle, and was communi- cated to human beings ; and, according to the last reports, upwards of 70,000 cattle were killed by it during the year and 30,000 men. As to the cattle plague, this was not the time for a cattle plague debate, the proper occasion for which would be when a Bill was introduced on the subject. He was sorry to say, however, that there had been recently a fresh outbreak of cattle plague in London. The existence of the disease here was suspected for some little time owing to the removal of cattle from some dairies. At last it was discovered that the disease existed in one London dairy where there were 39 cows, which all had the disease, and all of which were killed. This happened in the preceding week, and he trusted that the slaughter of these cattle had prevented the further spread of the disease. With regard to contagious and infectious diseases, the 8 two terms were treated pretty much as convertible ; but iufection was the term, being, in fact, the genus, while contagion was the species. Infectious diseases witc tliosc which were cuniiuunicatcd from man to man, or were generated in the air, or by means external to man. Yellow fever was not Contagious, though it was infectious ; and what pos.siblc harm, therefore, ■was tliere in Dr. .Seaton's visit to the ship at the Mutherbank ? The disease was communicated by the air and not by contact witli persons. Perhaps the hon. member would say, ' Why. then, impose any quarantine?' The answer was, that it was not a medical but a commercial quarantine ; it was imposed, not through fear of the s))read of yellow fever, but in order that our ships and merchandise should not be exposed to quarantine abroad, and subjected to the loss which that would entail. The laws con- nected with the comnmnication of diseases were pretty well known by this time. There might be some few special disea.scs upon which addi- tional knowledge was required. But surely the Health Ofhco, in which there were two or three medical men of great scientific attainments, aflordod a better means of investigation tlian that proposed by the hon. member — a Commission composed of a chemist and a lawyer. (A laugh), lie did not know wliat would be the business of the lawyer, except, he supposed, to impose the restrictions of law upon the spread of di.«;case. But the hon. gentleman would sec that with men who had spent all their lives in the investigation of the subject, and with all the appliances at their command, the Privy Council had means at their disposal much better than the com- mission which the hon. baronet recommended. The hon. baronet had alluded to cholera. He was happy to say that upon this important subject most careful and accurate investigations had been carried on, the results had been tabulated, and in a few days a voluminous report would appear, which, he trusted, would be satisfactory to the hon. baronet. There Avcrc other points to which the hon. baronet had called attention, but, as he had considerable difhculty in hearing the hon. gentlemen's remarks, he trusted that would be sufficient excuse if he desisted from pursuing the subject further." — Times, Mmj -ilh, 1SG7. The motion for an address was then withdrawn. AVliatcvcr notice might be taken of the motion, it was certain to be productive of some gain. A fact or a fallacy mtist needs be drawn forth, and, by tlie process of " quod erat clemonstramhan,^^ or by that of '^ quod est absurdum,^^ the cause of trutli must be a gainer. In tlie question of the commnnicability of disorders, politics do not enter. ]5oth parties have born either right or very wrong in tlicir legislation and administration. It may be presumption in nic to think I am right, but it is not im- possible, For a long time it was considered that '' Nature abhorred a vacuum," and, although I may not aspire to the position of a Torricelli, I may to that of the sceptic, who, while the Royal K5oeiety were puzzling over the problem propounded by the Merry Monarch, '* JVJiy a carp of a given " weight does not cause the huchet of xoaler into which it is thrown '' to weigh heavier? " suggested that the experiment sliould be tried. I sliall, I am confident, be pardoned, if I am not altogether acquitted, for having brought the subject, however imperfectly, before Parliament and the country. I have, from time to time, asked Questions in the House of Commons'^ on the subject of the communication of disease by the process of infection^ and I had intended to use the Questions as landmarks to guide mc on my road, but speak- ing without notes, the first reference I made to these documents showed me that I could not read what a few hours before, in the daylight, had been legible enough. But I will not compromise by naming one who seconded me (unasked) in the daring heresy of supposing that the statement in the Sixth Report of the Medical Officer of the Privy Council — " And though the present and other " illustrations cannot increase knowledge (which has long " been conclusive) with respect to the causation of disease " — is not to be accepted as a dogma, or of suggesting that a chemist and a lawyer might bo as good a tribunal to inquire into the nature of the so-called infectious diseases of man and beast, and to judge of the value of the evidence adduced, as the two or three gentlemen connected loith the Board of Healthy of great scientific attainments ^ loho had j)rettg well ascertained the nature of cdl diseases, whether contagious or infectious. Availing myself of the subject of the preceding motion to suggest the shocking idea of confining prisoners in a gaol affected, by what is deemed an infectious disease, I had in memory Avhat occurred the previous year in Mountjoy Prison. I am happy to have preserved this extract in refutation of the thought. * Mr. Gladstone, "They (Questions) have now become a very serious, and I am hound to add, a very important part of the business, and therefore not frivolous or trifling" (hear, hear). — "Times," July 2nd, 1881. 10 "Dr. F. R. CuuiSE, writing in the ' British >fcdical Journal,' gives details of the recent outbreak nf cholera in ^luuntjoy Prison. They will serve to correct various erroneous statements that have been made on the subject. There has been no new case since December 27. The attack commenced on Sunday, December 23, the health of the establishment having been previously quite satisf;\ctory. The epidemic lasted live days, during which time nine cases of Asiatic cholera, with collapse, oecured, and four terminated fatally. The inhabitants of the prison are convicts, together with about 140 untried prisoners, now confined under the Habeas Corpus Suspension Act. Most of the cases of cholera occurred among the convicts. The outbreak was immediately notilied to the Government, and the most active sanitary measures were at once put into force, under tlie direction of the medical olhcer of the ])risou, Dr. Itobert M'Donnell. To the i)romptitude and energy with which these measures Avere carried out undoubtedly may fairly be attributed the rapid subjection of the attack. Perhajjs the most interesting point in connection with this particular visitation is the difliculty in tracing its origin. A'o case of cholera has taken place among the oflicers of the establishment or their families. The prisoners in the various divisions of the prison do not communicate with each other, nor with the same oflicers ; nevertheless, cases arose simul- taneously in these divisions. The water supply is derived from the reservoirs of the north side of the city. It is received in a supply-tank, from which it is pumped by a steam-engine to cisterns on the top of the building. This supply-tank is pumped empty every 24 hours. From its situation it is absolutely secure from all risk of contamination from sewage, etc. The adjoining Female Convict Prison is supplied from the same tank. But no case of cholera occurred in the Female Prison. The food recently supplied has, on examination, been reported of unexceptionable quality. The different divisions of the prison are not on the same diet, neither is the food for them cooked in the sanio vessels. ]S'evertheless the disease a])peared in all the divisions. The disease could not be ascribed to atmospheric influences, for the prison is on one of the healthiest situations in Dublin." — I'iincs, Jdnuanj Slli, 1867, Since I brought tlic subject bctbre the House some progress, as f consider, has been made in the road which I travelled over, as Avill be seen by the follinving from the '^ Pall Mall Gazette " of May 22nd,"^18C.7 :— OCCASIOXAL NOTES. "Mr. Cave explained to the House of Commons last night that our quarantine establishments are kept up for no useful ]iurpose whatever, but wholly and solely to satisfy the projurced to cling to what they considered a charnel-house, without proper medical aid, are constantly on the verge of riot and mutiny, in order to force their way out from the poisonous ship. The first supplies that came from the shore, we are assured by a passenger, were three barrels of saw-dust ! When at length the sick are to be removed, there is no steamtug or proper means of transference. The poor dying emigrants are tied into a rude seat made from a hogshead and lowered front the yardarm, under the hot sun, after much difliculty, into one row- boat, and then again hoisted into the Falcon. Tliree persons on an average are thus transferred in three-quarters of an hour. One poor woman died during the process, and no doubt the majority of the others died afterwards. It forcibly occurs to the quarantine i>flicials that this is a very slow and cruel process, and on the urgent representation of the sanitary superin- tendent of the city, they condescended to request the captain to assist them with tlie shii)'s boats. W'a cannot wonder that after this performance the cholera raged fearfully in the hospital ship. . . There ought to be some place where, after the weary voyage, the quarantine jiatient can step on shore, and where the poor steerage passengers can escape the effluvia and ])oison generated in those close holds after a long crowding of human beings together." — Xcir York Tiincf, Mai/, 18G6. Here, however, is the true balm of Gilead : — " The Custom-house officials of New York are furnished with small vials, containing each an ounce of some greyish cholera mixture, with which they immediately dose each person, sick or well, who arrives in that port."— /^a// Mall Gazette, August ith, 1866. This is acting on the safe side. But, how do wc act in England with regard to the cholera? In his 8th Report, the Medical Officer of the Privy 21 Council saySj '• I have no hesitation in asserting that England ought to resist cholera by Quarantine." The infect iveness of the disease belongs to the dejecta of cholera patients, " which acquire tlieir maximum of infective power, while undergoing decomposition." The ''Pall Mall Gazette," writing in May, 1866, has this article, anticipating by two or three months the Report. QUARANTINE FOR CHOLERA. " The ' Post' trusts that the Order in Council for placing the ' Helvetia' in quarantine at Liverpool may not be, and may not he construed to be, an indication of any disposition to return to the system on the part of this country. In truth, the time of quarantine has passed away. It is now recognized that of all methods of preventing the spread of infection none can he more unwise — as undoubtedly none can be more ungenerous — than to intensify the disease where it already exists by keeping the victims shut up together in the narrow walls wherein it hrst appeared, debarred from all the chances of recovery that the succour of the rest of the world can give, and at the same time to condemn those of them not yet infected to the peril of a forced contact with those — and those only — who are already suffering from the infection. The mental torture of such a situation might well be enough to induce disease even where there was no predisposition to it. Quarantine regulations have been and are disappearing, one by one, from the statute books of all enlightened European nations. The public mind is apt to take very sudden and somewhat unreasoning alarm on matters of this sort, and there does not appear to be ground for indulging in panic at present ; but at any rate, if it should hereafter appear that the cholera is to be expected — of which we shall certainly have good warning from the Continent — it would be the wisest plan to render compulsory the erection in every considerable seaport town of hospitals such as that at Liverpool, where the sick can be properly attended, and have at least all those chances of recovery which human skill and care can give, instead of seeking to resort to the barliarous system of cutting oft' from them all chance of recovery by keeping them cooped up together, and cut off" from proper succour, in the narrow limits of their vessel. As regards the 'Helvetia,' the ' Tost' thinks the Privy Council have acted with prudence and discretion, and trusts that they will not be induced to do more than that, at any rate, in order to meet the fears which are so easily excited upon slender grounds, and with so much difhculty allayed." — Pall Mall Gazette, May, 186. I recollect an analogous case occurring (with different results) during a cholera visitation in Rome. A young surgeon went about doing what he could to benefit his townsfolk. The report spread that he was disseminating the disease. The people rose, and tore him to pieces in the ])ublic streets, to he on the safe side. But here is another case for condemnation (?) : The Cottage Hospital, North Ormesby, Middlesbrough. "REGULATIONS FOR PROBATIONERS AND NURSES. " 10. To attend the sick, both poor and rich, at hospitals or private houses, by night or by day. After eight weeks" attendance upon int'ccliutis cases the nurse must return, or be exchanged for another." In the " Pall Mall Gazette" of August 25th, 18()G, will be found a letter, signed Forbes Wiuslow, M.D., '' On the Depressing Passions in Relation to Cholera," I will take the liberty of adding, that it is a common tradition, in the Iionio of the King Cholera., that he was met coming out of a village in which a number of deaths had occurred, and was accused of being the cause. He stoutly denied the charge, adding, that lie had only killed one, while fear had killed tlie rest. It has been said, too, with some truth, as I venture to submit, that King Dirt and King Drunkenness have often as much to do with di.-^ease at home as the arrival of the parent disease from abroad. At any rate, the stiggcstion is worthy 23 of consideration. At Mauritius " the most stringent qiiaran- " tine regulations are in force, but sanitary regulations in the " town are overlooked. The Coolie population is dirty in " the extreme." But as I do not affect originality, I shall do best by giving the following extract from a Southampton paper of December 15th, 1866. I have refrained from mentioning names, or I could have adduced the authority of men of great practical knowledge (at Southampton and elsewhere), who have written, conclusively, as I think, on the non-infectious nature of the cholera and yellow fever. The latter is now admitted at head-quarters. " CHOLERA AND YELLOW FEVER. "As the question of the contagiousuess and possible importation of such diseases as the above has recently formed the subject of discussion in our columns, our readers will doubtless be interested in the perusal of the following extracts from a very able work recently published by Dr.Shrimpton, of Paris, upon ' Cholera ; its Seat, Nature, and Treatment.' Having quoted the opinions of several eminent physicians of the Indian Army, together with a number of irresistible facts adduced by them to show the non- contagious character of cholera, Dr. Shrimpton says : — " When we see the disease breaking out on the same day, September 19th, 1865, at Cette, Aries, Aix, and Courbevoie ; on October 1st, at Nancy and St. Cloud ; the 5th, at j\Ielun ; the 6th, at Caen and St. Germain ; appearing simultaneously at distances so great from each other, how is it possible to prove that contagion spreads ' gradually frum commune to commune, from house to house, from individual to individual V No, the disease is not propagated in this way. Not only does the disease appear suddenly in persons the most distant from each other, but one or more persons may be attacked at the same time in a family, in a house, or in a public establish- ment. No one has ever seen cholera transmitted fron one individual to another. Cases are well known of children that had bee :i suckled by their mothers affected with cholera until the last moments of their existence, without having taken the disease; Again children at the breast that have died of cholera have not given the disease to their mothers {de la Berge et Monnerct CoiujU'iidiuiu, page 272). "If we were now asked what was our personal opinion on the manner in which cholera is propagated we would answer as follows : the disease is not propagated by contagion, by infection, by poison, or by any emanation from the bodies of cholera patients. " Everything in cholera seems to preclude the idea of contagion ; there is no period of incubation, no virus, no miasma ; even the nature of the disease itself, its seat, and its mode of propagation are quite opposed to all the principles of action of contagion. " A^o infection. — Where are the ferments, the effluvia, the miasmata of cholera'? No one has ever discovered the least trace of these mephitic 24 gasos, of those iiiicrozo:iii\'S, of which there has been so much talk. The atmosphero has not the least been infected with antiscjttics and preparations is uard,' or 'jusl-h-tiise,' attached to the Aylesbury Union Workhouse, and was under treatment for small pox by Mr. linlnrl Ceili/, the medical officer of that establishment. The man had expressed a desire to go out and see his friends, but Mr. Ceely, being a/ { tlic Privy Council (18G(i}, in wliich he states, pp. :50-40, the mode in which cludera-contagium isg(>nerated ; whether tiie discoverer had (livulgcil his metliod of obtaining that deadly agent ; and. if not, why not ; and whether the annual report of the medical otlicer, which was not accessible to members till towards the end of July in the last, would be so at an early period in this Session. "Mr. CoHRY said the opinions expressed in the paragraph referred to were not those of a single discoverer, but were the results of the investigation of a number of scientilic men. With regard to the rei)ort, he could niit hold out any hope that it would be laid ujion the table mucli earlier than it was last year." Dr Frankhand hud been trying experiments with eluilcrine, and science informs us tliat by words ending in *' ine '' organic bases are understood, ^'as morphine, quinine, nicotine, &e., ttc." The Medical Officer of the Privy Council, too, has been trying experiments with " Cholera Contagium," and science 83 tells us that by words ending in '' urn '' metallic elements are named, as potassimn, sodium, magnesium," &c., &c. We have thus two great discoveries in chemistry. (The latter was not that of a single discoverer.) There is a story of an ingenious artist having discovered the method of rendering glass malleable. On taking it to his sovereign he was asked whether he had divulged his secret to anyone else, and on his replying in the negative, the despotic ruler ordered him off instantly to execution, for, said he, such an invention would supersede the use of all other materials and cause ruin to thousands. Fortunately we live under a milder rule ; the former of these discoverers is not in danger of his life ; nor is it probable that the number of scientific men will be rewarded. But what becomes of the answer of the Home Secretary to my question ? He would not undertake to say whether it was true or not, but it was published as a very valuable document tending to put the imhlic on their guard in dealing with ivhat were supposed to be cholera cases. Am I wrong in classing this statement among the pious frauds we have heard of, asserting what is not true, that good may come of it ? That the Report of the Medical Officer of the Privy Council should be withheld so long, and at such a juncture as the present, is unreasonable. No doubt the gentlemen at the Board of Health " have pretty Avell ascertained the nature of all diseases ; " but why should we be kept so long in igno- rance of what is going on there. Nature acts by uniform laws. " We must get by what we know, to what we wish to know." Whether I have picked up a pebble on the shore of the great ocean of science, or only found a viare^s nest, I leave it for others to decide. If only the nest, I shall not stand alone. One hundred years ago Smollett was on the look-out for Halcyon's nests floating on the sea off the coasts of Nice and Genoa, but he did not succeed in finding one. He did, however, discover at j\Iont- 34 pellicr (a place ^vith the name of wliicli everything that is salubrious is still associated, and at that time celebrated for the most skilled practitioner in Europe), " a very treacherous climate, and an ignorant and rapacious quack doctor.'' If it be admitted that the spread of a number of diseases in man has eiToneously been attributed to infection, may we not infer that the diseases in cattle arc open to the same mistake ? It is pretended that the diseases of cattle are best understood (as they ought to be), by veterinarians, but not to the exclusion of physicians. Such exclusive dealing would repudiate the maxim of " Fiat exjjerimentuni in corpore vili,^^ and make vivisection a piece of wanton cruelty. Vaccination would be relegated to the care, and to the advantage of the cow-leech. And this reminds me that (in the Third Report of the Commissioners on Cattle Plague, celebrated for tlie beauty of its chromographs), there is a portrait of ^Ir. Hancock's hand, as it appeared after having been inoculated with the virus of that most terrific disease. The result being that it was a complete, but simple case of vaccination. Keitlicr more nor less. But to the pebble, or the mare's nest. In the second part of the volume, on Fermentation, Putrefaction, and Decay, by Lie big, he suggests that diseases in the blood may originate by a similar chemical fermentation. For example, in the process of malting, the sacharine fermen- tation is set up in the insipid barley. The wort made from this undergoes the alcoholic fermentation and becomes beer. This will ao-ain run into the acetous fermentation and turn to vinegar, and that again into the putrid fermentation ; and so into decay and dissolution. I have omitted the use of yeast, because", though it might represent the contagious clement, it is not necessary for the fermentation of beer, wine, or cider. These may be regarded as so many diseases occurring spontaneously, which having passed off, the beer is less likely to undergo them a second time. Stmilia simih'bus cura7itur ; and this has been alleged as 35 a ground for expecting security from smallpox by inoculation and vaccination; but homoeopathy does not pretend that similia promiscuously administered in infancy will secure immunity from similibus in after life. Liebig mentions a terrible dis- order caused by eating the sausages of Wurtemberg, which from tlieir composite character, are very liable to ferment ; putrefaction taking place in the centre of the sausage, and com- municating itself to the person who cats it in this state. Tlie victim is consumed by a fermentation brought about by chemi- cal action, in which likewise the disease itself had its origin. But the gas emitted in each of these examples of fermen- tation, differing entirely from the matter in which it originated, cannot produce a similar chemical fermentation or disease. Each process produces its own specific results alone. The gas which is generated during the fermentation of beer will suffocate before it will inebriate. Although the sausage, fermenting spontaneously (if the statement be true) is the parent of a dreadful disease, it throws out no infectious vapour or molecule ; no poisonous matter can be detected in the sausage ; " boiling water and alcohol destroy it, without acquiring similar properties.'^ There is no sausagine denoting- its active principle. " It is equally impossible to obtain such a principle from the virus of small pox or plague." What then becomes of the illustration, and the argument founded on it, by the Medical Officer of the Privy Council, when he says that diseases descend as regularly from a parent as dog from dog and cat from cat, and that it would be as irrational to look for the spontaneous origin of any disease, as it would be to look for spontaneous combustion during a discharge of fire-works. According to this theory we must look for the cause of the cold caught in a damp bed to the damp person who has slept in it. " When a " known cause produces the same action in all cases sub- " mitted for examination, we must revert to the same cause " in considering the same actions in cases not examined, for " we have no right to assign to it a new cause, in order to save c 2 36 " us tlio trouLlc of a clo.^ov invcistigatlon."' — Lielig. But " we must get, tlirough facts that we know, to tliose wc want " to know."— .IM. In the year 185G-57, papers relating to the history and practice of vaccination were presented to both Houses of Parliament. The writer (\\x. Simon) states that " lymph, '' under the influence of air and moisture tends, like other " dead organic matter, to putrid decomposition," &c., &c. Used in this state, it produces the same effect as that which occurs sometimes in the dissecting theatre to the surgeon who wounds himself in the operation. The disease which follows (dangerous though it he) is not communicable, "unless it be by similar process." In the Appendix to these Papers will be found the foUoAving evidence by Dr. Jcnner : — " Reflecting that the operations of nature are generally uniform, y cxiwsinpj sheep for sale at the Metro- jKilitan Cattle Market without jiroper covering, they having been recently shorn. " Mr. Rickets, solicitor, of Frederick Street, Gray's Inn Road, instructed by Mr. Love, prosecuted ; and Mr. Field, Solicitor, of Finchlcy, defended. 39 " Last week it was proved that the sheep were exposed in the cattle market on a bleak, cold, and wet day, the ground being covered with snow, without any clothing on them, the sheep having been recently shorn. To prove that the defendant had been guilty of cruelty, Professor Spooner, of the Royal Yeterinaiy College, was called, and he deposed as follows : — I consider the acts narrated are very cruel, and that the animals must have suffered a great deal. I have examined meat from animals that have been so exposed, and have found that it was very much deteriorated. The very fact of the animals standing with their backs arched, their heads hanging down, and shivering, would show that they were suffering great pain. The skin of the sheep is highly sensitive and thin, and the removal of the wool would expose the nerves. The present practice of shearing sheep in cold weather is a most cruel one, and ought to be suppressed." — April llth, 1867. And we must recollect that not only were the sheep exposed to the wet and cold of the season 1862, but the grass on which they fed was grown under circumstances adverse to its wholesome properties. Some ])ractical men do not hesitate to characterise the disease as that well known (possibly in a milder form) by the name of Scab, '' a disorder full of terrors to the flock masters in Great Britain and the colonies." At the Peel E-iver, in 1864, the Government having decided to suspend the operation of the penal clauses of the Scab Act, rendering the destruction of diseased sheep imperative, and to adopt a modified course, allowing tlie use of curative measures instead, " grave doubts are entertained by many flock owners as to " the disease ever being thoroughly eradicated ;" but in 1865 it is stated, "■ the disease of the Scab, which at one time " caused so much alarm to flock owners, has happily abated, " and the Return of tlie Inspector-General exhibits a great " diminution in the number of sheep affected throughout New " South Wales." The remedial measure seems to have been as beneficial in its operations as the punitive. The example, however, set hj the mother country of stamping out a disease, "■ the origin and nature of which is still unexplained," has been lately followed by the colonists with all the energy of youth, as Avill be seen by the following extract referring to the cattle plague : — 40 "llOCKHAMrTON. " From our files of Rockhanipton papers, wc quote the following : — " XovEL Imtort. — One of the new arrivals bv the fJrcat Pacific lirought ashore on Friday a monster Tom cat without submitting him to the formality of any uflicial inspection. Fortunately, however, fur the ])eace of the town, !Mr. -Macpherson, the Sheep and Cattle Inspector, seeing Turn on tlie wharf, and knowing that a late regulation forbids the introduction of any quadrupeds from Europe, arrested him on the spot, to the intense disgust of the owner and a large mob of sympathising admirers of Grimal- kin. The Inspector marched oft' his prisoner at some risk to himself from the claws of the brute. On returning from the races, on Friday, he found the owner of the cat and about 50 men and women at his house. The cat was demanded, and a good deal of threatening language used. The Inspector, however, was firm, and showed his authority to the belligerents, who thereupon subsided ami submitted to the fate destined for their favourite. He was ]»ut into a bucket of water, from which he sprang on to the inspector's sliouldcrs, ami after a good deal of trouble was finally drowned in another bucket. He was then consigned to the earth by his late owner and admirers." — Xorthcni Arijus. In addition to the precaution earned out as above, avc liave the fact of three canary bird.s being kept in quarantine at Brisbane, for fear of the Rinderpest from England ! But to return to the infectious nature of the small pox in sheep ; the question was put in Committee on the Cattle Plague Prevention Bill, at my suggestion, (for I had not the honour of serving on that Committee), about the disease being communicated at the long range of 500 yards. The answer was that the fact was proved thus : — " I have had eases in my '* experience abroad. You have stock going up to pasture, " through one road, another stock going up to another pasture, '' quite distinct from the other, by another road, and these two " roads being, say, within 400 or 500 yards; and tlic disease " has been propagated from farm to farm." It will be recol- lected, that the Ijcap at llhodcs took place abroad. But why not try an experiment at home? A circle with a radius of 1,000 yards from the centre of infection would allow of the oOO yards range, and 500 beyond for the sake of security. Plumstead Marshes would afford space enough, Tlic disease being small pox, expcrinicuts in vacrinatinn were ordered by the Lords of the Cuuncil ; the report on the vaccination of sheep was sometime in preparation (the experi- ments commencing in October, 1lague has actually appeared in any shcij, yard, or jdace, the sick animal should at once be removed with all due precautious. It is certainly the safest and best to poleaxe the 59 animal at once, and to buiy it entire, and then to disinfect the particular lair as above described, clear out the stable or shed, disin- fect the -whole of it, and all the apparatus, also all the animals, aiul only to let the animals enter the shed, &c., again after it is completely sweet and dry. " 2. — If, however, a proprietor is desirious of keeping a sick animal because its illness does not appear sevei-e or fatal, he should place it in a separate shed, which must not be the same as, or near to, the quarantine shed, and be distant from all healthy animals, and so situated that the prevailing wind does not blow from this hospital shed to-\\-ards the healthy or quarantine shed. The water should also not flow from this hospital shed towards the others, or the yard, or any meadow, but should be carefully drained a^\'ay and sent off the premises by a special sink. " 3. — To prevent the scattering of fteces by infected animals (and also by suspected animals and all animals suftering from diarrhoea), their tails should be so tied to one or other of their horns as to ])ro- tect them against being soiled by the intestinal discharges, and to- prevent them from distributing such discharges by the ceaseless motions peculiar to these organs. The spattering of fteces should be prevented by a copius supply of rough straw, with some sand, saw- dust, or ashes placed behind and underneath the animal. The straw and faeces should be dealt with as has been described. Animals affected ■with plague or diarrhoja should not be led along the streets, highroads, and paths, as they would be certain to drop infectious faeces, which would then be distributed OA'er the entire leng-th of these roads by the feet of men and animals, and the wheels of vehiciles. " 4. — The sick animals should be disinfected repeatedly; their pens shoiild be cleaned and disinfected repeatedly during the coui-se of the illness. This should 1)6 done by persons either guarded by the safety-dress, or (and this is safest), by such as may not come into contact with healthy cattle, or have to enter healthy sheds. All tools, pails, fodder, &c., to be used in the hospital shed to be kept for that purpose only, and ilever to be used with healthy, or quarantine, or only suspected cattle. " 5. — If the proprietor of any dead piece of cattle, whether it has died naturally or been killed, should decide upon dismembering it instead of burying it entire, and upon iitilizing the hide, horns, tallow, and bones, he should disinfect the skin, horns, and hoofs, by steeping them for one hour in a strong solution of chloride of lime, containing lib. of the powder in each gallon of water, and afterwards washing them. The tallow .should be thickly })0wdered with chloride of lime all-over, and be sent directly to the boilers. It should not be boiled in any vessel employed on the farm. Under all circimi- stances, it is advisable to let this dismemberment of dead and fallen cattle be performed at the knacker's yard. 60 '< 6. — Flesh, l)lood, guts, lungs, and the bones of the head of infected animals should not be tralficked witli, tvs they cannot easily be disinfected. They should always bo buried. " /. Disinfection of Mcadous, Fields, liocids, S^-c. — 1. — Meadows infected by diseased cattle should be carefully cleaned of all dung, by burying each dropping on the spot where it lies, cutting out the round piece of turf with the dropping on it, and turning it upside down. The grass on the entire meadow sliould then be cut and burned. It should then be left without any cattle for at lca.st a month, including at least two wet days. " 2. — All roails, paths, streets of towns, or villages should be carefully and frequently scavenged. All carts, vans, or waggons used for carrying manure should be watertight, caulked, and painted, and should not be permitted to ooze and drop their fluid or semi-fluid contents on the road over which they are drawn. They should be kept clean and disinfected, as a precautionary measure, by the pro- ceedings above desci'ibed. " III.— GENERAL RECOMMENDATIONS.* " In conclusion, it must be pointed out to farmers, dairymen, and all persons having charge of cattle — "That the same great measures which are known to laaiutain and restore the health of human beings ^vill also maintain and restore the health of cattle. " Pure ail- : dry, spacious, well- ventilated and well-drained clean sheds, cleaii and dry meadows : jilenty of pure water : fiequent curry- in^ and washing : the prevention -of the development, by the destruction of the germs, of internal and external parasites, particularly entozoa : proper food in suitable (quantities, and at projjcr times : protection from inclement weather : the utmost cleanliness in the removal of manure : the storing of the manm-e at a great distance from the cattle shed, and, in addition, the most conscientious oljservance of the precautionary and disinfecting mcivsures above described. All these measures and agents together Avill secure the utmost possible health of stock, and the prosperity of the agriculturist and dairyman. But the neglect of any one of them will make the stock lialjle to become infected, and the more so the more several or all callateral conditions of the lundthy existence of animals are neglected. The negligent man is therefore certain to lose, to injure his neighbour by defeating his precautions, and to damage society ; but the watchful and i)ains- takiuf man will be rewarded, not only by the preservation of his property, but particularly by the consciousness that it has been pre- served by his own care and attention, and that thereby he has also benefited the State." * In '• Rtiid and Tliink," .Tune 4tli, 1878, I siiirpi'Sted tliat Dr. Thudichiiiu and other physicians sliould comply witli the directions as to the " Safety Dress" in cases of " Infectious Disease," in which, however, a lighter material might be permitted. J. C. J. REMARKS BY MISS NIGHTINGALE, ON A PAMPHLET ENTITLED i6 INFECTION." Anon, 1867. 62 REMAEKS. This Pamphlet is ably written. It reminds one very much of the arguments which in the middle ages might liavc been brouglit by an enlightened man against witchcraft, as a cause of disease. The disease-germ-fetisli, and the witehcvaft-feti.-h are tlie produce of the same mental condition ; both of tliem considered simply as superstitions, or harmless theories ; both of them spring from the same source, a desire to group together a number of detached phenomena, so as to make a kind of raft on which weak minds can float. This view can easily be confirmed, by reading any of the trials for Avitchcraft, and comparing the facts and inductions, in the Cattle Plague Report, and in other medical treatises on so called Contagious Diseases. But when either the witchcraft hypothesis, or the disease-germ hypothesis is made the basis of legislation on tlie assumption that any public good can follow from any Acts of Parliament, then the matter becomes very serious indeed ; and the fact of such legislation being possible can only be con- sidered as a striking proof iiow rapidly the (so called) scientific mind of iMigland, is sinking into a condition of abject superstition. This is not the only evil ; commerce will inevitably suffer to a greater extent than heretofore from these absurdities unless a check is put on tliem. 63 It cannot be otherwise, because the germ hypotliesis, if logically followed out, must stop all human intercourse what- ever, on pain or risk of disease or death. The germ hypothesis, moreover, is directly at variance in its results with ascertained sanitary experience, and to adopt it as a basis of legislation is, in strict logic, to declare that the Public Health Act, the Local Government Act, and all other Local Acts for improving the public health, have been founded on error. This Pamphlet is the first protest made publicly against this downward course. The Author deserves great credit for his audacity, and one can only hope that it will open the eyes of other members of the House of Commons to the course on which they have entered.