DIPHTHERIA.
THE Registrar-General gives us every week a return illustrating the manner in which society commits a superfluity of suicides over and above the natural amount of death entailed upon us by our human nature ; but once a quarter that same official philosopher Makes a dead set at the vices of our system, which have such a positive, active, and well-known mortal effect. Nothing is plainer m the course of pathology than the fact that the most vexatious diseases, those which inflict the greatest pain, which engen- der the largest amount of mortality, and abate the life of such as survive, are created by our own bad management, and in modern days to this incident of our social system is added the aggravating circumstance that many amongst us, in one sense perhaps the majority amongst us, know how gratuitously we per- petuate the causes of disease and death. In former times, epide- mic was understood to be a visitation of Providence ; at a some- what later date, atmospherical, topographical, and other influences were found to be more tangible causes ; but in our own day, the predisposing and proximate causes are, in most cases, traced either to that choice of site which is unsuitable for human residence, or to that construction of our dwellings in towns which would poison the finest site in the world. Epidemics are now discovered to be almost as much human manufacture as piece goods or steam- engines. At one time there appeared to exist an idea that science would ultimately arrive at a complete knowledge of the human frame and of all the diseases to which it is subject ; but the manufacturer of diseases, like the modiste, has discovered noveantes in this kind of fashion ; and whatever may be the pro- gress of science, the science of disease-manufacture manages to keep the start. The Registrar-General, in his last quarterly re- port, quotes the observation of Niebuhr, that the great epochs of history are marked out by epidemics ; perhaps because the pecu- liar turn of human activity just before had struck out that new fashion of disease. Certain it is that the list of epidemics has never yet been finished ; every now and then there is a new in- vention, the latest being that throat disease which has lately, if not still, been so prevalent, diphtheria. It has indeed existed for only a year or two, having been developed principally in France ; and in this country it is by some called. " the Boulogne disease." According to the theory in France, it is caused by the diffusion over the fauces of a particular kind of noxious gas, such as is en- gendered in drains. It may be gathered from circumstances that any local malady of the fauces, arising from cold, would form a predisposing cause, and, as it were, prepare the field of the mucous membrane to receive the seeds of that new malady which has had such a plentiful crop. It assumes various forms. In some, we have heard, it converts the mucous membrane of the throat to a leather-like substance ; and although there may be " nothing Mice leather" for external purposes, it appears to be a fatal equip- ment for the internal throat.
If you wish to create this disease, or others like it, the proper method is now explained. It is Dr. Barker to whom we owe an ingenious series of experiments on the subject. He prepared a close chamber, near an ordinary closed drain, so that the air from the drain should be drawn into the chamber, which should be ventilated in no other manner. In this chamber he placed various animals.
" A young dog in half an hour became very uneasy and restless ; he Milted, and had a distinct rigour, and in the course of a day was ex- hausted.' When he was 'removed he soon recovered.' Another dog was subjected to the cesspool air during twelve days.' In the first seven days he underwent a series of sufferings not unlike the symptoms of the diseases of children in hot weather ; on the ninth he was very ill and miserable.' After he was liberated, on the twelfth day, he remained very thin and weak for six weeks.' Dr. Barker then continued his experiments on the effects of definite doses of the gases in the sewers, and killed or poisoned se- veral sparrows, linnets, jackdaws, and dogs."
These animals had the advantage of concentrated doses, but ex- actly the same experiment is going on over the whole of Eng- land, particularly in those of our towns which are most densely packed, least well drained, and furnished with the most ill-con- structed dwellings. "It is now time," says the Registrar-Gene- rkl, " that this cruel experiment should cease " ; and he asks,
" when will the London Board of Works stop the experiment ?" No answer.
The practical answer indeed is not ready ; and we have some doubt whether the subject is in a condition to receive a prompt and substantial reply. On the contrary all the latest investiga- tions have not only tended to reverse former conclusions as based upon imperfect data, and themselves inconclusive and inaccurate, but have suggested entirely new branches of inquiry. We have not yet ascertained the best mode of removing refuse with refer- ence either to cheapness or to efficacy. We have not yet deter- mined the question, whether the removal of such refuse can be directly self-supporting through the value of the substance, the latest observation having thrown the very greatest doubt upon any such assumption. There can be no question that the re- moval in itself would " pay," though not by a direct process ; for nothing is more obvious than the fact that disease, with its con- sequences, direct and indirect, must occasion a much greater loss to the community at large than any conceivable expense for the purpose of removing it. The subject indeed has been placed in such a position as, not to procure, but to prevent any practical conclusion. It has been handed over to a popular " Board," characterized by all the faults of an elective assembly, with the aggravation that a de- feet of power incessantly checks that body when it attempts ac- tion, but irritates it to be perpetually on the verge of action ; so that it has consumed whole years in attempting to establish its own raison d'etre by bringing forward some scheme however imperfect. Schemers have canvassed the votes of the assembly, now for this project, and now for that ; and the representatives of all the London parishes have been engaged in a fight more hopeless than that of the men of Cadmus, with this distinction, that they have not been allowed to kill each other. Perhaps the best of all modes for settling the question would be to authorize by Parliamentary statute the appointment of a Royal Commission, empowered to receive and examine all plans, suggestions, and evidences upon the entire subject, with instructions to make a report within a given time, say two years or even one ; the exe- cutive department for managing our home business being sub- sequently empowered to carry out any practical suggestion to be made by the Commission, still under the control of Parliament. We should thus obtain practical suggestions in a positive, feasi- ble, and selected shape.
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