which the mucous membrane secretes or exhales a fetid gas similar to that given off from the feet of certain individuals.

The treatment of these cases does not differ from that mentioned above, except that variety in which there is a degeneration of the mucous membranes, characterized by dryness of the parts. The treatment described and practiced by Gottstein deserves special mention. The remedy which the author recommends consists in the simple occlusion of the diseased parts by means of a wad-tampon (the part having been cleansed before), which is to remain about twenty-four hours in the nose. It does not give rise to any troublesome symptoms, the patient feeling, on the contrary, soon very much relieved by it. One side ought to be occluded only at a time, and the other within the next twenty-four hours, while the first remains free during that time. The author reports excellent results obtained on fifteen patients thus treated within a very short time. In conclusion, let me add that these atropic cases do not tolerate astringent treatment, and aside from the measures just quoted, our treatment is limited to cleanliness and disinfectants.

INFECTIOUS DISEASES.

L. C. JOHNSON, M. D., FOUNTAIN CITY, Ind.

By infectious diseases, I mean those which originate from an infection of the system by certain peculiar poisons which have the ability to reproduce themselves. In this order of diseases are embraced the contagious, miasmatic, and the contagio-miasmatic diseases. By contagious diseases, I mean those whose specific poison multiplies and developes in the affected organism to such an extent as to be capable of communicating the disease from the sick to the well, directly, without undergoing any farther development or change outside of the body.

By miasmatic diseases, I mean those whose poison developes outside of, and independent from, any diseased organism. The sick cannot communicate them to the well. To the latter class belong the malarial diseases; to the former belong measles, scarlet fever, diptheria, blennorrhoea, puerperal fever, variola, typhus, syphilis, &c.

By contagio-miasmatic diseases, I mean those whose specfic poison undergoes two distinct stages of development, one within the body of the patient; the other outside of any living organism.

This order of development is beautifully illustrated by the transformatory process of development of many species of the lepidopterous order of insects. The larvæ of the pontia, or pieris brassica (common large white butterfly) fills his ravenous maw with our herbage, and after having eaten vastly more in proportion to his size than an ox, he secretes himself and is metamorphosed into a shining, pale green chrysalid, from which the perfect insect

emerges, a beautiful butterfly, flitting from flower to flower, feeding upon the food of the gods. None could be more innocent or

“More exquisite than when nectarean juice

Renews the life of joy in happiest hours."

Short and harmless is the life of the perfect insect. It soon deposits eggs on the under side of the leaves, which are to furnish food during the larval or eating period of development of the next generation, and dies.

Through some such process of development as this we may imagine the specific poisons to pass. The perfect organisms deposit eggs in air, earth or water, which find entrance to our systems with the air we breathe, the water we drink, or the food we eat, and here finding conditions suitable for their development into larvæ, they begin the eating, active part of their baleful lives in our blood and other tissues, and thus set up those morbid processes which we call cholera, typhoid fever, dysentery, the plague, pneumonia, and perhaps yellow fever. Whether we should call the specific poisons which produce the infectious diseases, prolomycetes, micrococcus, vibrio, zoogle, or class them as simlpy bacteria, I shall not presume to decide; but I think the experimental researches of Cohn, Naegeli, Oertel, Lebert and others leave no room to doubt the existence of living organisms as the special cause of infectious diseases.

Toxicology teaches us of many poisons that can cause sickness and death; but no disease produced by an inorganic poison is infectious, because such a poison cannot reproduce itself.

The same science also teaches us "that there is no single poison, organic or inorganic, which, while absolutely imponderable and imperceptible, may fall upon and decimate entire populations."

Selecting typhoid fever as a type of this class (contagio miasmatic) of diseases, careful clinical observation would lead us to suspect something like the following manner of development of its specific cause.

The ova of the protomycetes find entrance to the system with our injesta, and here finding conditions suitable for their development, begin their career by feeding upon the life-blood of their human victim, and for a period varying from a few days to a few weeks,

hold high carnival upon the vitals of the sufferer. Then, having reached a stage in their existence where other surroundings are necessary for their well-being, they leave the system with the stools, and we, in our anxiety to preserve the race, furnish the condition most favorable for their further development, by casting out the typhoid stools upon the ground, without disinfecting them, or worse still, into foul, unkept privies. The infected stools thus thrown out furnish to the thousands of chrysalids contained in them, all that could be desired for their development into the perfect protomycetes, which, after a brief life of innocence as perfect organisms, deposit their eggs in air, earth or water, to again enter the human system and begin another circle of their direful existence, and we pay the penalty with our lives, of our ignorance, or of our willful disregard of hygienic laws which we do understand.

Of course I do not claim to give the above as the exact and ascertained manner of development of the typhoid poison, for I deem it true that a blind devotion to, and a dogmatic assertion of theories, instead of honest investigation and experimental search for facts, has done more than aught beside to retard the advance of science; and in a special manner have the labors of those who pos. sessed a zeal without knowledge proved pernicious to the theory of a contagium vivum as the specific cause of the infectious diseases. This theory found advocates among writers of antiquity, but it was "wounded in the house of its friends" by those who claimed to see and to minutely describe the poison germs; but it was found that the terrible scourges which they figured with such labored precision, were harmless and very common infusoria. So the theory of living organisms as a specific cause of disease fell into disrepute, and has only struggled to its feet again during the last few years by its friends making the most thorough and exhaustive research in the domain of microscopic life.

To see what facts in the clinical history of typhoid fever justify the assumption that its protomycetic poison may develop in a manner analagous to the transformations of the lepidopterous insects, let us glance at the natural history of an uncomplicated case of typhoid. We first note its slow and silent approach as the autumn creeps upon the summer, with its dreamy, hazy evenings and cooler nights, while yet the mornings are fresh and the days

are warm.

So the summer of health is only disturbed by an ache here or a pain there, and a rather listless weary feeling of the entire system, which comes and goes, but ever returns with increased power as the system comes more and more under the influence of the poison which is preying upon its vitals, until the time comes when the vitiated blood is no longer able to support the strength of tissues, and the patient goes to bed with a chill and an aching head that echoes the cry of the nervous system for unpoisoned food. Now follow the rising temperature, the weakened intellect and besotted appearance of the face, coma-vigil and dreamy, rambling delirium, progressive and ever-increasing weakening of both mind and body—the entire syndrome unmistakably proclaiming a poisoned blood to be the essential pathology of the disease.

Do not we see in all this a natural effect following a specific cause? The protomycetic ova enter the system in thousands. Soon from the most mature are produced the first of the larva, which at once begin their ravages upon the blood. Nature sounds the alarm by an aching back and weary limbs; but the larva, like the first pattering drops of a thunder shower, increase from hundred to thousands, and from thousands to millions, and with his blood profoundly altered and deteriorated, the patient sinks beneath the avalanche, only to be raised by the most careful nursing and feeding.

Returning now to the consideration of the purely contagious diseases, we find that their specific poisons, whatever they may be, all have the power of perfectly developing within the animal organism, when once it is affected with them, so that all of these diseases may be communicated by direct inoculation from the sick to the well.

Selecting diphtheria as a type of this class, its direct contagiousness and its malignancy are all too strongly attested by the untimely death of Valleux, who died in less than three days after he had received into his mouth some of the saliva coughed up by a diphtheritic patient whom he was examining. In a similar manner Weber, Otto and others have met their death while in attendance upon the victims of this fell disease.

Though cases of this kind do not prove the direct inoculability