To the danger of one great source of possible error the author seems specially alive, the introduction of other matters into the system of the animal operated on than the mere morbid fluid inoculated, and this he has endeavored to guard against by the most scrupulous cleanliness in obtaining, preparing and introducing such fluids into the bodies of animals.
In touching upon the first question his first case is to define as clearly as possible what are the clinical features which characterize erysipelas in the human subject. He then details in all his experiments, and, from the kind of success of five out of twenty-five inoculations he believes there can be no doubt “that erysipelas is inoculable in rare cases; that fluids from an erysipelatous part, display a specific contagious action.” In three cases he inoculated animals from the human subject successfully with erysipelas, and in two cases animals were infected from other animals. He believes, too, that one human subject might be inoculated from another.
In regard to the second question propounded, four experiments were made with erysipelatous inoculation material, which had been potent in other cases, but here a portion of 2–4 per cent. solution of carbolic acid was added. In none of these cases was there any appearance of either local or general symptoms of any disease.
In answer to question III, all the author’s results were negative. In no case was erysipelas produced by even the most putrid inoculations, when they were not taken from an erysipelatous part. In several cases, however, the animals died of distinct septicæmia.
The observations on the last point which are related in detail, point to the conclusion that bacteria are present in some cases of erysipelas and absent in others, so that we may infer that the advance of the disease does not depend upon their presence.—London Medical Record.
CHOLERA INFANTUM.
A contribution to the etiology, pathology, and therapeutics of cholera infantum,[[4]] by Dr. T. Clarke, Miller, opens fairly and clearly a theme which will be uppermost in the thoughts of physicians in the approaching hot weather.
The writer begins by pointing out how differently the name Cholera Infantum has been applied, including every phase of choleraic diseases. But, “Classification of these diseases to be practical, must of necessity be rather coarse in order to adopt itself to the grain of the great mass—the rank and file—who in the main observe well, though not so systematically as we could wish. The great office-workers do not contribute largely to our mortality statistics, but we will derive great comfort as we proceed, in finding that the figures of these common men are stupendously significant—that the bullet and bayonet are in the aggregate little less important than the epaulette and the gold lace.” He supposed that in the large majority of cases reported as cholera infantum that the choleraic feature was present at some time during the illness, though very likely not at or very near the time of death. For these reasons he considers that the statistics presented are not materially impaired.
“The onset of cholera infantum is characterized by copious watery evacuations from the bowels, often attended by nausea and free vomiting. Attending upon this or even sometimes preceding it, or rapidly succeeding upon it, is the extreme muscular prostration and great depression of the respiratory functions; there is generally more or less griping pain and restlessness, and a rapid appearance of all the symptoms of collapse, coldness of the surface and tongue, feeble rapid pulse, and partial or total loss of voice. Cholera infantum proper, lasts but a few hours—hardly a few days—when it ends in recovery, death, or inflammatory disease of some portion of the intestinal tract; in the latter case the choleraic disease is rapidly rekindled by conditions similar to those which brought about the first attack.
“The condition under which cholera infantum appears, and the only condition essential to its development, is continued high temperature day and night—a mean thermometer above 75°, with small daily range. This high and slightly varying temperature continued from six to ten days, will invariably, in our climate, bring cholera infantum (together with the bowel trouble symptomatically more or less distinct, but pathologically akin to cholera infantum), and the longer this condition of things continues the more numerous and the more intractable the cases become. This is as true in the country as in the city, though we are led to think, as we read the books, that this is a disease of the city especially. Deaths are registered, to be sure, and the books are made in the cities, but if the conditions above mentioned exist in the country, the disease appears there—of course, not a great many cases, for the susceptible bodies furnished by a single block in the city would outnumber those of two or three square miles in the country—yet I am glad to admit that the conditions for obvious reasons are not so likely to be present in the country; the contrast, in point of green grass, shade, cool water, and moving air, is no less marked than is the percentage of mortality, and it is no more marked.