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to the body, it is in truth a natural act, always going on, and essential to life. I derive from some experimental researches made within the last twelve months, that as the combination of oxygen with carbon and hydrogen in respiration is due to a decomposition of the respiratory parts of the blood, so the combination is brought about by the fibrine of the blood acting as a ferment; and thus that the evolution of heat is as much a consequence of this zymotic change, as it is a consequence in those changes which mark and identify the process of vinous fermentation.

On this view, then, the action of an organic body, entering from an infected organism into a healthy organism, is rather to modify or render imperfect the natural zymosis of the healthy organism, than to excite a primitive zymosis; and this view is supported almost to demonstration by the fact, that if to blood charged with amylaceous compounds oxygen be freely supplied, carbonic acid and water, with elevation of temperature, can be obtained as products: while if another body, in putrescency, which more or less destroys the combining power of the oxygen, be brought into contact with the blood, the result is that the process is either stopped altogether, or is so far arrested that the ordinary products, carbonic acid and water, are replaced by fixed acid products, of which the lactic acid is the type.

Whichever view be correct, the general principle is not implicated. Whether the poison thrown off by the infected subject excite in the healthy subject an

acid zymosis, or modifies the natural zymosis, the results are the same in regard to symptoms. The symptoms are caused, not by the propagation of vital germs, but by the development of a chemical body, which by its presence gives rise to the symptoms, and by its ultimate elimination frees the system of all the symptoms, except such as are secondary in their nature-sequelæ.

Thus, in regard to scarlet fever, as I take it, there are required for its demonstration-first, a susceptible blood; secondly, the introduction of a foreign body; and thirdly, a modified zymotic change, in which the ternary compounds are resolved into a soluble oxyacid substance, which, passing into the systemic circuit, and brought to the skin and mucous surface as eliminating surfaces, acts there and everywhere as a direct irritant, and sets up those inflammatory changes by which the disease in its early stages is specifically characterised.

Of the nature of this secondary or systemic poison, the poison which is the direct cause of the symptoms, we have as yet no precise knowledge; but it is certain that it is to be found by a rigorous examination of the matters excreted by the subject of the fever; it is eliminated from the body, probably by the kidneys, perhaps by the skin, perhaps by the mucous membrane of the throat, perhaps by the bowels. So soon as it is found, the synthesis of scarlet fever will be a possible and an easy process.

From certain experiments which I have made for the production of acute inflammation of the serous

surfaces, from the existent analogies in symptoms between rheumatism and scarlet fever, and from the connection which may exist between the two maladies in the same case, I am, I feel, not far from the truth in suggesting that the two diseases, acute rheumatism and scarlet fever, are produced by similar poisons, and that the poison in each case is an acid having the physiological properties of lactic acid.

If we keep clearly in view the nature of the process given above, we are enabled (the explanation extends to other zymotic disorders) to see why it is the tendency of scarlet fever to present a series of acute symptoms, and then to pass away. The poisonous body introduced expends itself in the transformation of the fermentable matter of the blood into bodies of the acid series of fermentation-products; these products being capable of elimination from the system as they are formed, and the process by which they are formed stopping, the acute symptoms subside, leaving to be recovered from after effects which will be more or less severe, according to the amount of poison generated and the structural mischief which it shall have induced.

If this theory be true, it may explain the cause of the singular facts of non-recurrence of the disease, and of the decreasing tendency to it with increasing years. It is possible that in the young child the blood contains a substance capable of special fermentation, which in process of time, or under the eliminating action of an exciting poison, is removed from the economy. Nay, this same explanation may ex

tend to the causation of the types of the disorder, the symptoms being mild in those in whom the fermentable substance is in small quantity, severe in those in whom the fermentable matter is present in a greater quantity.

In closing this section, I have for a moment to recur to the origin of the propagating poison of scarlet fever, the poison which passes from one subject to another. There can be no doubt that on the circumstance of every case of scarlet fever producing an identical poison, rests the common idea that this poison is the sustaining cause of the individual symptoms. I read the question in a different way. I look on the transmissible organic poison as the product of a modified chemistry in the affected subject, as excrementitious in its nature, and as a necessary antecedent to the symptoms, but not as the diffused irritant on which the symptoms immediately depend.

I believe, indeed, that organic chemistry will at some time be able to prove that the organic poisons, by which the various diseases of epidemic type are propagated, can be produced in the laboratory by a synthetical process of research conducted on blood; that these poisons will be put into our hands as substantive things, and labelled in our museums as prussic acid and the alkaloids are now presented. But this subject, so profoundly interesting to the whole of mankind, as constituting the very foundation of scientific medicine, I must reserve for a future work.

THE TREATMENT OF SCARLET FEVER.

I knew some time ago a gentleman, who for many years was proprietor of one of the largest schools for youths in the neighbourhood of the metropolis, who had a novel way of treating scarlet fever. The treatment may be called heroic, but it was heroically successful. Whenever any one of his pupils was seized with scarlet fever, he had the youth out into the playground, and, covering him well, walked him about until the perspiration streamed from every pore. This effected, the sufferer was taken indoors, put into a warm bed, charged with warm fluids, and made still to perspire. The patient usually fell into a gentle sleep, and in nearly every case was virtually cured at once. In many cases it would be impossible to carry out literally this plan of treatment; but in all cases the same purpose might be easily effected by the hot air bath. In either way, the essence of the treatment of scarlet fever in its early stages is effected, for the essence of treatment is to produce that which nature is aiming at, profuse excretion by the skin; in other words, to expedite as quickly as possible the expulsion of the products of a malchemistry from the blood.

In cases where it is practicable, the true hot air bath, so-called Turkish, would be used with most efficiency. Where this is not obtainable, the plan, which has long been in use in this country, of making the bed a warm air bath, may be resorted to with immense advantage. For this purpose a cradle

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