412 OF RESPIRATION. 



ishing. This is partly clue to the extent and fatality of the epidemic dis- 

 eases, of which some one or other spreads through the island nearly every 

 year; but it is chiefly owing to the extraordinary mortality of infants from 

 Trismus nascent i urn, which carries off a large proportion of them between the 

 fifth and the twelfth days after their birth. It is in the little island of 

 Westmannoe and the opposite parts of the coast of Iceland, where the bird- 

 fuel is used all the year round, instead of (as elsewhere) during a few mouths 

 only, that this disease is most fatal ; the average mortality for the last twenty 

 years, during the first twelve days of infantile life, being no less than 64 per 

 cent., or nearly two out of three. 1 Now it is not a little remarkable that the 

 very same disease should have prevailed, under conditions almost identically 

 the same, in the island of St. Kilda, one. of the Western Hebrides ; the 

 state of which was made known by Mr. Maclean, who visited it in 1838. 

 The population of this island, too, was diminishing rather than increasing, 

 in consequence of the enormous infantile mortality; four out of every five 

 dying, from Trismus nasceutium, between the eighth and twelfth days of 

 their existence. The great if not the only cause of this mortality, was the 

 contamination of the atmosphere by the filth amidst which the people lived. 

 Their huts, like those of the Icelanders, were small, low-roofed, and without 

 windows ; and were used during the winter as stores for the collection of 

 manure, which was carefully laid out upon the floor, and trodden under foot 

 to the depth of several feet. On the other hand, the clergyman, who lived 

 exactly as did those around him, except as to the condition of his house, had 

 brought up a family of four children in perfect health ; whereas, according 

 to the average mortality around him, at least three out of the four would 

 have been dead within the first fortnight. Of the degree in which this fear- 

 ful disease is dependent upon impurity of the atmosphere, and is preventa- 

 ble by adequate ventilation, abundant proof is afforded by the experience of 

 Hospitals and Workhouses in our own country. Thus in the Dublin Lying-in 

 Hospital, up to the year 1872, the mortality within the first fortnight, almost 

 entirely from Trismus nascentium, was 1 in every 6 children born. The 

 adoption, under the direction of Dr. Joseph Clarke, of an improved system 

 of ventilation, reduced the proportion of deaths from this cause to 1 in 19i. 

 And further improvements in ventilation, with increased attention to clean- 

 liness, during the seven years in which Dr. Collins was Master of this Insti- 

 tution, reduced the number of deaths from this disease to no more than three 

 or four yearly. 2 A similar amelioration took place about a century ago, in 

 the condition of the London Workhouses, in which 23 out of 24 infants had 

 previously died within the first year, and a large proportion of these within 

 the first mouth ; for owing to a Parliamentary inquiry which was called 

 forth by this fearful state of things, the proportion of deaths \vas speedily 

 reduced (chiefly by improvement in ventilation) from 2600 to 450 annually. 

 329. It appears, indeed, that in all climates, and under all conditions of 

 life, the purity of the atmosphere habitually respired is essential to the main- 

 tenance of that power of resisting disease, which, even more than the ordi- 

 nary state of health, is a measure of the real vigor of the system. For, 

 owing to the extraordinary capability which the human body possesses ot % 

 accommodating itself to circumstances, it not [infrequently happens that in- 

 dividuals continue for years to breathe a most unwholesome atmosphere, 

 without apparently suffering from it; and thus, when they at last succumb 

 to some Epidemic disease, their death is attributed solely to the latter; the 



1 See Island undersoil fra Iregevidenskabeligt Synspunct. Af P. A. Schlcisner, 

 M.D. Copenhiii^n, 1 *!'.). 



2 See Dr. Collins's Practical Treatise on Midwifery, p. 513. 



