EFFECTS OF SUSPENSION OR DEFICIENCY OF RESPIRATION. 545 



in.). Syphilis, also, is wanting, or nearly so ; and yet, notwithstanding that 

 the number of births is fully equal to the usual average, the population is sta- 

 tionary, and in some parts actually diminishing. This is partly due to the 

 extent and fatality of the epidemic diseases, of which some one or other spreads 

 through the island nearly every year ; but it is chiefly owing to the extraordi- 

 nary mortality of infants from Trismus nascentium, 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 Ice- 

 land, where the bird-fuel is used all the year round, instead of (as elsewhere) 

 during a few months 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.* Now it is not a little remark- 

 able 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 Jive dying, 

 from Trismus nascentium, between the eighth and twelfth days of their exist- 

 ence. 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, and 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 fort- 

 night. Of the degree in which this fearful disease is dependent upon impurity 

 of the atmosphere, and is preventible 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 1782, the mortality with- 

 in 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 19 . And further improvements in ventilation, with increased 

 attention to cleanliness, during the seven years in which Dr. Collins was Master 

 of this Institution, reduced the number of deaths from this disease to no more 

 than three or four yearly. 3 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 month ; for owing to a parliamentary inquiry which was called forth 

 by this fearful state of things, the proportion of deaths was speedily reduced 

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



584. Thus it appears that in all climates, and under all conditions of life, the 

 purity of the atmosphere habitually respired is essential to the maintenance of 

 that power of resisting disease, which, even more than the habitual state of 

 health, is a measure of the real vigor of the system. For, owing to the extra- 

 ordinary capability which the human body possesses of accommodating itself to 

 circumstances, it not unfrequently happens that individuals 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 

 t 



1 See "Island undersogt fra kegevidenskabeligt Synspunct." Af P. A. Sclileisner, M. 

 D. Copenhagen, 1849. 



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



35 



