126 



NATURE 



{June 9, 1887 



Lisping. 



A CLERGYMAN, with usually an exceptionally distinct utter- 

 ance, was observed one Sunday morning at the beginning of the 

 service to speak with a pronounced lisp. After a time it wore 

 off, and his speech became as clear as usual. Has it ever occurred 

 to anyone what a very simple thing may cause a lisp ? 1 he case 

 in question was owing to a tiny slice of lozenge sticking to the 

 roof of the mouth just, to the left of, and close to, the front 

 tooth. This almost imperceptible impediment was sufficient to 

 render the speech so indistinct as to resemble a marked lisp. 

 Of course as the lozenge dissolved the lisp became no longer 

 observable, and the speech assumed its ordinary clearness. 



These being the facts, the question that occurs to every 

 thoughtful mind is, If the cause of lisping be so simple, why 

 cannot the remedy be as simple and yet effectual ? _ 



The answer I leave to be supplied by some of your scientific 

 readers. A Non-Lisper. 



ETIOLOGY OF SCARLET FEVER} 



AMONG the infectious or zymotic diseases there are 

 two at any rate (namely, scarlet fever and diphtheria) 

 of which it may be said that their spread is to a lesser 

 extent dependent on defective domestic sanitation than is 

 the case with some of the other zymotic diseases, as, for 

 instance, typhoid fever. Indeed, it is maintained by 

 competent authorities that scarlet fever and diphtheria 

 do not invade the houses of the poor with faulty sanita- 

 tion with greater frequency or with greater severity than 

 those of the well-to-do, however perfect the sanitary 

 arrangements. This view is based on the important 

 experience gained during the past twenty years, viz. that 

 epidemics of scarlet fever and diphtheria have been 

 brought about by milk. I may here state by way of 

 explanation that a fact well established, and needing no 

 further comment, is that scarlet fever and diphtheria are, 

 like small-pox, measles, whooping-cough, and typhus 

 fever, communicable directly from person to person. This 

 mode of infection, doubtless an important one, and 

 coming into operation in single cases wherever the ele- 

 mentary rules of isolation and disinfection are trans- 

 gressed, altogether sinks into insignificance when compared 

 with the infection produced on a large scale, if a common 

 article of diet like milk should become in some way or 

 another the vehicle of contagium, as has been proved to 

 be the case in a number of epidenic outbreaks. These 

 epidemics, known as milk scarlatina, milk diphtheria, and 

 I may add also milk typhoid, have this in common, that 

 almost simultaneously, or at any rate within a short time, 

 in a number of houses, having no direct communication 

 by person or otherwise with one another, there occur 

 sometimes singly, sometimes in batches, as it were, cases 



of illness : scarlet fever, diphtheria, or typhoid fever as 

 the case may be. And it was this peculiar character 

 which pointed to a condition which must have been 

 common to all these households. On closer examination 

 it was indeed found that all these households had this, 

 and only this, in common, that they were all supplied 

 with milk coming from the same source — that is to say, 

 from the same dairyman. Other houses supplied with 

 milk from a different source escaped ; and further it was 

 shown that, as soon as the consumption of the suspected 

 milk ceased also, the epidemic, as such, came to an end, 

 except of course the cases due to secondary infection 

 from person to person. The Medical Department of the 

 Local Government Board have had for years past their 

 attention fixed on these milk epidemics, and in the 

 Reports of the Medical Officer many of these are de- 

 scribed with great detail ; amongst these, Dr. Ballard's 

 Report in 1870 on enteric fever in Islington, Dr. 

 Buchanan's in 1875 o" ^'^ outbreak of scarlet fever in 

 South Kensington, and Mr. Power's on an outbreak of 

 scarlet fever in St. Giles and St. Pancras in 1882, are 

 specially to be referred to. Mr. Ernest Hart has tabulated 

 all the outbreaks of milk epidemics that have been in- 

 vestigated until 1 88 1, in vol. iv. of the Transactions of 

 the International Medical Congress for 1881. Now, 

 analyzing these outbreaks as far as they refer to scarlet 

 fever, there are several of them where the assumption 

 that the milk acquired the power of infection by con- 

 tamination from a human source cannot be excluded. 

 This infection if proven w^ould stand on the same footing 

 as if due to contagion from person to person, for it is 

 clear whether the contagium is conveyed from one person 

 to another by air, food, drink, or other articles, it always 

 remains contagion from person to person. Now, in some 

 of the epidemics tabulated by Mr. Hart, and recorded by 

 subsequent observers, i.e. after 1881, this mode of milk 

 contamination cannot be excluded, as I said before ; but 

 comparing the dates when the milk might be supposed tc 

 have become so contaminated with the dates when th€ 

 milk has actually produced infection, it will be found thai 

 a certain discrepancy exists, and as will be shown latei 

 another mode of infection, viz. from a person affectec 

 with scarlatina to the cow, and through the cow to th( 

 milk and then to human beings, cannot be excludec 

 either. There are other epidemics recorded in thes( 

 tables, in which the mode of infection of the milk is no 

 ascertained ; and in a third set, the milk acquired infectiv< 

 power in some way or another, but certainly not from i 

 human source. As an illustration of the first group 

 epidemics, i.e. probable contamination from a humar 

 source, I will refer to the table given by Mr. Ernest Har 

 on page 539 :— 



Lecture delivered by Dr. E. Klein, F.R.S., at the Royal Institution on Friday, May 27, i83y. 



