December io, 1891] 



NATURE 



23 



such gigantic concerns as Meister, Lucius, and Briining, 

 and the Badische Anilin und Soda Fabrik, with their 

 thousands of workmen, their splendidly equipped labora- 

 tories, and their scores of well -trained investigators, the 

 product of the most advanced chemical instruction that 

 the most eminent teachers in the world can impart, is a 

 sufficient indication of what " the scientific treatment of a 

 practical subject " leads to. 



Some days after his visit to Ludwigshafen, the writer 

 met Prof, von Baeyer at Munich, and the talk was of 

 Hochst and Ludwigshafen, and the influence which these 

 and many such places must have on the industrial position 

 of Germany. " And do you know to whom we owe all 

 this? "asked Baeyer. There was but one answer: "To 

 Liebig." " You are right. It is to Liebig and the 

 Giessen laboratory." What the Augustinian cell at 

 Wittenberg was to German theology, the little University 

 laboratory was to German chemical science. 



" The foundation of this school," says Hofmann, who 

 was himself one of its products, " forms an epoch in the 

 history of chemical science. It was here that experi- 

 mental instruction, such as now prevails in our labo- 

 ratories, received its earliest form and fashion ; and if at 

 the present moment we are proud of the magnificent 

 temples raised to experimental science in all our [Ger- 

 man] schools and Universities, let it never be forgotten 

 that they all owe their origin to the prototype set up by 

 Liebig half a century ago." 



Bureaucracies, being human institutions, have occa- 

 sionally been known to err, but that bureaucrat who— by 

 recalling the two Prussian students who had dared to 

 seek the instruction in Hesse-Darmstadt which they failed 

 to get in their own State — raised the storm of indignation 

 which found eloquent expression in the famous letters 

 that roused Germany and Austria to a sense of what 

 science could do for their material interests, has deserved 

 a better fate than oblivion. T. E. Thorpe. 



DIPHTHERIA. 

 Diphtheria : its Natural History and Prevention. By R. 



Thome Thome, M.B., F.R.S., &c. (London: Mac- 



millan and Co., 1891.) 

 '"pHE volume before us is a republication of the Milroy 

 i- Lectures, delivered by Dr. Thorne Thome before 

 the Royal College of Physicians in London, 1891 ; and all 

 must heartily congratulate the author on the ability with 

 which he discusses a complex and vastly important sub- 

 ject, and at the same time must be grateful to him for 

 having, by republication in a handsome form, made these 

 lectures accessible to a larger public. 



Diphtheria is an infectious disease which was known 

 before the Christian era, and was fully recognized and 

 well described by Bretonneau in 1821. In this country it 

 has of late years undergone, both as to its diffusion and 

 mortality, a remarkable increase. While in former years 

 diphtheria was considered a purely " rural " disease, of 

 late years its repeated occurrence in large towns has 

 raised it to an " urban " disease ; so much so that, " while 

 the metropolitan (death) rate (from diphtheria) for 1861- 

 70 was lower than that for the country generally, it 

 exceeded it during the two next periods, and the rise 

 which has taken place in the rate for 1881-89 is far in 

 NO. I 154. VOL. 45] 



excess of the corresponding one for England and Wales." 

 " There is thus far evidence that diphtheria as a cause of 

 death is increasing in the country as a whole, and that 

 this increase is very conspicuous in our greatest urban 

 community" (p. 5). It is significant that, "concurrently 

 (pp. 80-81) with the diminution of enteric fever, owing to 

 advance of knowledge in the principles of health, and with 

 the resulting intelligent administration of our sanitary 

 laws, we find that the diphtheria death-rate is increasing 

 in our midst." "But it is, above all, in our large towns and 

 cities that this enlightened sanitary policy has been most 

 tnarked during the past twenty years ; . . . and yet, 

 whereas when, in the past, sanitary defects abounded in 

 our large centres of population diphtheria was essentially 

 a disease of rural districts, that disease is now invading 

 our more cleanly towns and cities to an extent unknown 

 in the annals of their more faulty past." 



Now, what is this increase of diphtheria in general, and 

 the " formidable " increase in the London mortality from 

 diphtheria in particular, due to? Although Dr. Thorne 

 abstains from supplying a direct answer to this question, 

 an attentive reader, after perusal of the enormous body of 

 facts which Dr. Thorne produces, will be in a position to 

 draw his own conclusions. This increase is certainly 

 not to be explained by the better recognition and more 

 correct classification of the disease (in the earlier returns 

 of the Registrar-General certain forms of scarlatina, true 

 diphtheria, and certain non-diphtheritic forms of croup 

 are not well distinguished, in the later returns the dis- 

 tinction is carefully carried out), nor can this increase, 

 obviously, be due to any new condition as to soil, water, 

 and air. Dr. Thorne passes in review, and illustrates by 

 numerous examples, collected by the most competent 

 sanitary officers and inspectors, and minutely described in 

 the Reports of the Medical Officer of the Local Govern- 

 ment Board, the various conditions that have been, or 

 were suggested as having been, connected with the origin 

 and spread of various diphtheria outbreaks in this country ; 

 and a careful perusal of the immense body of facts re- 

 corded in this volume must impress the reader, not only 

 with the great caution with which Dr. Thorne draws his 

 conclusions, but with the admirably impartial way in 

 which he tells his story, and in which he pays due regard 

 to every detail, be it for or against. The one fact which 

 above all others stands out prominently, and which it 

 behoves everyone connected with our present system of 

 compulsory school attendance carefully to consider, is 

 the unmistakable influence of " school attendance " on 

 diphtheria. Not the fact that diphtheria spreads from a 

 child affected with diphtheria to another child with which 

 it is brought in contact, either at school or at play or 

 otherwise— a fact only too well known and unfortunately 

 often enough actually illustrated ; but the fact that 

 "school influence" — that is, an influence affecting 

 children aggregated in a confined space — has an im- 

 portant bearing on the generation of true diphtheria. 

 This " ' school influence ' tends to foster, diffuse, and 

 enhance the potency of diphtheria ; and this, in part at 

 least, by the aggregation of children suffering from that 

 sore throat which commonly is prevalent antecedent to,, 

 and concurrently with, definite diphtheria" (p. 219). Dr. 

 Thorne devotes a considerable portion of chapter iii. to 

 the consideration and discussion of this important subject,. 



