2 o6 EFFORTS OF NATURE 



formation of a secretion involves the detachment, 

 death, and destruction of the cell which formed it, 

 rests upon sound evidence. 



We have now to inquire how far the term " elimina- 

 tion" is appropriate, when speaking of the removal of 

 living disease germs from the blood. It is true we 

 are told that the living self-propagating germs of 

 scarlatina are "eliminated" by the skin and kidneys, 

 but no evidence is adduced in favour of such a view. 

 Like many doctrines, it is accepted as if it had been 

 proved, although arguments have not been adduced 

 in its favour. We may, however, now form a more 

 exact notion of the kind of matter the poison in 

 question really is, and of the way it escapes through 

 textures from the blood and from the body, and we 

 are, perhaps, for the first time in position to consider 

 the question with advantage. 



The desquamation of the cuticle, which almost inva- 

 riably takes place after scarlatina, and the desqua- 

 mation of renal epithelium, which not unfrequently 

 occurs after this disease, as well as in acute dropsy, 

 have been supposed to result from a tendency upon 

 the part of the skin and kidneys to " eliminate " the 

 scarlatina poison ; and it has been held that these 

 circumstances indicated an effort on the part of nature 

 to remove or " eliminate " a noxious poison from the 

 system. But it has not been shown whether the poison 

 is capable of being eliminated, nor proved that it cannot 

 make its own way out of the blood without the agency 



