234 THE TREATMENT OF DISEASES. 



The epidemic reached its height in 1858 and 1859, and during those two years it is 

 estimated that over twenty thousand people died from it. Since then, isolated cases 

 have been of frequent occurrence all over the country. A medical man in active 

 practice seldom goes more than three or four months without seeing a case. 



Diphtheria is a disease which attacks children more frequently than adults, and 

 girls more commonly than boys. It may occur at any season, and is little affected 

 by either heat or cold, draught or rain. In different epidemics it has been found 

 that neither the heat of the dog-days nor the frost of winter affected the prevalence 

 of the disease. Its development is apparently particularly favoured by poverty 

 and uncleanliness, for it quickly invades the hovels of the poor, where too frequently 

 men and animals are crowded together under the same roof, and dung-heaps, 

 privies, and other sources of putrefaction fill the air with their effluvia. It very 

 often breaks out in factories, schools, and barracks, which not uncommonly are 

 insufficient in size or defective in ventilation. But even families and people who 

 live under much more favourable conditions are not spared, and children who enjoy 

 the best of care and nourishment are frequently seized and carried off by this 

 fatal disease. Some people appear to be much more susceptible to its influence 

 than others ; thus of two families residing in the same house, and apparently under 

 identical conditions, one has suffered severely, whilst the other has entirely escaped. 

 A difference of susceptibility is also observed in members of the same family, and 

 this is not always in favour of the more robust. It is said that people of great 

 mental activity and a high degree of nervous susceptibility are especially prone to 

 suffer from the disease. 



Is it contagious ? Undoubtedly. We know that it is contagious, although we are 

 not acquainted with the exact mode in which the contagion operates. The infec- 

 tious matter is not capable of any wide diffusion through the air, but it clings in the 

 most persistent manner to particular places, houses, and even rooms. There is, we 

 believe, no known instance of its having been conveyed from one house to another 

 by a person not suffering from the disease. It is still very doubtful whether it can 

 be inoculated. There is a good deal of contradictory evidence on the subject. The 

 following case would appear to be a strong argument in favour of its inoculability. 

 M. Valleix, a well known and esteemed French surgeon and writer, was in attend- 

 ance upon a little girl suffering from diphtheritic sore throat. Under energetic treat- 

 ment she recovered. One day, however, while M. Valleix was inspecting her throat 

 he received into his mouth a small quantity of saliva driven out of that of the patient 

 in the act of coughing. Next day a little exudation appeared on one of his tonsils. 

 The other tonsil and the adjacent parts became speedily covered with false membrane, 

 a profuse discharge took place from the nostrils, delirium supervened, and in forty- 

 eight hours M. Valleix was dead. In another case of diphtheria the medical man in 

 attendance found it necessary to open the windpipe to relieve the breathing. There 

 was some obstruction from the accumulation of blood, when the operator, to save the 

 patient's life, applied his mouth to the wound in the neck, and sucked the fluid out. 

 In forty-eight hours he died from symptoms identical with those from which M. 

 Valleix suffered. Trousseau, the celebrated French physician who relates these cases, 

 being dissatisfied with the evidence advanced in favour of the view that the disease was 



