44. 



KNOWLEDGE 



[February 1, 1895. 



habits of the two birds, for while the razorbill lies along 

 the egg, placing it between one of its wings and its body 

 whilst incubating, the guillemot sits upright upon hers, 

 holding it in a cavity formed in the feathers between her legs. 



The razorbill's egg forms a very striking object, being of 

 a white ground colour, spotted and blotched with blick. 

 The guillemot's egg is remarkable for its great variety of 

 colouring, and although generally of a bluish-green of 

 varying shades, marked with rich brown spots and streaks, 

 eggs may be found of all shades, from a light blue to one 

 identical in colouring with that of the razorbill. The 

 shape of the guillemot's egg is not an invariable safeguard 

 to its rolling off its precarious resting-place, for coming 

 suddenly round a comer of a ledge I disturbed a guillemot, 

 and in flying from her egg she caused it to roll off the 

 shelf. It struck a gannet on the head in its downward 

 course, and finally landed in the nest of another ganuet, 

 which immediately devoured it. 



Those extremely elegant little gulls, the kittiwakes, were 

 the only other birds breeding on the rock, although at 

 times a peregrine falcon takes up its abode on one of the 

 most inaccessible ledges. The kittiwake builds a fairly 

 large nest of seaweed, and lays two or three eggs of greyish- 

 ■white marked with rich brown. It always selects a narrow 

 ledge, difllcult of access, and we could find no nests of thii 

 bird on the Bass which could be reached without a rop.\ 

 This gull is a very late breeder, not commencing to lay 

 until about the end of May, so that when the close season 

 expires at the beginning of August there are always un- 

 fledged young ones in a great many nests. So ardent a 

 desire is there, however, among the weaker sex for the skin 

 of this elegant bird to adorn the hats, that hundreds of 

 the old birds are slaughtered annually, while their young 

 are still unable to provide food for themselves, and a linger- 

 ing death to the nestlings is generally the consequence. 



In conclusion, let me recommend to all lovers of British 

 sea birds a visit to the Bass Eock, where so many species 

 may be found, and where their life-history may so easily 

 be observed. 



RECENT WORK ON DIPHTHERIA AND ITS 

 PREVENTION. 



By James C. Hoyle, M.B., M.K.C.S., D.P.H. 



CONSIDERABLE attention has lately been given 

 by the medical and lay press to the subject of 

 diphtheria. This arises from two causes. Firstly, 

 because, unfortunately, the disease has shown a 

 marked tendency to become more general, and 

 secondly, because recent investigation has resulted in 

 discoveries which we may confidently hope will prove 

 successful in combating this disease. 



The popular idea of diphtheria is undoubtedly a sore 

 threat of a very bad and sometimes fatal kind, and this is 

 dimly associated in the lay mind with " drains." Scientific 

 investigation has proved that diphtheria depends upon 

 the inoculation of some part of the respiratory passages 

 ■with a tiny micro-organism — the bacillus diphtheriae. 

 The microbes multiply around the seat of inoculation, 

 and generate a poison which produces in the patient 

 some or all of the symptoms of the disease. The local 

 changes are characterized by inflammation and the 

 formation of a yellowish membrane covering the aft'ected 

 parts. 



These recent discoveries are most opportune, as both 

 the total number of cases and the percentage mortality 

 have been steadily increasing of late years ; while the 

 disease, which formerly mainly affected rural districts, 



has shown a t3ndeney to find a home in large towns and 

 cities. 



In London this has been very marked, as the following 

 statistics will show: — 



In 1890 there were .5870 cases of diphtheria " notified" 

 by local medical officers of health to the Metropolitan 

 Asylums Board. In 1S93 the number of cases had risen 

 to 13,026. The disease was also more fatal. 



LoyDox Death Kate per Million- Peusoxj Living, per Axxrw : 



-.- -TV- 1 ..1. • Disease? of throat, m . , 



1 ears. Diphtheria. .. j- i .1 Total. 



' ujt di-hthena. 



ISSl 172 321 49.3 



1891 340 17 r 517 



1893 760 120 8'*0 



DiPHTUERiA Deaths per MiLLioy Person'< Livixr. (Mew 

 Annual Death Rates) -. 



1881-3. 18^t-fi. 1357-9. 1-0 2. 



Kngland and Wales 144 101 173 I9J 



London 2!3 227 31.5 377 



There is reason to believe that part of this increase i-? 

 more apparent than real, for belter medicil knowledge his 

 rendered the recognition of obscure cases raster. Tuis 

 view is strengthened by the fact that with the increase in 

 diphtheria there has been a decrease in the death rate from 

 diseares of the throat, other than diphtheria. UndoubteJly 

 many cases of what was formerly called "croup" wore really 

 diphtheritic. It has been estimated that eighty-two per 

 cent, of the deaths from diphtheria 

 occur in children under ten years 

 of age, ard there are few familits 

 where this fact will not be pain- 

 fully endorsed. 



This being the present unsatis- 

 factory state of affairs, it behoves 

 everyone to consider what can 

 be done to ameliorate matters. 

 Sanitarians in particular, and 

 medical men in general, ought to 

 receive far more confidence and 

 support from the laity than that 

 which is accorded them. Measures 

 and precautious suggested by a 

 knowledge of the causation and 

 danger of infectious diseases, 

 whether enjoined by statute or not, should be welcomed as 

 part of the fight which science is ever waging against 

 disease, and a more grateful recognition of the labours 

 of original investigators would honour alike the State and 

 the worker. 



To leave the dry bones of percentages and death rates, 

 let us consider some of the factors which sanitarians have 

 named as being concerned in the production of this disease. 

 First comes " drains." It is very difficult to say what is 

 the precise relation that defects in drainage bear to the 

 production of diphtheria. Broadly, it may be stated that 

 where sewers and main drains are defective, there the soil 

 and surface-water will become foul and germ-laden, and 

 sewer gas and other emanations will readily enter premises 

 where the sanitary arrangements are obsolete or defective ; 

 yet cases occur in houses where the sanitation is above 

 suspicion. Next we must consider the risk and danger 

 arising from direct infection. Ilemembering that the 

 bacillus is discharged in the mucus from the respiratory 

 passages of a patient, one would naturally expect to 

 trace direct infection in the majority of cases. Some- 

 times this evidence is very clear ; for instance, medical 

 men have themselves contracted the disease from a patient, 

 either by the sufl'erer coughing into the doctor's face, or 

 when during the performance of the operation known as 



A. — From the false mem- 

 brane of human diphtheria 

 of the fauces. The rods 

 are the bacilli ; the dark 

 masses are tissue cells. 



