a family which it has once invaded, is to be attributed in some degree to the persistence of the same cause as originated the first case. What that cause is, is as mysterious as the cause of any other epidemic disease. It is futile to attribute it, as is done without due reflection, to poverty, want of cleanliness, over-crowding, cesspools, dung-heaps, and other items in the unsavoury catalogue which has commonly the discredit of every epidemic visitation. Stench and insufficient diet, and filthy and over-crowded rooms have ever been the sad heritage of the agricultural labourer, but diphtheria is of recent origin. Doubtless, these insanitary adjuncts to the labourer's life predispose him and his children to the assault of any epidemic malady, but the specific cause of diphtheria, as of other forms of disease, is a something superadded which our senses cannot appreciate. Whether it be the sporules of a fungus permeating the atmosphere, and absorbed through the lungs into the blood, as suggested by Dr. Laycock, must as yet remain sub judicé. All that we can affirm in the present state of knowledge is, that anti-hygienic condi-
Bretonneau, observes the reporter, has collected some crucial cases. One is that of M. Herpiu, who was attending a child who had already communicated the disease to its nurse. At one of his visits, while sponging the pharynx, the child coughed up some of the membranous secretion, which lodged in his nostril. This was followed by severe diphtheritic inflammation, and he was reduced to the lowest stage of prostration. The same mishap occurred to another French surgeon, M. Gardron, whose life was seriously compromised. On the other band, direct experiments by inoculation have failed. Sufficient doubt, however, remains to justify every precaution in avoiding actual contact with the diphtheritic exudations, especially in reference to examining and applying medicaments to the throat. It is far from improbable, for instance, that the same spoon-handle used to inspect an affected throat, and one as yet only suspected, might convert suspicion into reality.
