We think the fact reasonably well established that this child contracted the disease from the letter in question-especially when considered in connection with so many similar cases.

The Medical Inspector for Somerset county, Pa., reported to the State Board of Health as follows:

Two years ago a child died from scarlet fever near Downey. The cradle in which the child died was afterward sold at auction, the purchaser having full knowledge of the death of the child. They washed the cradle thoroughly six times with boiling water, and did not believe that with such cleansing and the lapse of two years there was any danger. A babe eight months old was placed in the cradle to sleep. In ten days after scarlet fever appeared in mild form, which passed to recovery, but was followed by that of a boy two years old, then the mother, next an aunt who had assisted in nursing the children; then the grandmother, sixty years old; and last the father, with all of whom the form was very severe. There were no other cases in the neighborhood.

The Health Officer of Osage, Dr. J. H. Hoffman, writes:

"I was called a short time ago to a family of seven children, all sick with malignant scarlet fever, none of whom had been exposed to the disease, so far as could be ascertained. A short time prior, the family had purchased a dog of a family some distance away, and in that family there had been several cases of scarlet fever. I have no doubt the disease was brought from that family by the dog.

In another locality I was called to a family in which a boy had died, and four other children were sick with malignant diphtheria. The disease was not in the vicinity, and there had been no exposure in the ordinary way. The house and surroundings were in good sanitary condition. Investigation disclosed the fact that a week prior five cats died on the premises with all the symptoms of diphtheria. We usually call such outbreaks "sporaidic," but I have no doubt the disease germs are brought by animals.

For several years diphtheria periodically appeared in a certain locality in Hamilton county. Its nidus seemed to be near an old church building which was also used for school purposes. From this point the disease spread throughout the surrounding country. It was found that a large number of rabbits had been for five years hibernating under the church, and the resident physicians became convinced that the rabbits had planted the germs of the disease.

Dr. Charles E. Young, of White Plains, N. Y., writes that he was called to see a well-developed case of diphtheria, the patient being a woman twenty-four years old. Upon investigation she could recall no exposure to the disease, unless it came from a lock of hair. She then related how a child had died a year prior, from diphtheria. A lock of hair was clipped from its head, wrapped in paper and placed in a box. In rearranging the drawer she found the box, took out the lock of hair, contemplated it for some time, and then replaced it. The next

day the first symptoms of the disease appeared. hair was consigned to the fire.

The lock of

A physician in a country village was called to a child sick with scarlet fever, which resulted fatally. The source of infection was traced satisfactorily to a letter written by a mother one hundred miles distant, in whose family several were sick with the disease. On receipt of this letter the envelope was given to the patient of this doctor to play with.

Sanné reports a case where two persons received a note from a friend convalescing from scarlet fever, who wrote she was desquamating so freely she had to brush the dust from the paper on which she was writing. Several days later both recipients became ill with the disease.

It is now universally admitted that calves, horses, cats, fowls and rabbits are liable to a disease nearly identical with scarlet fever and diphtheria. Numerous instances are recorded where these diseases in animals preceded, accompanied or followed an epidemic among human beings.

Five children

Dr. Jacobi, of New York, mentions a case: were ill with diphtheria in one house; three kittens that played with them died, and post mortem examinations showed diphtheritic membranes in their throats. Dr. Bruce Low mentions an interesting case: A cat living in the house with a boy that had diphtheria took the disease, communicated it to the cat of another person, and four little girls that nursed the second cat became ill with diphtheria.

Gerhardt has published a case that seems to show that diphtheria of hens may be communicated to dogs and men, notwithstanding the opinions of Loeffler, Pfeiffer and Klein to the contrary. A large number of hens were brought from Verona to a village in Baden; some were suffering with the disease when they arrived, and about half of them died. All the chickens bred in incubators died; four cats kept in the place died of diphtheria, and four of the six men on this poultry farm had diphtheria. In 1885 Dr. C. J. Renshaw described some cases in which cats that had swallowed portions of diphtheritic membrane from human sufferers died of a disease resembling diphtheria.

It is probably true that epidemics of scarlet fever and diphtheria. the sources of which are mysterious, can be traced to cats and dogs. Household pets are well-known marauders. Nocturnal excursions are frequent, and at long distances. Cats

especially, because of their domestic habits, have a penchant for visiting neighboring houses, and especially when encouraged, to amuse a sick child.

The transmission of diphtheria to human beings from fowls is affirmed by Gerhardt, Debrie, Menard, Schrevens, and other writers. Cole reports a case in Jacksonville, Ill., where a sick chicken was taken into the house and fondled by a child two and one-half years old. Four days later the child was taken with diphtheria and died. There were no other cases of the disease in the neighborhood, and the affected chicken was the only source of infection.

It is evident from the limited investigations made that diphtheria prevails among fowls to a larger extent than is supposed. Their habits of living, running at random over wide ranges, picking food from garbage and manure piles, render them especially liable to infection. It is a common practice to bring sick chickens into the house for treatment, where children are permitted to handle them, and it is evident this disease is spread in this manner more extensively than has been supposed, and that many cases of mysterious sources of infection of children could be traced to infected poultry.

Dr. Charles McKinnis, of Ollie, reported several cases of scarlet fever in Jackson township, Keokuk county, that illustrate quite clearly the sources of infection. The disease occurred in three families. A sister of one of the families was residing in North English with a family in which scarlet fever was present. She visited two families in the locality above given. In eight days a child in one of the families visited took the disease; in eight days later a second child was taken down; in eight days a third, and on the seventeenth day a fourth one. These four cases were in one family. The doctor does not report the entire number of cases, but while two cases were severe none had died.

In one of these families the source of infection was not definitely determined, but may be readily accounted for since the father is a stock shipper, rides all over the country, and doubtless carried the contagion into his home in that way.

As far back as 1886, Hoffman demonstrated the presence of tubercle bacilli in the bodies of flies captured in a room occupied by a consumptive. The droppings of the flies were full of the bacilli, which were shown by experiment to be fully virulent.

Six years later, Dr. A. Coppen-Jones, of Switzerland, by employing cultures of chromogenic bacteria, proved that infection can be, and actually is, carried, not only in the bodies of flies, but also by their feet. They come from the barn yard and from the reeking corruption of the carcass; they come from the swill pail and from sewage, they come from everywhere and everything that is suggestive of filth and infection. Their feet and legs are covered with morbific matter and they come into the kitchen and crawl over the bread, and sugar, and fruit, and cake, and pie-over everything not securely covered, depositing not only the filth of their feet and legs, but evacuate the contents of their body, which in all examinations have been found laden with bacteria often of the most poisonous kind! Decency and a due respect for health suggest that money spent for screens for doors and windows, and for sticky fly paper is money well spent.

A source of danger among school children is the slate and pencil. It is a common practice in schools to give the slate and pencil to pupils, without any regard to individuality that the same child have the same slate and pencil each day. The pencils go from mouth to mouth, while the slates are cleaned with saliva by the fingers, thus conveying to the mouth any bacteria that may be on the slate. Thus, if a child have a diphtheritic sore throat, the disease germ might be conveyed to the mouth of a healthy child.

They should.

Library books are also a source of danger. never be handled by persons sick with contagious diseases, especially scarlet fever. So impalpable is the dust of desquamation, and the vitality of the disease germ so great that the handling of exposed books after a lapse of years would be dangerous.

Drinking cups in schools are unquestionably a source of infection, especially from diphtheria. Teachers should impress upon pupils that drinking cups should be cleansed and made sterile by the use of boiling water, and the habit which now prevails in schools, railroad cars, stations and public parks of promiscuous drinking from cups never made sterile is a reckless exposure to the contraction of diphtheria and other contagious diseases.

A school water-bucket might easily become infected by immersing a dipper therein direct from the lips of a child just coming down with diphtheria, or who has returned to school

during convalescence and before the disease germs were absent from the throat, which may be several days. The frequent changes of water in the bucket would, however, make this danger less than from the use of the cup by a child having an inflamed throat, and drinking from the cup directly after a sick child had used it.

Safety requires that no chances be taken. No child who has had dipththeria should be permitted to attend school until it has been satisfactorily demonstrated that the germs of the disease have entirely disappeared from the throat, not only of the convalescent but of all other children in the family who are attending school. Further, no two children should be permitted to drink from the same cup; each should have his individual cup.

The danger of contracting disease from money is illustrated in the case of Alexander Waltzfelder, bookmaker's cashier at Harlem race track, near New York. He had contracted the habit of carrying bank bills in his mouth, and one day accidentally bit his lip. The wound at once began to swell. He was treated by Dr. Irving, of New York. The wound healed, and a cure seemed to have been secured. Soon after he received a bruise on one leg-a slight abrasion of the skin- while getting on a car. The leg soon began to swell, and he became so ill he was taken to the Presbyterian Hospital, where the physicians diagnosed blood poisoning, the primary cause being the old bank note trouble. Every possible effort was made to save his life, but the disease germs permeated his whole system, and he died.

It is too much to expect that the hygienic principles involved in these suggestions will be thoroughly adopted by the present generation, yet it is possible that the children can be so in doctrinated with the facts of bacteriology that ere long there will be such general use of preventive measures as will very materially aid in the protection of life and health.

RESPONSIBILITY OF PHYSICIANS IN CONTAGIOUS DISEASES.

An extensive acquaintance with the physicians in Iowa warrants a belief in their exalted character, intelligence and conscientious regard for their relationship to the public health, as