Contagion and Infection.

A very large number of the diseases which affect our death-rate are due to some infective germ or bacillus which, by contagion, causes the spread of the disease from one to another, and I may state as examples scarlet fever, diphtheria, whooping-cough, influenza, typhoid fever, epidemic pneumonia, phthisis, &c., and our duty as medical men is to prevent as far as our knowledge allows a spreading of the disease. We are careful to isolate the patients in hospitals or private houses; to have them nursed by trained women who thoroughly understand the laws of infection, and we use all kinds of methods of treatment which have as their object the destruction of the germs of the disease and the restoration of the patient to health. Sometimes it happens that the dose of the disease—if I may so term it—which is introduced into the blood is too virulent, and in spite of all our efforts the patient succumbs.

Some of the diseases which affect our death-rate are caused by morbid growths, such as cancers, &c. page 8 Our present method of disposing of that mass of disease—germ-infected tissue or cancerous infiltrated tissue—is inconsistent with the methods of germ-destruction which we adopt during life. Our present method is to coffin the body with its diseased structures and the germs of disease, and to bury it a considerable depth in the ground. Probably to all of us during the course of our experience in practice cases where the dead and even the buried dead have affected the health of the living are not uncommon. To cite an example, not long ago a patient died of a form of pneumonia. He was put into the coffin, which was closed. His brother, aged forty-one, came down just before burial and wished to see the face of his dead brother. The coffin was opened. This happened on a Tuesday; the healthy brother, apparently in the best of health on the Tuesday, died of the same disease on the Friday. That mass of germs, whose period of active life is unknown to us, is put into a closed coffin (which in the course of a few years must decay) and is buried in the earth. To cite another case, a body was buried, and through excavations being made was brought within a few inches of the surface. A depression took place immediately above the body, and this became filled with water. A person wishing to fill up this depression attempted to remove the water, which was foul-smelling, but he had to desist after ten minutes' work. He became infected with a disease which seriously affected his health for a period of some months. This body had been buried for fifty years. Of what disease he died is unknown. I believe that a virulent epidemic of yellow fever was traced to the opening-up of an old cemetery in Rio.

If, however, the body is examined after death by a skilled pathologist, and the exact cause of death is certified to by him—it being a part of his duty in all cases of suspicion to examine the contents of the stomach and other tissues for poison—then this method of the disposal of the dead might give way to a method more in keeping with our action in treating disease during life, and the dead body with its germs of disease cremated. Even after cremation, if there happen to he any suspicion of death having been caused by arsenical page 9 poisoning, the arsenic can be detected in the ashes of the cremated bodies. I fear, however, that this more complete and cleanly method of disposing of our dead will not become universally adopted for many years to come.

To illustrate how the uneducated mind views cremation I will recite you a story which I have heard told: A dignitary of the Church had several parishes under his control to which he appointed vicars. To one of these he appointed a clergyman who became extremely popular. After a few years he removed this parson to another parish, much to the disapprobation of the people with whom he had been living for so many years. Shortly afterwards the dignitary died, and by the desire stated in his will was cremated. When one of the old parishioners, who had been annoyed at the removal from his parish of his favourite pastor, heard of it he exclaimed. "Well, it served him right for taking Mr. So-and-so from us."