has been suggested, occasionally start the "straw fungi" anew somewhere; but that the other discharges or fomites do would seem to be problematical.

We will now go to the consideration of the phenomena observed in connection with the occurrences of measles, in order to see how far they support the conclusions here arrived at as to the causation of the disease. The principal conclusion is that the affection is caused by the inhalation of the spores of the fungi grown upon the dead grasses and other vegetable material used in man's bedding; or, to put it plainly, that it is, in effect, a straw fever in the sense understood in speaking of the disease contracted by handling reeds as "reed fever." Although it is conceded without question that this latter highly characteristic specific eruptive fever is caused by a reed fungus, or by reed fungi, because the evidence is thrust so obtrusively on us that there is no escape from the conclusion; yet we have not reached the inference that another somewhat less characteristic specific eruptive fever is caused by straw fungi, partly because it is not so obvious that straw is as apt at times to get mildewed in damp bed-ticks as reeds are to get mildewed in damp trenches, but chiefly perhaps because of the frequent occurrence on a large scale of the one affection and the comparative rarity and limited extent of the other. Few people handle reeds, and therefore the restricted attacks of reed fever have declared its source; but whole nations have slept on straw for ages, and the commonness of straw fever among all classes has afforded no special clue as to its origin. And when at last, five-and-twenty years ago, the clue was given to the world by Dr. Salisbury, it was scornfully thrown aside.

Men who can see readily enough the folly of those rustics who suffer once in a way from handling mildewed reeds without taking due precautions, cannot see the danger to which they continuously expose their households through the mildewing of straw in the bedding. No doubt reed fever stands out clearly an artificially created complaint, whilst the obscurity surrounding the cause of measles has been such that we have come to regard them, philosophically, as a natural inevitable disease—

a sort of dispensation or "revengeful plague " to which mankind, especially in childhood, must submit. But to those who look to physical causes for hitherto unexplained phenomena, the much despised "straw mildew theory" may some day bring light.

cause

CHAPTER XI.

Dr. Kennedy's "case in which a disease like measles arose from an unusual " (flax-seed meal), reported in Braithwaite's Retrospect, 1863Dr. Kennedy recognised the affinity of the affection to measles, but the subject was allowed to drop-Case of morbilloid disease caused by musty canary seed-Two coopers affected by Penicillium in a cask -Dosage.

IN Braithwaite's Retrospect1 for 1863 is an interesting and highly suggestive contribution by Dr. Kennedy, from which I must extract largely.

A healthy boy of fifteen had a handful of powder from a paper-bag dashed in his face by a schoolfellow; "and there can be no doubt that some of it got not only into his eyes but down his throat-for he was laughing at the moment. The powder turned out to be flax-seed meal, which, by some accident, the other boy had found in the room. The boy was at once seized with smarting and watering of the eyes, running from the nose, cough, and dyspnoea. . . . He made his way home. . . . By the time he reached it his face had become much swollen, the eyelids and eyes very red, and the dyspnoea urgent. The excitement of the system was very great; and all this within two hours of the accident. When seen the following day he had, except the rash, all the look of a boy suffering from a sharp attack of measles. His face was still swollen, his eyes were injected, and had a strange dark-red line round them, giving

1 Braithwaite's Retrospect of Medicine, vol. xlvii., p. 2. "A case in which a disease like measles arose from an unusual cause; with remarks." Dr. Henry Kennedy.

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a very peculiar expression to the countenance; and he had a constant loud cough, with dyspnœa. His pulse was 120. Two years previously I had attended him in a well-marked attack of measles, with cough. . . . I confess I thought that quiet and a little time would suffice to get him well. . I was much disappointed; and finally, after waiting a few days, when a considerable amount of general bronchitis had supervened, I was compelled to treat the case as if it were ordinary measles; and by the end of three weeks, and not till then, could he be pronounced well. The last symptom which remained was dyspnœa. . . . The boy is now perfectly well. . . . The direct connection between the accident and the immediate supervention of the symptoms could hardly leave a doubt that the two stood to each other as cause and effect.

...

Dr. Kennedy then refers to and quotes some of Dr. Salisbury's experiments, and observes :-" To the facts detailed in this paper the case which came under my own notice is now to be added. For if there be other agents than the fungi of wheat straw capable of generating a disease like measles, where will such powers end. For it must be repeated again, the experiments of Dr. Salisbury are conclusive :-That certain bodies which are being constantly generated in vegetable matter, are capable of causing certain diseases when inoculated into the human frame. Nay, further, that inoculation is not essentially necessary; and on this point the case detailed by myself seems to be most important, for it shows that the mere contact of fungi with the mucous membranes is sufficient to cause disease, and of a very severe character."

In a footnote here Dr. Kennedy says:-" Some may think that the case given by myself may be explained in a different way; that the symptoms may have been caused by the mechanical effects of the meal, and arose too soon to attribute them to the effects of fungi. This view of the case may, of course, be held; but the following reasons induce me to keep to that stated in the text :-It was clearly established that the meal thrown in the patient's face was mouldy; and since then, my friend Dr. K., the present editor of this Journal, has

succeeded in bringing meal of the same kind into a similar state, and, by means of the microscope, detecting in it fungi very like, if not identical with, some of those figured in the plate of Dr. Salisbury. These fungi Dr. K. showed myself; so that the fact is actually established, that fungi may have existed in the meal used by the boy in the school. But then, it will be said, the effects of the fungi arose too soon, for the symptoms were immediate. This I think may be questioned. There is certainly no comparison whatever between the effects of inoculation on the skin and on a mucous surface.

Nor is it to be forgotten, that in the case detailed, the dose, if I may so speak of it, was large, and applied to the eyes, nose, and mouth at the same moment. For these reasons, then, I consider this case an example of a disease, like measles, being caused by the application of the fungi which are produced in flax-seed meal which had become mouldy."

From "the preceding facts," Dr. Kennedy says:-"The following deductions may, I think, be fairly drawn—1. That certain acute diseases affecting the throat and air-passages may be caused either by inoculation of certain vegetable fungi or by direct contact of the same with the mucous membranes. 2. That, as far as is yet known, the diseases so produced seem to have the closest resemblance to measles."

It will be seen from the foregoing extracts from his paper how near Dr. Kennedy was to grasping the notion that measles are caused by "straw fungi." He was within an ace of it, but the thought of mildewed and mouldy straw in bedding no doubt escaped him. Yet he had but to educe the damp state into which straw slept on for years will get at certain seasons, to have had before him the precise conditions for the growth on it of abundance of the same class of vegetation as that found on the flax-seed meal, and that inoculated by Dr. Salisbury, as well as the conditions for its being brought into contact with the mucous surfaces of the air-passages. And then a little reflection would have shown him that if the contact is not brought about so violently, in one large dose, as it was in the case of the boy he had seen, yet the infection takes place just as surely