CHAPTER XX.

The outbreak of measles in the Castle of Fredensborg and the implication of the royal and imperial inmates-Inference that the infections were a consequence of the use of paillasses which became damp in certain of the rooms from seasonal conditions-The dampness of the rooms dependent on an insufficiency of chemical light-That the degree of air-contamination was unusually high is to be inferred from the proportion of adults infected-What is recognised as general sanitation is not to be supposed to have been concerned in this outbreak--The conclusion was that it occurred simply from contagion-The view that contagion had nothing whatever to do with it-Effects of seasonal conditions on the organism-Omission to inquire into the conditions surrounding the outbreak-The exemptions of the Princess of Wales, the Czar and Czarina, and the King of Denmark, had no relation to the degree of exposure to the hypothetical contagium— The infections and exemptions of other than royal and imperial personages in the castle-All governed by the degree of air-contamination to which each individual was subjected-Excreta-disposal system of the castle probably not concerned.

THAT the indiscriminate and sometimes deadly sanitation-atlarge of modern times has had the effect of reducing the sum of measles among certain classes, has to be admitted. Further, it has to be conceded that this promiscuous and chance-directed sanitation would still have done a good deal towards lessening the amount of the disease, even without invaluable, but unsuspected, aid from upholstery. Yet the steps of hygiene in the dark must needs be uncertain. And a striking and instructive instance of an exception to class-exemption from measles where exemption might confidently have been looked for-where, indeed, the exalted position of the infected leaves no escape from the view that they were protected by the most perfect sanitation

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known to science (quantum valeat)—is that of the Princesses Louisa, Victoria, and Maud of Wales, and of the other royal and imperial guests in the Castle of Fredensborg last October (1887). This unexpected occurrence of the malady sets the door wide open to speculation as to the actual conditions under which the royal and imperial visitors were placed, for the time being, in respect of the laws of health, or of the prevention of infective disease. Writing at this side of the world without the means of procuring information concerning the household arrangements of the royal castle, I am nevertheless induced to try to evolve the environment of its infected inmates—or, rather, to educe the special conditions which led to their infection. If the circumstances admit of it, the production of the facts will be one of the best of tests of the soundness or otherwise of the "straw mildew theory."

In the first place it is to be assumed that for many years the beds constructed for the younger branches of our royal family have been fitted with the steel mattress. This description of bed has been so largely introduced into the bedrooms and nurseries of the best houses, that it is unlikely that the oldfashioned beds have been retained in the households of the Prince of Wales. Be this as it may, however, no doubt many heads of families, from a dislike of change, or for one reason or other, have not approved of the new bed; and the question now is whether or not the King of Denmark has resisted the innovation—whether the beds of the royal and imperial personages in the Castle of Fredensborg were state beds of an ancient type, with paillasses, or were modern beds with steel in place of straw. It is an inference from the "straw mildew theory" that certain members of the royal and imperial party were in some way exposed, for many days, to an atmosphere so far vitiated by straw fungi as to amount to efficient contamination; and, as it has been shown that the bedroom is indicated as the place in which efficient contamination occurs, the probabilities that the infection came in this instance from the paillasse far outweigh the probabilities that it derived from straw in any other shape or form. It is not likely that there was such a quantity of plaited

straw, or straw matting, in and about the bed-chambers of the castle as to have led to efficient contamination. On the whole, therefore, I conclude that the under-bedding was of straw, and that the seasonal conditions at the time caused it to become so damp as to favour the germination and support the growth of the "straw fungi."

In case it should seem improbable that bed-chambers in royal residences ever become so damp as to permit of the mildewing of the paillasses in them, it may be observed that in most, if not in all, palaces and castles in Europe, some of the bedchambers have northerly and westerly aspects, or are in other ways insufficiently visited by the rays of the morning and midday sun. Rooms into which a due amount of chemical light is not admitted, are never free from more or less moisture over and above the normal amount, as I endeavoured to show in my work, "The Prevention of Consumption," and are not to be kept dry and sweet and wholesome by any ordinary household processes. And as the royal and imperial guests at Fredensborg formed altogether a large party; and as it is hardly to be supposed that the question of a sufficiency of chemical light in bedchambers enters into the calculations of royal hosts, or of Lord Chamberlains, or Comptrollers of Households, or of those who have to attend to the assignment of apartments, or of those who are in a position to make their own dispositions in royal residences; it is nearly a certainty that some of the royal and imperial guests at Fredensborg occupied bed-chambers more or less damp, principally because of the insufficiency in the sum of chemical light let into them.

It is an inference that the imperial children of Russia had bed-chambers or nurseries of this description; and as they were not so spacious, probably, as the state rooms, the contamination of the air in them would be greater and more rapidly brought about than in the larger rooms. Moreover, efficient air-contamination for the young is sooner arrived at than for adults; and they have longer hours of sleep and consequently greater exposure. All the conditions concurred, seemingly, for the early infection of the children of the Czar and of Prince George

of Greece; but though the degree of efficient contamination of a given volume of air is much less for children than for adolescents and adults, it is to be inferred that the degree of contamination in some of the bedrooms of the royal guests was unusually high, seeing that the Princesses Louisa, Victoria and Maud of Wales, the Princess Marie, wife of Prince Waldemar, and Prince Hans of Glücksburg, brother of the King of Denmark, were attacked with the measles. The infection in one household of so large a number of those who are supposed to be beyond the age most susceptible to the measles poison, viewed in connection with all the phenomena to which attention has been drawn in this volume, is presumptive proof that infection and exemption are merely questions of dosage, and that personal immunity in its true sense is a delusion based on a misinterpretation of facts. Given a certain degree of contamination of the air with the spores of the "straw fungi” and a certain amount of exposure to it, and I submit no one will escape infection at any age. As I conceive, and have essayed to show, the right interpretation of the fact that youths and adults do not more frequently contract measles at epidemical seasons, is not that they are past the age of highest susceptibility, or that they are protected by one or more previous infections, but simply that, for reasons already given, they so rarely get a full dose of the measles infection. That appears to me, from the facts, to be the whole secret of the exemption, or so-called immunity, alike of the young nursling and of the full-grown man. Consequently the unusually large proportion of adults who got a full dose of the measles poison in the Castle of Fredensborg, argues an unusually high degree of air-contamination with the straw fungi in the bedrooms of a residence of that class. Hence I conclude that the cause of the contamination was continued dampness of the paillasses.

One thing is certain. If, as the hygienists suppose, the decrease of measles among the independent classes of Great Britain is entirely the result of the improvement in the general sanitary conditions surrounding those classes, it follows that the general sanitation in the royal residence of Fredensborg was not

up to the level of the general sanitation in British houses of the better stamp. There is no logical way out of the conclusion. But as there is no warrant for assuming that the Danish faculty is one whit behind the rest of the world in all that relates to hygiene, or that His Majesty of Denmark is not hedged round with a system of sanitation equal to that which is supposed to protect all other crowned heads from infective disease, it is obvious that sanitation is not to be credited with all the classexemption in England. If, in fact, the highest forms of sanitation then known would have protected against measles, the royal visitors to Fredensborg should not have had measles. Their infection, therefore, points to a flaw in the conclusion that sanitation (as commonly understood), of itself, is the cause of this class-exemption; and indicates that there are other elements to be taken into the calculation before the final result is to be had. One of these elements is the paillasse.

Another element is contagion. The etiologist, however, with what would appear to be a rare inconsistency, supplements the shortcomings of hygiene by means of contagium vivum. Or rather, in this instance he throws over insanitation and falls back on contagion pure and simple. The royal and imperial inmates of the castle "caught" the measles one from the other in the ordinary way-the first to be infected having taken it from some stray infection from an unknown (or perhaps known) source. This fast and loose style of slipping from one explanation to the other may be convenient, but it looks more like a device for stopping a gap than an attempt to get at the root of the thing. As hinted in the last chapter the alliance between sanitation and contagion, re exemption from measles, is an incongruity. For if the hygienist is right, the contagionist is wrong: and the etiologist should elect on which side to take up his position, instead of see-sawing backwards and forwards, now claiming a series of exemptions for sanitation, and then, when sanitation fails, attributing a group of infections to contagion. However, one has to deal with reasons as one finds them; and the cause that was universally assigned for the outbreak of measles at Fredensborg is contagion.