Chapter VIII: MISCELLANEOUS.--Bayle's New Lamp Chimney.--With engraving (4)

It was in 1729 that the Portuguese government learned of the discovery of the diamond that had been made in the rivers of the environs of Diamantina by some adventurers who had entered this region in search of gold. Since that epoch the exploitation of this gem, pursued under varied regimes, and with diverse success, has never ceased. As soon as it heard of this discovery, the Portuguese government thought it would make as much profit out of it as possible, so it no longer authorized any other exploitation in the Diamantina regions than that of the diamond, and it imposed upon such exploitation a tax that was fixed at 28 francs per laborer in 1729 and 224 in 1734. From 1734 to 1739 all operations were suspended, and a more lucrative organization for the treasury was sought for. In 1739 the era of contracts was inaugurated. The exploitation of the diamond was farmed out for four years to a _contratador_, who was to work a certain territory with a number of men, fixed at 600 as a maximum, and to pay into the treasury a sum per workman (whether working or not) that varied from 1,288 francs per year in 1734 to 1,344 francs for the last contract, that ended in 1772. At this epoch the government took the exploitation of the diamond in hand, and gave it in charge of a special administration, which was submitted to the direction of the treasury of Lisbon, and which had at its head a comptroller. This new regime lasted till 1845. In order to render the surveillance of the treasury agents efficient, and prevent smuggling (which can be so easily done with an object like the diamond), it was necessary to impose a special regime over the entire region of Diamantina, and, in fact, the latter was, up to the independence of Brazil, submitted to Draconian regulations.

We only know the quantity of stones that were discovered during the period when operations were directed by the Royale Extraccao, from 1772 to 1845, and this was 269,870 grammes, or more than 1,300,000 carats. It should be understood that what was taken by stealth does not enter into this total, and it must be stated that during the latter years, when the Extraccao existed only in name, smuggling must have been active.

Since that epoch the exploitation has been continued by lessees of the diamondiferous grounds. It is almost impossible to estimate what the territory has produced. The discovery of the Cape deposits has given it a terrible blow. Although the Brazilian diamond is much more beautiful, and for this reason is held at a much higher price, these new exploitations, by annually throwing large quantities of stones upon the market, have led to a great reduction in the price, and the Diamantina exploitations, which have become long, difficult, and costly, have received a serious set-back. So the annual production of this region, which was estimated for the years preceding 1870 at 3,000 oitavas (about 52,000 carats), is now scarcely 500.

The rivers in the environs of Diamantina rim at the bottom of deep and narrow gorges that have been scooped out to depths of 300 or 400 meters through the denuded plateau in whose center stands the city of Diamantina. In the bed of these rivers, in places where they have not yet been worked, there may be found, underneath a stratum of modern sand, another of rocks, and finally a diamondiferous deposit of rounded pebbles, mixed with sand. This gravel, which is characterized in the first place by the fact that all its elements are rounded, and next by the presence of a large number of minerals (among which the most important are all the oxides of titanium, different oxides of iron, tourmaline, and a whole series of hydrated phosphates of complex composition), is called in the language of the country _cascalho_. It is the matrix of the diamond, and the latter is extracted from it by washing. It is arranged in roundish masses upon the beds of the rivers, and is met with at depths ranging from a few decimeters up to 25 and 30 meters.

The same material, with the same name, is also found deposited at all heights upon small terraces at the sides of the valleys through which the rivers flow. It is coarser and less rolled, and has very likely been deposited by risings of the rivers during the period when the valleys were being formed. These deposits bear the name of _gupiarras_. Finally, it is found in a still coarser state, mixed with red earth and deposited in horizontal strata upon the upper plateau. It is then called _gorgulho_.

Of these different deposits, the most important are those of the river beds, the material here having undergone a true mechanical preparation and being richer. These are the deposits that have been the object of the most important exploitations.

The year is divided into two distinct seasons--the dry, from May to September, during which rain is exceptional, and the rainy, from October to April. As water is necessary for all the operations, no work can be done upon the high plateaux except through rain water stored up in large reservoirs. These beds form what are called the "rainy season washings." In the rivers the working of the beds requires a preliminary drying, which is effected by diverting the river's course. Now in all this rocky and denuded region the water that falls runs immediately to the river, and causes terrible freshets therein; so operations capable of keeping the bed dry would be out of proportion to the probable results of the exploitation, whence it follows that the latter is only possible in dry weather, and these deposits are therefore called "dry season washings."

These deposits are still worked in our day as they were in the time of the Portuguese. In order to dry the bed a dam is constructed, and the river is either diverted into a plank flume supported by piles, or into a canal dug along the shore, or by means of tight walls, according to the lay of the place. The second process, which is preferable to the first, is in fact impossible when the river runs, as is often the case, in a narrow, abrupt, walled channel. These works are sometimes very important. In 1881, the Acaba Mundo flume was 140 meters in length and 5.2 m. wide, and, with a velocity of 2.25 m., discharged 4,500 liters per second; still longer ones might be cited that discharged as much as 8,000 liters.

In the dry part of the river the extraction of the sand, stones, and cascalho is done solely by hand. The men carry the sand upon their heads in small wooden bowls called _carumbés,_ which hold about 15 kilogrammes, and throw it somewhere where the deposit will not interfere with the exploitation. Almost all of these men are negroes, who run with their load upon their head over the white sand, singing some song of their country. It, is very picturesque, but it is doubtful whether it is economical.

Since the century and a half that these rivers have been dug and redug, it may be admitted that wherever the cascalho has been easy of access it has been removed; and that wherever it has not been, little attempt has been made to work it. How have these attempts, which have doubtless been made at several periods, come out? This would at present be very difficult to ascertain. The exploitations have been too numerous to allow us now to estimate the value of a bed from the data furnished by geology, and local tradition is too uncertain or exaggerated to allow us to place much confidence in it.

We can, at the very most, say that if some points still remain intact it must be because the exploitation of them was too difficult with the processes that were employed, and this should be a reason, were it desired to attempt new operations, for having recourse to entirely different modes of work.

It would seem rational, as regards this, to try to put to profit the hydraulic power that the flumes and canals render disposable for mechanically extracting the sand. The field to be worked being naturally long and narrow, it would be the proper thing to employ a series of inclined planes distributed along the banks, actuated by water wheels, and corresponding to so many small working points. The river often flows through a genuine canon with nearly vertical walls, where space would be absolutely wanting for installing wheels elsewhere than at the exit of the canal, and if may become necessary to distribute the power of these wheels along the works. In these regions of difficult access and few resources it is necessary to dispense with complicated apparatus, and one might in such a case, it would seem, try electric motors, whose installation would be easy. An exploitation in accordance with these ideas was begun for the first time in 1883 upon the Ribeirao de Inferno at Portao de Ferro. We shall describe it.

Once established in the country, the first thing to do is to form roads so as to secure communications with the neighboring villages and forests, and afterward to cut down trees for building houses. These latter are usually constructed, for these works, of untrimmed wood and mud, with thatched roof. There were thus constructed at Portao de Ferro a few kilometers of roads, then some houses for the engineers and special workmen, barracks for 200 laborers, stores, kitchens, etc., a forge, and a shop with a lathe and a saw run by a wheel at the side. It was afterward necessary to repair the old lateral canal which had been dug out of the rock in the times of the Royal Extraction, but which had been torn open for a considerable length. This necessitated the erection of tight walls of dry stone, grass, and mud, for a length of 200 meters, and with thicknesses of from 6 to 10 meters.

In order to divert the water into this canal, it was necessary to raise its level 5 meters. The dam, then, had to support a strong pressure, and it could not be built upon sand. It therefore became necessary to build a temporary dam and to turn the river into a plank flume, so as to make it possible to dig at the location of the permanent dam in order to reach a solid bottom at a depth of nearly 4 meters. The permanent dam thus had a total height of 10 meters, with a thickness of 15 at the base and 7 at the top. It was constructed of dry stone, grass, and earth, with the addition of strong wood-work. The rocks upon which it had to be built were full of fissures, and when it was desired to close it great leakages of water occurred, which came near ruining it and necessitated the construction of a second wall behind it and a talus of earth in front. The dam as shown in Fig. 1, when finished, had a thickness of 25 meters at the base. It was closed on the second of July, and had a storage capacity of 55,000 cubic meters.

The principal excavation was begun at the point where the bed was deepest, and which consequently the older miners must have had most trouble in reaching. Here were set up two Letestu pumps that were actuated by a four-horse wheel.

These pumps lifted 50 cubic meters per hour. All except the pump chambers and pipes was made of wood on the spot. The water that was lifted was carried away from the works in a flume 160 meters in length, which likewise removed the water from the motive wheels.

For the service of the same excavation two simple acting inclined planes were installed that were moved by a four-horse wheel. Fig. 2 gives a general view of the arrangement.

The tracks of these planes were made of wood. Steel rails, however, had been brought for the cars, along with the cables and the metallic parts of the windlass; but all else was made upon the spot, including all the wooden pulleys for transmitting motion from the wheel to the windlasses.

This excavation reached bottom at a depth of 16 meters. The second touched bottom at about 10 meters, and gave access to a subterranean canal, which was followed for about 20 meters. The extraction of sand was effected here by an inclined plane moved by a Gramme machine. The generatrix had to make 1,500 revolutions, and be set in motion by an overshot wheel. As time was wanting, it became necessary to diminish to as great a degree as possible the number of parts to be employed in the transmission of motion, and since there was an abundance of water, a velocity of 15 revolutions was accepted for the wheel, which, with a total fall of 4.8 meters, had to give a power of eight horses. A three meter pulley was placed upon the shaft of the wheel. This was made of freshly cut wood that had been exposed to the sun. In order to give it sufficient stability and prevent its warping, it was placed against the wheel in such a way as to rest upon the latter's spokes. This rendered it necessary to give up the idea of using a belt, since it was not possible to prevent its getting wet. Cords could not be found in the country, and so it was necessary to make use of a too heavy chain, which was in no wise intended for such a purpose, and which at a velocity of 15 revolutions began to swing and necessarily absorbed much power. The large pulley drove one of 0.4 m. upon an intermediate shaft. Upon this latter a 2.6 m. wooden pulley directly drove, through a belt, the 0.2 m. pulley of the generatrix.

From this may be judged what the country's resources are. The motor, by means of a belt, actuated a windlass provided with suitable checking gearings. The distance of the two machines was 116 meters. Save the transmission by chain, the whole worked in a satisfactory manner. The performance could only be estimated in a lump, by comparing on the one hand the theoretical work of the fall of water, and, on the other, that of the vertical elevation of the car; and, further, one was obliged to estimate the weight of the latter. If we allow 1,000 kilogrammes for the weight of a car that received 360 liters of dry sand or 300 of wet, the performance was 19 per cent., and appeared to be satisfactory, considering the conditions under which the installation was made. This experiment was at all events of such a nature as to indicate the use of these machines in cases where the arrangement of the locality absolutely necessitates a transmission of power.

The first workmen reached Portao de Ferro December 15, 1882, and the material shipped from France did not arrive until April 25, 1883. Operations were suspended about the 25th of September, since, for a fortnight already, there had no longer been any doubt as to the manner in which the river bed had been cleaned by former operators.

As a result of this first experiment, the proof remained that it would be easy in future exploitations to introduce into the country methods of work that are quicker and more economical than those now in use. In fact, all the operations were performed with natives of the country, with the exception of a carpenter and blacksmith from Rio Janeiro.--_La Nature._

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WHAT WE REALLY KNOW ABOUT ASIATIC CHOLERA.

NEW YORK, September 1, 1884.

_To the Editor of the New York Medical Journal_:

SIR: I have been exceedingly interested in Dr. Bartlett's suggestive article in your issue of August 30. But a sufficient number of well-established facts are known to account for all the peculiarities and vagaries of cholera.

1. Cholera has existed in Hindostan for centuries. It was found there by Vasco da Gama in 1496, and there is a perfectly authentic history of it from that time down to the present.

2. It is never absent from India, from whence it has been conveyed innumerable times to other countries. It has never become domiciled in any other land, not even in China, parts of which lie in the same latitude; nor in Arabia, to which country pilgrims go every year from India; nor in Egypt, nor Persia, with which communication is so frequent; much less in any other part of the world. Canton in China, Muscat and Mecca in Arabia, lie nearly in the same degree of latitude as Calcutta, in which cholera is always existent; yet these places only have cholera occasionally, and then only after arrivals of it from Hindostan.

3. The arrival of cholera in other countries is often involved in some easily removable obscurity, which is deepened only by the ignorance and want of veracity of quarantine and other officials.

4. Cholera is almost always preceded by a premonitory diarrhoea, which lasts from one or two to three or four or more days before urgent and characteristic symptoms show themselves. Of 6,213 cases, no less than 5,786 had preceding diarrhoea. The sufferers from this sow the germs of the disease in numerous, often distant and obscure, places, to which no choleraic person is supposed to have come.

5. The discharges swarm with infective bacteria of various kinds, some of which, especially Koch's comma bacilli, seem to be specific.

6. The disease has been reproduced in men and some few animals by their swallowing the discharges.

7. The discharges, according to the experiments of Thiersch, Burdon-Sanderson, and Macnamara, are not virulent and poisonous for the first twenty-four hours; on the second day eleven per cent. of those who swallow them will suffer; on the third day, thirty-six per cent.; on the fourth day, ninety per cent.; on the fifth day, seventy-one per cent.; on the sixth day, forty per cent.; and after that the discharges have no effect--the bacteria die, and the poison becomes inert.

Professor Robin reproduced cholera in dogs, and the celebrated dog Juno died of cholera in Egypt last year. Professor Botkin, of the University of Dorpat, reproduced cholera in dogs by the subcutaneous injection of the urine of cholera patients. Even if the comma bacilli are not found in the urine, other bacteria are; and even Koch supposes that they secrete a virulent poison similar to that of some insects, which may be absorbed into the blood and escape from the kidneys.

8. Some of the manners and customs of the Hindoos are very peculiar. They always defecate upon the open ground, and will not use privies or latrines This is a matter of religious obligation with them. It is also obligatory upon them to go to stool every morning; to use the left hand only in wiping themselves; to wash their fundaments after stool; to wash their whole persons and clothing every day; and, finally, also to rinse their mouths with water, and this they often do after washing in foul tanks, or still fouler pools of water. On steamships, where tubs of water were provided for washing their fundaments after defecation, Surgeon-General De Renzy saw many Hindoos rinse their mouth with the same water.

9. The population of Hindostan is nearly three hundred millions, and at least one hundred million pounds of fæcal matter is deposited on the open ground everyday, and has been for centuries.

10. Much of this foul matter is washed by rains into their tanks and pools of water, which they use indiscriminately for washing, cooking, and drinking purposes.

11. The poison of cholera has repeatedly been carried in soiled clothing packed in trunks and boxes, and conveyed to great distances.

12. Articles of food, even bread and cake, as well as apples, plums, and other fruit, handled by persons in the incipient stages of cholera, have been known to convey the disease.

13. The number of epidemics produced by cholera discharges getting into drinking water are almost innumerable, and those from contaminated milk are not few.

14. The first case of cholera is generally counted from the first fatal one, whereas this is almost always preceded by non-fatal ones, which have escaped notice. And each subsequent fatal case is interwoven by one, or several, or even many, non-fatal causes. If the string of a row of beads is broken, and the beads scattered everywhere, it would be just as improper to say that they had never been upon a string as to say that, because all the fatal cases of cholera cannot be traced to equally fatal ones, no connection ever existed between them.

These points are necessarily stated categorically, but every one can be proved, if proof is called for. The numerous and very large pilgrimages of the Hindoos must not be forgotten.

John C. Peters, M.D.

83 Madison Avenue.

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DR. KOCH ON THE CHOLERA.

An important and influential conference[1] upon cholera was opened in Berlin at the Imperial Board of Health on the evening of July 26. There were present Drs. v. Bergmann, Coler, Eulenbrg, B. Fränkel, Gaffky, Hirsch, Koch, Leyden, S. Neumann, Pistor, Schubert, Skreczka, Struck, Virchow, and Wollfhügel. The conference had been called at the instance of the Berlin Medical Society, whose President, Prof. Virchow, explained that it was thought advisable Dr. Koch should, in the first instance, give a demonstration of his work before a smaller body than the whole society, so that the proceedings might be fully reported in the medical press. He mentioned that Herr Director Lucanus and President Sydow had expressed their regret at being unable to be present, as well as many others, including Drs. Von Lauer, Von Frerichs, Mehlhausen, and Kersaudt. Before the meeting Dr. Koch exhibited microscopical specimens and drawings of the cholera bacillus, and demonstrated the method of its preparation and cultivation. The preparations included specimens of choleraic dejections dried on covering glasses, stained with fuchsin or methyl-blue, and examined with oil immersion, one-twelfth, and Abbe's condenser; also sections of intestine preserved in absolute alcohol, and stained with methyl-blue. There were also cultures in gelatin, etc.

[Footnote 1: A detailed report is published in the _Berliner Klinische Wochenschrift_ Aug. 4.]

Dr. Koch commenced by remarking that what was required for the prevention of cholera was a scientific basis. Many and diverse views as to its mode of diffusion and infection prevailed, but they furnished no safe ground for prophylaxis. On the one hand, it was held that cholera is a specific disease originating in India; on the other, that it may arise spontaneously in any country, and own no specific cause. One view regards the infection to be conveyed only by the patient and his surroundings; and the other that it is spread by merchandise, by healthy individuals, and by atmospheric currents. There is a like discrepancy in the views on the possibility of its diffusion by drinking water, on the influence of conditions of soil, on the question whether the dejecta contain the poison or not, and on the duration of the incubation period. No progress was possible in combating the disease until these root questions of the etiology of cholera are decided.

Hitherto the advances in knowledge upon the etiology of other infective diseases have done little toward the etiology of cholera. These advances have been made within the last ten years, during which time no opportunity--at least not in Europe--has occurred to pursue researches; and in India, where there is abundant material for such research, no one has undertaken the task. The opportunity given by the outbreak of cholera in Egypt last year to study the disease before it reached European soil was taken advantage of by various governments, who sent expeditions for the purpose. He had the honor to take part in one of these, and in accepting it he well knew the difficulties of the task before him, for hardly anything was known about the cholera poison, or where it should be sought; whether it was to be found only in the intestinal canal, or in the blood, or elsewhere. Nor was it known whether it was of bacterial nature, or fungoid, or an animal parasite--e.g., an amoeba. But other difficulties appeared in an unexpected direction. From the accounts given in text-books he had imagined that the cholera intestine would show very slight changes, and would be filled with a clear "rice-water" fluid. He had not fully recollected the conditions met with in post-mortem examinations had formerly made, and was therefore at first surprised to meet with quite a different state of things. For he soon found that in a large majority of cases remarkably severe lesions were present in the intestines. In other cases the changes were slighter, and eventually he met with some which, to a certain extent, corresponded with the type described in text-books. But it was some time, and after many inspections, before he was enabled to correctly interpret the varied changes met with. In spite of a most careful examination of all other organs and of the Mood, nothing was found to establish the presence of an infective material, and attention was finally concentrated on the intestinal conditions.

There were cases in which the lower segment of the small intestine, most marked immediately above the ileocæcal valve, extending thence upward, was of a dark reddish-brown color, the mucous membrane being covered with superficial hæmorrhages. In many cases the mucous membrane appeared to be superficially necrosed, and covered with diphtheritic patches. The intestinal contents in such cases were not colorless, but consisted of a sanguinolent, ichorous, putrid fluid. Other cases showed a gradual transition to a less marked change. The redness was less intense, and was in patches, while in others the injection was limited to the margins of the follicular and Peyerian glands, giving an appearance which is quite peculiar to cholera. In comparatively few cases were the changes so slight as to consist in a somewhat swollen and opaque condition of the superficial layers of the mucous membrane, with delicate rosy-red injection, and some prominence of the solitary follicles and Peyer's patches. In such cases the intestinal contents were colorless, but resembling meal-soup rather than rice-water. In only a solitary instance were the contents watery and mucoid. Microscopical examination of the intestine and its contents revealed, especially in the cases where the margins of Peyer's patches were reddened, a considerable invasion of bacteria, occurring partly within the tubular glands, partly between the epithelium and basement membrane, and in some parts deeper still. Then he found cases in which, besides bacteria of one definite and constant form, there were others also accumulated within and around the tubular glands, of various size, some short and thick, others very fine; and be soon concluded that he had to do here with a primary invasion of pathogenic bacilli, which, as it were, prepared the tissues for the entrance of the non-pathogenic forms, just as he had observed, in the necrotic, diphtheritic changes in the intestinal mucosa and in typhoid ulcers.

Passing to speak of the microscopical character of the contents of the bowel, Dr. Koch said that owing to the sanguinolent and putrescent character of these in the cases first examined, no conclusion was arrived at for some time. Thus he found multitudes of bacteria of various kinds, rendering it impossible to distinguish any special forms, and it was not until he had examined two acute and uncomplicated cases, before hæmorrhage had occurred, and where the evacuation had not decomposed, that he found more abundantly the kind of organism which had been seen so richly in the intestinal mucosa. He then proceeded to describe the characters of this bacterium. It is smaller than the tubercle bacillus, being only about half or at most two-thirds the size of the latter, but much more plump, thicker, and slightly curved. As a rule, the curve is no more than that of a comma (,) but sometimes it assumes a semicircular shape, and he has seen it forming a double curve like an S, these two variations from the normal being suggestive of the junction of two individual bacilli. In cultures there always appears a remarkably free development of comma shaped bacilli. These bacilli often grow out to form long threads, not in the manner of anthrax bacilli, nor with a simple undulating form, but assuming the shape of delicate long spirals, a corkscrew shape, reminding one very forcibly of the spirochaete of relapsing fever. Indeed, it would be difficult to distinguish the two if placed side by side. On account of this developmental change, he doubted if the cholera organism should be ranked with bacilli; it is rather a transitional form between the bacillus and the spirillum. Possibly it is a true spirillum, portions of which appear in the comma shape, much as in other spirilla--_e. g_., spirilla undula, which do not always form complete spirals, but consist only of more or less curved rods. The comma bacilli thrive well in meat infusion, growing in it with great rapidity. By examining, microscopically, a drop of this broth culture the baccilli are seen in active movement, swarming at the margins of the drop, interspersed with the spiral threads, which are also apparently mobile. They grow also in other fluids--_e. g_., very abundantly in milk, without coagulating it or changing its appearance. Also in blood serum they grow very richly.

Another good nutrient medium is gelatine, wherein the comma bacilli form colonies of a perfectly characteristic kind, different from those of any other form of bacteria. The colony when very young appears as a pale and small spot, not completely spherical as other bacterial colonies in gelatine are wont to be, but with a more or less irregular, protruding, or jagged contour. It also very soon takes on a somewhat granular appearance. As the colony increases, the granular character becomes more marked, until it seems to be made up of highly refractile granules, like a mass of particles of glass. In its further growth the gelatine is liquefied in the vicinity of the colony, which at the same time sinks down deeper into the gelatine mass, and makes a small thread-like excavation in the gelatine, in the center of which the colony appears as a small white point. This again is peculiar; it is never seen, at least so marked, with any other bacterium. And a similar appearance is produced when gelatine is inoculated with a pure culture of this bacillus, the gelatine liquefying at the seat of inoculation, and the small colony continually enlarging; but above it there occurs the excavated spot, like a bubble of air floating over the bacillary colony. It gives the impression that the bacillus growth not only liquefies the gelatine, but causes a rapid evaporation of the fluid so formed. Many bacteria also have the power of so liquefying gelatine with which they are inoculated, but never do they produce such an excavation with the bladder-like cavity on the surface.

Another peculiarity was the slowness with which the gelatine liquefied, and the narrow limits of this liquefaction in the case of a gelatine disk. Cultures of the comma bacillus were also made in agar-agar jelly, which is not liquefied by them. On potato these bacilli grow like those of glanders, forming a grayish-brown layer on the surface. The comma bacilli thrive best at temperatures between 30° and 40° C., but they are not very sensitive to low temperatures, their growth not being prevented until 17° or 16° C. is reached. In this respect they agree with anthrax bacilli. Koch made an experiment to ascertain whether a very low temperature not merely checked development but killed them, and subjected the comma bacilli to a temperature of 10° C. They were then completely frozen, but yet retained vitality, growing in gelatine afterward. Other experiments, by excluding air from the gelatine cultures, or placing them under an exhausted bell jar, or in an atmosphere of carbonic acid, went to prove that they required air and oxygen for their growth; but the deprivation did not kill them, since on removing them from these conditions they again began to grow.

The growth of these bacilli is exceptionally rapid, quickly attaining its height, and after a brief stationary period as quickly terminating. The dying bacilli lose their shape, sometimes appearing shriveled, sometimes swollen, and then staining very slightly or not at all. The special features of their vegetation are best seen when substances which also contain other forms of bacteria are taken--_e. g_., the intestinal contents or choleraic evacuations mixed with moistened earth or linen and kept damp. The comma bacilli in these conditions multiply with great rapidity so as to far outnumber the other forms of bacteria, which at first might have been in far greater abundance. This state of affairs does not last long; in two or three days the comma bacilli began to die off, and the other bacteria began to multiply. Precisely the same thing takes place in the intestine, where, after the rapid initial vegetation is over, and when exudation of blood occurs in the bowel, the comma bacilli disappear and putrefactive bacteria predominate. Whether the occurrence of putrefaction is inimical to the comma bacilli has not been proved, but from analogy it is very probable. At any rate, it is important to know this for certain, for if it be so, then the comma bacilli will not thrive in a cesspit, and then further disinfection would be unnecessary. These bacilli thrive best in fluids containing a certain amount of nutriment. Experiments have not yet shown the limits in this respect, but Koch has found them capable of growing in meat broth diluted ten times.

Again, if the nutrient medium become acid in reaction their growth is checked, at least in gelatine and meat infusion; but singularly enough, they continue to grow on the surface of a boiled potato which has become acid, showing that all acids are not equally obnoxious to them. But here, as with other substances which hinder their growth, they do not kill the bacilli. Davaine has shown that iodine is a strong bactericide. He experimented with anthrax bacilli in water to which iodine was added, and the bacilli were destroyed. But practically the organisms have to be dealt with in the alkaline contents of the bowel, or in the blood or fluids of the tissues, where iodine cannot remain in the free state. Koch found that the addition of an aqueous solution of iodine (1 in 4,000) to meat infusion, in the proportion of 1 in 10, did not in the least interfere with the growth of the bacilli in that medium. He did not pursue this line of inquiry, seeing that in practice larger quantities of iodine than that could not be given. Alcohol first checks the development of the comma bacilli when it is mixed with the nutrient fluid in the proportion of 1 in 10, a degree of concentration which renders it impracticable for treatment. Common salt was added to the extent of 2 per cent. without influencing the growth of the bacilli. Sulphate of iron, in the proportion of 2 per cent., checks this growth, probably by precipitating albumimites from the fluids, and possibly also by its acid reaction; certainly it does not seem to have any specific disinfecting action--i.e., in destroying the bacilli. Indeed, Koch thinks that the admixture of sulphate of iron with fæcal matter may arrest putrefaction, and really remove what may be the most destructive process to the comma bacilli. Hence he would distinguish between substances which merely arrest putrefaction and those which are bactericidal; for the former may simply serve the purpose of preserving the infective virus. Among other substances which prevent the growth of the comma bacilli may be mentioned alum, in solutions of the strength of 1 in 100; camphor, 1 in 300; carbolic acid, 1 in 400; oil of peppermint, 1 in 2,000; sulphate of copper, 1 in 2,500 (a remedy much employed, but how much would really be needed merely to hinder the growth of the bacilli in the intestine!); quinine, 1 in 5,000; and sublimate, 1 in 100,000. In contrast with the foregoing measures for preventing the growth of these bacilli is the striking fact that they are readily killed by drying. This fact is proved by merely drying a small drop of material containing the bacilli on a cover-glass, and then placing this over some of the fluid on a glass slide. With anthrax bacilli vitality is retained for nearly a week; whereas, the comma bacillus appears to be killed in a very short time. Thus it was found that although vitality was retained--depending largely upon the number of bacilli--for a short time, yet withdrawal of the nutrient fluid for an hour or even less often sufficed; and it never happened that the bacilli retained vitality after a deprivation lasting twenty-four hours. These results would seem to point to the fact that the comma bacillus does not, like the organisms of anthrax and vaccinia, pass into the resting state (Daner-zustande) by drying; and if so, it is one of the most important facts in the etiology of cholera. Much, however, remains to be done, especially with regard to the soiled linen of cholera patients being kept in a damp state. He found that in soiled articles, when dried for a time, varying from twenty-four hours and upward, the comma bacilli were quite destroyed. Nor was the destruction delayed by placing choleraic excreta in or upon earth, dry or moist, or mixed with stagnant water. In gelatine cultures the comma bacilli can be cultivated for six weeks, and also in blood serum, milk, and potato, where anthrax bacilli rapidly form spores. But a resting state of the comma bacilli has never been met with--a very exceptional thing in the case of bacilli, and another reason why the organism must be regarded rather as a spirillum than a bacillus, for the spirilla require only a fluid medium, and do not, like the anthrax bacilli, thrive in a dry state. It is quite unlikely that a resting state of the comma bacillus will ever be discovered; and, moreover, its absence harmonizes with our knowledge of cholera etiology.--_The Lancet_.

* * * * *

[THE MEDICAL RECORD.]

MALARIA.--THE NATURAL PRODUCTION OF MALARIA, AND THE MEANS OF MAKING MALARIAL COUNTRIES HEALTHIER.

[Footnote: An Address delivered at the Eighth Session of the International Medical Congress, Copenhagen, August 12, 1884.]

By Conrad Tommasi Crudeli, M.D., Professor of Hygiene, University of Rome, Italy.

Before entering upon my subject, I must crave the indulgence of those of my colleagues whose language I have borrowed for any italicisms that I may use, as well as for the foreign accent which must strike their ears more or less disagreeably. Desiring to respond as well as lay in my power to the invitation with which I have been honored to discuss the hygienic questions relating to malaria, I have chosen the French language as being the one in which, apart from my mother tongue, I could express myself with the greatest ease and precision.

I shall be pardoned also, I hope, for having employed the terms "malaria" and "malarial districts" in place of the more commonly used expressions "paludal miasm" (_miasme paludeen_) and "marshy regions" (_contrées marécageuses_). The substitution is not a happy one from a literary point of view, but I have made it deliberately and for the following reason: The idea that intermittent and pernicious fevers are engendered by putrid emanations from swamps and marshes is one of those semi-scientific assumptions which have contributed most to lead astray the investigations of scientists and the work of public administrations. This idea, so widespread and so well established by the traditions of the school, is radically false. The specific ferment which engenders those fevers by its accumulation in the atmosphere which we breathe is not exclusively of paludal origin, and still less is it a product of putrefaction. Indeed, in every region of the globe between the two Arctic circles there are swamps and marshes, steeping-tanks of hemp and flax, large deltas where salt and fresh waters mix, and yet there is no malaria there, although putrid decomposition is on every side. On the other hand, in the same parts of the globe there are places which are not and never were marshy, and in which there is not the least trace of putrefaction, but which, nevertheless, produce malaria in abundance. I reject, therefore, wholly the paludal assumption, and in order to express this view in the title of my paper, have been forced to employ terms which to my hearers may sound like italicisms.

The Italians generally have not this paludal notion, for experience taught them long ago that malaria is produced nearly everywhere--in marshy districts as well as in those which might almost be called arid; in a volcanic soil as well as in the deposits of the Miocene and Pliocene periods and the ancient and modern alluvia; in a soil rich in organic matters as well as in one containing almost none; in the plains as well as on the hills or mountains. The word malaria (bad air), which it is the sad privilege of Italy to have lent to all languages to express the cause of intermittent and pernicious fevers, represents, then, among the majority of our rural populations, the idea of an agent which may infect any sort of country, whatever may be its hydraulic and topographical conditions, and whatever may be its geological formation. This word, therefore, is the one best suited to designate this specific ferment in question, and I have on this account, employed it and its adjectival derivatives in order not to resuscitate the idea of the exclusively paludal origin of the morbific agent.

I shall not tarry long to speak of the nature of this ferment, for the studies bearing upon that point, although far advanced, are not yet completed. I may remark, however, that the idea that the ferment is formed of living organisms is a very old one, and has not arisen suddenly because of the modern theories of the parasitic nature of disease. From the time of Varrar (who believed that malaria was made up of invisible mites suspended in the atmosphere) to our own day this theory has been several times advanced by hygienists. Independently of the general considerations which led Rasori, and later Henle, to formulate the doctrine of the _contagium vivum_ of infection (long before the progress of microscopical science had revealed the existence of living ferments), there were peculiar circumstances as regards malaria which should have impelled minds to look in that direction, even in times long past.

Some of these circumstances are of a nature to strike every serious observer, and deserve a few moments' attention. How could one maintain, for example, that this ferment is a product of chemical reactions taking place in the ground, when it is seen to remain constantly the same whatever may be the composition of the soil from which it emanates! As long as the paludal theory held sway, the chemical interpretation of this identity of the product in every latitude was easy. Rica does not hesitate to admit that when a swampy tract is heated by the sun's rays to the necessary point for the putrid decomposition of the organic matters contained in it, the "chemical ferment," or rather the "mephitic gases," to which is attributed the morbific action, are developed, whatever may be the distance from the equator at which this marshy region lies. But since it has been ascertained that malaria is produced in soils of the most varied chemical composition, _the persistent identity of this product_ has become chemically inexplicable; while it is however readily conceivable, if one admits that malaria is an organized ferment which easily finds the necessary conditions for its life and multiplication in the most varied soils, as is the case with millions of other organisms vastly superior to the rudimentary vegetables which constitute the living ferments.

The same thing may be said of _the progressive intensity of the morbific production in abandoned malarious districts_. This fact has been historically proved in several parts of the earth, and especially in Italy. A large number of Grecian, Etruscan, and Latin cities, even Rome itself, sprang up in malarious territories and attained a high state of prosperity. First among the reasons for this success must be placed the works undertaken with a view of rendering these places more salubrious, and which lessened the evil production, _but almost never extinguished it completely_. After the abandonment of these localities, the production of malaria recommenced in a degree which went on increasing from age to age, and which has rendered some of these places actually uninhabitable. This was seen, in the time of the ancient Romans, in Etruria, when it was conquered and laid waste, and in several parts of Magna Græcia, and of Sicily. From the fall of Rome even to the present day, this phenomenon has been manifested in a very evident manner in the Roman Campagna, in certain parts of which, even up to the time of the Renaissance, it was possible to maintain pleasure houses, but which are now unhabitable during the hot season. In many cases the physical conditions of the soil have undergone no appreciable change during centuries, so that it is impossible to attribute so enormous an augmentation of malaria to an increase in its annual production, itself increased by a progressive alteration of the chemical composition of the soil. But if, on the contrary, it be admitted that malaria is caused by a living organism whose successive generations accumulate in the soil, the interpretation of this fact becomes very simple.

There are, finally, _peculiarities in the local charging of the atmosphere with malaria_ which can be explained only in this manner. If the malarial miasm were composed of gaseous bodies emanating from the soil, or rather of chemical ferments formed beneath the ground and raised into the air by gases or watery vapor, the charging of the atmosphere with the specific poison ought to arrive at its maximum during the hottest part of the day, when the ground is heated the most by the sun's rays, and when the evaporation of water and all chemical actions attain their maximum intensity. But this is very different from what actually occurs. The local charging of the atmosphere is always less strong during the meridian hours than at the beginning and the end of the day, that is to say, after the rising, and especially after the setting, of the sun. Now it is precisely at these hours that the difference between the temperature of the lower layers of the atmosphere and that of the surface of the ground is the greatest, and that the ascending currents of air starting from the ground are the strongest. If malaria consists of solid particles contained in the soil, one may readily understand how their elevation _en masse_ into the atmosphere should take place especially at these two periods of the day.

All these facts, which can be easily verified if the subject of malaria be studied on the spot and without any preconceived notions, explain the tendency which has always been manifested to attribute this specific poisoning of the air to a living organism which is multiplied in the soil; and they also explain the ardor with which hygienists have applied themselves to the production of the scientific proof.

Unfortunately the investigations undertaken for this end have for a long time been fruitless, for the preconceived paludal theory has led investigators to occupy themselves exclusively with the inferior organisms inhabiting marshes. Among these organisms they studied especially the _hyphomycetes,_ which had already acquired so great an importance in dermatology; and their entire attention was concentrated upon the aquatic algae, without even taking the precaution to determine whether the varieties which they thought to be malarial were found in all malarious swamps, or whether they were capable of living within the human organism. It has thus happened that each observer has indicated as the cause of malaria a different variety of alga, whichever he found to be most abundant in the swampy ground that he had to examine. Thus Salisbury has indicated the _palmella gemiasma,_ which is found with us in places perfectly free from malaria, while it is often wanting in malarious marshes in the center of Italy; Balestra, a species of alga which is as yet indeterminate; Bargellini, the _palmogloea micrococca;_ Safford and Bartlett, the _hydrogastrum granulatum;_ and Archer, the _chitonoblastus oeruginosus_. There is not a single one of these species the parasitic nature of which has been demonstrated; and as regards the two last named varieties, it can be positively denied that they are capable of producing a general infection, for the diameter of their spores and filaments is greater than that of the capillary blood vessels.

It was only in 1879 that Klebs and myself, after having been thoroughly freed, by a long series of preparatory studies, from the unfortunate paludal idea, undertook together some investigations in malarious districts of the most varied character, marshy and not marshy. We employed the system of fractional cultivation, making experiments on animals with the final products thus obtained. We felt ourselves justified in recognizing the malarial ferment in the _schizomycete bacillus_. The numerous researches made subsequently by us, and by many other observers, in the soil and in the air of several malarious localities, as well as in the blood and in the organs of men and animals specifically infected, have put it henceforth almost beyond doubt that we really have to do with a schizomycete. Very recently, MM. Marchiafava and Celli have succeeded in demonstrating that the germs of this schizomycete attack directly the red blood-globules, and destroy them, causing them to undergo a series of very characteristic changes which admit of easy verification, and which render certain the existence of a malarial infection.

Several observations made recently in Rome tend to demonstrate that the schizomycete of malaria does not always assume the complete bacillary form described by Klebs and myself; but this morphological question possesses no further interest for the hygienist. For him the essential thing is to know that he has to deal with a living ferment which can flourish in soils of very varied composition, and without the presence of which neither marshes nor stagnant pools of water are capable of producing malaria.

We must not think, however, that all earth containing this ferment is capable of poisoning the superjacent atmosphere. Popular experience, certain modern scientific investigation, and the facts which one can often verify when the soil, which was malarious in ancient times and which has since ceased to be so, is turned up to a great depth, all agree in proving that the ground remains inoffensive as long as it is not placed in certain conditions indispensable for the multiplication of this specific ferment. Up to this point the organism lives, so to speak, in an inert state, and may remain so during centuries without losing any of its deleterious power. There is nothing in this fact that ought to surprise us, since we know that the life and the power of evolution belonging to the seeds of plants of a much higher order than these vegetable organisms constituting ferments, may remain latent for centuries, and may then revive at once when these grains are placed in the conditions suitable for their germination.

Among the conditions favorable to the multiplication of the malarial ferment contained in the soil, and to its dispersion through the superjacent atmosphere, there are three which are absolutely essential, and the concurrence of which is indispensable for the production of bad air (malaria). First, a temperature which does not fall below 20°C. (67.5°F.); next, a very moderate degree of permanent humidity of the soil; and finally, the direct action of the oxygen of the air upon the strata of earth which contain the ferment. If a single one of these three conditions be wanting, the development of malaria becomes impossible. This is a point of prime importance in the natural history of malaria, and it gives us the key to most of the methods of sanitary improvement attempted by man.

Let us see first what can be done in this direction without the labor of man. For nature herself makes localities salubrious by _suspending_ for a greater or less time the production of malaria. It is thus that winter brings about in every country a freedom from malaria which is _purely thermic_, for it is due simply and entirely to a sinking of the temperature below the required minimum. Indeed, if the temperature in winter rises above this minimum, there are often sudden outbreaks of malaria. Sometimes, during very warm and dry summers, the heat extracts all the humidity from the malarious soil, and thus procures for us a freedom from the disease which is _purely hydraulic_. This may continue for a long time (as happened in the Roman Campagna during the years 1881 and 1882), but may also be completely destroyed by a single shower. Nature also sometimes renders a district healthy in a manner _purely atmospheric_, by covering a malarious soil with earth which does not contain the malarial ferment, or with a matting formed of earth and the roots of grasses growing closely together in a natural meadow.