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2
With regard to scarlet fever, I have this to say, that while little is at
present known about the conditions, atmospheric or otherwise, which
determine its revival from time to time in a population, thus much is
certain, that it does not arise spontaneously—no disease of its class ever
does. The seeds of the malady—something given off from a person
suffering under it—are always present; isolated cases are never wanting
in the metropolis. The human systems constituting a population may
be regarded as the soil in which the seed is capable of expanding,
vivifying and reproducing its like; but on the one hand the soil is not
always in a condition to favour the process, nor on the other are atmospheric
conditions always such as to permit of the maintenance of the
vitality of the seed, or to promote its germination. From time to time,
however, the necessary conditions arc present, and then an outbreak of
scarlatina occurs. There is nothing in this which is not in accordance
with the analogy of nature. Up to the present time medical science has
not determined, with any precision, what the necessary conditions for an
outbreak are; but, standing upon the everlasting mundane truth that
e nihilo nihil fit, it declares absolutely and infallibly that a germ must
exist and be somehow introduced into the human system before scarlatina
as a disease can manifest itself therein. And experience supports the
dictum. Here then is a truth with important practical bearings ! If
we do not know with exactness what the condition of the system is
which causes the germ of scarlatina to be inoperative at one time and
at another time favours its operation on the body, we know, at any rate,
that it is the duty of all who would check the spread of the disease to
do their utmost to destroy the vitality of the germs given off from the
sick, and to prevent, as far as possible, their gaining access to other
human systems. There is no reason whatever to believe that ordinary
local conditions of unwholesomeness, except in so far as they favour the
retention of the germs of the malady, as dirtiness in a habitation, or
favour personal intercourse with the sick, as crowding and bad ventilation,
have any close connection with the outbreak of the malady
anywhere, although there is abundant evidence that all of them do more
or less influence the final result in death or recovery of any individual
case. Hence, taking a practical view of the subject, it is obvious that
the provisions of the old Nuisances Removal Act are mainly of use to
us in combating scarlet fever by enabling us to enforce general