EDITORIAL ARTICLES. 239

three and a half months after the operation made no noise even on severe exercise. Excellent drawings showing the condition of parts after death are given in the paper.

Of the various operations that have been suggested, excision of the paralysed vocal cord is the easiest to perform, and if successful ia removing the respiratory impediment it would doubtless be preferred to any other. Unfortunately there is not great room to hope that it would accomplish that object, since it appears most likely that the abnormal sound is due in large measure, if not altogether, to. the condition of atrophy and adduction of the arytenoid cartilage, and consequent abnormal position of the aryteno-epiglottic fold of mucbus membrane. Experiment alone can determine these points, and we are pleased to gather from Dr Clarke's paper that he intends to pursue his researches on the subject.

THE ANIMAL ORIGIN OF DIPHTHERIA.

VETERINARY surgeons have recently been laid under the reproach that they were in complete ignorance regarding a highly important disease of one of the domestic species until it was described for them by certain members of the sister profession. Until Drs Power and Klein discovered and described the Hendon outbreak, it had never been suspected that bovine animals were subject to epizootics of scarlatina. There cannot be found either in British or foreign veteri­nary literature the description of a disease of cows having the characters of the Hendon malady. It is true that the description given of the latter disease might be applied to cow-pox, but cow-pox does not cause scarlatina in the human subject. If further experience and investigation (and there is still substantial shelter to be obtailled behind the if) should demonstrate that scarlatina is to be met with as a cow disease, with the clinical and anatomical features of the Hendon affection, then veterinary surgeons will have to invent whatever excuses are possible to hide themselves from the not unmerited censure.

The discovery, if such it may be called, of the connection between human scarlatina and disease of the cow fell with the force of a shock on the milk-consuming public. But worse is still to come. In the annual report of the medical officer to the Local Government Board issued last year, there appeared a paper I calling attention to the fact that diphtheria of the human subject may be due to infection from pigeons, fowls, turkeys, pheasants, cats, pigs, sheep, or horses. The writer ofthe paper, it would naturally be thought, must have had good grounds for believing in such a wide extension of diphtheria among the domestic animals. Was the circumstantial evidence sufficient in the

1 Report by Dr Turner on his experience:; of diphtheria, especially in its relation to lower animals. R

EDITORIAL ARTICLES.

cases observed to exclude the possibility of a human source ofinfection, and to prove the identity of the affections witnessed in the above­named animals with the diphtheria of the human subject; or was this identity experimentally demonstrated by infecting these animals with materials from human beings, and thus producing a disease apparently identical with that to which the human outbreaks were ascribed? These are the questions that at once suggest themselves, and a few quotations from the paper will suffice to answer them.

We take them from the evidence adduced to incriminate horses as at times constituting the starting-point of human diphtheria.

The writer says: "Horses, it is well known, suffer from sore throat, one variety of which is called 'strongles;' but diphtheria does not appear to be recognised as a disease occurring amongst them. With­out asserting that strongles is in all cases diphtheria, I think it is possible that some of the many diseases classed under that name may have kinship with the human diphtheria disease." That is the theory. Here is the proof: "At Moulton the first case of diphtheria at a farm­house occurred shortly after a horse had died of strongles; the second was that of a man working on the farm as 'horse-keeper,' and in the neighbouring village of Ouesden, where a man who had recently recovered from diphtheria was for a short time employed to groom a mare, the animal in question was in a few days affected with strongles, as shown by much swelling at the angle of the jaws, and a very foul discharge from the nose. At Yately diphtheria in the human subject was in two instances coincident with strongles amongst the horses. Other instances of a similar character have come to my knowledge, and if the nature of the employment pursued by persons (or their parents) who have died of diphtheria be noted, it is surprising what a large proportion will be found to have followed occupations more or less connected with horses, or other of the lower animals."

These observations of Dr Turner will materially lighten the labours of medical practitioners in tracing the infection in cases of diphtheria. Let them merely inquire whether the patient (or one of his relatives) has been near a horse or other lower animal. When he gets an affirma­tive reply, he need not further pursue his investigation.

Can anyone with the most elementary knowledge of equine diseases read the sentences just quoted and preserve a serious countenance? How could anyone acquainted with the clinical characters and morbid anatomy of strangles for a moment believe that it could be diphtheria, or capable of exciting diphtheria in human beings? To set forth the reasons for believing the contrary would be to insult our readers. It is as clear as anything can be that Dr Turner is utterly ignorant regarding the nature of this disease, whose very name he mis-spells. That a medical officer of health should have little or no knowledge regarding this disease of horses is not surprising, but it surely is only reasonable to expect that he would make himself acquainted with

CLINICAL ARTICLES.

what is known regarding the pathology of a disease before venturing to suggest that it might be diphtheria. In what district, we wonder, are many diseases classed under the term" strongles " ? It would be far nearer the truth to say that many different diseases are classed under the name diphtheria. Certain it is there are few diseases of either man or animals with more distinctive characters than strangles.

But even if the pathological and clinical characters of that everyday disease did not make it utterly impossible to believe that it could have any <.etiological connection with human diphtheria, no one would be justified in rushing into print on such a slender train of circum­stanti1j.1 evidence as Dr Turner adduces: "The first case of diphtheria at a farmhouse occurred shortly after a horse on the farm had died of strongles; the second was that of a man working on the farm as horse-keeper." There is not much force in that, unless it is intended to prove that being a horse-keeper, or residing at a farm where a horse has died of strangles, will not give immunity from diphtheria.

But we have already quoted enough from this absurd paper. The marvel is that it ever found a place in such a responsible publication as the Local Government Board Report. We should not have deemed it worthy of notice had we not observed that the speculations con­tained in it have more than once of late been gravely quoted as evidence of the animal origin of diphtheria. The question whether any of our common domestic animals may become the subjects of true diphtheria, and serve as centres of infection to human beings, is certainly an important one. It has during the past twenty years or more formed the subject of much controversy; and although the pre­ponderance of the evidence, both clinical and experimental, appears to give a negative answer, it cannot be said that the question is settled. It is certain that for its solution there will be required more careful observation and experimentation, and less frivolous theorising, than Dr Turner appears to have brought to bear on the subject.

eLI N I CAL ART I C L E S. --0--

SPERMATIC ANEURISMAL VARIX IN THE OX.

By THOMAS WALLEY, M.R.C.V.S.,

Principal of the Royal Veterinary College, Edinburgh.

CASES of this description are of comparative rarity in connection with any of the vessels in the human subject. They are of extreme rarity in the lower animals. In conversations on the subject with several surgeons practising in this city I have been struck by the almost uniform expression of astonishment at the character of the