THE GREAT WHITE PLAGUE. 301 



which he examined on autopsy, of people who had died of all sorts of 

 disease, besides those dying of old age. 



There are two conditions essential to the development of consump- 

 tion. In the first place, there must be the presence of the bacilli of 

 Koch as its specific or essential cause. In the second place, the body 

 must be predisposed to the disease by various unhealthful factors, such 

 as vicious heredity, alcoholism, poverty and the like. Most of us are 

 able to resist the bacillus because our bodies are sufficiently strong to 

 resist the organism, and because there are in our tissues certain germi- 

 cidal properties, which are ordinarily sufficient to cope with and destroy 

 the bacillus. The layman will easily get the idea from the following 

 experiment: Some rabbits were inoculated with tubercle bacilli and 

 placed in relations generally deleterious to health; these became con- 

 sumptive. Another group, selected from these same rabbits, were like- 

 wise confined, but were not subjected to infection, and these did not 

 develop the disease. Whilst among a third group, which were inocu- 

 lated like the first, but which were, on the contrary, favorably located 

 as to hygiene, most of the rabbits escaped the disease. 



The tubercle bacillus is indeed originally a saprophyte, feeding 

 upon dead or decomposing material. Its next congenial habitat is such 

 tissue of living animals as has been previously devitalized by unwhole- 

 some factors; that is to say, these factors have rendered the tissues of 

 the body vulnerable to the onset of the bacillus and certain other micro- 

 organisms which later join it in its work of devastation. These pre- 

 disposing factors render the tissues a fruitful soil in which the bacillus 

 and its allies may germinate and thrive. I should like to touch briefly 

 upon certain of these predispositions. 



It was formerly held that consumption is a hereditary disease. 

 But we know now it is practically impossible for such to be the case, 

 for parents can not transmit the bacillus to their offspring. What 

 parents may transmit is a tendency to the disease, resulting from un- 

 healthful conditions in their own organisms. Such hereditary trans- 

 mission may be manifested by the offspring in the scrofulous tempera- 

 ment. The child may have a pallid skin and flabby flesh; and 

 inflammation of the mucous membranes, as would be indicated by red- 

 dened and suffused eyelids, coryza and congested and unhealthy throats. 

 There would be adenoid growths in the back of the nose and enlarged 

 tonsils, so that such children would be mouth breathers, starved for 

 oxygen. The glands of the neck and in other parts of the body would 

 become enlarged. Besides these things, there might be malformations 

 of the thorax and a capacity for breathing evidently below the average, 

 congenital affection of the heart and the rest of the circulatory system, 

 slow teething and deficient and tardy ossification. There would, in 

 short, be evidence of defective development and of a generally torpid 

 condition of the system. 



