Miscellaneous Papers. 317 



THOUGHTS ON TUBERCULOSIS. 



(Abstract.) 



By J. M. McWharf, M. D., Ottawa. 



T>Y THE TERM PHTHISIS, or consumption, we understand 

 -'-^ that it is a disease characterized by wasting or emaciation 

 Tubercle, tubercular disease and tuberculosis have gradually come 

 to be regarded as identical with the term phthisis. As we study 

 this important morbid condition it is essential that we consider it 

 under general heads, as its pathology, symptoms, diagnosis, prog- 

 nosis, and treatment. Its pathology involves a consideration of 

 the histology, chemistry and general pathology of tubercle ; that 

 is, its cause, natural progress, and the theory of its production. 

 The term tubercle would include the various forms, as infiltrated, 

 milliary, cretaceous, and calcareous ; its morbid anatomy, the 

 lungs, the pleura, bronchial glands, alimentary canal, peritoneum, 

 trachea, larynx, liver, mesenteric and lymphatic glands, spleen and 

 kidneys, with other textures and organs. 



Causes of tuberculosis are age, sex, hereditary tendency, vitiated 

 air, climate, contagion, and occupation. Time or space will not 

 permit me to enter more fully into detail. A discussion of the sub- 

 ject at this time must be upon a broad and general sense. During 

 the ebb-and-flow tide of medicine, great changes have been evolved, 

 and yet I doubt not that there are many yet in store for future de- 

 livery. Since a.d. 1810 our ideas and conceptions of this disease 

 have radically changed. To-day we hold that tuberculosis is a spe- 

 cific, infectious, inflammatory condition, nonvascular, and nodular; 

 that it holds the parasite in its substance; that it attacks any and 

 every part of the body. When the tubercle is limited to the foci, 

 there is a strong possibility of its spreading to other parts of the 

 body. This tubercle is the most serious enemy to the human race. 

 First, it contains the germ ; secondly, this germ slays its thousands 

 in many ways. Meat and milk of tuberculous animals are very im- 

 portant factors in the production of this disease. The researches 

 of bacteriologists have proven beyond a doubt that there is an un- 

 ceasing contest being waged between the invading bacillus upon 

 the one side, and the living organism or leucocytes upon the other. 

 The leucocytes st:ind guard while the bacterial invaders make the 

 onslaught, and should the latter prove victorious the disease will be 

 established. 



