PROCEEDINGS OF SECTION I. 703 



THE CURE OF CONSUMPTIVES. 



Now that I have tried to impress you with the prevalence of con- 

 sumption, and I have shown you how many in the present state of things 

 are the opportunities and facilities for those people who are susceptible to 

 contract the disease, I want to deal with the question that is so often asked 

 — Can a person suffering from consumvtion he cured ? The answer to this 

 question is yes and no. A man's chances of recovery from consumption 

 depend upon several factors, such as his natural power of resistance, 

 the length of time he has suffered from the disease, and the particular 

 strain of bacillus with which he has become infected. The last fact 

 is not sufficiently recognised. There appear to be certain strains of 

 tubercle bacilli which are mild, almost harmless, and others that are 

 extremely virulent. 



If one man contracts consumption from another who is suffering 

 from a chronic mild type of the disease, then the person last infected 

 will usually also sufier from a mild form of consumption. But if, on 

 the other hand, a man contracts consumption from one who is suffering 

 from rapid or galloping consumption, then the last infected is likely 

 also to suffer from rapid consumption. I regard a man suffering from 

 rapid consumption (acute caseating tuberculosis) as far more dangerous 

 than a person suffering from the more common forms of consumption, 

 and I think that persons suffering from rapid consumption should 

 accordingly be strictly isolated, and the doctor who notifies the case 

 should definitely state on his certificate that the patient is suffering 

 from the more dangerous form of the disease. 



To come back to the point of my discussion. A man's chances 

 of recovery depend in part upon the virulence of the strain of bacillus 

 which has invaded him. It also depends upon the extent of the damage 

 that has already been wrought by the disease. 



If a portion of a man's lung has been destroyed by the action of 

 the tubercle bacillus it is never replaced by new lung. The part des- 

 troyed, if not too great, may be replaced by scar tissue ; but sometimes 

 one or more whole lobes of the lung may be completely destroyed, 

 and when that has happened there can be no question of cure in the 

 ordinary sense of the word. 



I show you a photograph of the right lung from a patient who had 

 consumption, and you will see that it is a mere space — there is no 

 spongy lung tissue at all. In a case like this there can be no question 

 of cure (Plate III., fig. 8). 



I mention this fact particularly because in the daily papers you 

 can always see the advertisements of certain unscrupulous men who 

 assert that their quack remedies will cure consumption in any stage 

 of the disease. 



The matter is wholly different in the earlier stages. I affirm 

 most emphatically that the great majority of cases of consumption 

 can be completely and permanently cured if the appropriate treatment 

 is adopted in the very early stages of the disease. 



