421 



gUiirds or protects himself he survives. One need scarcely consider the 

 few individuals, shall we say the survivals of the fittest, able to live under 

 filth and filthy air conditions. Fittest does not necessarily mean the best 

 — the slums of cities do not represent civilization, neither do baclvward 

 cities represent the civilization of today. We have not yet reached a stage 

 where we look far ahead into the future. We still act upon the principle 

 of letting the future take care of itself. After us the flood. 



CoNiosis (Konls, dust; osis, a state or condition) may be defined as a 

 peculiar state or condition due to inhalation of dust (dust with more or 

 less infection derived from dried spittle) ; it is a reaction of the body. 

 The reaction varies from a mere feeling of discomfort up to decided pain- 

 ful sensations, perhaps with a feeling of ill health or threatened sickness. 

 Metabolism is more or less disturbed, depending on the amount of reaction ; 

 there is deviation in temperature; the sensory organs and the sensorium 

 are more or less affected, likewise the circulatory and excretory systems, 

 with variations in the secretion of gastric juices. Pain may be localized 

 in old injuries or weak parts of the body. The severity of the reaction 

 depends on the amount of exposure. The reaction may last a few hours 

 or indefinitely under continued exposure.^ 



In attempting to define the term Coniosis one feels himself in th'i 

 position of the physician in court when asked to define insanity : he may 

 very well know what it means and to whom to apply the term when mak- 

 ing an insanity inquest — but to make a definition that will be satisfactory 

 to a quibbling lawyer is a difficult matter. The definition of Coniosis 

 (which the general practitioner of medicine may regard as ill health) 

 may not be satisfactory to the student of specific diseases, there will be 

 quibbling. 



If a man wants to know why it is difficult to make a good definition 

 of insanity he should spend a few months among the insane. If he wants 

 to know why it is difficult to define Coniosis or dust infection he should 

 carefully observe a number of dust victims. (A man may even study him- 

 self, how he reacts under good and bad air conditions.) 



1 In a paper on Atypical Cases and Dnst Infection (American Medicine, 1 Oct., 

 1004) I used the following definition : 



"It is cliaracterizod clinically by an irritation of mucous membranes ; vague 

 wandering pains throughout the body, mostly referable to the muscles or ligaments ; 

 lassitude," headache, feverishness and anorexia, up to vomiting, marked nervous dis- 

 turbance, and severe localized pain. The manifestations may vary considerably in 

 different individuals, and the symptoms may be wlioUy subjective. It is often fol- 

 lowed by other, specific, diseases." 



At that time I had assumed that the term Coniosis was preoccupied. 



