CONSUMPTION 



CONTAGIOUS DISEASES 441 



tion. i >|-n air exercise, varied according to circum- 

 stances, li^'lit xymiia.-tu-s, lii''ii ( >" <>f the .skin, and 

 bathing, unless contra-indicated, urn to I"- rum 

 mended. Siiflirient sleep, abundant and regular 

 meiils of simple nourishing food, and warm li^'lit 

 clothing are essential. Kxposiire to chills or damp 

 must be strictly avoided, and tlie utmost care taken 

 that no ' cold be allowed to persist. If a cough 

 continue, or any other symptom of consumption 

 show itself, medical advice should be obtained at 

 once. 



When consumption is distinctly present, there 

 are two lines open to the physician the defensive 

 and the offensive and rational treatment should 

 combine these. In carrying out the former, an 

 attempt must be made to improve the general 

 condition, so that effective resistance may be 

 offered to the invasion of the bacillus. For this 

 ] in i po.se all means of fattening the body should be 

 adopted ; and of these, par excellence, cod-liver oil, 

 which has come to be regarded almost as a specific 

 for consumption. As Dr C. J. B. Williams says : 

 ' The beneficial operation of cod-liver oil extends to 

 every function and structure of the body.' Fatty 

 foods, butter, cheese, cream, milk, koumiss, glycer- 

 ine, &c. are similarly of service. Care must be 

 taken to maintain the appetite. The moderate use 

 of alcohol, in one form or another, is advisable. 

 Attention should be bestowed on the carrying out 

 of those general hygienic rules which have been 

 indicated. The chest should be gently expanded 

 by such means as reading, singing, and regulated 

 open-air exercise. Disadvantageous climatic and 

 atmospheric conditions are to be removed, where 

 possible. This is specially of importance in our 

 moisture-laden climate. Often a change of resi- 

 dence from seaside or city to the highlands proves 

 beneficial, or, where the disease is pronounced, 

 removal from the northern to a more temperate zone. 

 Where comparatively short journeys can alone be 

 contemplated, Bournemouth, Hastings, Ventnor, 

 Torquay, Penzance, and other places on the 

 southern shores of England may oe thought of. 

 Where longer ones are possible, the variety is 

 immense, from the Mediterranean and Atlantic 

 stations to the slopes of the Rocky Mountains. 

 In many cases a sea voyage is best ; but this 

 is contra-indicated under certain conditions, and 

 should never be undertaken without medical 

 advice. In connection with all these plans, wise 

 consideration will be given to the fact that appar- 

 ent advantages are unfortunately counterbalanced 

 bv disadvantages which are less easily gauged. 

 "While much benefit is to be expected in suit- 

 able cases, it is unnecessarily cruel to send a 

 patient to die away from home. The offensive 

 method of treatment rests on the hypothesis of 

 the opposition offered by certain drugs to the 

 life and development of the bacillus. The first 

 vague feeling after such a system found expres- 

 sion in the various respirators, whose efficacy 

 has from time to time been vaunted. There are, 

 however, grave objections to the use of these. 

 Firstly, such instruments of necessity render the 

 movements of respiration less easy ; and secondly, 

 it is questionable whether, in the diseased state of 

 the lungs, much of the antiseptic influence reaches 

 the diseased portion. More recently an attempt 

 has been made to introduce into the body certain 

 drags, which experiment indicated as antagonistic 

 to the life of the bacillus. These have been admin- 

 istered by the mouth, by the rectum, subcutane- 

 ously, and by injection into the air passages 

 directly. Thus creosote, iodoform, terebene, 

 sulphurous acid, menthol, and other drugs, have 

 been exhibited. The method is still on trial. 

 Most encouraging reports have been published 

 from time to time, but it cannot be said that 



. i i.unt v of result ha- yet been attained. For the 

 ii-lici oi' Mitlering and the jtalliation of distressing 

 symptom-, .-in endless number of remedies might be 

 named. No disease taxes more fully the patience 

 and resource of the physician, and, apart from the 

 general lines indicated, each case iniiht l*e regarded 

 individually. 



Consumption in the Lower Animals. The con- 

 sum pt ion of the lower animals has been proved to 

 be essentially the same disease an that occurring in 

 man. Its immediate dependence on the tubercle 

 bacillus has been established. It affect* the Inivine 

 species more especially. It is comparatively rare in 

 the sheep, and very rare in the horse and do-, i 

 rabbits, and poultry are extremely susceptible to the- 

 disease. The same class of causes appears in giv< 

 rise to it. Its extreme frequency in cows in probably 

 referable to the more or leas confined life which 

 these animals lead in comparison with the horse 

 and dog. The udders or the tubercular cows 

 frequently exhibit signs of the disease, and in those 

 cases the Bacillus tuberculosis has been demon- 

 strated in the milk. It is a question whether the 

 bacillus is found in the milk of tuberculous- 

 animals apart from such local disease. But the 

 probable communicability of the disease from the 

 lower animals to man makes it desirable that 

 consumption should be included among the con- 

 tagious diseases, so that tubercular cattle may he 

 destroyed. The symptoms presented by tuber- 

 cular animals are in the main similar to those seen 

 in man, and in the later stages are recognised 

 without much difficulty. At first, however, con- 

 sumption is less easily distinguishable a fact 

 which renders legislation on the subject extremely 

 difficult. 



Contagion, the communication of a disease 

 from the sick to the healthy, either by direct con- 

 tact of a part affected with the disease, or through 

 the medium of the excretions and exhalations of 

 the body. The term is sometimes used of all 

 methods by which disease is communicated, but 

 more generally of those in which direct contact has 

 taken place between the healthy body and the 

 diseased one, or some object which has touched it; 

 more subtle means of transference, especially 

 through the air, being termed 'infection.' This 

 distinction, though it cannot be considered a 

 fundamental one, is practically convenient ; for 

 some diseases (e.g. sypnilis, ringworm) are always, 

 or all but always, propagated by contact ; others 

 (e.g. measles, influenza) much more often through 

 the air ; while in some (e.g. anthrax ) the symptoms 

 and course of the disease are much modified by the 

 method of communication. See INFECTION, and 

 GERM THEORY OF DISEASE, in Vol. V. p. 168. 



Contagious Diseases Acts were passed 

 in 1865, 1867, and 1868 for the seaport and 

 military towns, Aldershot, Canterbury, Chatham, 

 Colchester, Dover, Gravesend, Maiustone, Ply- 

 mouth and Devonport, Portsmouth, Sheerness, 

 Shorncliffe, Southampton, Winchester, Windsor, 

 and Woolwich ; and in Ireland, the Curragh, Cork. 

 and Queenstown. To a certain extent they also 

 applied in other towns, and similar acts were 

 largely adopted in the British colonies. The main 

 features of this legislation were ( 1 ) the registration 

 and police supervision of prostitutes; (2) the 

 periodical examination of these women, which might 

 be compelled ; (3) their detention in hospital when 

 necessary. The acts were from the first strongly 

 opposed as contrary to constitutional freedom and 

 public morality, as giving undesirable safety to 

 vicious practices, as dangerous to virtuous women, 

 as treating unequally the two sexes, and as en- 

 couraging clandestine prostitution. Their opera- 

 tion was inquired into by a Royal Commission 



