150 THE CAUSATION OF DISEASE. 



so serious that it almost tempts one to ask : Has such civiliza- 

 tion any justification ? The destruction of life among savages 

 is, no doubt, greater than among civilized peoples, but death 

 is at least prompt : whereas in civilized countries, tens 

 of thousands of children are yearly tortured slowly to 

 death, while as many grow up crippled for life. A number 

 of children doubtless die of scarlatina, diphtheria, and so 

 forth, through no fault of the parents — and here again death 

 is more or less prompt ; but the chief number die of impro- 

 per feeding — of a disease popularly known as " consumption 

 of the bowels." This is a sort of dysenteric diarrhoea, the 

 main features of which are — large belly, slimy, bad- coloured, 

 foul-smelling, and, sometimes, bloody motions. It is ob- 

 viously an enteritis due to improper feeding. The unhealthy 

 bowel is no longer able to properly act upon the food, which, 

 therefore, decomposes, causing flatulent distension of the belly 

 and foul-smelling motions. Such being the case, no wonder, 

 then, that the child should get thin and die, or that, if it 

 survive, it should grow up puny and delicate. At a time of 

 life when every cell in the body is craving for food, the 

 tissues are being both starved and poisoned : starved by the 

 non- conversion of food into blood, poisoned by the absorption 

 of abnormal intestinal products. I am inclined to think that 

 this disease takes some share in the causation of both rickets 

 and scrofula ; but let this pass. Certain it is that it is a 

 very common complaint ; among the poor of London, in a 

 greater or less degree, it is universal. I have scarcely ever failed 

 to get a history of slime and foul-smelling motions in those 

 children whose history I have thoroughly investigated; and that, 

 not only in the case of children artificially fed, but in those 

 brought up at the breast also, though to a much less extent. 

 A history of slime and foul- smelling motions is a perfect test of 

 the disorder. The mother should always be questioned concern- 

 ing this latter symptom. Healthy motions have an unpleasant 

 smell, but there is a wide gap between this unpleasantness 

 and that due to the disease whereof I speak. If we have a 

 history of foul-smelling motions extending over long periods 

 of time, we have a distinct evidence of chronic intestinal disease ; 

 and chronic disease of this mucous tract, whose business it is 



