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SCIENCE. 



[N. S. Vol. IX. No. 223. 



that deflaite species cause definite diseases. 

 That they provohe diseases he recognizes ; that 

 they cause them he denies. His own position 

 is essentially as follows: Disease and health 

 alike are attributes of the activitj' of living 

 cells. 



Health is the result of the normal activity and 

 disease of the abnormal activity of these cells, 

 and it is hardly more correct to say that dis- 

 ease is caused by bacteria than to say that 

 health is caused by their absence. Disease is a 

 process, not an entity, and is really caused by 

 some condition of the living cells which makes 

 them liable to act abnormally when stimu- 

 lated. No disease can appear in the body 

 except such as are predisposed in the living 

 cells. The bacteria serve as a stimulus just 

 as the spark serves as a stimulus for gun- 

 powder. The spark is not the cause of the 

 explosion, though it may excite it. There is a 

 certain amount of resistance to be overcome 

 before the cells will start to act abnormally, and 

 the bacteria simply overcome this resistance. 

 We are learning to appreciate more and more 

 fully that one animal may be predisposed to a 

 disease while another is more resistant, a fact 

 in itself which shows that we are speaking very 

 loosely when we say that the bacteria cause 

 the disease. According to Hueppe disease is 

 the result of a number of factors of unequal 

 weight. External conditions constitute one 

 factor, the condition of the body cells a second, 

 and the presence of certain bacteria a third. 

 When together they produce disease. Break 

 the chain as one link and there is no disease. 

 The school of Koch has paid attention to one of 

 these links, the school of Virohow to the sec- 

 ond, while Petinkoffer is trying to study the 

 third, i. e. , external conditions. Hueppe in- 

 sists that neither one causes the disease, but all 

 three together. Disease is a vital activity, and 

 while bacteria are needed to stimulate it they 

 don't properly cause it. 



This conception, of course, largely deter- 

 mines the position which Hueppe takes in the 

 other topics considered. The question of com- 

 bating the disease by combating the bacteria 

 is only one side of the matter. Prevention in- 

 volves something more than simply looking 

 after the bacteria. Hygienic measures are mis- 



directed if they look simply toward the destruc- 

 tion of bacteria. The disinfecting mania which 

 developed a few years ago he regards as exag- 

 gerated and largely needless. Hygienic measures 

 in the past have been very useful and produced 

 a decided improvement in public health, but 

 this has not been because they have destroyed 

 the ' specific ' bacteria. Rarely do we succeed 

 in this object. Sanitariums for tuberculosis pay 

 little attention to the matter of germs. The 

 success has resulted from the fact that hj'gienic 

 measures and cleanliness, together with fresh 

 air and sunlight, have improved the general 

 health, given the cells greater vitality and made 

 the individual less disposed to acquire the dis- 

 ease. They are successful because they have 

 been directed to the second link in the chain 

 rather than the third. 



It is a question whether his position is quite 

 so much at variance with generally accepted 

 belief as Hueppe is inclined to think. In de- 

 nying that distinct bacteria are ' specific ' he 

 fails satisfactorily to reconcile this position 

 with the fact that definite species do provoke 

 definite diseases. He fails to make it clear just 

 how the bacteria act to produce distinct dis- 

 eases if they are not specific. It is a somewhat 

 curious position to assume that the silk worms 

 have always had a special predisposition to 

 pebrine, but that this disposition only appeared 

 when the pebrine organism made its appear- 

 ance, especially as it appears that all individuals 

 yield to the attacks of this germ. But appar- 

 ently Hueppe would assume that the animals 

 have had this predisposition to a disease which 

 never had a chance to develop until the proper 

 organism produced the stimulus. Hueppe has 

 perhaps just as truly overdrawn the case from 

 his point of view as Koch did from his own 

 standpoint. But certainly all bacteriologists 

 may read with profit this somewhat new set- 

 tiug-forth of the problem of bacterial diseases, 

 and Hueppe is certainly to be thanked for bring- 

 ing forward so forcibly the part which the vital 

 activity of the organism plays in the matter of 

 disease. He has certainly done a valuable ser- 

 vice in pointing out that the problem of the 

 physician and bacteriologist is to be directed 

 toward the man and not the bacterium. 



H. W. C. 



