January 4. 1889. J 



SCIENCE 



disinfection, to check its spread even among an unvaccinated popu- 

 lation, as has been illustrated many times of late in the anti-vacci- 

 nation city of Leicester, England. We must now put tuberculosis 

 among these diseases, and, though its theoretical suppression is 

 simple, its actual extermination is a very difficult probletn. It lies 

 largely with the medical profession how long tubercular disease 

 shall decimate the human race. The physicians are the educators 

 of the people in these matters. When the doctor shall teach that 

 tuberculosis is contagious, the people will believe, and will govern 

 themselves accordingly. In combating contagious diseases the pre- 

 ventive measures taken often give discouraging results. This will 

 be particularly so in tubercular disease. Halfway measures secure 

 less than halfway results, and these alienate the support of those 

 who only indifferently believe in contagion and the importance of 

 precautionary measures. Efficient means of suppression are radi- 

 cal, and bear hard on the individual : they are not complied with, 

 and they produce violent opposition. Yet, difficult as it may be, 

 the medical profession should take aggressive action against this 

 disease. We have no right to wait for the discovery of a specific, 

 or the gradual evolution of a phthisis-proof race. We must take 

 the world as we find it, full of men and women predisposed to tu- 

 bercular phthisis, and with no idea of its contagious nature. What 

 can we do about it ? 



1. Teach the people the true nature of tuberculosis; that no one 

 ever has tubercular consumption unless the tubercle bacilli find their 

 way into the lungs. 



2. Teach them also, that, even if it finds its way there, it will not 

 grow unless the conditions are right. Teach fathers and mothers 

 how to rear healthy boys and girls. Tell them what to eat and 

 what to wear, to exercise, to breath fresh air. This alone would 

 exterminate phthisis. 



3. The contagion must be destroyed. Fortunately in this disease 

 there is no need of isolation. Disinfection is enough. The con- 

 sumptive patient gives off the poison only in the sputum, or per- 

 chance the other excreta, if the disease extend beyond the lungs. 

 The virus is not given off from these while moist. We must there- 

 fore disinfect all sputum at once with mercuric bi-chloride. Cloths 

 must be used instead of handkerchiefs, and then burned ; or, if the 

 latter are used, they should be often changed, and immediately put 

 in a bi-chloride solution and boiled. Bed-linen should be treated 

 in the same way. Frequent disinfection of the entire person, and 

 fumigation of the apartment, would be safe additions to the pre- 

 ventive measures. 



4. Persons who have a marked predisposition to the disease had 

 best not come in close contact with the phthisical. Children should 

 never have tuberculous nurses, wet or dry. In the case of con- 

 sumptives very great attention should be paid to ventilation, and to 

 the alimentation both of the patient and the attendants. 



Such measures, if rigidly carried out, would be of enormous ser- 

 vice in preventing this disease. But with the increasing preva- 

 lence of tuberculosis among domestic animals, something more is 

 imperatively demanded. Active measures should be taken to free 

 the country from animal tuberculosis. The proper authority for 

 dealing with this, as with all other contagious diseases of animals, 

 is the Bureau of Animal Industry of the Department of Agriculture. 

 It is a wasteful method for States to act independently. The pow- 

 ers and expen<hture of this bureau should be greatly increased, and 

 it should take active measures against this disease. The exact 

 measures suggested are. — 



1. The reporting of all cases of tuberculosis in domestic animals 

 to the proper authority, by both owners and veterinaries, or other 

 persons having a knowledge of the same. 



2. The slaughter of all infected animals, and the isolation and 

 slaughter of all exposed to infection. The government should par- 

 tially indemnify all owners of slaughtered cattle. 



3. Thorough disinfection of all buildings occupied by diseased 

 cattle. 



4. The confiscation of the flesh and milk and milk products of 

 all tuberculous animals. 



Pasteur's Method. 



"Pasteur's method hardly attracts any attention now, and seems 

 to be in a fair way to die a natural death." Such is a statement 



made by Dr. Charles W. Dulles, in his report on hydrophobia to 

 the Medical Society of the State of Pennsylvania. In support of 

 this statement, he quotes from a report of Dr. Dujardin-Beaumetz 

 to the effect that there were nine deaths from hydrophobia in Paris 

 during 1887, which was more than in 1880,1883, 1884, or 1886. 

 Five of these deaths were of persons less than fifteen years old. In 

 one of the cases the patient was not bitten at all, but was simply 

 licked on an abraded spot. Eight of the patients were bitten by 

 dogs, and one by a cat. Two of the nine patients had been treated 

 by Pasteur; and their death is explained by Dujardin-Beaumetz on 

 the ground that his method was not thoroughly carried out. The 

 total number of persons treated by Pasteur was only 306 persons 

 from Paris, bitten by dogs supposed to be rabid, as against about 

 300 a month one year ago. 



These facts, Dr. Dulles thinks, show two very important things. 

 One is, that the application of Pasteur's method has had no effect 

 in reducing the usual mortality from so-called hydrophobia in Paris, 

 which confirms the opinion in regard to its merits which he has 

 repeatedly expressed ; the other is, that, in spite of the artificial 

 stimulus furnished by the French reception of Pasteur's method, 

 the number of those who fall into the terror of hydrophobia is 

 diminishing in France, and this leads to the hope that before long 

 France will compare favorably with Germany and America, which 

 have refused to be carried away by the false notions in regard to 

 hydrophobia put forward by one who knows nothing about it but 

 what he has manufactured in his laboratory. 



There is a great significance in the fact that disbelief in the 

 theories of Pasteur, which some of his partisans have stigmatized 

 as harsh or unscientific, has been found to go with a singular im- 

 munity from the ravages of so-called hydrophobia. This holds 

 true to such an extent that one may safely say that the degree of 

 acceptance of Pasteur's theories in any country will furnish a meas- 

 ure of the number of cases and deaths from hydrophobia. In Ger- 

 many these theories have never obtained a foothold, and hydro- 

 phobia is almost unknown : in America the attempt to import 

 them ended in speedy failure, and here hydrophobia is almost 

 equally unknown. 



A detailed account of fifteen fatal cases of hydrophobia is given 

 by the author of the paper. Attention is called by him to the fol- 

 lowing points, which are brought out in a study of these cases : — 



1 . The Effect of Anticipatioti of Hydrophobia. — This is said 

 to have been present in seven of the fifteen cases, and may be sus- 

 pected in more. 



2. The Lack of Evidence of Rabies in the Animal which did 

 the Biting. — Not one of the animals furnished more than ground 

 for a suspicion that it was rabid. The fact that a fighting dog 

 bites a man who interferes with it, is no evidence that it is rabid, 

 nor is the manifestation of a vicious temper a good evidence of 

 rabies. The same may be said of death in a fit. 



3. The Effect of a Diagnosis of Hydrophobia. — In ten of the 

 fifteen cases it is stated that the physicians made an early diagnosis 

 of hydrophobia, and presumably they failed to conceal the fact from 

 the patient. 



4. The Effect of applying the Test of the Water. — This is said 

 to have been done in seven of the fifteen cases, and it was probably 

 done in almost all of them. 



5. The Assertion that Canine Symptoms were Present. — Five 

 of the patients are said to have whined, or howled, or snapped, or 

 bitten at their attendants. 



6. The Ereqtiency of Forcible Restraint. — This is said to have 

 been employed in eight of the cases. 



7. The Uselessness of administering Narcotics. — Powerful 

 narcotics are said to have been used in ten of the cases, and they 

 were probably used in all. Curare is said to have been used in four 

 cases. 



In concluding his report, Dr. Dulles says, " I have on several 

 previous occasions declared my belief that hydrophobia is not a 

 specific inoculable disease. I believe this more firmly to-day than 

 ever before. I do not deny that men and women and children 

 sometimes fall into a peculiar state after a dog-bite, and die in due 

 time ; but I do deny that this is attributable to any specific virus 

 in the dog's saliva. The same thing has occurred too often from 

 other causes to justify one in charging it to a specific virus when it 



