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A WEEKLY NEWSPAPER OF ALL THE ARTS AND SCIENCES. 



Eighth Year. 

 Vol. XV. No. 376. 



NEW YORK, April 18, 1890. 



Single Copies, Ten Cents. 

 •53.50 Per Year, in Advance. 



THE SUPPEESSION OF CONSUMPTION. 



We have in consumption to deal with a disease that causes 

 upwards of 60,000 deaths every year in the United Kingdom; 

 and it is estimated , on the basis of three invalids for each 

 ■death, that about 200,000 persons suffer from it within that 

 period. This disease pervades all ranks of society, from the 

 mansion of the rich to the cottage of the poor, and it attacks 

 in its course childhood, youth, maturity, and old age. Can 

 we suppress consumption, — a disease that has so wide an area 

 of distribution, and that possesses such a fatal character? I 

 have come, after due and careful investigation of the sub- 

 ject, to the conclusion that we can. The issue here raised 

 is of immense importance. It is a question of life or de.ith 

 for hundreds of thousands; and I earnestly request careful 

 consideration of the evidence I shall adduce in support of 

 the case, which, I say, not only completely justifies, but also 

 necessitates, the conclusion that we now have it in our 

 power to suppress consumption. And I would at once note 

 the fact that there is no essential reason why that should 

 not be accomplished. Man is not born to die from this dis- 

 ease, and, in fact, from four-fifths to six-sevenths of the race 

 do not. We have unquestionable evidence that consump- 

 tion has been completely recovered from, that a considerable 

 reduction in its amount has been effected in some cases (for 

 example, among prisoners), that it has been arrested for 

 longer or shorter periods, and that persons with the signs of 

 the disease have been able to completely escape from it:' 

 consequently we must sooner or later ascertain the means by 

 which tliat has been effected, and then we shall apply that' 

 knowledge to the prevention and cure of this disease. 



What is the cause of consumption, and how does it operate 

 in the production of the disease? The authorities have from 

 time to time propounded theories that were said to give satis- 

 factory information on these points. I take as examples of 

 these theories the following:^ climate, a certain height above 

 the sea-level, cold, change of temperature, impure air, night 

 air, carbonic acid, bad or insufBcient food or clothing, dys- 

 pepsia, the non-assimilation of fat, diathesis, disease of the 

 nerve-centre, cough, catarrh, bronchitis, pneumonia, pleu- 

 risy, dampness of the soil, inheritance, the Bacillus tuber-' 



1 Sydenham, Walshe, Laennec, Heitler, Roger and Boudet, Ewart, Friennd, 

 Fuentes, Blake, Herman Weber, Cruveiltiier, PoUock, Austin Flint, Fuller, 

 Stokes, etc. 



2 Williams, Fuchs, Murrhy, BouiUand. Scot-Allison, Briquet, Boyle, Baude- 

 loque, Bucheteau, Shephard, MacCormac, Ruchle, Herard and Cornil, Bou- 

 • hardat, Bennett, Hutchinson, Brakenridge, Dobel, Lebert, Lugo!, Allbut, Rob- 

 erts, Memeyer, Clark, Williams, Broussais, Grisolle, Buchannan, Bowditch, 

 Thompson, Cotton, Boberts, Koch, etc. 



culosis, etc., and ask. Does any one of them afford adequate 

 information on these points? Submit them to critical ex- 

 amination, and the answer to this question is an emphatic 

 negative;' for they either have no foundation in fact, or 

 have for their basis conditions that, on the one hand, occupy 

 so wide an area of distribution that they include within their 

 sphere of action a large number of persons who have never 

 shown any signs of the disease, and, on the other, are so 

 limited in the field of the disease that they aie only found 

 associated with a greater or less number of its cases, and 

 consequently can afford no adequate explanation of its cause 

 and mode of operation. So obviously, indeed, is this the 

 fact, that I shall only note a few of them in passing, and 

 then examine in detail the important, because it is popular, 

 theory of Koch. 



Is consumption limited to, or even more prevalent in, any 

 particular climate? No: the disease is co-extensive with the 

 civilized world. Truly, consumption is more prevalent be- 

 low than above certain altitudes, but within the same limits 

 the vast majority of the human race is living free from the 

 disease. Further, while on the one hand consumption is 

 found at high altitudes, as in Madrid and in certain cities in 

 South America, on the other it is unknown in certain tribes 

 inhabiting districts below the sea-level in Asia. To cold and 

 change of temperature has generally been assigned an im- 

 portant place. That is an error; for in cold climates, as in 

 Canada, Sweden, and such places, as well as in the classes 

 most exposed to cold, there is little consumption, and in the 

 severe winter of 1854-55 more men died from it in the bar- 

 racks at home than in the camp before Sevastopol; and a 

 similar argument may be held with regard to the causal in- 

 fluence of change of temperature. 



The majority of those who breathe impure air, night air, 

 or who have bad or insufficient food or clothing, etc., do not 

 get consumption ; and the same fact holds good for the dis- 

 eases that are alleged to produce it. What an appalling 

 amount of consumption there would be if every one who 

 had a cough, or who caught a cold, became consumptive! 

 Dampness of the soil is another alleged cause of this dis- 

 ease, but in the cases cited in proof of that theory drainage 

 was not the only factor that was present. We know that as 

 parts of Lincolnshire get drained, ague disappears, and con- 

 sumption takes its place; and we have the same fact in 

 America and in Switzerland." There was the least cpnsumxj- 

 tion in the most wet department of France. Consumption 



1 Louis, Hanot (Jaccond's Dictionary), Andrew, Pollock. Ziemssen. 

 - HavUand, Kelly, G-reen CU.S.A.), Damaschind. 



