258 



SCIENCE. 



[Vol. XV. No. 377 



We are now in a position to state the ease that has been laid 

 before us. We have seen that the accepted theories of con- 

 sumption must be rejected, because they either have no 

 foundation in fact, or they do not accord with and are inca- 

 pable of affording an adequate explanation of all the known 

 facts of the case; and that Koch's theory falls within these 

 categories. A new theory — that consumption is the direct 

 result of the reduction of the breathing surface of the lungs 

 below a certain point in proportion to the remainder of the 

 body, and is solely produced by conditions that tend to re- 

 duce the breathing capacity — has been brought before us, 

 and the following evidence adduced in its support: — 



1. Consumption has been experimentally produced by con- 

 ditions that tend to reduce the breathing capacity. Koch's 

 successful experiments were directly produced by those con- 

 ditions. 



2. We can at any time watch the direct production 

 of consumption by these conditions in the dust-inhaling 

 trades. 



3. The trades and occupations that directly compress the 

 thorax, or impede the respiratory functions, ai*e notorious 

 for their production of consumption. 



4. A large amount of consumption is produced in the army 

 every year by those conditions. 



5. Consumption has been repeatedly produced by confine- 

 ment, both in man and in animals. » 



6. The children of consumptive parents who become dis- 

 eased have been carefully brought up under such condi- 

 tions. 



7. Consumption bears the mark of the effects of the pro- 

 gressive action of such conditions from its commencement to 

 its termination. 



8. There is no recorded case of consumption, experimental 

 or not, in which those conditions were absent. 



9. Where such conditions are absent, there is no con- 

 sumption in man or animal. 



10. Upon their introduction, consumption immediately 

 appears, both among men and in animals. 



11. The disease presents a perfectly natural series of 

 events when viewed in this light. 



12. Its presence in our midst is due to the changes in our 

 habits, mode of life and surroundings, that are being effected 

 by the progressive advances of civilization. 



13. Consumption has been prevented by the removal or 

 counteraction of those conditions. The immunity of moun- 

 taineers is due to their capacious lungs. 



14. The disease has been frequently arrested for a longer 

 or shorter period by the accidental or deliberate adoption of 

 measures that tended to compensate for or counteract those 

 conditions. 



15. And both the experimental and the practical applica- 

 tion of measures that tend to compensate for and counteract 

 those conditions have invariably been followed by the arrest 

 and subsequent complete recovery from consumption, where 

 the disease was not too extensive; and the same process has 

 obtained in the thousands of cases of cure by nature and by 

 Sydenham. Therefore this theory is founded on fact, and is 

 both in strict accord with and capable of affording an ade- 

 quate explanation of all the known facts of the case. And 



consequently we now have it in our power to secure, with 

 absolute certainty, the prevention of and recovery from 

 consumption. I have laid down the principles that must 

 guide us in carrying out this work, and now it only remains 

 for me to point out the directions in which we must move, 

 in order to secure the general application of this knowledge, 

 and the consequent practical suppression of' consumption. 

 The State loses the services of a large number of men every 

 year from consumption in the army and in the various de-' 

 partments of the civil service. That not only represents a 

 considerable financial loss, but in the case of the army it 

 also constitutes a serious source of danger to the State. The 

 trades and occupations that produce so much consumption 

 should be the subject of careful inquiry to ascertain how 

 this production can be reduced to a minimum. That this 

 inquiry is urgently called for, is evident from the following 

 statistics, taken from the supplement to the "Registrar- 

 General's Report," which show, that, out of a thousand 

 deaths among various classes, there were from phthisis,' 

 among Cornish miners, 690; earthen ware- manufacturers, 

 473; printei's, 461; file-makers, 433; cutlers, etc., 371; brew- 

 ers, etc., 334; stone-quarriers, etc., 308; drapers, etc., 301; 

 publicans, etc., 295; tailors, 285; cotton-manufacturers, etc., 

 272; wool-manufacturers, 257; shoemakers, 254; builders, 

 etc , 252; carpenters, etc., 204; hosiery-manufacturers, 168; 

 laborers (agriculture), 122; gardeners, 121; fishermen, 108; 

 farmers, etc., 103 



Physical education should be made a necessary part of our 

 system of national education. We look to the government 

 for action in the above dii'ections, and their serious and im- 

 mediate attention should be given to them. Life-assurance 

 companies and sick-benefit societies can co-operate most 

 materially in the prevention of consumption, and save their 

 members considerable sums of money annually by insisting 

 upon their members having or obtaining the required amount 

 of lung development. And every available opportunity 

 should be taken of placing before workingmen's clubs 

 and societies the immense importance of physical develop- 

 ment. 



It is of great importance that the consumptive patient 

 should be placed under treatment as soon as possible, and 

 that it be uninterruptedly continued until the recovery is. 

 complete. For this purpose we require hospitals and insti- 

 tutions placed in the most favorable conditions in the coun- 

 try and at the seaside, and I am sure the means will be 

 gladly found for opening these institutions when once their- 

 necessity and immense importance have been realized. With 

 such institutions, so placed, and this system of treatment 

 thoroughly and continuously carried out, I am certain we 

 shall have reduced the mortality from consumption to truly 

 insignificant proportions before the next century has escaped 

 from its infancy. And I have the right to express a clear 

 and emphatic opinion on this subject; for I myself and my 

 patients have unquestionably completely recovered from the 

 disease. A great, a splendid, a noble victory over this disease 

 lies in the hands of the profession. Shall we let doubt stand 

 between us and its practical achievement? 



G. W. Hambleton. 



1 Ite disease is very rare amoDg gypsies. 



