SCI E N CE.-SUPPLEMENT. 



FRIDAY, APRIL 29, 1887. 



HEALTH MATTERS. 

 A theory of consumption. 



The origin of consumption continues to be a 

 subject of discussion and also of experimentation. 

 Several theories liave been advanced and evidence 

 adduced for their support. The older idea was 

 that the disease was hereditary, and that one in 

 whom the ' seeds of consumption ' were planted, 

 as it was expressed, was already condemned. 

 Subsequently the dampness of the soil was de- 

 clared to be the principal factor in producing the 

 disease. Still more recently the theory of con- 

 tagion has been developed, and the bacillus tuber- 

 culosis has been regarded by Koch and his fol- 

 lowers as its germ. While there are some who 

 maintain that heredity is never to be considered 

 as a factor, the majority of physicians are not 

 prepared to accept this, even though they may be 

 inclined to look upon the bacillus as playing the 

 principal role. 



During the past year a fourth theory has been 

 advanced by G. W. Hambleton, licentiate of the 

 King's and Queen's college of physicians, Ireland. 

 The theory that consumption is caused by climatic 

 conditions, changes of temperature, or wetness of 

 soil, he combats most vigorously. Instead of 

 being limited to, or even more prevalent in, any 

 particular climate, he finds it co-extensive with 

 the civilized world. That it is more prevalent be- 

 low than above certain altitudes does not help the 

 theory much, for within these same limits are 

 found living the vast majority of the human race 

 free from the disease. At Madrid and certain 

 cities in South America which are at high alti- 

 tudes, phthisis exists, while among some Asiatic 

 tribes inhabiting districts lying below the sea- 

 level, it is unknown. In cold climates, as Canada 

 and Sweden, there is little consumption; and the 

 same is true of those classes most exposed to cold 

 in all regions. In the severe winter of 1854 - 55, 

 fewer men died from it in camp at Sevastopol 

 tlian in the barracks at home. In France, con- 

 sumption prevails least in that department which 

 has the dampest soil ; and in Lincolnshire, as 

 drainage is introduced, the ague disappears, and 

 consumption takes its place. In reference to the 

 bacillar origin of the disease, he claims that 

 neither physicians, clinical clerks, nor nurses, who 



are constantly exposed to the bacilli, have ever 

 been known to become phthisical throvigh attend- 

 ance at hospitals where consumptive patients are 

 treated. 



Wherever civilized men permanently congre- 

 gate, whether on the level of the sea or at any 

 altitude, in every j)art of the world, irrespective 

 of what is called climate, there consumption is to 

 be found or speedily makes its appearance. The 

 natives of America, Africa, and the South Sea 

 Islands were entirely free from consiimption tiU 

 they came in intimate relationship with civilized 

 Europeans. Even now in the interior of Africa 

 there are tribes, who have not come in contact 

 with civilized men, that are absolutely free from 

 this scourge. Phthisis is a disease of civilization, 

 and in the conditions of civilized life must be 

 sought an explanation of its cause. Those dwell- 

 ing in cities are more affected than those living 

 in the country, and those engaged in sedentary 

 occupations than those living in the open air, con- 

 sumption being remarkably low in agriculturists 

 and fishermen, and rare among gypsies. The 

 military life ranks high in the list of those occu- 

 pations that are favorable to consumption. 



The explanation given by Mr. Hambleton of 

 these facts is, that man, in a state of civilization, 

 does not hold himself erect : he stoops more or 

 less. The weight of his shoulders is thrown on 

 the thorax, and consequently the latter is impeded 

 in its movement, and his chest is narrow. Man, 

 in the uncivilized state, holds himself erect ; the 

 weight of his arms is borne by the spine ; his 

 chest is broad, well developed, and freely mov- 

 able ; and he passes the whole of his existence in 

 active exercise in the open air. The trades and 

 occupations that supply the greatest number of 

 cases are those in which small particles of various 

 substances are constantly inhaled, those that ne- 

 cessitate little movement or even a cramped posi- 

 tion of the chest, and those where a considerable 

 time is spent in small and badly ventilated roonjs. 

 In the army those who become phthisical are 

 those who have a chest capacity below the average. 

 In short, the conditions that produce consumption 

 are those that reduce the capacity of the lungs 

 below a certain point. 



In support of this theory, Mr. Hambleton gives 

 the results of some experimental investigations 

 which he has made, in the form of the following 

 propositions : l**. That artificially induced reduc- 

 tion of the breathing surface of the lungs below a 



