328 DB NOVO OEIGIN OF BACTERIA 



/ 

 contagionist doctrines that bacteriologists seem invariably io 

 favour. 



Formerly the malady was commonly ascribed to the conjoint 

 influence of bad hygienic surroundings, poverty, and expogure, 

 together with deficient and improper food, more or less putrid. 

 Of these conditions, it would seem quite possible that some 

 peculiarities in food may have been, and may still be, most 

 potential in favouring the development of the disease. It seems 

 to me that Mr. Jonathan Hutchinson has distinctly strengthened 

 this view, and brought forward some valuable evidence in support 

 of his own position that badly preserved and semi-putrid fish is 

 one of the most important factors pertaining to this category. At 

 all events, whether his conclusions are to be accepted as correct 

 or not, his personal researches in South Africa and in India in 

 collecting evidence on this very important subject, involving as 

 they must have done so great an expenditure of time and labour, 

 are surely worthy of the highest praise.' 



The conclusion to which he has come in regard to the relative 

 frequency of the spread of the disease by contagion and its de novo 

 origin is very similar to that arrived at by the Leprosy Commissioners 

 in India. Their verdict, given in 1890-91, was that the influence 

 of contagion was " as small as, or even rather less than, in the case 

 of tuberculosis," ' and that in the great majority of cases the disease 

 originates de novo. This I regard as a perfectly logical position, 

 and one quite explicable in accordance with known facts. But it 

 would be absolutely repudiated by many, perhaps by most, ultra- 

 contagionists, as may be gathered from an article on Leprosy in the 

 "Quarterly Review" for April, 1903, from the pen of Dr. Geo. Pernet. 

 Referring to this verdict of the Commissioners in India, and 

 reflecting perhaps the prevailing medical opinion of to-day, this 

 writer says (p. 397) : " But did any one of the Commissioners or 

 does any one with knowledge of the subject contend that tubercu- 

 losis arises de novo f What induced the Commissioners to come to 

 the conclusion as to the de novo origin of leprosy is a psychological 

 puzzle, and it is difficult to see how the supporters of such an 

 hypothesis account for the presence of Bacilli in the leprous 



' An account of his investigations will be found in the " Transactions of the 

 Royal Medical and Chirurgical Society," 1902, p. i6i ; and in "The Lancet," 

 May 9 (p. 1316), 23 (p. 1465). and 30 (p. 1938), 1903. 



' At that time the influence of contagion was believed to be very slight in 

 tuberculosis. 



