By Dr. J.S. CHRISTISON, Chicago.
A proclamation by an eminent physician that he has discovered a
specific cure for consumption in its most prevalent and insidious
form, known as tuberculosis, might well create a deep and universal
interest, since there are comparatively few of us that do not have
this deadly enemy within the limits of our cousin kinship. And if
German slaughter house statistics are to be taken as representative,
no less than ten per cent. of our domesticated horned cattle are a
prey to the same disease, though seldom discovered during life. This
fact would suggest that tubercular consumption is still more prevalent
in the human family than has yet been supposed, and that many carry it
under the cover of other maladies.
But unfortunately for any hope for a specific remedy, the
preponderance of evidence points to the fact that consumption is much
more a product of individual habits and social and climatical
conditions than a resultant of any one agency. Indeed, the causative
evils may vary not only in their degree, but also in their number and
order of action in the period of its evolution.
If it were hereditary in the sense that it is transmitted by the blood
as a specific germ or virus, then the offspring of consumptives would
have an attenuated form of the disease, which, by reasoning from
analogy, ought to secure them exemption from any further danger along
that line. Such, however, is not the case. But if we say a special
fitness is inherited, then we can understand how the offspring of
consumptives are prone to develop it, since they are not only born
with hereditary qualifications, but not infrequently they are cradled
amid the very agencies which fostered the evil in their parents, if,
indeed, they were not primarily causative.
That the contribution of heredity to consumption is great is
undoubtedly the case, and, more than any other factor, it would seem
to have a directing power in the army of inducing evils. But the fact
that the greater number of the offspring of consumptives escape the
disease, even where the general family resemblance is quite
pronounced, is readily explained by the difference in personal habits,
the circumstances of different periods or the domestic regulations
instituted by medical counsel. Also the fact that consumptives so
frequently spring from neurotic parentage and the victims of
dissipation, especially alcoholic, still farther goes to show that the
hereditary element is essentially a reduced power of resistance to
formative evils, and that as a negative condition it may hold the
balance of power in focusing the forces. Thus, heredity, in disease,
can be understood as in no sense implying a specific force, but rather
an atonic or susceptible condition, varying in its precise character
and producing a _pars minoris resistentiæ_--a special weakness in a
special way.
That the germ _bacillus_ does not originate consumption there can be
no doubt, unless consumption is not to be regarded as a disease until
it is full fledged, for otherwise the germ would be present in the
earlier formations, as well as the later, which, according to good
authority, is not the case. But that this parasite has a special
affinity for consumptive tissue there is no question, and that it
thrives therein with great rapidity, hastening retrogressive changes,
is also to be granted. But, as yet, this is all we are entitled to
believe.
We thus see that the lines of successful treatment must be both
constitutional and local; that the constitutional cannot be specific,
and the strictly local cannot be curative. The constitutional must be
of a negative and positive character, having regard to the support of
the healthy remnant, and which will require correction of any
deficiency whatsoever in order to remove the morbid constitutional
habit. The local will be cleansing of the affected organs from the
germs and morbid products.
The evident selective affinity of Koch's lymph for tuberculous tissue
may enable it, in certain cases, to effectually seal the arterial
capillaries about the affected parts, owing to the intense vaso-motor
disturbance produced. This would starve the germs, which, with the
tubercular matter, may be expectorated through the moisture and motion
of the lungs. In incipient cases the tubercles might be as readily
absorbed as catgut ligature, and the germs, if any, fall to phagocytic
prey. The Koch lymph is evidently not a poison to the germs, and
probably has no other action on the affected organs than that of an
irritant, having a selective affinity by virtue of the kinship with
its contents. This theory of its action is supported by our common
knowledge of the power of pyogenic agents to awaken old or slumbering
inflammations, and the fact that septic fevers, such as small-pox,
have been known to leave the consumptives with the last stages free
from every symptom.
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