own métier, in speaking of these things. Not so. I am dealing with
a question on which minds accustomed to weigh the value of
experimental evidence are alone competent to decide, and regarding
which, in its present condition, minds so trained are as capable of
forming an opinion as regarding the phenomena of magnetism or radiant
heat. 'The germ theory of disease,' it has been said, 'appertains to
the biologist and the physician.' Where, I would ask in reply, is the
biologist or physician, whose researches, in connection with this
subject, could for one instant be compared to those of the chemist
Pasteur? It is not the philosophic members of the medical profession
who are dull to the reception of truth not originated within the pale
of the profession itself. I cannot better conclude this portion of my
story than by reading to you an extract from a letter addressed to me
some time ago by Dr. William Budd, of Clifton, to whose insight and
energy the town of Bristol owes so much in the way of sanitary
improvement.
'As to the germ theory itself,' writes Dr. Budd, that is a matter on
which I have long since made up my mind. From the day when I first
began to think of these subjects I have never had a doubt that the
specific cause of contagious fevers must be living organisms.
'It is impossible, in fact, to make any statement bearing upon the
essence or distinctive characters of these fevers, without using terms
which are of all others _the most distinctive of life_. Take up the
writings of the most violent opponent of the germ theory, and, ten to
one, you will find them full of such terms as "propagation,"
"self-propagation," "reproduction," "self-multiplication," and so on.
Try as he may--if he has anything to say of those diseases which is
characteristic of them--he cannot evade the use of these terms, or the
exact equivalents to them. While perfectly applicable to living
things, these terms express qualities which are not only inapplicable
to common chemical agents, but, as far as I can see, actually
inconceivable of them.'
Cotton-wool Respirator.
Once, then, established within the body, this evil form of life, if
you will allow me to call it so, must run its course. Medicine as yet
is powerless to arrest its progress, and the great point to be aimed
at is to prevent its access to the body. It was with this thought in
my mind that I ventured to recommend, more than a year ago, the use of
cotton-wool respirators in infectious places. I would here repeat my
belief in their efficacy if properly constructed. But I do not wish
to prejudice the use of these respirators, by connecting them
indissolubly with the germ theory. There are too many trades in
England where life is shortened and rendered miserable by the
introduction of matters into the lungs which might be kept out of
them. Dr. Greenhow has shown the stony grit deposited in the lungs of
stonecutters. The black lungs of colliers is another case in point.
In fact, a hundred obvious cases might be cited, and others that are
not obvious might be added to them. We should not, for example, think
that printing implied labour where the use of cotton-wool respirators
might come into play; but the fact is that the dust arising from the
sorting of the type is very destructive of health. I went some time
ago into a manufactory in one of our large towns, where iron vessels
are enamelled by coating them with a mineral powder, and subjecting
them to a heat sufficient to fuse the powder. The organisation of the
establishment was excellent, and one thing only was needed to make it
faultless. In a large room a number of women were engaged covering
the vessels. The air was laden with the fine dust, and their faces
appeared as white and bloodless as the powder with which they worked.
By the use of cotton-wool respirators these women might be caused to
breathe air as free from suspended matter as that of the open street.
Over a year ago a Lancashire seedsman wrote to me, stating that during
the seed season his men suffered horribly from irritation and fever,
so that many of them left his service. He asked for help, and I gave
him my advice. At the conclusion of the season, this year, he wrote
to inform me that he had folded a little cotton-wool in muslin, and
tied it in front of the mouth; and that with this simple defence he
had passed through the season in comfort, and without a single
complaint from his men.
Against the use of such a respirator the obvious objection arises,
that it becomes wet and heated by the breath. While casting about for
a remedy for this, a friend forwarded to me from Newcastle a form of
respirator invented by Mr. Carrick, a hotel-keeper at Glasgow, which,
by a slight modification, may be caused to meet the case perfectly.
The respirator, with its back in part removed, is shown in fig. 4.
Under the partition of wire-gauze q r, is a space intended by Mr.
Carrick for 'medicated substances,' and which may be filled with
cotton-wool. The mouth is placed against the aperture o, which fits
closely round the lips, and the filtered air enters the mouth through
a light valve v, which is lifted by the act of inhalation.
During exhalation this valve closes; the breath escapes by a second
valve, v', into the open air. The wool is thus kept dry and cool; the
air in passing through it being filtered of everything it holds in
suspension. The respirator has since taken other forms.
FIG. 4.
*****
Fireman's Respirator.
We have thus been led by our first unpractical experiments into a
thicket of practical considerations. But another step is possible.
Admiring, as I do, the bravery of our firemen, and hearing that smoke
was a more serious enemy than flame itself, I thought of devising a
fireman's respirator.
Our fire-escapes are each in charge of a single man, and it would be
of obvious importance to place it in the power of each of those men to
penetrate through the densest smoke, into the recesses of a house, and
there to rescue those who would otherwise be suffocated or burnt.
Cotton-wool, which so effectually arrested dust, was first tried; but,
though found soothing in certain gentle kinds of smoke, it was no
match for the pungent fumes of a resinous fire. For the purpose of
catching the atmospheric germs, M. Pouchet spread a film of glycerine
on a plate of glass, urged air against the film, and examined the dust
which stuck to it. The moistening of the cotton-wool with glycerine
was a decided improvement; still the respirator only enabled us to
remain in dense smoke for three or four minutes, after which the
irritation became unendurable. Reflection suggested that, besides the
smoke, there must be numerous hydrocarbons produced, which, being in a
state of vapour, would be very imperfectly arrested by the
cotton-wool. These, in all probability, were the cause of the
residual irritation; and if these could be removed, a practically
perfect respirator might possibly be obtained.
I state the reasoning exactly as it occurred to my mind. Its result
will be anticipated by many present. All bodies possess the power of
condensing, in a greater or less degree, gases and vapours upon their
surfaces, and when the condensing body is very porous, or in a fine
state of division, the force of condensation may produce very
remarkable effects. Thus, a clean piece of platinum-foil placed in a
mixture of oxygen and hydrogen so squeezes the gases together as to
cause them to combine; and if the experiment be made with care, the
heat of combination may raise the platinum to bright redness. The
promptness of this action is greatly augmented by reducing the
platinum to a state of fine division. A pellet of 'spongy platinum,'
for instance, plunged into a mixture of oxygen and hydrogen, causes
the gases to explode instantly. In virtue of its extreme porosity, a
similar power is possessed by charcoal. It is not strong enough to
cause the oxygen and hydrogen to combine like the spongy platinum, but
it so squeezes the more condensable vapours, and acts with such
condensing power upon the oxygen of the air, as to bring both within
the combining distance, thus enabling the oxygen to attack and destroy
the vapours in the pores of the charcoal. In this way, effluvia of
all kinds may be virtually burnt up; and this is the principle of the
excellent charcoal respirators invented by Dr. Stenhouse. Armed with
one of these, you may go into the foulest-smelling places without
having your nose offended.
But, while powerful to arrest vapours, the charcoal respirator is
ineffectual as regards smoke. The smoke-particles get freely through
the respirator. With a number of such respirators, tested in a proper
room, from half a minute to a minute was the limit of endurance. This
might be exceeded by Faraday's simple method of emptying the lungs
completely, and then filling them before going into a smoky
atmosphere. In fact, each solid smoke particle is itself a bit of
charcoal, and carries on it, and in it, its little load of irritating
vapour. It is this, far more than the particles of carbon themselves,
that produces the irritation. Hence two causes of offence are to be
removed: the carbon particles which convey the irritant by adhesion
and condensation, and the free vapour which accompanies the particles.
The cotton-wool moistened with glycerine I knew would arrest the
first; fragments of charcoal I hoped would stop the second. In the
first fireman's respirator, Mr. Carrick's arrangement of two valves,
the one for inhalation, the other for exhalation, was preserved. But
the portion of the respirator which holds the filtering and absorbent
substances, was prolonged to a depth of four or five inches (see fig.
5). Under the partition of wire-gauze q r at the bottom of the space
which fronts the mouth was placed a layer of cotton-wool, c, moistened
with glycerine; then a thin layer of dry wool, c'; then a layer of
charcoal fragments; and finally a second thin layer of dry
cotton-wool. The succession of the layers may be changed without
prejudice to the action. A wire-gauze cover, shown in plan under fig.
5, keeps the substances from falling out of the respirator. A layer
of caustic lime may be added for the absorption of carbonic acid; but
in the densest smoke that we have hitherto employed, it has not been
found necessary, nor is it shown in the figure. In a flaming
building, indeed, the mixture of air with the smoke never permits the
carbonic acid to become so dense as to be irrespirable; but in a place
where the gas is present in undue quantity, the fragments of lime
would materially mitigate its action.
In a small cellar-like chamber with a stone flooring and stone walls,
the first experiments were made. We Placed there furnaces containing
resinous pine-wood, lighted the wood, and, placing over it a lid which
prevented too brisk a circulation of the air, generated dense volumes
of smoke. With our eyes protected by suitable glasses, my assistant
and I have remained for half an hour and more in smoke so dense and
pungent that a single inhalation, through the undefended mouth, would
be perfectly unendurable. We might have prolonged our stay for hours.
FIG. 5.
Having thus far perfected the instrument, I wrote to the chief officer
of the Metropolitan Fire Brigade, asking him whether such a respirator
would be of use to him. His reply was prompt; it would be most
valuable. He had, however, made himself acquainted with every
contrivance of the kind in this and other countries, and had found
none of them of any practical use. He offered to come and test it
here, or to place a room at my disposal in the City. At my request he
came here, accompanied by three of his men. Our small room was filled
with smoke to their entire satisfaction. The three men went
successively into it, and remained there as long as Captain Shaw
wished them. On coming out they said that they had not suffered the
slightest inconvenience; that they could have remained all day in the
smoke. Captain Shaw then tested the respirator with the same result,
and he afterwards took great interest in the perfecting of the
instrument.
*****
Various ameliorations and improvements have recently been introduced
into the smoke respirator. The hood of Captain Shaw has been improved
upon by the simple and less expensive mouthpiece of Mr. Sinclair; and
this, in its turn, has been simplified and improved by my assistant
Mr. John Cottrell. The respirator is now in considerable demand, and
it has already done good practical service. Care is, however,
necessary, in moistening the wool with glycerine. It must be
carefully teazed, so that the individual fibres may be moistened, and
_clots_ must be avoided. I cannot recommend the layers of moistened
flannel which, in some cases, have been used instead of cotton-wool:
nothing equals the wool, when carefully treated.
An experiment made last year brought out very conspicuously the
necessity of careful packing, and the enormous comparative power of
resisting smoke irritation possessed by our firemen, and the able
officer who commands them. Having heard from Captain Shaw that, in
some recent very trying experiments, he had obtained the best effects
from dry cotton-wool, and thinking that I could not have been mistaken
in my first results, which proved the dry so much inferior to the
moistened wool and its associated charcoal, I proposed to Captain Shaw
to bring the matter to a test at his workshops in the City. He was
good enough to accept my proposal, and thither I went on May 7, 1874.
The smoke was generated in a confined space from wet straw, and it was
certainly very diabolical.
At this season of the year I am usually somewhat shorn of vigour, and
therefore not in the best condition for severe experiments; still I
wished to test the matter in my own person. With a respirator which
had been in use some days previously, and which was not carefully
packed, I followed a fireman into the smoke, he being provided with a
dry-wool respirator. I was compelled to quit the place in about three
minutes, while the fireman remained there for six or seven minutes.
I then tried his respirator upon myself, and found that with it I
could not remain more than a minute in the smoke; in fact the first
inhalation provoked coughing.
Thinking that Captain Shaw himself might have lungs more like mine
than those of his fireman, I proposed that we should try the
respirators together; but he informed me that his lungs were very
strong. He was, however, good enough to accede to my request. Before
entering the den a second time I repacked my respirator, with due
care, and entered the smoke in company with Captain Shaw. I could
hear him breathe long slow inhalations; his labour was certainly
greater than mine, and after the lapse of seven minutes I heard him
cough. In seven and a half minutes he had to quit the place, thus
proving that his lungs were able to endure the irritation seven times
as long as mine could bear it. I continued in the smoke, with hardly
any discomfort, for sixteen minutes, and certainly could have remained
in it much longer. The advantage arising from the glycerine was thus
placed beyond question.
During this time I was in a condition to render very material
assistance to a person in danger of suffocation.
Helmholtz on Hay Fever.
In my lecture on Dust and Disease in 1870, I referred to an experiment
made by Helmholtz upon himself which strikingly connected hay fever
with animalcular life. About a year ago I received from Professor
Binz of Bonn a short, but important paper, embracing Helmholtz's
account of his observation, to which Professor Binz has added some
remarks of his own. The paper, being mainly intended for English
medical men, was published in English, and though here and there its
style might be amended, I think it better to publish it unaltered.
From what I have observed (says Professor Binz) of recent English
publications on the subject of hay fever, I am led to suppose that
English authorities are inaccurately acquainted with the discovery of
Professor Helmholtz, as far back as 1868, of the existence of uncommon
low organisms in the nasal secretions in this complaint, and of the
possibility of arresting their action by the local employment of
quinine. I therefore purpose to republish the letter in which he
originally announced these facts to myself, and to add some further
observations on this topic. The letter is as follows: [Footnote:
Cf. Virchow's 'Archiv.' vol. xlvi.]
'I have suffered, as well as I can remember, since the year 1847, from
the peculiar catarrh called by the English "hay fever," the speciality
of which consists in its attacking its victims regularly in the hay
season (myself-between May 20 and the end of June), that it ceases in
the cooler weather, but on the other hand quickly reaches a great
intensity if the patients expose themselves to heat and sunshine. An
extraordinary violent sneezing then sets in, and a strongly corrosive
thin discharge, with which much epithelium is thrown off. This
increases, after a few hours, to a painful inflammation of the mucous
membrane and of the outside of the nose, and excites fever with severe
headache and great depression, if the patient cannot withdraw himself
from the heat and the sunshine. In a cool room, however, these
symptoms vanish as quickly as they come on, and there then only
remains for a few days a lessened discharge and soreness, as if caused
by the loss of epithelium. I remark, by the way, that in all my other
years I had very little tendency to catarrh or catching cold, while
the hay fever has never failed during the twenty-one years of which I
have spoken, and has never attacked me earlier or later in the year
than the times named. The condition is extremely troublesome, and
increases, if one is obliged to be much exposed to the sun, to an
excessively severe malady.
'The curious dependence of the disease on the season of the year
suggested to me the thought that organisms might be the origin of the
mischief. In examining the secretion I regularly found, in the last
five years, certain vibrio-like bodies in it, which _at other times I
could not observe_ in my nasal secretion... They are very
small, and can only be recognised with the immersion-lens of a very
good Hartnack's microscope. It is characteristic of the common
isolated single joints that they contain four nuclei in a row, of
which two pairs are more closely united. The length of the joints is
0.004 millimetre. Upon the warm objective-stage they move with
moderate activity, partly in, mere vibration, partly shooting
backwards and forwards in the direction of their long axis; in lower
temperatures they are very inactive. Occasionally one finds them
arranged in rows upon each other, or in branching series. Observed
some days in the moist chamber, they vegetated again, and appeared
somewhat larger and more conspicuous than immediately after their
excretion. It is to be noticed that only that kind of secretion
contains them which is expelled by violent sneezings; that which drops
slowly does not contain any. They stick tenaciously enough in the
lower cavities and recesses of the nose.
'When I saw your first notice respecting the poisonous action of
quinine upon infusoria, I determined at once to make an experiment
with that substance, thinking that these vibrionic bodies, even if
they did not cause the whole illness, still could render it much more
unpleasant through their movements and the decompositions caused by
them. For that reason I made a neutral solution of sulphate of
quinine, which did not contain much of the salt (1·800), but still was
effective enough, and caused moderate irritation on the mucus
membrane of the nose. I then lay flat on my back, keeping my head
very low, and poured with a pipette about four cubic centimetres into
both nostrils. Then I turned my head about in order to let the liquid
flow in all directions.
'The desired effect was obtained immediately, and remained for some
hours; I could expose myself to the sun without fits of sneezing and
the other disagreeable symptoms coming on. It was sufficient to
repeat the treatment three times a day, even under the most
unfavourable circumstances, in order to keep myself quite free.
[Footnote: There is no foundation for the objection that syringing the
nose could not cure the asthma which accompanies hay fever; for this
asthma is only the reflex effect arising from the irritation of the
nose.--B.] There were then no such vibrios in the secretion. If I
only go out in the evening, it suffices to inject the quinine once a
day, just before going. After continuing this treatment for some days
the symptoms disappear completely, but if I leave off they return till
towards the end of June.
'My first experiments with quinine date from the summer of 1867; this
year (1868) I began at once as soon as the first traces of the illness
appeared, and I have thus been able to stop its development
completely.
'I have hesitated as yet in publishing the matter, because I have
found no other patient [Footnote: Helmholtz, now Professor of
Physics at the University of Berlin, is, although M.D., no medical
practitioner.--B.] on whom I could try the experiment. There is, it
seems to me, no doubt, considering the extraordinary regularity in the
recurrence and course of the illness, that quinine had here a most
quick and decided effect. And this again makes my hypothesis very
probable, that the vibrios, although of no specific form but a very
frequent one, are at least the cause of the rapid increase of the
symptoms in warm air, as heat excites them to lively action.
I should be very glad if the above lines would induce medical men in
England--the haunt of hay fever--to test the observation of Helmholtz.
To most patients the application with the pipette may be too difficult
or impossible; I have therefore already suggested the use of Weber's
very simple but effective nose-douche. Also it will be advisable to
apply the solution of quinine _tepid_. It can, further, not be repeated
often enough that quinine is frequently adulterated, especially with
cinchona, the action of which is much less to be depended upon.
Dr. Frickhoefer, of Schwalbach, has communicated to me a second case
in which hay fever was cured by local application of quinine.
[Footnote: Cf. Virchow's 'Archiv.' (1870), vol. li. p. 176.]
Professor Busch, of Bonn, authorises me to say that he succeeded in
two cases of 'catarrhus aestivus' by the same method: a third patient
was obliged to abstain from the use of quinine, as it produced an
unbearable irritation of the sensible nerves of the nose. In the
autumn of 1872 Helmholtz told me that his fever was quite cured, and
that in the meantime two other patients had, by his advice, tried this
method, and with the same success. [Footnote: Prof. Helmholtz, whom I
had the pleasure of meeting in Switzerland last year, then told me
that he was quite convinced that hay fever was produced by the pollen
afloat in early summer in the atmosphere.]
********************
VI. VOYAGE TO ALGERIA TO OBSERVE THE ECLIPSE.
1870.
THE opening of the Eclipse Expedition was not propitious. Portsmouth,
on Monday, December 5, 1870, was swathed by fog, which was intensified
by smoke, and traversed by a drizzle of fine rain. At six P.M. I was
on board the "Urgent." On Tuesday morning the weather was too thick to
permit of the ship's being swung and her compasses calibrated. The
Admiral of the port, a man of very noble presence, came on board.
Under his stimulus the energy which the weather had damped appeared to
become more active, and soon after his departure we steamed down to
Spithead. Here the fog had so far lightened as to enable the officers
to swing the ship.