NationalLibraryOfScotland/medical-history-of-british-india huggingface dataset:
56
from fields in which, or near which, charbonous carcasses have been
buried. Sometimes it has been observed that charbon has appeared in
animals ordinarily refractory to the disease following the ingestion of
charbonous meat, as in pigs, birds, dogs, lions in menageries, and even in
man, etc. Bonnet d'Iseghem has observed the transmission of charbon
to a person who had eaten cooked charbonous meat.
Pasteur has observed that sheep fed with aliment previously soiled
with charbonous germs became in a certain proportion sick. He has
observed that guinea-pigs fed on aliment with which the spores of
charbon have been previously mixed contract charbon with difficulty.
He has found spores in the excrement of sheep and guinea-pigs. He
has recognized that we may considerably increase the mortality when
we mix sharp-pointed materials with charbonous fodder—materials which
are calculated to more or less wound or excoriate the digestive passages,
especially the first part of these. In this way he has fed sheep with
aliments watered with liquid of culture containing spores, causing charbon
in a number of them; he increased the mortality by mixing with it
thorns, barley awns, etc., capable of wounding the first digestive pas-
sages; he has recognized the fact that in these cases, as in cases of
charbon naturally contracted, the same lesions show themselves in the
mouth or pharynx, etc., and has consequently been led to the conclusion
that absorption often takes place in these parts of the digestive passages.
Toussaint, according to the lesions of animals dead of anthrax, has also
come to the conclusion that the virus is absorbed in the commencement
of the digestive passages. M. G. Colin having shown that following a
charbonous inoculation the virulence shows itself successively, as do also
the other alterations, in the ganglia situated in the course of the lympha-
tics setting out from the point of inoculation, Pasteur and Toussaint
have recognized, by the examination of the cadavers of animals dead of
charbon, that the virus is often absorbed in the mouth and pharynx,
basing their opinions on the lesions observed in the neighbourhood in
the ganglia. M. G. Colin observed the successive invasion with the
virulence and morbid changes of the neighbouring ganglia. Toussaint
observed the successive invasion by the bacilli, which he saw proliferate
in a prodigious manner in the ganglia.
M. Rodet, basing his opinion on the state of the ganglia, was of the
opinion that guinea-pigs which had ingested charbonous matter and con-
tracted charbon therefrom, had done so when the digestive mucous mem-
brane was wounded, the virus penetrating by the buccal mucous membrane.
In the guinea-pig, as in the rabbit and sheep, there is no local lesion at the
seat of inoculation; but we often find infiltration, œdema and tumefaction
of the ganglia in the neighbourhood of the region inoculated; the lymph
of the infiltration is, as we have seen, generally poor in bacilli; but the
57
tumefied ganglias ft, infiltrated, and marked with blood-spots, are very
rich in them. M. Rodet has besides noticed that guinea-pigs which
have swallowed charbonous material have not contracted the disease; and
he has noticed animals of the same species become charbonous from eating
the eadaver of a guinea-pig dead of charbon, the osseous debris of which
had doubtless wounded the bucco-pharyngeal mucous membrane.
In short, when we inoculate charbonous virus into the lingual,
buccal, pharyngeal mucous membrane; when we chafe, wound, or other-
wise injure these mucous membranes, and deposit charbonous matter on
them, we induce charbon with initial lesions in the neighbouring
structures.
Dr. de Maurans has also noticed the influence of the action of rough,
pointed forage, etc., in the development of charbon; he has observed
that in Provence charbon shows itself more particularly during drought,
when the animals consume dry herbs or leaves of almond trees, which
wound the mucous membranes of the first digestive passages. It has
also been noticed that animals which are suffering from the lesions of
aphthous fever are more prone to contract charbon. It has also been
seen that in Beauce, the mortality is greatest when animals are conduct-
ed to graze on stubble fields, as they are then more liable to wound the
mucous membranes, etc.
Perroncito caused "guinea-pigs to be fed with food mixed with the
adult bacilli and saw only one become charbonous; having fed ten others
with food sprinkled with spores, six became affected. From these
experiments the following conclusions may be drawn: that following
the ingestion of aliments soiled with the charbonous virus, infection may
occur in the intestine; it is more difficult and rarer with the bacilli than
with the spores; it may, however, occur when bacilli are included in
pieces of meat and escape the action of the gastric juice, which is in
reality a bactericide, and find parts of the intestine deprived of epithe-
lium by the action of parasites or by the action of hard irritating por-
tions of food; charbon which results from ingestion is generally due to
the introduction of spores, but even the spores require for their absorp-
tion portions of intestine deprived of its epithelium.
The mucous membrane of the intestine, even when normal, may,
according to Kitt and Koch, absorb the spores of charbon. Although
the gastric juice generally destroys the bacilli it respects spores. Koch
having caused animals to swallow spores included in a potato, saw that
they died of intestinal charbon, whilst sheep fed in the same way on
bacilli were not affected; whilst the observations of Toussaint and Pasteur
tend to establish the fact that absorption occurs by the bucco-pharyngeal
mucous membrane, or that it is favoured by wounds of various kinds,
58
Koch thinks that it occurs in the intestine, and that the spores fix them-
selves in the follicles or Peyer's patches and then gain entrance to the
lymphatic system.
Be whatever it may the real point of entry,
there remains no doubt that the ingestion of food and water soiled with
charbonous germs may induce the disease. It is, however, advisable to
add that the ingestion of charbonous germs is not always followed
by the development of the disease—far from it; we may even presume
that the introduction of germs into the digestive passages is a rare cause
of the disease in practice, either on account of the germs being ingested
in insufficient quantity, or being attenuated, or being taken into the
system of an animal already immune as the result of spontaneous vaccina-
tion at pasture.
To sum up, then, the development of charbon appears to be frequently
due to the ingestion of forage, herbs, fodder, or drink containing germs.
The digestive passages play an important part in the absorption of the
bacilli; numerous experiments show that the ingestion of charbonous
materials is more or less frequently followed by the appearance of the
disease. Without denying that charbonous germs, and notably the
spores, may be absorbed by the bucco-pharyngeal or the gastro-intestinal
mucous membrane in an intact state, we must nevertheless admit that,
according to the facts and experiments related, the penetration of germs
by way of the intact digestive mucous membrane is difficult and rare.
This penetration is facilitated, and the mortality increased, when the
mucous membrane is excoriated, wounded, or removed, as occurs when
animals are fed upon rough, hard, and pointed forage. It is demon-
strated that absorption may occur in the mouth and pharynx when the
spores are in the food or drink; inoculation and infection then occurs, as
it does following an inoculation in the skin. It is equally demonstrated
that it may occur in the intestine, so that we may get localization of the
principal lesions in that organ.
Contagion by inhalation.—Infection may occur through the me-
dium of the air; not that the air expired by sick animals carries the
microbes, but because spores preserved on the surface of pastures, roads,
etc., may be suspended by the wind, and may be thus inhaled and deter-
mine charbon following their absorption by the respiratory passages.
Roche, Lubin, and Garreau have cited cases of contagion by the air.
The Medical and Veterinary Society of Eure and Loir have observed
that charbon may be transmitted by the medium of the air. Carmague
has seen sheep become charbonous when inhabiting stables freshly
cleansed. Pasteur has noticed sheep contract charbon by smelling or
breathing air near the soil of graves where charbonous animals had
been buried. Charbon also is more especially noticed in times of drought
when the animals raise clouds of dust whilst travelling. Lastly, it has
59
been observed that cases of broncho-pulmonary charbon occur in man
as the result of the inhalation of charbonous dust.
The charbonous virus may in reality be absorbed by inhalation
sometimes the germs may be arrested in the nasal cavities, trachea,
bronchi, and be afterwards expelled with the mucus. Nevertheless the
microbes may pass through the epithelium of these parts. Muskatblath
has produced charbon by injecting the bacillus into the trachea. Buch-
ner has obtained it by pulverizing in the respiratory passages, waters
charged with the spores. Tchistovitch has produced charbon by the
intertracheal injection of the bacilli.
Transmission through the skin.—The virus of charbon deposited
on or placed in contact with the skin, may be absorbed when it is
wounded, pricked, excoriated, or torn, when there is an accidental wound,
or when it is scratched or wounded by bodies bearing the virus. In
this manner animals pastured on stubble may get wounds on the limbs,
and so the charbon virus may gain entry. In the same manner a grain
of one of the Graminaceæ (Stipa capillata) introduced into the wool
works its way into the skin, and, penetrating this, gives rise to an
abscess through which charbon is said to be introduced. Proust saw
a butcher who contracted malignant pustule by pricking himself with
one of these seeds when working on a Russian sheep in Paris, In New
Caledonia another of the Graminaceæ, the Andropogon Allionii, causes
analogous and sometimes mortal wounds in sheep. Spear grass (And-
ropogon), babul, and ber trees are also liable to wound the skin in
India and afford an entry to the virus. It has also occurred that char-
bon has been introduced into a farm and transmitted by shearers who
had previously shorn the fresh skins of two sheep dead of sang de rate.
Man has been known to contract malignant pustule by carrying the
wool which he has been sorting to his lips. Also, both man and animals
may contract charbon owing to their being inoculated by flies.
Transmission by the bites of flies.—The rôle played by flies,
although exaggerated by the vulgar, deserves some attention, especially
in India. Davaine and Raimbert have caused charbon by inoculating
the material from the feet and suckers of flies which have been left
under a watch-glass with charbonous blood, and although this does not
prove that flies may transmit the disease by biting, it proves that
they can carry the contagion from place to place; flies having a soft
proboscis, those which do not bite, impregnate themselves with virus
by alighting on charbonous material; when so soiled they may soil
wounds, and perhaps in this manner give rise to charbon. As to flies
having rigid proboscides, those which bite, as Hypoboscides, Stom-
oxyidæ, Tanystomata, Bombyliidæ, etc., they may doubtless inoculate an
60
animal with charbon after having bitten and soiled the proboscis with
blood of charbonous animals. In this connection it may be remarked
that in the Hôtel Dieu Hospital in Paris, M. D. Mollière had under
treatment and cured a man attacked with anthrax (malignant pustule)
following the bite of a fly which he had smashed on the bite. Besides,
the intervention of the fly may be an occasional cause in certain cases,
where, owing to the itching which it gives rise to, the person scratches
and may thus inoculate charbon, or indeed any other virus, he has, on
his hands or under his nalis; this frequently happens to those who work
with charbonous dèbris.
Whether the fly directly inoculates, or whether it simply gives rise
to irritation, causing the person to scratch and inoculate himself, it is
none the less true that it is commonly believed to be a source of trans-
mission. It often happens, however, that local accidents of a different
nature inducing malignant pustule are wrongly interpreterd. It is not,
nevertheless, impossible that flies soiled with the virus of charbon may
become agents in its transmission. It may be taken as a general rule
that the bites of most flies in this particular are of little danger, their
bites being in themselves rarely dangerous.
In short, it is recognized clearly at the present day, and is a generally
admitted fact, that the development of charbon in countries where it is
endemic and propagates itself, is more especially due to the pre-ervation
of the germs from buried cadavers, dèbris, products and dejecta, etc.
The germs may be disseminated and charbon imported into districts in
various ways, by the movement of flocks or herds, by the transportation
of forage taken from contaminated sources, by dogs, which, after having
ingested charbonous material, may pass out the germs (spores) with their
excrements, and thus contaminate the herbage on which they are depo-
sited, or the water in which they drink after having made a meal off a
charbon carcass, and jackals and other scavengers may do the same; or
by water flowing, as in inundations; or by wool impregnated with de-
jecta or blood containing the virus, or by water in which it has been
washed, etc., etc. Burials, clandestine, defective, not sufficiently deep,
those made in places to which animals are permitted ready access, in
earth containing many worms, etc., explain, together with the utiliza-
tion of charbonous dejecta, the frequence and persistence of the disease.
Burials of carcasses carried out in sandy, calcareous, and chalky soils are
less dangerous, the germs in such cases not remounting to the surface,
but remaining where deposited; but even in these cases the tops of
graves are dangerous, because there is every possibility of the soil cover-
ing them being contaminated with germs which have escaped from the
carcass.
Formerly the development of charbon was considered to be spon-
61
taneous and attributed to diverse influences. At the present day the
expressions "spontaneous development,'' "spontaneous birth," are em-
ployed to express the natural development of the disease following
reception of the germs from the media surrounding the animals. The
causes cited formerly to explain the spontaneous development of the
disease may be considered as simple circumstances favourable to con-
tagion; they act by favouring the preservation and multiplication of the
germs and their introduction into the organism. These causes are
numerous, and it is at the present time easy to interpret their mode of
action. For a long time an elevated temperature and warm seasons have
been marked as favourable to the development of the malady, and more
particularly have warm moist seasons been blamed; this is in reality due
to the fact that a relatively elevated temperature and a certain degree of
moisture favour the multiplication and development of the germs, the
formation of spores, etc. For years it has been noticed that charbon
more especially occurs at the end of spring or commencement of autumn,
during the summer, during warm years, during warm seasons, tempes-
tuous and humid, during warm succeeding moist weather, etc. Ponds,
marshes, morasses, swamps, low-lying alluvial ground, sedgy vegetation,
and stagnant water generally are cited as causes. All these favour the
preservation and multiplication of the germ of charbon and its introduc-
tion into the organism; there is a propitious ensemble of conditions;
a favourable medium which furnishes suitable aliment; contact of the
air, and an elevated temperature, favourable to the formation of spores.
Forage and water may contain the bacilli, and the animals by in-
gesting them may contract charbon. Dust may convey the virus and
it may be thus conducted into the organism. All localities where
charbon is prevalent contain in their soil, water, or the herbage which
grows upon them, the germs of the disease. Places having a humid
soil, a clay subsoil, favour the preservation and multiplication of the
germs; and their waters, as well as their herbage, may communicate
charbon. It has been pretended that changed aliments or foods in
excess may cause charbon, but this has no trace of truth in it, provided
that the foods do not contain the virus of the disease. Decomposd water
cannot produce charbon if it does not contain the virus; and neither
excessive fatigue nor insufficient food ever produce the malady of
themselves. It has been remarked, as we have already stated, that
charbon more particularly appears in rainy years, especially when the
rains are followed by excessive dryness. The rain water dissolves a
large quantity of organic and mineral materials which, when heat
follows, constitute a favourable medium for the development and
multiplication of the germs. We have also blamed damp habitations,
badly kept and ventilated; but whatever be their defective hygiene,
62
they cannot cause the development of charbon if they do not contain
the germs. Sometimes, however, as we shall see presently, debilitating
influences play a certain part by inceasing the predisposition.
We may take it as a fact that anthrax, like charbon syptomatique,
is a malady arising out of certain soils which are capable of preserving
the virus. Its development, like that of charbon symptomatique, depends
greatly on infection from the soil and infection by the soil; it appears
more particularly when the humidity of the soil becomes lower after it
has been subject to humidity and a sufficient elevation of temperature
for the development of spores to take place.
Absorption of the virus, its mode of action, pathogeny.—A.
Absorption.—The invasion of the organism by charbon microbes fol-
lowing their accidental or experimental inoculation or their introduc-
tion into the respiratory or digestive passages, is produced by a
mechanism nearly always the same. When they penetrate in the form
of spores these germinate and are transformed into rods; in all cases
the germs are principally absorbed by the lymphatic system. They
rapidly multiply in the lymph spaces and the lymphatic vessels; they
quickly gain the neighbouring lymphatic glands and are there temporarily
arrested, multiply, completely invade, and then pass beyond them,
gaining, by means of the lymphatic vessels, other ganglia; and in this
manner finally gain admission into the general circulation. M. G.
Colin observes that the virus inoculated into the extremity of a hind
limb causes engorgement, tumefaction, and assumption of virulence,
firstly of the popliteal ganglion, then of that of the groin, etc., and
finally the bacilli become spread through the general circulation after
having multiplied in the lymphatic vessels; then the general symptoms
appear,—engorgement and virulence of the opposite member and of the
whole body.
As to the blood-vassels, it is not demonstrated that they do not
absorb charbonous microbes, more especially when they are cut or
opened by inoculation; it is not difficult to admit that we may arrest
the development of the malady by dividing the lymphatics which carry
the bacteria, or by extirpating the ganglia which receive them; more-
over, we shall see later on that in man, cauterization or extirpation
of the primary malignant pustule may contribute to recovery. In all
cases the penetration of the bacteria into the venous circulation accele-
rates the evolution of the malady, if the number of microbes introduced
is important. In reality, when the virus of charbon is directly intro-
duced in any quantity into the vein (Delafond, Toussaint, etc.) it
multiplies rapidly, and the subjects die more quickly than after sub-
cutaneous inoculation; but when the number of the microbes introduced
63
into the vein is inconsiderable, their multiplication is slower and more
difficult.
Be that as it may, the vessels preside over the absorption of the
virus deposited in a wound, and the penetration of the microbes from
the region inoculated may take place very rapidly, for, if five minutes
after inoculation the inoculated part be amputated, it does not always
stop the course of the malady, which clearly shows that a part at least
of the virus has penetrated beyond the amputated portion.
According to M. G. Colin, the virus of charbon inoculated by
subcutaneous punctures into the ear of a rabbit caused charbon and
death, although the ear was amputated 5, 4, and 3 minutes after the
inoculation. According to Davaine, the virus of charbon deposited in
wounds on rabbits, of the extent of a shilling, made by excision of the
tegument, did not generally cause charbon when the wounds were
cauterized with sulphuric acid, etc., one hour after the inoculation, and
hence it may be concluded that the nature of the wound influences the
rapidity of the absorption. There is great irregularity in the duration
of the absorption of the virus of charbon, even following inoculations
by puncture (subcutaneous). M. G. Colin has observed that inoculation
of the horse produces a marked local lesion, and that excision or
cauterization of the tumour may prevent general infection. M. Rodet
has observed that even in the inoculated rabbit the virus propagates
itself with variable rapidity; sometimes excision after 5 minutes have
elapsed since the inoculation, does not prevent infection, whilst excision
after from 1 to 10 hours stops it in certain cases. Moreover, excision
arrests or does not arrest the infection, according as it is deep and well
removed around the seat of inoculation.
The germs are taken up by the lymphatic vessels and multiply in
the lymph, their propagation varies according to the conditions which
the inoculated part is in, and according to the activity to the virus
being greater or less. The rapidity of their absorption depends on the
facility with which they gain admittance to the lymphatic system; in
cases of accidental contagion they may remain for a considerable time
at the point of inoculation before entering the lymphatics.
Incubation.—The time which elapses between the moment of the
introduction of the virus and that of general infection varies from one
to several days, according to the class of animal, the species, age, the
state of health, the dose, and activity of the microbes. The develop-
ment of charbon may be hastened by numerous influences, such as
youth, extirpation of the spleen (Berlach), bleeding (Rodet), cold
(Pasteur), method of alimentation (Feser), fatigue, privation, etc.
Phagocytism.—Resistance of the system.—The organism, whatever