The sun., 1880-12-12
SOME NEW BOOKS.
Il Consumption Contagious =

asmuch ns IN private practice, and both civil
and military hospitals no measures" or very
inadequate measures. OF prevention arc en-
poyed." How largo part OF tho communities Is
interested In determining tho communicability
OF nhthlss is plain enough from the fact that
from one-cghth TO one-sixth Of all tho deaths
which occur after u certain age are attributed
to this disease. Now whether tubercu-
losis cnn be transmitted not only by in
heritance but also through the medium OF food
tmilk. flesh. and 40 'orthl. through breathing
the exhalntions Of a diseased person. or through
inocuation. Is n question upon which medlcal
science cannot be yet said to have pronounced
fnal conclusive. and universally accepted judg-
ment 1t is n question TO which widely different
replies have been given in different countries
and at different cpochs. but II cannot be denied
that tho drift Of recent investigation points to
an affirmative answer Under these clrcum-
stances no popular treatise on medical subject
is likely to be moro widely and earnestly read
than the littlo volume compiled by DIR. II. @.
CLApp Of Boston, and published under the title
Is Consumption Contag Gus? (Ous. Clamp 4 SOM
DIR. Clnpp has hero presented. in n compact and
lucid form. nearly all tho material data and
noteworthy conclusions OF the department OF
medical literature bearing on this theme.
Promising that the word contagious" is
used throughout this book in its broadcast sense
OF ofcommunicable. transmissibe. or catching"
we may marx two or three facts indicating the
revolutions which have taken place in medical
opinion touching the propricty OF applying
such n term to consumption. From the time OF
Galen down to the close OF the last century. al
most all the celebrated medical writers in the
world believed tho disease TO be contagious.
Riverius declared contagion to be the chief
cause OF phthsis valsalva constantly avoided
being present at the dissection OF the lungs OF
persons who had died OF that disease. and Nor
gagni avowed that he had never dared to mako
more than very few autopsies OF such sub
jects. In Italy the belief has at no time died
out among medical practitioners. while the pop
ular conviction on this head is 30 deeply rooted
that n consumptve patient could not be moro
Stunned and dreaded II he had the plague. So
far however. rs central and northern Europe
and the United States were concerned. reac-
ton against this opinion set In about hundred
years ago. and went 30 far that. about the
middle OF this century. the contagiousness OF
consumption was almost universally treated rs
an exploded theory. Thus. Sir Thomas Wat
son, lec,urng in 1897. declared himself salts
fed" that the disorder does not spread by con-
tagion. DR.. Walshe. writing few years later,
considered the influence OF contagion any
thing but proven" AS late as 1879 DR.. Cotton.
senior physician to the Brompton Hospital for
consumptives. came out very strongly against
contagon. After proving from statistics OF
his hospital. which covered period
OF some twenty years, the absolute
immunity OF attendants and employees from
this disorder, he propounded this theory to the
believers In the communicability OF phthisis.
whether permanent residence In consump-
ton hospital and long continued working in
its wards was not very good way. indeed not
b. tnbt thaI Ia lnttIt t,nt
DR.. Cotton's experience has heretofore eonstl-
tuted an almost insuperaole stumbling block 10
those advocates OF tho conaeion theory who
have relied on historical and descriptive evil
dence. In such conflict OF testimony 1t was
INDISPENSABLE. in order to reach scientific dem
onstration. to provo by concrete experiment
that tuberculous matter could be propagated
by incubation. This. as we shall see. was the
ground on which the controversy was ultimate
ly to turn.
Meanwhile however. a decided change had
come over the views OF the medical profession
in Europe and America. based. for the most
part. on suggestive observations made in the
course OF practice. The report OF the Massa-
chusetts Board OF Health for 1872 contained an
analysis OF some extensive correspondence on
the causes or antecedents Of consumption. In
Btituted by DR.. Bowditch. Out OF 1872 ply
sicians who answered DR.. Bowditch's query,
is consumption contagious 2" ITO replied in
the affirmative while 81 were doubtful. In
1878 DR.. Holden OF Newark N. j., published
the results OF similar inquiry. Out OF 250
physicians who expressed an opinion on the
subject 126 affirmed the contaRiousness of
phthisis. while so were doubtful About ten
years earlier DR.. William Budd. In an article on
the nature and propagation OF phthsis. pub
lished In the London Lancet. took strong ground
for contagion. His conclusion was that tuber-
culosis is a true zymotic disease OF specific ma
turo. in the same sense as typhoid. scarlet
fever. typhus. syphilis. &C.. are. and
that like these Diseases. tuberculosis
never originates spontaneously. but is
perpetuated solely by the law of continuous
succession. Among the evidences for this as
ser.ion he adduced considerations founded on
the pathology OF phthiss. consisting in the evo-
luton and multiplication within the organism
OF a specific morbid matter, with tendency to
elimination. and casting off OF the same oO-
served in zymotic diseases generally. He
cited also the numerous recorded instances in
which there Is testimony to show communica-
ton from one person to another: and he re-
ferred to the geographical distribution OF
phthisis In past and present times. and espe-
cially its current fatality in countries-the Sand
wich Islands. for example-which are known
10 nave Deen entlrely lree from IL WHen urst
discovered by Europeans. In the greater fre-
Quency OF the disease on low levels and its en-
tire absence, except through importation at
high levels DR.. Budd recognized the physio-
graphical conditions which govern zymotic
mslades in general. while he pointed out the
high rate OF prevalence In crowded communi-
ties. converts. harems. barracks. penitentiaries.
&c.-that is 10 say. in the very same social en-
vronment where other zymotic diseases are
observed to be most readily propagated.
Such was the divided state OF opinion on this
Bubject-the array OF affirmative evidence being
explained by skeptics as examples Of coinc-
dence and predisposition." or met by such
awkward counter-iacts as those supplied by DR..
Cotton-when tho German and French ply
slcians undertook to determine by actual ex-
pertinent whether tuberculosis can be trans
nitted. arst through the medium OF food or OF
Inhalation. and second through incubation.
Is tho pearl disease" In cows-so called
from the grape-like appearance OF the tubercu-
lar masses-absolutely identical with tubercu-
losis in manf Among the weighty authorities
on the affirmative side OF this question is Prof
SchGppel OF TnbnRen. who has made a thor.
ough study Of the subject. while Prof. VirchoN