New-York tribune. [volume] (New York [N.Y.]) 1866-1924, 1891-10-25
CONSUMPTION.
HOW TO PREVENT TT-CORNET'S INvESIlGA'
TON.
Professor Huxley in The Fortnightly Review
Ai"AeS''i iAN~J - L.. al .hisicaI M

+nt naV ' Infectious had been placed by previous
investigations beyond doubt The prlncipai que %
tion SET before himself by Cornet had reference ~
! the mart PLAYED by the air in the propagation oi
| lung disease Is the breath OF persons suncl-
inc from pthsi> charged, as assumed 10y SUM- Sro
| with bacilli? Or is it, as assumed by otheIs, ny
| from the organism? The drawing oil tne ar
through media able to intercept its floating par
! ces and the examination of the media alser t
| ward might, at first sight, appear Ine HiosO
simple Way of answering this question;
| Rnt TO examine a thousand ntres OF ar "oulu
require considerable time ana th,s Gy
twelfth of the volume which man DreathlnS quet.
lv expires every day II the air were only sparingy
charged with bacilli, the amount necessary IJl d
thorough examination might prove oSa 9or es
Instead of the air, therefore, Cornet chose toI ca
animation the precipitate from the air; that Is
10 say, the dust of the sickroom, which must
contain the bacilli in greater NUMBERS 'nan 'ii'
air itself. -,
He chose for his field of operations seven as
tinct hospitals Krankenhausern), three lunauc
asylums rrenanstalten), hfty-three private houses
| and various other Localities, including prlvate
| asylums, lecture-rooms, surgical wards, puplls
| buildings and the open street. The smalinesS oil
the bacili has given currency TO erroneous nooos
regarding their power of floating In the AR;
The bacilli are not only living bodies, but heavy
bodies, which sink in water and pus, and much
dust from places inaccessible to the sputum issu-
ing directly from the coughing patlenu lie
rubbed it OFF high-hung pictures, CLOCK,
the PATIENTS bed, and also off the walls behind H.
The enormous care necessary in such experiments,
and, indeed, in the use Of instruments generaliy,
has not yet, fear, been universally realized ny
| medical men. With q care worthy OF imitation,
| Cornet sterilized the instruments with when ms
dust was collected, and also the vessels In wnlch Ii
was placed.
The cultivation Of the tubercle bacilli directly
from the dust proved impacticable Their extra
| ordinary slowncss Of development enabled othcr
organisms-weeds of the pathogenic garden-whGh
were always present, to overpOwer and practically
stihe them Cornet, therefore, resorted to the
infection of guinea-pigs with his dust. III tuoers
f.11, al cnNht
virulence would be obtained which the microscope
could never furnish. The dust, after being lnul,
mately mixed with q suitable liquid, was lnJectel
| into the abdomen of the guinea-plg. for every
sample of dust, two, three, four or more anlnlaiS
were employed. In numerous cases the lnleete t
animal died day or two after mOcuidtloh' o4Ia e
tubercle bacillus, which, as already stated, Is cN-
tremey slow of Developments, put TO organisms
! which set up pertontis and other fatal disorders
Usually, however, some of the group OF guinea
pigs escaped this quick mortality, and to permit oil
the development of the bacilll: they were allowed
TO live on thirty, forty or nifty days Inc sur
vivors were then killed and examined. In some
cases the animals were found charged with tuberce
bacilli, the virulence of the 1nocuated mat'er
being thus established In other cases the organs
of tie guinca-pigs were found healthy, thus PROV
ing the harmlessness Of the dust
1t must here be borne mind that the bacillt
mixed with Comets dust must have first fioated
in the air, and have been deposited by IT, Consder-
ing the number of persons who suffer from pnthsl,
and the billions Of bacii eXpectorated by each OF
them, 1t would seem n fair priOri deduction that
wherever people with their normal proportion Of
consumptve subjects aggregate, the tubercc
bacillus must be present everywhere. Hence inc
doctrine Of ub1uity" cnunciatcd and defended
by many writers this question. Common
observation throws doubt upon the doct Tlne, Whlls
the experiments Of COrnet are distinctly opposed
to it, Tested by the dust deposited on their lurnl-
ture or rubbed from their walls the wards OF some
hospitals were found entirely free from Dacl,ii'
while Others were to be found richly and fatally
endowed with the organism. Cornet It. may be
remarked, does not contend that his negative re-
suits possess demOnstratve force. lie is quite
ready to admit that where he failed to find them,
bacilli may have escaped him But he Justly
remarks that, until we have discovered hacterium
magnet, capable of drawing every bacillus from It's
hiding place, experiment must remain more or less
open to this criticism. Comets object Is practical
one. lie has to consider the probability rather Ts
possibility, even in places where no bacilli show
themselves, may be admitted, while the proba-
are practically free from danger.
How he asks does the tubercle bacillus reach
the lungs, and how is it transported thence into
the air. Is it the sputum alone that carries the
organism or do the bac!lli mngle with the breath
| This is the problem Of problems the answer TO
which will show whether we are able to protect
| ourselves against tuberculosis whether we can
impose limits on the scourge, or whether, with
hands tied, we have TO surrender ourselves to It's
malignant sway. If the tubercle bacilli are
carried outward by the breath. then nothing re-
mains for us but to wait till an infected pun of
| expired air conveys us TO our DOOM. kind OF
| fatelism sometimes dominant in relation 10 this
question wouG thus have its justification. There is
no inhabited place without its proportion of phths-
ical subjects, who if the foregoing suppost on were
correct would be condemned TO infect their neigh
bors. Terrible in this case would be the doom of
| the sufferer, whom we should be forced to AVOID,
rs In earlier ages the plague stricken were avoided
Terrible moreover, to the invalid would be the
consciousness that with every discharge from his
lungs he was spreading death among those around
him. "Such state Of things, says Corlet,
| "would soon loosen the bonds Of the family and
Of society" Happily the facts Of the case are
very different from those here set forth.
Il would not says our, author, "go into this
subject so FULLY would not here repeat what is
already known, were | not convinced that, in re.
gard to this special point the most erroneous notions
are prevalent, not only among the general public,
but even among highly-cultivated medical men.
| Misled by such nDtions precautions are adopted
which are simply calculated to defeat the end in
view Thus it is that while one physician anXiously
guards against the expired breath Of the phhsical
patient another is careful to have his spittoon 50
covered up that no bacii escape into the air
by evaporation Neither Of them makes any in
auiry about the really crucial point-whether the
patient has deposited all his sputum III the spittoon,
thus avoiding the possibility of the expectorated
matter becoming dry, and reduced afterward to a
powder capable Of being inhaled.
While positive phthis0phobia appears to have
taken possession Of some minds, others ignore al
most completely the possibility Of infection. The
fact that investigations have been published Of late,
the breath sufficiently indicates that the conclusive
Of earlier investigators have not received
| the proper amount of attention.
I'VE must regard it," says Cornet, as firmly
established that under circumstance can the
bateria contained In liquid or strewn upon a wet
surface escape by evaporation or be carried away
by currents Of air. BY an irrefragable series Of
experiments Nageli has placed this beyond doubt
The evidence that the sputum is the real source
of tuberculous infection is conclusive; and here
Cornet earnestly directs attention to the fact that
! in the houses of the poor the patient commonly
spits upon the floor, where the sputum dries and ID
rubbed into infectious dust by the feet Of persons
passing over il. The danger becomes greatest when
the dry floor is swept by brush or broom. There is
still graver danger connected with the habits Of
wcll-to-do people who occupy clean and salubrious
houses This is the common practice Of splitting
into northumberland. Here the sputum Is
soon dried by the warmth of the pocket. the sub
seuuent use of the handkerchief causing it to be
| r,,hlnnd int virnlent dust This constitutes n