The times. [volume] (Washington [D.C.]) 1897-1901, 1899-04-30
AND A FEW OF HIS BIG BULLETS.

his recent researches on various tropical
diseases are marred by the careless blum
ders, reckless haste, and dishonest pla-
glarism which have previously ruined his
scientific reputation. 1t is not, however,
with Koch's reputation that we are here
concerned, but with the new danger he
has added to life in tropical Africa Black
water fever is admittedly the most dead
ly, the most obscure, of the diseases from
which Europeans now suffer in that I'M
healthy country. The malady causes
breaking up of the red corpuscles of the
blood in the kidneys, and accordingly its
most conspicuous symptom is that the
urine Is dark brown or black-much the
same color as stout. Several theories have
been proposed 10 explain the nature OF the
disease. At first it was attributed to the
action of malarial parasites, but this idea
has been disproved, as the blood of patients
suffering from black water fever is fire.
quently free from these organisms. Sam
bon has recently advanced strong reasons
for considering that the fever is due to the
parasite that causes Texas fever in cat
tie. In opposition to both of these organic
theories there is third explanation, which
attributes the fever to quinine poisoning.
This idea was originally proposed by Tom
aselli, of Catania, who studied the disease
in Sicily and Sardinia. He noticed that
the administration of strong dose of
oXysm Of black water fever in patients suf-
fering from the disease He accordingly
concluded that black-water fever is simply
quinine poisoning. The theory has been re-
peatedly discussed, and fresh observations
made by kuchel Kohlstock, Stendel, and
others. The theory, however. is untenable.
Black water fever attacks people who have
never taken Quinine, overdoseS OF qui-
nine in healthy people do not produce the
symptoms of the disease, and quinine,
when properly applied, checks and even
cures it,
Some authors, such as Plehn, who once
accepted Tomaselli's theory have now re-
nounced 1t, recognizing that though qui-
nine may produce a paroxlsm OF black
water fever In patients suffering from the
disease. it can never produce the disease.
Nevertheless, Koch. after observing six
teen cases in the hospital at Dar-es-
Salaam, In which he noticed the usual ac-
ton of quinine in patients suffering from
| black-water fever. has reproposed Toma-
selli's discredited theory and dogmatically
asserts 1t as a now incontrovertible fact.
Neither in Koch's public lecture in Berlin.
nor in his recently issued REESE Berichte''
is there any acknowledgment of Tomaselli' S
work. But that is only Koch's way. He
similarly announces his belief in the agency
of mosquitoes In spreading malaria, as II
that were quite his own idea, instead OF
! having been proposed by Manson and prov
ed by Ross researches in Calcutta.
Owing to Koch's reputation among the
uneducated his views have received the
widest publicity. and it will take years be-
| fore the REPUTATION has become as widely
known. There is already a considerable
| prejudice against quinine; it has a nasty
taste, and people say that it gives them
headache, brings on sickness or makes
| them deaf Every tropical doctor knows
how difficult it is to persuade irritable, few
er-stricken patients to take quinine prop
erly Now that Koch has declared that its
action is to bring on the most deadly Afri-
can fevers, people are refusing to take 1t al
all. The British Medical Journal for
! September "a contains a piteous lament
| from DR.. r. Moffatt, of Uganda. declaring
that quinine is the only thing that will cure
black-water fever, and that some of his pa
tents now refuse to take 1t in consequence
| of Koch's reckless utterances. The victims
OF tuberculin may be reckoned by scores:
but Koch's advocacy OF the view that black
water fever is quine poisoning will proba-
| bly, kill its hundreds. ~