The Bridgeport evening farmer., 1909-01-21
LETTERS TO THE EDITOR
A DOCTORS QUESTIONS

A DOCTORS QUESTIONS To the Editor of the Hartford Times: The account of the trial and acquit- tai of q physician for not reporting supposed cases of diphtheria, during which trial the fact was brought out that disease germs may often be found in the throats of healthy people, un- avOidably suggests some questions, the nature of which in themselves demand answers.
 This fact has long been known in medicine, but this is the first instance, so far as l know, in which 1t has been made public ir this vicinity.
 If diphtheria or other disease caus- ing bacilli may easily be found in the throats of healthy people: l. Are not those in whom they are present in more danger than others of developing the disease and of spread ing it if the bacilli are really the cause of the disease?
 2. Should not cultures be taken from the throats of every person at neces- sary and regular intervals so as to isolate those who have them until free from the germs so as to stamp out'' the disease?
 3. Should not anti-toxin, if that is really a specific preventative of diph- theretic infection. be administered as often as necessary to all who are found harboring diphtheria bacilli in their thrOats?
 4. If germs are really the cause of infectious disease how else is it Fin the power of man to cause all germ diseases to disappear from the World' than by discovering, isolating and de- stroying the germs3
 5. On the other hand, if diphtheria germs may easily be found in the throat ts of healthy people can they not be just as easily found in those who have tonsilitis or other throat affec- tions?
 6. If dihptheria germs, for instance, may be easily found in tOnsil1tis, spas modic crouD and other affections Of the throat how can laboratory exam inaticns alone determine whether the disease is diphtheria. tonsilitis or some other throat disease?
 2. If diphtheria germs may be found in the thrOats of healthy people how valuable as evidence is the fact that they are found in a case of throat dis ease that that case is diphtheria?
 8. Is it the custom of physicians to depend upon the diagnosis of the lab oratory doctor rather than upon his own observation and knowledge?
 9. If physicians depend on the re- suits of the examinations of cultures instead of the symptoms of the sick person, is there not Q possibility that many quarantineS are unjust and that much expensive and dangerous anti toxin is used besides other conse- quences entailed when dangerous disease is diagnosed?
 10. If the reports of the exanina- tion of cultures are to be relied upon in freeing families from quarantine (and they are supposed to be so relied upon) how can one tell whether the quarantine is not unnecessarily pro- tracted? As Quarantines sometimes tn n SnUar9J after the patient seems perfectly we'll before examinations happen to fail to reveal the bacilli this question is not imperti- nent.
 Il. When a person has been quar- antined with dihptheria is he usually set free upon the first report of germ free culture or is it the custom to ex- anime several cultures more so as to be sure that there are none of those fearful bacilli present?
 Il. If disease (diphtheria) germs may be easily found in healthy people and in mild throat diseases, how are we to know whether the many reputed cures with anti-toXin were really cured with that remedy or that the statistics of cures do not include many cases of tonsilitis and other diseases Of the throat and that the patient recovered in spite of the disease and the rem edy; and may such statistics be relied upon as fact? In view of the fact that health boards in some places are trying to make this expensive and doubtful, not to say dangerous, rem edy, compulsory, this question is per- tinent to the public.
 13 It is known that the danger of infection from diphtheria is about in proportion to the severity of the case, but severe ases occur in which the bacilli cannot be found. If, there fore, the germs may be found in L. aof h@ in cases of dirhtneria, how can 1t be proved that they are the cause of the disease?
 IA. Are disease baciTi really some thing extraneous to the human organ ism, or are they a product of lowered vitality in the individual caused by some other physical circumstances
 15. If the logical deduction from the fact that disease germs may be found in healthy people and may not be found in disease is that they are not the cause of disease but are the result of something else and merely accom- pany the disease (which many scien- lists contend to be true) should not that deter health boards from too rad ical measures based on the theory that they are the cause of disease? And should it not influence everybody to use all the sanity they possess when obliged to judge and act on matters which rest upon scientific theories?
 As the zealous health commissioner of one of our large cities proposes to order compulsory injection of poisoned horse serum (anti-toxin) into all who are exposed to diphtheria in the face of the fact that a number have died and others been more or less seriously affected as a result of the practice, it is we'll that the public should find an- swers to these questions and decide whether such procedures would be well comed here.
 If any one is inclined to answer these question publicly I trust they may be answered as squarely as they are asked without raising scientific dust or appealing to the fear of dis ease.
 .- Yours for 'health'',
 M. D.
 Hartford, 1909.
 REV MADISGN r. PETERS