Omaha daily bee. (Omaha [Neb.]) 187?-1922, 1919-04-27

diS SpOkeH ot Us SeCOItudIy lAIcN-
tons. The above mentioned facts
explain the reason for giving a
primary and secondary cause of
death III filling out death eertif-
icate No. statistical purposes.
Evolution Of Disease.
Whether the body ever returns to
a normal state after recovery from
an infectious disease is still an open
question. In the large majority of
eases it apparently does, but we
must always remember that time
only can answer this question in
any individual case. Certainly a
"spell' Of any one of the infectious
diseases is not regarded by the pro-
fession as interfering with the usual
expectancy. 1t is true, however, that
diseases that owe their origin to past
illness are affections Of organs, as
for example Bright's disease,
chronic heart disease, locomotor
ataxia, the organs being involved in
the infectious process at the time
Of the acute Infection, and apparent
ly subs,ding with it. / say apparent
ly advisedly. because although the
acute Inflammation subsidies, it too
often gives place to a chronic in
flammatlon that extends over years.
This chronic inflammatory state is
no longer dependent In most cases
upon the infectious principle which
caused the initial lesion, but is d
slow sclerosis, or scar formation
which consists In a gradual &C .trac-
ton and substitution of the iormal
tissues of part by scar tissue. The
change Is especially prone to occur
in organs that have sustained an in
jury of one kind or another, and is
virtually a vicarious evolution that
the tissues are subject toS There is
a danger in the new condition that
arises from the contractions and the
loss in organic cellular elements,
since in the one case functions are
interfered with. in the other, meta
bolism is disturbed. {Metabolism is
the chemical change within the
body in nutrition and secretion).
The seriousness of the lesion de-
ponds upon the organ in which the
original injury was located, and it's
importance to the vital processes of
the body. One or two illustrations
will suffice to elucidate our point. A
person has typhoid fever and APP
parently makes a complete recovery.
Ten, ] . or 20 years afterwards he
seeks medical advice for shortness
of breath and cough. His case is
diagnosed as chronic heart disease.
Whence came the lesion of his heart
valves? When closely questioned he
may remember that the physician
who attended him at the time of his
fever did remark that there was
some slight evidence of injury to the
heart. But even this evidence of
the connection between his present
trouble and the earlier typhoid is
now no longer necessary; we have
learned through experience the con-
nection. Are typhoid bacilli caus-
ing tho present trouble? Assuredly
not! The original cause was an in
fiammation of the heart valves from
the typhoid bacilli or some other
micro organism which gained an en-
trance into the body during his at
tack of typhoid. The heart lesion to
all appearances healed. But a scar
remained that. according to the man
ner of all scar tissue, continued to
contract, until throsgh the
disability it Produced in the
functioning of the heart gave
rise to symptoms. Substantially
the same history is obtained in many
cases of Brights disease, the ante
cedent disease being either scarlet
fever, measles, diphtheria or typhoid.
Sickness in Relation to Family
Income.
Sydenstricker, Wheeler and Gold
berger of the public health service
made an investigation into disa bling
sickness among the population of
seven cotton mill villages in South
Carolina in relation to family in
come during May and June, 1916.
The study covered TAT households
composed of 4,161 persons. They
conclude public Health Reports,
November %, 1879: A higher sick
ness Involving inability to work.
rate and a greater amount of work
ing time lost on account of such
sickness were found among members
OF families whose incomes were low
than among members Of the families
with d, more favorable economic
status. Only when a family income
Appropriated $40 per half month per
adult male unit Tor about 5000 year
for family of normal size in
1870 did the sickness rate appear to
be as low as that suggested by SINH
lar censuses in number of locali-
ties in the United States as the nor
NAL rate. Low economic status ap-
peared to be a more striking con-
comitant of high sickness rate
among females than employment in
mill work. A greater proportion Of
disabling illness. of relatively long
duration. appeared among persons
whose family income was below the
average than among persons with a
more favorable economic status. In
the analysis of morbidity facts
economic status should be given
proper emphasis.