Imágenes de páginas
PDF
EPUB

majority to special training in a double aspect as to ecclesiastical questions. If the theological element seem too strong, I would be content with two theologians and give the casting vote to the president, who would always be a judge; but I should press for equal numbers of judges and doctors--doctors, of course, who were really learned in ecclesiastical law. Such a court so constituted would be a modification and not a contradiction of the one suggested in the Commissioners' Report. It would be a more full, complete, and satisfactory carrying out of their own intentions than their own embodiment of them.

It will not be in the present Parliament, I fear, that any legislation can follow. It is now the breathing time to canvass the details of the Report. But I should do so with great moderation, and swallow a great deal to get the ecclesiastical judicature reformed in the direction which the Commission points out. Its Report has been received in a very satisfactory way by the decided majority of both parties in the Church in their various periodicals, as well as by the great mass of moderate public opinion; while such blatant hostility as the shriek of the Liberation Society over the provision that the members in the various courts must profess adhesion to the Church in whose causes they are judging is a strong testimonial to the equity of the scheme in the eyes of peaceable and sensible bystanders. Perhaps the truest expression would be that the Blue Books as a whole, reports, historical appendices, and evidence, all taken together make up a decided literary success, which is the utmost that could in the present aspect of politics be expected for the publication. It has also produced another most valuable effect in clearing the stormy air and smoothing angry brows. Ever since the revival of energy and devotion in our Church, numbers of our most devoted Churchmen have with more or less justice felt that they have not met with the sympathy which their self-sacrifice merited. No doubt the authorities of whom they may complain are the first to disclaim the reasonableness of the complaint. But the condition of dignitary has up till now, though of course in an ever-diminishing ratio, been a survival of the pre-1833 days. The older generation has now practically passed away, and the revival itself is now to a great degree in its second generation. The Church, as a whole, has become the Church of the revival among Low as well as among High Churchmen; but something tangible was needed to prove this fact, and the missing evidence stands out clear in the present Report. This is why I venture to call it an olive branch, and I very confidently leave it to work its gradual but sure work of conciliation in the ever-spreading, ever-deepening Anglican Communion.

A. J. B. BERESFORD-HOPE.

THE GERM-THEORY of ZYMOTIC DISEASES. CONSIDERED FROM THE NATURAL HISTORY POINT OF VIEW.

In a former article (November 1881) I set forth the 'germ-theory' of Zymotic diseases, as recently built up by micro-pathological study, on the basis of the admirable researches of Pasteur on fermentation → and putrefaction. I now propose to show that the evidence in its favour afforded by the natural history of those diseases is scarcely less cogent. And I shall further inquire what light is thrown on a question hitherto regarded as insoluble-that of the origination of the specific types of those diseases-by the application of that method of inquiry which, in Mr. Darwin's hands, has revolutionised the views of Naturalists in regard to the origin of species.'

6

The idea that such diseases as Small-pox, which spread by human communication, and of which the virus multiplies itself in the human body, are generated by a contagium vivum of some kind, is by no means a new one; having been suggested by the resemblance of the definite course followed by these diseases to the development, maturation, and decline of living organisms, and by the analogy between the regeneration of the contagium within the body in greatly increased amount, and the production of seeds or eggs. These general relations were brought out with great force more than forty years ago, by one of our most philosophic physicians, the late Sir Henry Holland, in a thoughtful chapter of his Medical Notes and Reflections;' but it is only now that their true meaning is becoming apparent in the clear light of the doctrine of disease-germs. On the other hand, the idea of a process analogous to fermentation' in the blood, produced by the chemical action of some materies morbi introduced into it by the breath, seemed most applicable to the case of those 'specific' fevers which originate in malarious or miasmatic emanations; and this was the doctrine embodied in the term 'zymotic,' which, first introduced by the late Dr. W. Farr, has since come into general acceptance.

[ocr errors]

Now that we can certainly trace every form of fermentation and putrefaction to the development of 'saprophytes,' or minute plants vegetating on decomposable organic matter, all the facts which supported the doctrine of 'zymosis' go to strengthen the doctrine of 'organic germs,' and vice versâ; so that here, as in many other cases,

ideas which formed the bases of rival systems are themselves found to be but different forms of expression of one and the same fundamental truth.

As

The importance of these 'saprophytes,' alike in the economy of Nature and in service to Man, can scarcely be over-estimated. Dr. William Roberts well expressed it,1—

Without saprophytes there could be no putrefaction; and without putrefaction the waste materials thrown off by the animal and vegetable kingdoms could not be consumed. Instead of being broken up, as they now are, and restored to the earth and air in a fit state to nourish new generations of plants, they would remain as an intolerable incubus on the inorganic world. Plants would languish for want of nutriment, and animals would be hampered by their own excreta and by the dead bodies of their mates and predecessors-in short, the circle of life would be wanting in an essential link.

Again, he points out,—

A large proportion of our food is prepared by the agency of saprophytes. We are indebted to certain bacteria for our butter, cheese, and vinegar. Our daily bread is made with yeast. To the yeast plant we owe all our wines, beer, and spirituous liquors. As the generator of alcohol, this tiny cell plays a larger part in the life of civilised man than any other tree or plant.

Thus, while among the most minute in size, and the simplest in form, of all living beings, these saprophytes derive from their peculiar endowments an unequalled potency for good. Unfortunately for us, however, they have a terrible potency for evil also; and it is the noble aim of Science to be able, by the thorough study of the conditions under which that potency is acquired and exerted, to keep it under efficient control. That study is as yet only in its infancy; but the progress it has already made affords ground for the confident expectation that the Science of Preventive Medicine will ere long furnish us with the means (should we be wise and firm enough to use them) of exterminating all the grievous 'pests' to which flesh is heir.

I commence my survey with a class of diseases of which we have fortunately little experience in this country, but which over large areas of the land-surface of the globe are more wide-spread and destructive than any others—those, namely, which are traceable to emanations from the soil designated as malarious. There are many localities, especially between the tropics, in which malarious fevers are not only the principal forms of disease, but where they give rise to two-thirds of the total mortality. In fact, as Dr. Parkes concisely put it, when a warm climate is called 'unhealthy,' it is simply meant that it is ‘malarious.' There are even some into which, at certain seasons of the year, it is almost certain death for an unacclimatised person to remain for only a few hours; many more in which a longer stay is almost certain to induce a more or less severe form of periodic fever; and large tracts whose inhabitants are the subject of that slow

1 Address in Medicine to the annual meeting of the British Medical Association at Manchester, 1877.

general blight of the constitutional powers, chiefly manifested in the diminution of the red corpuscles of the blood with increase of the colourless, which is recognised as the 'malarial cachexia.' Of the fearful potency of the malarious poison in its worst forms we have had conspicuous examples in the Walcheren Expedition of 1809, in which 10,000 men were struck down by it; more recently, in the terrible visitation by which Mauritius was ravaged a few years ago; and (on a smaller scale) in the two ill-fated Niger Expeditions, the first conducted by Macgregor Laird in 1832, and the second fitted out by the British Government in 1851. But those only who are specially conversant with India are aware that, in its less malignant form, the malarious poison is every year causing a far greater destruction of life among the inhabitants of that vast peninsula than it has done in the worst of the occasional outbreaks of cholera, small-pox, &c.; the average annual mortality from malarial fevers being twice as great as from all other forms of zymotic disease put together.

The less violent but often more persistent forms of malarious. disease are familiar to us through the evil reputation of the Roman Campagna, the poisonous atmosphere of which affects its inhabitants with periodic fevers, and often permanently debilitates them by disordering the blood-making process.

6

It is in the milder' intermittent' fevers that we recognise the most characteristic action of malaria; their regular periodicity being an indication of alternating conditions of dormancy and activity in the operation of the poison, which strongly suggest successional phases in the history of a living organism. The malarial fever of tropical regions is generally of the remittent' type; there being a periodical abatement of the symptoms, without any distinct intermission of them. And while an intermittent fever has no definite termination -so that the person who has been once the subject of it seldom gets entirely rid of the tendency to its recurrence remittent fevers. usually run a definite course, terminating after a few weeks in either death or recovery. There can be no reasonable doubt that the poison is of essentially the same character in both cases; and it is a fact of no small significance, that intermittent and remittent fevers (save the worst forms of the latter) are alike controlled by the judicious administration of quinine.

Now the prevalent idea is, that malaria is essentially a product of marshes; and it is popularly believed to be generated by the action of heat on decomposing vegetable matter in the presence of air and moisture. This idea, however, is by no means consistent with facts; for (as we are assured by one of our best authorities, Dr. Maclean,2 of Netley Hospital), although malaria indisputably infests low, moist, and warm localities, yet marshes are not as a rule dangerous when abundantly covered with water; it is when the water's level is lowered, and the saturated soil is exposed to the

6

2 Article Malaria,' in Dr. Quain's Dictionary of Medicine.

drying influence of a high temperature and the direct rays of the sun, that the poison is evolved in abundance.'

When the British army under Wellington, during the Peninsular War, was operating in Estremadura, it was assailed by a remittent fever of such destructive malignity, that the enemy and all Europe believed the force to be annihilated; yet the country was so arid and dry for want of rain, that the rivers and small streams were reduced to mere lines of widely detached pools. The same army was scourged by a fever of like malignity in the bare open country by which Ciudad Rodrigo is approached from the side of Portugal, at a time when the vegetation was so burned up that the whole country resembled a brick-ground. Both these districts are flooded with rain water during the rainy season, and are then healthy; only becoming malarious when the drying process begins under the action of a powerful sun.

So, again, it is not during the rainy months of winter and spring that the Roman farmer dreads the low-lying parts of the Campagna, which are then occupied by vast herds of sheep, cattle, and horses, while the arable lands are cultivated by large gangs of labourers. But with the approach of summer, the sheep and oxen are driven away to the Apennines; all the labourers that can be spared go off to the hills; and when recalled at harvest time, they reap all day under a scorching sun, and sleep at night on the ground shrouded with heavy pestilent vapour, which prostrates even the hardiest of them, filling the hospitals of Rome in autumn with fever-stricken patients. This malarious condition has been persistent from very ancient times; and as it prevails over large tracts on which no stagnant water lies, it is obvious that the popular notion of its origin is incorrect. Professor Léon Colin (of the Val-de-Grace Military Medical School), who some time ago carefully investigated the condition of the Campagna, came to the conclusion that a telluric poison' is generated in it by the energy of the soil, when that energy is not utilised by its natural consumers-cultivated plants; and if we substitute for Dr. Colin's unknown quantity' the definite term 'saprophytic vegetation,' we shall find that all the facts of the case are brought into harmony.

6

6

In the first place, the microscopic researches of Professor. Tommasi Crudeli of Rome, and Klebs of Prague, based on Pasteur's doctrine of disease-germs, have shown that the lower strata of the atmosphere of the Agro Romano, its surface-soil, and its stagnant waters, contain micro-organisms of the Bacillus type, which they have cultivated' in various kinds of soil, and then introduced by inoculation into the blood of healthy dogs. All the animals thus experimented on became the subjects of malarial fever, which ran its regular course, producing the same enlargement of the spleen as is seen in the human subject naturally affected by the disease; and the spleens of these animals were found to contain a great quantity of the bacilli. Not only Professor Crudeli, but two other physicians in Rome, have detected

« AnteriorContinuar »