I In the retrospect from the vantage ground of half a century of sanitary progress we recognize that during the third quarter of the last century the people of England were waging a successful war on domestic uncleanliness as a contributory, if not the sole cause of epidemic diseases. The health officer of England insisted that domestic filth was the actual cause of many of the low forms of disease, and named them accordingly, “filth diseases.” This official act of the highest health authority of that country led to the practice of cleanliness in the home and its surroundings. Filth in every form was removed as the necessary remedial Filth But during the fourth quarter of the last century The whole scheme of sanitation was at once changed: agents that would kill germs were eagerly sought by many scientists, and germicides were found in abundance. Cremation was most effectful, and was available in the destruction of masses of The Scheme of Lister announced that these disease-producing germs entered wounds and prevented healing, and that a germicide was required which would kill the germ in the wound and would not injure the living, healthy tissue. Further investigations showed that these dangerous germs were not confined to dust heaps, but existed in the unclean recesses of the human body. An eminent German surgeon declared that germs of a dangerous character existed in the folds of the skin of the palms of the hand which no amount of washing with soap and water could remove, and could be destroyed only by some agent directly applied. Sanitation of the body as well as of the dust heap now became the paramount question and especially did this apply to the practice of surgery. How infection affects the body was the supreme mystery that the scientists of the past strove in vain to penetrate. By no devices of their laboratories could they detect the agents that caused the epidemic. There was only one satisfactory explanation The Mystery It is a cause of devout thankfulness that while these things were hidden from the “wise and But that prophecy has been literally fulfilled. During the last summer there has been a traveling object lesson that visited the different sections of the State of New York and taught the people, especially the children, all the essential facts as to the nature of the infection of tuberculosis, its effects on the body, and the methods of prevention and cure. As infective diseases cause the vast majority of cases of severe and crippling affections and of deaths in every community, the value of a knowledge of the nature of infection and how it affects the body, by the people of all How Infection To understand how infection affects the body involves an inquiry as to the nature of infection, its mode of entrance into the body, and its operation on its organs and tissues. The terms “infection” and “contagion” are often used as synonymous; but a strict definition according to the medical significance of each limits the former to “the transmission of disease by actual contact of the diseased part with a healthy absorbent or abraded surface,” and the latter to “transmission through the atmosphere by floating germs.” But in the final analysis the cause of disease in both infection and contagion is so similar in its action that the medical profession has adopted the term “communicable disease” in all cases where the disease is communicated from one person to another by means of a germ, whatever may be its method of attack on the body. The common characteristic of “communicable diseases” is their germ origin. What is this communicable germ or agent? A bacterium—a little stick, staff—so called from the rodlike shape it assumes in the process of growth. The individual bacterium (plural, bacteria) is an organism representing a low form of vegetable What the Now, as it requires only thirty minutes for one cell to divide, it has been estimated that a single bacterium will in twenty-four hours increase to the number of over sixteen million five hundred thousand, and in forty-eight hours to two hundred and eighty-one million five hundred thousand. At this rate of increase, in three days there would be a mass of bacteria weighing about sixteen million pounds. As the multiplication of bacteria depends upon conditions that soon interfere with or interrupt their growth, as the want of food, their own secretions, What is the function of bacteria in the economy of nature? It would be surprising if such a menace to human life as some species of bacteria have proved themselves to be had no other place among the forces of nature than to prevent the The Function of Thus, there may be and doubtless is at all It is a most interesting fact, therefore, that this most deadly foe of man becomes dangerous only when the latter is harboring in his body waste or decomposing matters that are slowly poisoning him. It is in the process of digesting this material that the bacterium excretes poisons—toxins—of the most virulent nature, which are absorbed into the blood of the human victim, creating the condition popularly known as blood poisoning. Bacteria perform a most important function in the economy of nature, viz., the conversion of decaying and dead matter into food for plants. Biologists assert that without bacteria plant life on the earth would be scanty or entirely wanting; they are the natural intermediaries between plants and animal in point of food production. They are therefore called scavengers, because they live on decomposing matter; but in the very act of digesting such waste they convert it into products essential to plant life (carbon dioxide and ammonia) and by their excretions restore to vegetation its chief supply of food. It appears on the same authorities that bacteria not only assist materially in maintaining vegetable and animal life on this planet, but It naturally occurs that to meet the various conditions under which decomposing matter exists in nature there is a great variety of species of bacteria, each species being adapted to a special field of operations. These species are distinguished from one Bacteria for In these latter days of popular knowledge of scientific progress, but without precise information of details, bacteria are associated in the public mind with disease, especially of the epidemic form. While this prejudice is useful in stimulating the people to adopt and enforce preventive measures against conditions that tend to promote bacterial life in their homes and in their own persons, yet it should be understood So throughout the animal kingdom we find that few are susceptible to a common disease; or, in other words, that the same species of bacteria attack in equal force several varieties of animals. The explanation of this peculiarity is found in the variations of the quality or intimate nature of the tissues and organs of different species of animals. The same may be said of our own bodies—the several organs vary greatly in their susceptibility to the attacks of the different kinds of bacteria; hence the latter are classified as specific and nonspecific, according as they cause specific or nonspecific disease. The distribution of bacteria is limited only by the existence of plants and animals; that is, the existence of decomposing vegetable and animal matter. Though they are more abundant in the earth where such matter is found most abundantly, yet they abound in the air, the water, on plants, animals, and insects, on our own bodies, and in every cavity leading to the exterior. As bacteria are always searching for food, the number present is a sure indication of the degree of cleanliness of the thing, individual, or locality where they are found. The movements of bacteria from one point to another are through the medium of some The tubercle bacillus is borne on the air through the medium of particles of dust, and in cities where the victims of tuberculosis scatter these germs profusely in the streets, public conveyances, churches, and places of resort, in the act of The Deadly Foul as is the air of the unventilated tenements of the poor, it has been demonstrated that the dust which saturates the furniture, carpets, rugs, and hangings of residences of the wealthy contains sixty per cent of street filth. Considering the second inquiry as to how infection affects the body, we must constantly bear in mind that a bacterium, though a scavenger, is a conservator of nature. Its real function in the orderly processes of animal and vegetable life is How Bacteria Therefore, wherever we find bacteria in the active processes of growth, that is, multiplication, we may be assured that they have found matter that should be rescued from waste and converted into useful food for plants. It follows that when we find a bacterium actively growing in any part of our bodies, it has found some It is also important to understand that waste matter is found under a great variety of conditions, and that for its proper conversion into useful food for plants there must be a correspondingly large number of species of bacteria each having its special field of operation. It is due to this variety of bacteria that there are so many infective diseases; for each species of bacteria creates its own individual form of disease. This statement requires the following explanation, viz., a bacterium in a quiescent state is harmless; everyone has within his body innumerable bacteria, as the tubercle and typhoid bacilli; but they are inert, and hence innocuous. It is only when they find their proper food, decaying matter, that they begin to multiply, and in that act they secret a poison, toxin, which is absorbed, and, entering the circulation, causes in the individual a special class of symptoms peculiar to that toxin, or poison. These symptoms constitute a disease, the technical name of which is usually fanciful, depending on some feature of the symptoms, but explaining nothing as to its essential nature. For example, the typhoid bacillus finds its food in certain minute glands of the small bowels. If these glands are in a perfectly The poisoning of the body by the excreted toxin of the multiplying cells, which is simply plant food, occurs because it is removed only in part by the digestive organs, the circulation that conveys it to the other eliminating organs being efficient for that The Toxin The termination of this process must be either the death of the colony from exhaustion of the food supply in the glands, or the exhaustion of the patient by the excess of toxins that accumulate The final disposition of the typhoid bacilli, after a course of fever, was believed to be by their elimination from the body through the various organs devoted to the discharge of waste products; but recent investigations have proved that the typhoid bacillus may remain in the body for long periods without apparently affecting the health of the person, but when communicated to another, it will cause an attack of fever of the most virulent type. In one instance an outbreak of typhoid fever was traced to a woman who had fever upward of fifty years ago. It was found that the excretions of her body contained immense quantities of living typhoid bacilli. She was a cook by trade, and it was found on tracing her history that wherever she had worked there had been epidemics of typhoid. How far these curious incidents in the life of the typhoid bacilli are common to other bacilli is not known; but if it is true of other infectious diseases, the fact will explain the origin of those obscure and mysterious cases that occur without any known exposure to the infection. In concluding this inquiry as to the nature of infection and its effects on the body, the following statement of a biologist as to the bacterium seems justified: “When it enters a living body, it aims directly at the destruction of the Bacteria Aim to Viewed in the light of the past history of infectious diseases, this is not an overdrawn picture. If we estimate the deaths from smallpox in ancient times, from cholera in modern times, and from tuberculosis (consumption) throughout all time, the destruction of human life by bacteria cannot be overstated. The bacterium has been a wickedly implacable foe to the human race in the past. Invisible, intangible, everywhere present, it has proved omnipotent in its destructive attacks upon communities. But our century opens with a far brighter outlook for the race. Elementary forces which, through ignorance of their true functions in the economy and conservation of nature, were permitted in the past to expend their energy in the destruction of life, have been revealed by science to be man’s most helpful agents in the promotion of comfort, health, and longevity. Electricity was for ages only a thunderbolt, an object of terror, and an agent of destruction, visiting the human residence only to kill its owner and burn the structure. To-day the same natural force is man’s most obedient and humble servant, quietly visiting his home to furnish him heat and light, annihilating So the bacterium, once the terror of mankind as the invisible and apparently unknowable cause of devastating pestilences, proves to be the useful purveyor of the by-products of man’s digestion of waste matter which is thereby converted into food for plants. It visits man in the pursuit of its humble calling to obtain his contribution to the sum total of plant food. It searches every tissue, every organ, every recess, however obscure, but so stealthily that its coming and going and its immediate presence are not known if absolute cleanliness of the body exists. It is only when dying tissues or organs, or accumulations of dead matter, are found that its presence becomes known. Even then it would prove harmless and its presence would be unrecognized if its excretions of plant food (toxins) were not necessarily absorbed and did not enter the circulation, thus poisoning the body it is relieving of dead matter. Briefly, what are man’s defenses against bacteria? Chiefly two, viz., first, killing it by depriving it of food; and, second, killing it directly by what are known as germicides. The first method is effected by cleanliness of Man’s It is not sufficient to keep the skin clean by daily baths, while the mouth, nose, throat, and other internal surfaces and organs are covered or filled with effete matter. We must be every whit clean if we would escape the results of the scavenging processes of bacteria of some variety or species. That condition can be secured and maintained in an organism that itself is constantly decaying in all of its tissues and organs only by strict compliance with the natural laws governing the operations of the body as an independent organism in which all of its forces tend to promote its health and conservation. Every tissue and every organ has its special means of renewal of its tissue by the removal of dead particles through the outlets and the reception of fresh material through the inlets of the body. Waste and supply are exactly balanced, as in the most precise and delicate machine. If the outlets become clogged, so that all the waste cannot escape at that proper time, dead matter, the food of bacteria, begins to accumulate, and disease must result. In the same manner, if the food is in excess of the demands, or of a quality not suited to the needs of the tissue or organ, waste begins to accumulate, bacteria swarm in the decomposing That even the most feeble minded may be able to regulate their habits so as to secure an adequate supply of food both in quality and quantity, and the prompt removal of waste matter, so as to secure that degree of cleanliness of internal organs essential to escape from bacterial attacks, the mechanism of the body is endowed with instincts that make it automatic in its action. Such are appetite and taste for food and drinks; the desire for exercise, rest, and sleep; the impulse of the organs in an active state, etc. It is only when these natural monitors are interfered with that the mechanism begins to fail in its elimination of waste, and bacteria find the conditions favorable for their functional activity. The second defensive measure is the destruction of the bacteria by means of agents that will destroy the microÖrganism before or after its entrance into the body, but without injuring the healthy tissues. There is a great variety Destroy the It would be impossible even to summarize, except in a volume, the vast number of so-called germicides that have been brought to the attention of the public for use; but in the practice of surgery the chief reliance is placed upon The Value of It is impossible to estimate the resources of |