The collective investigation record / edited for the Collective Investigation Committee of the British Medical Association by Professor Humphry and F.A. Mahomed.

  • George Murray Humphry
Date:
1883-4
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Licence: Public Domain Mark

Credit: The collective investigation record / edited for the Collective Investigation Committee of the British Medical Association by Professor Humphry and F.A. Mahomed. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    96/530 (page 86)
    262. —To this question I am inclined to answer, No ; and yet I am doubtful, from a consideration of the following- cases, which came under my care in 1879, that this No should not be Yes. Case.—J. M. C., a middle-aged man, a stone mason by occupation, had been ill for some time with bronchial catarrh, to which the symptoms of pulmonary phthisis became added, and were accompanied by increased temperature and sweating, to which he quietlv succumbed. His wife, a comparatively healthy woman of about his own age, nursed him and slept -with him during his illness, and she eventually mani- fested symptoms of phthisis, and died about two months and a half after her husband. A son, a boy of 14, in constant attendance on his mother, sickened after her, and in about three months died. Their daughter, a girl of 16, showed signs of being influ- enced by the same disease, but a timely removal to more healthy surroundings seemed to protect her. Her sister, a robust young woman, a school teacher in some part of England, came to stay for a short time toward the death of her brother, and had at her coming no signs of chest complaints. Yet she felt not quite so well during her resi- dence here. She and her sister are at present quite well, and do not show any symp- toms of phthisis. 1 he present tenants of the house where these deaths occurred were very healthy before they went to it, but since then I have frequently seen members of the family ill with bronchitis. I write these notes purely from memory. [Note.] It is a house of two apartments in Dumbarton. I have reason to think that all of them slept in one room, thus rendering the house overcrowded. It is by no means a damp house, and not isolated. It is, however, iu close proximity to the river. The drainage of it is not good, the drains communicating directly, without intervening ■cesspools, with the common servers. There are no trees in its immediate vicinity. 263. —Upwards of fifty years’ experience enables me to say that I have witnessed many cases of pulmonary phthisis which have appeared to have for the exciting cause communicatiou rvith persons suffering from the same disease, in whom there has been an hereditary predisposition. As, for instance, in families, the most diligent nurse among the sisters has been the next to succumb. But I do not remember any case so caused where there has been no hereditary disposition. 265. —I have to give an account of the following case without my notes. The main particulars are, I believe, fairly accurate. Case.—E. L., aged 24, nurse at the Chest Hospital, Victoria Park. Born in India. Her father, a soldier and a drunkard, died when she was young, disease un- known. Her mother alive and intemperate. E. L. left her home at an early age to escape from the family, and had seen nothiug of them since, and heard nothing with regard to consumptive taint. E. L. nursed cases of heart disease, bronchitis, aud consumption of all lands. Complained of feeling ill iu Jan., 1881, but had been out of health for last two or three mouths. This was about the end of her second year at the hospital, and she had the appearance of being- strong and healthy. Latterly she had lost flesh. The physical signs were slight but suspicious of incipient disease at the left apex. A week later (end of Jan.) she was taken suddenly ill with shivers and fever. The-physical signs were those of acute pleurisy all over the left lung. This was followed by rapid consolidation, softening, and excavation of the upper lobe of the left lung within two months. The disease became then to a great extent quiescent, and she gained flesh and improved. Went to a convalescent home for the spring and summer, where she first had a little diarrhoea. Returned to the hospital in the autumn. Got gradually worse : ulceration of the bowels, and progressive con- solidation and softening of both lungs, aud she died in Jan, or Feb., 1882, about a year after physical signs were noted. She had been a teetotaler all her life, but having uo home to go to, used frequently, when she had leave from the hospital, to return wet through to the skin, and often got cold. There was no post mortem examination. There were no particular cases of phthisis under her charge noticed, but the greater number of the cases are phthisical. 266. —In the course of twenty-five years’ practice I only remember one case in which phthisis seemed to have been transmitted from a husband to a wife. I doubt whether the bacillus can germiuate in a perfectly healthy individual, with- out the concurrence of a foul atmosphere, and a continuously high temperature.