The contagion of phthisis : read in the Section of Medicine at the Annual Meeting of the British Medical Association in Worcester, August 1882 / by C. Theodore Williams.

  • Charles Theodore Williams
Date:
1882
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Credit: The contagion of phthisis : read in the Section of Medicine at the Annual Meeting of the British Medical Association in Worcester, August 1882 / by C. Theodore Williams. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    [Reprinted for the Author from the British Medical Journal, Sept. 30, 1882.] THE CONTAGION OF PHTHISIS. Read in the Section of Medicine at the Annual Meeting of the British Medical Association in Worcester, August 1882. By C. THEODORE WILLIAMS, M.A., M.D., F.R.C.P., Physician to the Hospital for Consumption, Brompton. The discovery of the tubercle bacillus by Koch, and the highly interesting series of experiments which led up to it, have naturally caused us to review phthisis in its various aspects, and especially in that which relates to contagion. How far consumption is infectious, is a question which has been under discussion for centuries, and on which great difference of opinion has prevailed, and still prevails, in various countries, the north of Europe holding, as a rule, its non-contagiousness, and the south its contagiousness. The chief difficulty lies in the fact that many of the most potent agents of causation in phthisis, such as dampness of soil, bad venti- lation, and deficient food, are also conditions which would promote the multiplication of low organisms ; and, on the other hand, heredity, which is the source of a large amount of phthisis, cannot be reconciled in its action with the bacillus theory; for, if a man had strongly inherited phthisis in his tissues, are we to believe the bacilli have been transmitted in the seminal fluid of his father ? How can we account for the cases where the parents, having died of consumption, the children are necessarily attacked on arriving at a certain age, with a severe type of the disease ? And, moreover, there are several instances —of which one striking one is present to my mind—where the children, who happened to be scattered in various parts of the world, were yet attacked, and succumbed to the fell disease at about the same age. The microscope tells us that Koch’s bacilli are present in phthisical sputum in fair abundance, as well, of course, as on the walls of cavi- ties, and in tubercle of various kinds. Now, when we consider the number of consumptive people who, being under no restriction, go about coughing and expectorating freely in the streets and parks of London, and remember that this sputum abounds in bacilli, that it dries, and, becoming dust, is wafted about in the atmosphere, and doubtless inhaled by a large proportion of the population, we must admit that the bacilli, though ever present, are not very active in ill- doing, and probably because the soil they enter is not always suitable. The forms of contagion in phthisis which have been most discussed are the following. 1. Infection through breathing the same atmosphere— i.e., infection by inhalation. 2. Infection through marriage. 3. Infec- i tion through the milk of diseased animals, or even of phthisical women. With regard to the prevalence of the first form of infection, it has been urged by the contagionists that it is far more common than is