| Show I 1 M modern crusade against consumption by DR 8 G EGHAN lecture before the mens club published by request i the question of heredity ot or consumption has been a great point of controversy among authorities there is no fact which has haa as yet been proven to W substantiate the theory 0 of the transmission of tuberculosis from father to child the most cases ot of coagan ital tuberculosis are supposed to be transmitted by tho th mother ther through the blood curp current elit but coni considering dring the great prevalence of the disease the congeni congenital tat tuberculosis Is s ono one of the rarities in medicine it is however a common fact that by heredity a certain predisposition to tuberculosis may be transmitted in vegetable and animal kingdoms it is a common observance that each individual reproduces itself not only in its form size function and in its nature but in its ito reaction to environment and its ability to withstand or to be overcome by the action of various poisonous and disease producing germs and this Is true not alone ot individuals but organs and cellular tissue of the organs the aff springs of consumptive parents inherit a certain susceptibility to the invasion ot of the germs gerins but not the disease the resist resl stence ened that any mau man with normal constitution liar has to withstand the infection or if infected to check the vr progress ogress and bring it to spontaneous cure in the constitution of children of consumptive parents is somewhat decreased it if any other influences be added to this his which would degrade the vitality of the constitution they will render the individual 11 an easy victim to the germs of 0 tu tuberculosis er cu losis it is also observed that children of consumptive parents have as a rule a flat and narrow chest and a lack of normal expansion of the upper parts partis of the lungs on the other hand it does not follow that an individual born of tuberculosis parents should necessarily contract conti act or die of 0 con cn even a strong hereditary predisposition to tho the disease can be avgi avoided ded by keeping up a robust state of health dust la Is another great factor in rendering tho lungs susceptible to the at tack of the germs it is composed ot of minute particles of every imaginable thing which Is light enouf enough h to float in the air when examined under the microscope it shows particles from the hoofs hairs skin and so forth of domestic aneals animals also from our clothing shoes hair nails and so on from the dirt of the street and fields and besides they carry with them many kids bof 0 germs of different diseases dug busl L continually inhaled dries drics irritates ta ter and exhausts the cells ot of tho the mucous lining of the lungs and decreases to a great extent their resisting power to withstand the foreign germs germis dust in public buildings such as in theaters ball rooms railroad cars and ohp like Is of the most dangerous kind not alone that it may contain more germs hut but the composition of the dust Is of the most moat irritating character for the mucous lining of the lungs it Is mostly composed of minute particles ot clothing furniture animal matters etc I 1 I 1 I 1 diseased condition the upper air passages especially of the nose which induces the person to breathe through the mouth and inhale tho the dust or germs directly into the lunnis is also a favorable factor to the development of tuberculosis alcoholism Is another factor which destroys the resistance of the constitution tu habitual drinkers bring upon themselves a disposition to tuberculosis even while their appearance remains robust and their weight normal the fight for the eradication of consumption from human society is not tho acquisition of our modern modere time years before the christian era regarded consumption as contagious and believed eved that the disease could bo transmitted from one person to another hundreds of years before the discovery of the tubercle germs measures similar to our own to check the spreading of consumption were in practise in some countries in naples ilav itay there was a law given from tho throne to burn the clothing of the diseased after hi his death there were pamphlets and public lectures to eu lighten enlighten the people about tho disease in westphalia West phalla germany in old times they burned the bedding and c clothing of consumptive patients after their death I 1 dut but all the measures taken in the dirrig previous to the discovery of tubercle germs were aimless they did not know the main source propagating the disease prof koch shaped the fhe problem 0 of cou combat ilat against the infectious disease as follows he said all the intel intec cloua diseases should bo be fought against first according to lo their development I 1 second according to the way of their n origin of all vic tho infectious diseases is tho the person ill III with the disease thus tho the aim of modern modera combat against consumption c on is to render the diseased pe persons radons harmless to their surroundings the tubercular patients in general imay may bo be divided in two kinds those who pre arc not infectious to their surroundings roun dings and those who are infect bious in the incipient stage that Is in the beginning of tho the disease when there is no expectoration c consumption on Is not contagious and in this stage the patient has the greatest chanco chance of recovery col aerl by the cure of these patients or keeping their lesions in latent form that is checking their fu further lither progress tile tho modern combat against figal rist con sum coln is arriving to a great success jhb pessimistic view about incura of consumption was held until ble bloness riess a time ago not alone that all the known methods were not efficient treatment of the disease focient in hi tho the lugas of but the examinations of who had died of tuberculosis patients hopeless C condet condition ondi tion on wore were manifesting a leanner Le Lean annec pec it a noted F french physician that until fit to a short time ime ago declared and to bo be sentenced consumption to leave have to do death ath meant the same but the discoveries of 0 f the curea tubercular bei ber cular in the lungs of per pa sons tons who had died of daffe rentI cut causes there throw y w light ight on tile tho matter cases of cured observed many were the dissection tubercular gular during never of the persons who had bad shown any symptoms of tuberculosis when they were allye and thus they bad never had lily q kind ind 0 of f mAnt at all to that repa the cored processor 11 they e were e spontaneous ati the work of nature a successful r struggle ili intruder odthe tri ider UP fact the treatment I 1 of consumption took a new phase the search of medical or specific agents was partly abandoned and a systematic constitutional treatment commenced with a conscious aim e the so called sanitarium treatment is a a hygienic dietetic treatment given in well equipped and well situa situates teu in hygienic treatment for colsum consumption eption is as old as the history of the disease Arela Areta eus thirty years before christ and balsus fifty years after recommended the sojourn at see seashores shores or traveling on the sea twenty three years after christ recommended forrest air and hun shine galen two hundred years after christ advocated the benefit of high attitude altitude lie he said dry and warm climate will heat heal the ulcerating ulce rating disease ot of the lungs but from those dates until a short time ago the ria natural tural dieterle tro treatment kment did n not 1 at find a firm abbis for the reason that only the progressed cases came to their recognition the disease in its incipient stage remained fema ined there unrecognizable one of the greatest achievements of medicine medi pine of today in the treatment of tuberculosis s la 18 the recognition of the disease in its commencement the much talked of of profi prof koch although it did not find its value as a specific curative agent for consumption furnished a most sible able agent for the recognition of the disease a its incipient inci pent stage and besides this today the method of ghyst physical cal examination for the diagnosis of consumption has developed to a great extent oster osier bays as follows the diagnosis of the tuberculosis in its commencement men cement Is of great importance too often precious time is in wasted ana aina golden opportunities allowed to slip by the failure of the physician or of the patient to understand the condition early cases should bo be managed in a masterly way A great deal of harm has been done in this respect by the drugs it is not the drugs themselves that do so much harm but weeks are lost in trying to check a cough or control a fever la in a patient who Is allowed to continue work and be up and about the ohp conscious aim of sanitarium treatment Is to produce robustness and increase the resistance ot of the constitution of the patients pat lenta at the same time to instruct them how to liv live teaching them the elementary prineo plea pies of the hygiene more especially those which are more intimately related to their particular caso case hero here they are taught how to dress how to eat telling thorn them the nutritive power and digestive qualities of different diff erent victuals they are arc trained how bow 10 clean themselves how to cough how to protect their expectoration from being further infectious to themselves and to their surroundings they are told what occupation they should pursue after their discharge from the treatment they are instructed how ani and when and how much to take physical exercise in one word wilta rj urns ams are not alone treating the patients in their ailment but are schooling them during the entire period of treatment to bo be and to remain healthy the lines of treatment pursued in sanitariums are mainly hygienic and dietetic in some borne cases accompanying P a medical treatment the patients are exposed as much h as possible to tho the open air during the day and night under the supervision of the attending physician the patients pass their time mostly in repose in a suitable position according to their basea either lying or reclining or sitting some patients are allowed to do a certain amount of walking from half an hour I 1 to two hours a day but open opan s mostly given them in perfect repose once or twice a week they receive a warm bath and a a cool sponging every day this Is also prescribed according to the caso case perfect ferfera cleanliness of the body Is maintained during the whole period of treatment great attention jr Is given to their allmetta tion alon generally speaking they receive a fattening diet that does not mean they axe are stuffed with food As diseases usually receive their names from the most prominent symptoms emaciation being the most sign of tuberculosis bercu losis hence the term of consumption is given to it from time immemorial endeavor has been made to counteract the loss of weight in consumption by all alimentation great care Is given to the value of nutritive riess of the meals to their tastiness and to their serving in an appetizing manner ner the sanitariums for have shown great successful results in every country fifty per cent of all the incipient cases have been curadi and the rest improved and kept in latent form and also in other stages of the disease cures and great im proved prove ments have been m made e the constitutional treatment will always remain a main factor in the treatment of tuberculosis even if we arrive to the discovery of a specific agent since the disease not alone produces a local lesion but also effects the entire constitution ution unfortunately sanitarium treatment is not in tile the reach of all very littlon percentage of the diseased axe are able to receive such treatment the great est cst need of our time I 1 to institute sanitariums for the poor classes it was the great endeavor of my venerable teacher prof V T lyden of berlin germany to arouse the nations and convene the medical men of the horldt in berlin and work conjointly for the cmil eradication cation of this great scourge of burna humanity ritty to open free sanitariums for tho poor classes and interest the philanthropic societies in this work in franco france and in belgium the government has opened d in large cities many stations with the name despen Di spen saire 1 these stations are exclusively for the persons buffering from diseases of the lungs these places are guiding the consumptive who are either in an advanced stage and are not fit for sanitarium treatment and also those who aro are returned from the sanitariums or those who have not been ablo able to receive sanitarium treatment ment on account of financial or other causes in these stations no treatments are given hero here mostly the diagnosis are made and the patients aro are sent back to their physicians but keeping at the same time a watch on them tier here e they are taught how to protect themselves and their surroundings from the infection how to cough how to diehn feet their expectorations expect orations from these stations officers are aut kent to the homes of the patients to investigate the sanitary condition of the houses to see tho the rooms and the number of amir ocell pants pant here they receive f rot free pocket spit cups and a linen sack to brins bring their clothing every eek to receive free with team steam heat beat with these stations places aara are also connected where patients can get free or at cost milk wine meat and other things necessary for their alimentation d strengthening these Dispensa ire are connected with the sanitariums and are doing a great work by educating and directing the patients in the most sanitary condition possible another important step which the el civilized world has taken for the fl fight to eradicate consumption I 1 is passing 9 a law prohibiting spitting on public places and streets it Is today a roost most certain fact that the sources of live tubercle bacillus among us Is the expectoration i tion of the tubercular patients and it is also a certain fact that the most prevalent manner of infection is occurring through inhalation of dust containing the bacillus after the crusade of 1896 97 inaugurated by the new york health board it was shown that secondary cases in given tenements or flats occurred in exact proportion to the intelligence and honesty displayed by the becu occupant pant in carrying out the prescribed rules for the disposal of expectoration mortal ity of consumption iou among the inmates and abid attendants 0 the large charity institutions Is the negligence in the care of expectoration the death rate of tuberculosis li ir prisons and peni aries has bees beer decreased considerably since thin jhb necessary necee saxy hygienic steps have been taken to that effort the death rate of consumption in prisons and penitentiaries aries has been very great comparing it with that of the tha outside world according to cornet comet it Is five times greater nearly from 60 50 to 80 per cent of all deaths in prisons are from tuberculosis since the isolation of tubercular prisoners from the others othera increasing the rations and giving more nourishing substances and strict observances observance vanc es of rules of spitting in the special etc the death rate of consumption has been diminished about 40 per cent the statistics of all countries in r regard gard to tuberculosis since the discovery of its causative agent the tubercle bacillus and the well directed combat to its eradication show rather surprising smaller figures of death in prussia in the period from there were deaths of consumption to each population in the period f fram rpm 1887 1893 that is about 40 less in england comparing the death rate of the same periods we find 23 less in scotland 31 less in austria 22 less according to the recent statistics in |
