TUB&RCULOS 
 
 OICSK 
 
 CONSUMPTION 
 
 f 
 
 JK 
 
 BY 
 
 H. H. SPIERS, M. O. 
 
 R. NA. OHIO, 
 

 GipgtaH?.J.3l2^: 
 
 COPYRIGHT DEPOSIT; 
 

TUBERCULOSIS 
 
 OR 
 
 CONSUMPTION. 
 
 — BY — 
 
 J 
 H. H. SPIERS, M. D., 
 
 I) 
 
 RAVENNA, OHIO. 
 

 THE LIBRA 
 CONGRL 
 One Copy Received 
 
 FEB. 9 
 
 Cop^wwht pntpv 
 
 CLASS «-XXo. Nn. 
 ^ 7. I L> %^\ 
 COPY 8. , 
 
 COPYRIGHT I902, 
 BY 
 HENRY H. SPIERS, M. D. 
 RAVENNA, OHIO. 
 

 4 
 
 To 
 A Weak, Common 
 
 and 
 
 Suffering Humanity 
 
 These Articles 
 
 are 
 
 Respectfully Dedicated 
 
Preface to First Edition. 
 
 In offering these papers for 2 second reading, it is the 
 hope they will diffuse a brighter light by a collective ren- 
 dering. Short articles, given from time to time, on various 
 topics, and in many journals, seldom come under the eye 
 of one individual. Hence the necessity of unity in presen- 
 tation. The intractable nature of tuberculosis is our only 
 apology. 
 
 Respectfully, 
 
 H. H. SPIERS, M. D. 
 Ravenna, Ohio. 
 
 Preface to Third Edition 
 
 Fourteen years ago the law of tuberculosis was given 
 the Portage Count}* Medical Society, at Ravenna, Ohio. In 
 December, 1890, it was presented to the profession at large 
 through the Cleveland Medical Gazette. During this pe- 
 riod of twelve or fourteen years, the writer has constantly 
 been before the medical public, upwards of one hundred ar- 
 ticles have issued from his pen, in current medical literature. 
 To-day, as never before, the causation and prevention of 
 tuberculosis is clearly recognized. 
 
 In this third edition of tuberculosis the writer endeav- 
 ors to present more clearly the manifest workings of law. 
 In this attempt the generous patronage of an unbiased pro- 
 fession is asked. 
 
 H. H. SPIERS, M. D. 
 Ravenna, Ohio, Jan. 31st, 1902. 
 
PRELIMINARY STATEMENT. 
 
 As my view of the origin of tuberculosis is at variance 
 with established teaching, perhaps a. simple statement of be- 
 lief is necessary. 
 
 i. Tuberculosis is a constitutional disease, dependent 
 largely on the evils of civilization, and governed by the fol- 
 lowing law : The death rate from tuberculosis is in direct 
 ratio to suspension of atmospheric influence. 
 
 2. The suspension or abeyance of atmospheric influ- 
 ence may take place from within or from without. From 
 without through impure or impoverished atmosphere ; from 
 within through defective lung tissue, original or acquired. 
 
 3. Abej-ance of atmospheric influence, in whatever 
 way induced, causes a depraved tissue or dyscrasia, through 
 which the tubercle bacilli enter and grow. 
 
 4. The growth of tubercle bacilli, being dependent on 
 the precedent state or condition of the individual, is never 
 ■per sc the primary cause of tuberculosis. 
 
 5. Tuberculosis may exist, though infrequent, in the 
 absence of tubercle bacilli, but can never exist without the 
 precedent state or condition. 
 
 6. The plant growth, being a secondary condition or 
 modifying influence in this most fatal disease, treatment di- 
 rected against this growth must ever remain barren of per- 
 manent curative results and dangerous to the patient. 
 
 7. The precedent or primary condition being subject 
 to law, and under control, tuberculosis is under control. 
 
II 
 
 MEDICAL THEORIES. 
 
 When a small boy there came to my hands a pamphlet, 
 which stated' the earth is flat, like a table, and rests on 
 four huge elephants ; each elephant stands oil four tortoise. 
 
 Child-like I ask mother, what do the tortoise stand on? 1 
 
 To me the theory was highly significant, but to be 
 complete it required a little earth filling. 
 
 Many theories of the past have been shown to rest on 
 equally unstable bases. Many theories of the present, I 
 apprehend, will be shown equally illusory. 
 
 Many questions will be asked in the same child-like 
 simplicity, and many learned disqusitions will be given to 
 prove that which never did exist. Such is life, and such is 
 the history of all human progress, with its periods of per- 
 tinacity and vacillation alternately shown. Would you then 
 discard all theory ^ By no means. Theory answers a great 
 purpose in the world's advancement on scientific lines. 
 
 Our theories are in one sense our ideals. We search 
 for and endeavor to establish that which we really believe 
 to be true. Thus far, theory is laudator}'. But it is evi- 
 dent a theory must be based on some thing more than pure 
 imagination. 
 
 is the earth flat like a table, etc.? Would it not be better 
 to take established truth as a ground-work, and build on 
 this? 
 
 But where can established truth be found? 
 
 In medicine, in theology and in law we are constantly 
 in search of it. 
 
 Oft-times truth lies close beside us and zve see J 
 not. 
 
 To-day the great medical telescope is located in Ger- 
 many. Multitudes of people flock to hear its revelations. 
 
12 
 
 Nothing worthy of credence, observation or regard is seen, 
 except through this instrument. 
 
 To-day it is a bacillus— To-morrow a coccus. 
 Each day is prolific in new schemes of detecting, cap- 
 turing and destroying microbes. A very laudable under- 
 taking to say the least. 
 
 One microbe is accused, tried and condemned and the 
 sentence is pronounced. Another passes through the same 
 ordeal and comes out innocent. 
 
 In the fatherland, a microbic court-of-law is in session 
 at all seasons of the year. The strangely curious thing is : 
 That whether innocent or guilty it matters not. No mi- 
 crobes have received capital -punishment in situ. 
 
 In other words, no remedies have been found that will 
 eliminate or destroy the microbe without causing the death 
 of the patient. Let us look further. 
 
 The savant Koch has demonstrated that in tuberculosis 
 there is generally found a microbe at the seat of lesion. 
 This is called the bacillus tuberculosis, for it is found in no 
 other disease. That the microbe is present is universally ac- 
 knowledged. They have been seen in colonies, in diseased 
 tissue, by innumerable observers. Seeing is believing. 
 Thanks to our distinguished contemporary. That this ba- 
 cillus is the cause of the disease named has been received 
 without serious question. 
 
 The only serious question has been how to rid the sys- 
 tem of the microbe. 
 
 The result of treatment has been already shown. 
 
 That the disease may be modified by the presence of the 
 bacillus, I think there can ])e no serious doubt . 
 
 That the microbe has any casual action in producing 
 the disease is, in my judgment, pure speculation. 
 
 Astronomers tell us that presumably the planet Mars is 
 inhabited. 
 
 If inhabited, who can say its people are not well up in 
 the arts and sciences —possibly have telescopes. 
 
 Imagine a resident of Mars engaged in the stud}- of as- 
 tronomy. Through his telescope he views the surface of 
 
—13— 
 
 the earth and sees a flock of crows hovering near the car- 
 cass of a sheep. What are these crows doing ? Day by day 
 he watches them closely. They are eating the sheep. At 
 once he concludes that the sheep are being killed by the 
 crows. A book is written. This is standard authority in 
 Mars. 
 
 But one observer sees a dead sheep on which there are no 
 crows. Again he looks and descries another. He publishes 
 his observations, and asserts that sheep die from other causes 
 than crows. Is not the conclusion a valid one? 
 
 Again and again observers have found bacilli in the 
 sputum and lung tissue of phthisis pulmonalis. Observations 
 to this effect have been published from time to time. The 
 microbe is charged with causing the disease. This is stand- 
 ard authority. But one observer finds a case of phthisis pul- 
 monalis in which no bacilli can be found in the sputum or 
 lung tissue. He publishes the results of his observations 
 and I assert that people die of phthisis pulmonalis, in which 
 the bacilli do not enter as a factor. 
 
 Is not the conclusion a valid one ? 
 
 A new observatory is now erected on the planet Mars. 
 Its telescope is of the finest make and highest power. The 
 observer brings his instrument to bear on the planet earth, 
 and sees not only dead sheep and live crows in abundance, 
 but also multitudes of little birds which he calls sparrows. 
 He watches these little birds closely. They are engaged in 
 a contest with the crows. " They fight fiercely. At length 
 the sparrows are victorious and the crows are driven from 
 the field. 
 
 The astronomer concludes his writings by saying that 
 in order to prevent the death of sheep on the earth it is only 
 necessary to increase the number of sparrows. A few tim- 
 idly object to this teaching, but it is standard authority in 
 Mars. Sparrows are now plenti ful, but sheep still die. 
 Something wrong. 
 
 A new scheme is now devised to clear the earth of its 
 dread visitant, phthisis pulmonalis. It has the sanction of 
 high medical authority. Phthisis pulmonalis is caused by 
 
— 14— 
 
 tubercle bacilli. Two methods are open to rid the system of 
 these microbes; the direct and the indirect, analogous to our 
 dealings with the Indians in the past. Direct, to kill him: 
 indirect, to take him from his feeding ground. In either 
 event the microbe or Indian must die. A few timidly ob- 
 ject, but this is standard authority. Tuberculin is plentiful, 
 but mankind still die of phthisis. Something wrong. 
 
 Science, though slow, makes progress even in Mars. 
 A pains-taking observer has been watching a sheep for 
 many months. He has seen the animal die. Crows could 
 not have killed him, for none are in that neighborhood. A 
 brother astronomer examines the sheep and says he finds 
 foot-prints in the earth near by — probably crow tracks. 
 The crows killed the sheep, but were driven away by the 
 sparrows, or fled from sonic other cause Science in Mars. 
 
 Likewise in earth science is progressive. A pains- tak- 
 ing observer has been watching a case of phthisis pulmon- 
 alis for many months. No bacilli are found in the sputa, 
 though many examinations for the same have been made. 
 The patient dies. No bacilli are found in the lung tissue. 
 A brother scientist examines the body and finds tubercular 
 nodules in the lungs. The bacilli caused the patient's 
 death, but were either driven away or fled Jrom some other 
 cause Science in the earth. 
 
 The second observer in Mars reasons thus: Sheep die 
 from various causes. Crows alone do not kill sheep. 
 Crows simply eat the flesh of sheep after the}" are dead. // 
 is the condition of the shce-p that allows the crow to begin 
 cat i u o\ 
 
 The second observer in the earth reasons thus: Man- 
 kind die from various causes. Tubercle bacilli alone do 4 
 Bot kill mankind. Tubercle bacilli simply enter the tissue- 
 as a feeding ground. // is the condition of the system that 
 allows the bacilli to enter. 
 
15- 
 
 LAW IN TUBERCULOSIS. 
 
 In mathematics, whenever a regularity can be traced, 
 the general proposition expressing that regularity is called 
 a lav\ . For many years I have been led to believe that 
 tuberculosis is obeying certain fixed law, as the planets obey 
 law in revolving around a central sun. To the general ob- 
 server this statement may seem chimerical. 
 
 Zone. Ventilation. Death Rate. Ratio. 
 
 Frigid o Perfect o . . . . Zero i 
 
 Torrid 5 . . . Less perfect 5 . . . . Small 1 
 
 Temperate 10 . . Least perfect 10 ... . Great 1 
 
 The ratio between ventilation and death rate is always 
 constant. 
 
 Tuberculosis obeying law ? Apparently no order in 
 appearance or disappearance. No regularity in mode or 
 extent of visitation. Coming and going like the wind, or a 
 bird of the air — all is chaos, discord and confusion. So 
 thought the ancients of the worlds about us. But soon law 
 is discovered; order is evolved; a system is formed and it is 
 found that not only do the planets move, but in regular 
 orbits and with matchless precision. Stand by the seaside 
 and watch the incoming and outgoing tide. Note with ac- 
 curacy the flood and ebb of waters. Without previous 
 knowledge }~ou could assuredly say these waters move in 
 obedience to law. A law now fairly well understood — the 
 law of gravitation. 
 
 Stand by the bedside and observe the death rate from 
 tuberculosis. Note the accuracy the figures tally year by 
 year: Frigid zone, o; Torrid zone, small; Temperate zo::e. 
 great Without previous knowledge you could assuredly 
 say these factors are essentials to the formation of lav.-. 
 On these essentials is based the law of tuberculosis. Extend 
 your observations to the coast line of a continent. Mark 
 the varied difference in tidal wave in the various latitudes. 
 Truly, you could say this law is not equally potent at all 
 places — but observe it is, nevertheless, the same law, an 1 
 the difference in height of tidal wave is due to the coast line 
 
-i6— 
 
 of the continent. Extend your research to prevalence of 
 tuberculosis in the cities of the world. Mark the varied 
 difference in places of the same latitude. Truly, you could 
 say here is absence of law. But observe the same law pre 
 vails, and the difference of prevalence is due to abeyance 
 of atmospheric influence. 
 
 I herewith give, from standard authors, the maximum 
 
 of tide for the places named; 
 
 Bay of Fundy ,75 ft. 
 
 Boston 10 ft. 
 
 Straits of Magellan 50 ft. 
 
 Florida Reefs 2 ft. 
 
 Head of Persian Gulf 36 ft, 
 
 Mid-ocean 2 to 3 ft. 
 
 I herewith append, from W. Halle, a partial tabic 
 
 showing the prevalence of tuberculosis per ten thousand, 
 
 1889 to 1890, for cities named. 
 
 Brunn 76.7 
 
 Baltimore 24.9 
 
 St. Petersburg 48.8 
 
 London .........18.4 
 
 Vienna : 54.4 
 
 Rome. 22.5 
 
 As the difference in height of tide along the sea coast 
 does not invalidate the law of gravitation, neither does the 
 difference in per cent of tuberculosis in the various cities 
 invalidate the law of tuberculosis. 
 
 In truth, the law in both cases is verified by the appar- 
 ent contradiction. 
 
 In dealing with the problem of the tides we find it 
 complex and difficult. Equally complex and difficult is the 
 problem of tuberculosis. If the tide and tuberculosis be 
 alike based on law, they should alike be susceptible of dem- 
 onstration, and barring preconceived opinions, should alike 
 be worth}- of credence. 
 
 As already stated., the death rate is modified by abey- 
 ance of atmospheric influence. The stabled cow, the penned 
 sheep, the tame rabbit, the caged monkey, lion, tiger or 
 elephant almost invariably die of tuberculosis. Seldom*, or 
 never, do these animals die of this disease if living in the- 
 
open air. The disease prevails much more among those 
 whose vocations are sedentary than among those whose 
 occupations are out of doors. The mortality in prisons has 
 been shown to be four times as great as outside. The 
 death rate from phthisis is estimated at fifteen per cent of 
 the total mortality, while in prisons it is from forty to fifty 
 per cent. 
 
 Primary tubercular lesions are, in a majority of cases, 
 connected with the respiratory organs. 
 
 "There is nothing essentially destructive or necessarily 
 fatal in tuberculosis. That in all stages it may be checked 
 and enable the person affected to live man)- years, and die 
 subsequently of old age or other disorders." 
 
 The Rev, josiah Strong, author of "Our Country," 
 said in ni)' presence, a number of years ago, words like 
 these: "When a young man I was declared consumptive. 
 Sentence of death was pronounced by able physicians, east 
 and west. I took no medicine; ate plain food and lived 
 wholly in the open air. Today I am the picture of health." 
 
 Dr. Joseph Parish, of Philadelphia, gives a similar 
 experience. 
 
 Many, no doubt, can recall cases that have a like bear- 
 ing. It is, therefore, seen a constant ratio exists between 
 ventilation and death rate. As the ventilation becomes poor, 
 the death rate increases and vice versa. The law then, as 
 laid down in October, 1890, is simplified thus: The ratio 
 between ventilation and death rate is always constant. In 
 order to present this more clearly to the intellect, through 
 .the eye, I have arranged the following table: 
 
 Zone Ventilation Death Rate Ratio 
 
 Frigid ......... o .• . Perfect o Zero . . . . 1 
 
 Torrid 5 Less perfect 5 Small . . . . 1 
 
 Temperate .... 10 ... „ Least perfect 10 ... . Great . . . . 1 
 
 If, then, a regularity be traced, what shall we say of 
 law:* According to the definition, law must exist. 
 
 But it has been said that confinement, with insufficient 
 ventilation means the presence of the bacillus. Observe 
 this. Exposure to atmosphere breathed by consumptives 
 is not attended with danger so long as good ventilation is 
 
maintained. Observe this: 111 ventilation, whether in the 
 private room or crowded tenement, invariably increases the 
 death rate. Good ventilation, then, insures immunity. Ill 
 ventilation insures death. Can this much be said of the 
 absence or presence of the bacillus? Is tuberculosis caused 
 by the bacillus? Before the world today it stands not proven . 
 
 Look upon that field, with its depression in the center. 
 The rains of heaven fall upon that field. The depression is 
 filled with water and it becomes a shallow lake. Rushes, 
 reeds and grasses, peculiar to low places, begin to grow in 
 that lake. Did the rushes, reeds and grasses cause the de- 
 pression? Did the rushes, reeds and grasses cause the lake? 
 Drain the lake, the rushes, reeds and grasses disappear. 
 But, says the objector, can we not take these rushes, reeds 
 and grasses and make them grow on the arid mountains? 
 Yes, we can; but how great the labor and how small the 
 result. 
 
 Yes, we can; but nature does not work in that way. 
 
 Look upon that man as he walks the streets. A bad 
 family history, a prolonged illness — the depression in that 
 field. Grinding poverty or pampered luxury has been his 
 lot — the rains of heaven. Bacilli begin to grow in his 
 lungs, are found in his sputum — the rushes, reeds and 
 grasses. Did bacilli cause that man's history or illness? 
 Did bacilli cause poverty or luxury? Take away the con- 
 ditions, the bacilli disappear. But, says the objector, can 
 we not inject bacilli, or a pure culture, into the healthy 
 tissue and cause the disease? Yes, we can; but how great 
 the labor and how small the result. 
 
 Yes, we can; but nature does not work in that way. 
 
 Tuberculosis caused by the bacillus? Tuberculosis is 
 transgression of natural law. Violation of law brings its 
 penalty; observation of law its reward. Standing near a 
 spot sacred to every true American, I declare tuberculosis 
 can be controlled. Not by the injection of chemicals — not 
 by the injection of tuberculin, but by the observation of law. 
 
—i 9 — 
 
 MARRIAGE, 
 
 Should an attempt be made to analyze the cause of 
 marriage one would inquire into the nature of the desire im- 
 planted in the human breast. No attempt is made other 
 than to express a judgment that it is largely social. In the 
 beginning it was said: "It is not good that man should be 
 alone." In this later da}' one portion of scripture seems to 
 be tacitly acknowledged. 
 
 Whatever the incentive that leads to marriage, whether 
 love, impulse or ambition, in the eyes of the law united 
 they are. The incentive -per se may be of little import, 
 but the union is the weal or woe of two lives and succeeding 
 generations. Generally speaking, the incentive is of great 
 import. 
 
 Two of opposite sex meet in a car or at a party and are- 
 enraptured one with the other — a mutual liking. In what it 
 consists even the participants can not explain, but it leads 
 to marriage. 
 
 One part}- sees another to whom he or she is attracted 
 with an unwonted impulse, Every opportunity is sought 
 for an introduction. The acquaintance leads to a wooing, 
 which ends sometimes in an unrequited love, but more often 
 in marriage. 
 
 Another desires to rise in the social or financial scale — 
 a very laudable ambition. Who does not. if honestly at- 
 tained? The hand and heart are sought wholly for this 
 purpose, under the guise of a fervent love — and ends in 
 marriage. 
 
 There are also those of sordid nature whole being is 
 wrought up with having a good time. Matrimony has joys 
 untasted. To these joys they are allured and seek kindred 
 natures in marriage. 
 
 Some seek wedlock as an oasis in the desert of life. 
 
— 20 — 
 
 It is a constant theme of conversation; little else is thought 
 of. Any one of the opposite sex is accepted readily. 
 These subjects marry early in life. 
 
 Some look on wedlock as a snare into which the unwary 
 are entrapped. The subject is frequently referred to, but 
 discernment is necessary in selection. These parties are 
 hypercritical, and marry late in life, if at all. 
 
 Again, we have the intellectual devotee, whose ques- 
 tions, imaginary and otherwise, would deny the most ardent 
 of lovers — who, in truth, settle marital questions as do the 
 majority of people. 
 
 Then there is the philosopher, who looks on wit, beau- 
 ty and wealth as the mere accident or incident of fortune — 
 the externals of life. Theoretically, these people have no 
 choice except in health and a moral nature. Practically, 
 the number who thus marry is very small. 
 
 On examination, it is seen that in marriage, as in other 
 things, all have a motive. Whatever the motive, the result 
 attained is the home, the foundation and true secret of all 
 organized society. On the purity of the motive hinges the 
 secret of connubial happiness. Let those who contemplate 
 wedlock and desire happiness study carefully this phase of 
 the question. It will amply repay them. 
 
 But marriage is something more than the union of two 
 parties for life; it is the offspring — it is to give to that off- 
 spring a vigorous life. 
 
 Many a man or woman is deterred from marriage from 
 fearing its burdens and responsibilities, largely how shall 
 we feed, clothe and educate those granted us; but how few 
 ask the greater question, how shall we best transmit health 
 and long life to our children? A vigorous constitution — a 
 fortune in itself — readily secures the great obje:t c - of life. 
 Physical weakness, however great the fortune, is doomed to 
 doubtful victory or defeat. 
 
 How much wiser the parent who transmits health than 
 wealth ! How much wiser the state that frames laws to 
 secure healthy citizens than the one which legislates to 
 amass individual wealth ! How little regarded by legislators ! 
 
—21 — 
 
 Marriage is union — the joining of two segments, each 
 incomplete in itself. Children are the fruit of this union. 
 
 It is as consonant with reason to say that parents beget 
 children after their kind as trees yield fruit after their kind. 
 Observation shows it equally true. Still further, not only 
 are the mental and physical excellencies or defects trans- 
 mitted, but also the virtues or vices are transmitted in ex- 
 cellence or deject. Let us endeavor to illustrate transmit- 
 ted defect by a few familiar examples. 
 
 A married couple start in life with good health as a 
 fortune. By arduous toil a small tract of land is bought 
 and a house erected. Another small tract is added. Still 
 another, and so on, until five or six hundred acres are 
 bought and paid for. Their life has been alone. Xo SaD- 
 bath, no company, no holiday, no rest — continual toil early 
 and late. I said alone — not so. Eight children have been 
 added to that family. All are in poor health. The par- 
 ents have been so engrossed in securing a competence as to 
 forget a law of their being. 
 
 Work — so commendable in all — carried to an extreme 
 proves a vice. This vice is transmitted in physical weak- 
 ness. The children must ever suffer the sin of their par- 
 ents. We see this law illustrated in the wage-earner's fam- 
 ily. Arduous toil, long hours, low wages, high rent, 
 meager diet, etc., are some of the ways in which labor is 
 degraded and physical vigor in parent and child emasculated. 
 Legislation in behalf of those thus down-trodden is de- 
 manded. It would be beneficial to the human race. 
 
 Not alone in this regard is manual labor. Intellectual 
 work is subject to the same law and grievance. Many a 
 brain worker in the race of life has fallen by the wayside, 
 or in an attempt to live or secure a competence has trans- 
 mitted feebleness to his offspring. One instance of in- 
 tellect and application is recalled, who buried twelve chil- 
 dren under two years of age. 
 
 This law is illustrated in the drink habit of today. 
 How often we see the imbecile, the idiot and the deformed 
 in the family of the confirmed drunkard ! Who can say 
 
— 22 
 
 these children are not equally deformed in their moral na- 
 ture? They certainly are. How readily we condone an 
 obliquity in a child when we know the weakness of the par- 
 ents. In these and kindred cases law can accomplish much 
 but I am satisfied education can do more. Not until man- 
 kind clearly apprehend the law of their being will they be 
 enabled to rise above a common level, even with the aid of 
 human statute. How inefficient the best of statutes with- 
 out an enlightened public sentiment! Thus must it ever be 7 
 ' 'line upon line and precept upon precept. Tr Education pre- 
 cursory of true liberty. 
 
 Dipsomania is not alone in its work of deterioration. 
 It is but one in a series — though perhaps the greatest that 
 is leading us down. Tobacco, opium, chloral, etc., have 
 their votaries and claim their victims. Vicious habit is 
 hydra-headed, and requires the actual cautery of education 
 and law. Future generations demand it as their life. 
 
 Rapid child-bearing is confirmatory of this law. In all 
 great efforts of nature periods of rest are required. It is seen 
 in the field and forest. In frequent births the mother's rest 
 is short or nil, her vital force is reduced, and the children 
 suffer from lack of nourishment intra and extra-uterine. 
 This is seldom seen in the typical American home. More 
 often is seen the pale face and wasted form of the mother 
 striving to rear an only child in luxury that she may be a 
 devotee of fashion. This much is open. Withdraw the 
 curtain — too often is seen a tri-annual abortion. 
 
 Among a privileged few is sometimes seen the family 
 physician. To whom shall w e attach the blame ? To the 
 frail mother ? In the writer's judgment, nine-tenths of all 
 abortions are procured at the instigation or request of the 
 father. To whom the blame ? To all concerned Does 
 such action affect a future offspring ? Yes— mentally and 
 physically — and that in a deleterious way. It is crime in 
 the sight of God and man. 
 
 Sickness in either parent causes feeble offspring. A 
 father who begets children during a convalescence or illness 
 entails weakness in those children. A mother seriously ill 
 
—23— 
 
 during gestation either aborts or the child shows an infirm- 
 ity. Of course, there are exceptions, but the rule may be 
 laid down as established, that no -party should become a 
 -parent whose health is seriously impaired. 
 
 Age in one or both parents modifies the offspring. The 
 parents, not having reached maturity, it is of ten seen that 
 the first or second child is feeble and subsequent children 
 are strong. With the mother nature has hef limitation. 
 Not so with the father. In marriages where there is dis- 
 parity of years, care should be exercised. How often we 
 See the old man marry the young woman ! Are the children 
 vigorous ? That depends. Some men are young at seventy, 
 while others are old at forty. Age alone should be no bar 
 to offspring. 
 
 To recapitulate, vice transmits defect: 
 
 ( To secure a 1 
 
 Vice in 
 Parents. 
 
 Overwork, 
 mental or 
 physical. 
 
 J Choice. 
 
 J 
 
 \ 
 
 ! Necessity. 
 
 { competence. 
 | To obtain 
 1 a living. 
 
 Rapid child bearing, 
 abortion, etc. 
 
 Feeble 
 }r Off- 
 spring, 
 
 Excess or ( Drink Habit and others, 
 vicious 
 habit. 
 
 Sickness. 
 I Age. 
 
 The question may be asked, are the male and female 
 equals in marriage? In accountabilit}^ to God and man, in 
 the relations of life one to the other, they are equal partners. 
 In the transmission of excellence, defect, similarity, etc., 
 they may be equal partners, but at times there must be in- 
 equality. In the early months of pregnancy the child is 
 subjected to maternal impressions. During gestation and 
 nursing the fetus or infant is living on pabulum distinctly 
 the mother's. One would naturally infer the disposition 
 and dyscrasia of the child to be largely of the mother. Is 
 the inference the observation? An intelligent mother says: 
 "When enceinte I longingly desired to attend dances. My 
 husband thought it not best and refused to go. My only 
 child from his boyhood until now has a mania for danc- 
 ing.^ Another equally intelligent says: "I am ashamed of 
 
-2 4 — 
 
 ni}' daughter's actions, yet am pleased she is trying- to do 
 better, for I know it is all my own fault. She acts just as 
 I did in the early months of gestation." 
 
 There is an inequality. At conception the father in- 
 delibly stamps an impress, and the being passes from his 
 control. His work is done. Not so the mother. In gesta- 
 tion the blood of the mother is the life of the child. So 
 also in nursing. If the blood be impoverished the life of 
 the little one is endangered. Abortion commonly occurs. 
 The mother having a constitutional diathesis, the father be- 
 ing in health, the diathesis is more certainly transmitted. 
 Reverse the conditions; the diathesis is less certainly trans- 
 mitted. The mother then has a greater power in transmis- 
 sion than the father. This can be clearly shown only in a 
 limited number of diseases. Maternal heredity is stronger 
 than paternal heredity in syphilis. The family tree in tub- 
 erculosis inclines heavily toward the mother. The fetus in 
 utero. may be attacked with small-pox provided the mother 
 is the subject of the disease. It is seen that while maternal 
 impressions may affect all children it can only be presumed 
 that maternal exceeds paternal heredity in all disease. Yet 
 the presumption must ever be a strong one. 
 
 Heredity is more or less a factor in gout, diabetes, 
 mellitus and insipidus. The males having the disease are 
 in preponderance to the females. This inequality does not 
 show the male more readily transmits the diseases named, 
 but that he is more subject to them. In fact, it rather 
 shows the female the greater in transmission and the lesser in 
 subjection. In that remarkable disease, hemophilia, this 
 principle is still more strong. The mother transmits but 
 does not inherit the tendency to hemorrhage, or, as a Dar- 
 win might put it, the mother is a higher type of development. 
 
 To formulate: 
 
 i. The maternal impressions influence offspring. 
 
 2. In all so-called constitutional or specific infectious 
 diseases a transmission, if shown, is largely of the female. 
 
 From the above we would deduce: A race or stock is 
 most surely improved by selection of mothers. 
 
—25— 
 
 I have dwelt somewhat at length on the incentive to 
 marriage. Perhaps not wisely. In every community there 
 are some who have great faith in human statute. If there 
 be a beneficent change in any regard it must be by law. My 
 view accords more to education. In a democracy, enlight- 
 enment must precede statute. It is with this endeavor the 
 apparently little incentive is shown. If one's inclination to 
 a partner runs in a pretty face, amiability, wealth, etc.. 
 how absurd to so legislate as to restrict him to poverty in 
 feature, disposition and fortune ! 
 
 But if it be clearly shown that certain actions invaria- 
 bly produce certain results; that a life of temperance and 
 virtue is excellent and transmits excellence; that a life of 
 debauchery and vice is defect and transmits defect, how 
 clear it must appear to every well-thinking man and woman 
 that there is but one way to enoble and elevate mankind: 
 To -practice virtue and shun vice. Virtue is the obser- 
 vance of law, vice the violation of law — the law of our be- 
 ing. Let us shun vice and cling to virtue in marriage. 
 
26- 
 
 HEREDITY, 
 
 John Milton, in "Paradise Lost," speaks of our first 
 parents as "the loveliest pair that ever since in love's em- 
 braces met." Milton is given to imagery, but who can 
 think of a being more perfect than one fresh from the Crea- 
 tor's hand, unsullied by environment, untarnished by sin? 
 To me the creation should not only be lovely, but perfect in 
 every particular. 
 
 Looking back through the ages, I do not see Mother 
 Eve with husky voice or disturbed respiration; neither do 
 I see Father Adam with bacilli or tubercular nodules in the 
 lungs. To me the conception is a perfect creation — perfect 
 in form and in health. 
 
 We are told our parents fell from this estate. The 
 exact nature of the sin will ever puzzle theologians, but this 
 much is certain: Adam and Eve violated law. "Of man's 
 first disobedience and the fruit of that forbidden tree whose 
 mortal taste brought death into the world and all our woe 
 with loss of Eden." 
 
 Then, as now, violation of law brings its penalty, ob- 
 servation of law its reward. 
 
 Evidently, the Adam of today is not the Adam of 
 creation. 
 
 Had we a complete account of disease since creation — 
 embracing not only literature but observation — I firmly be- 
 lieve the record would show no tuberculosis in the early 
 centuries. 
 
 All animate creation living wholly in the open air are 
 free from tuberculosis. Our ancestors were nomads — wan- 
 dering from place to place in search of game or pasture, 
 sleeping under nature's canopy — life akin to animate crea- 
 tion. The disease, in the early centuries, must then have 
 been unknown, for we have no evidence that nature's laws 
 
—27— 
 
 have in any waj r been modified or changed. 
 
 If, then, no tuberculosis lurked in the tissues of our 
 first parents, if the disease did not exist in the early cen- 
 turies, how does it appear that one-seventh of the present 
 mortality is due to its inroads? A frank question, and it 
 should receive a candid answer. 
 
 Tracing the genealogy of the patriarchs from Adam to 
 Noah, we find a longevity unparalleled in the history of 
 mankind. During this period two things stand out in bold 
 relief — out-door life and length of days. These great object 
 lessons may receive various interpretations. To me only 
 one appears satisfactory: Out-door life — a sequel to crea- 
 tion; longevity— a sequel of out-door life. Interpret them 
 as you ma)', length of days and out-door life ever appear 
 together. 
 
 But it may be asked, is not immorality also associated ? 
 Yes, it is — a depravity of mankind, but not a depravity of 
 the patriarchs. 
 
 An exuberance of animal spirits — with lack of self- 
 restraint with the multitude — a consistent life of the few. 
 
 We read of the general wickedness; of one hundred and 
 twenty years given for repentance; of the flood, with the 
 destruction of mankind. We also read "Enoch walked 
 with God;" "Noah was a just man and perfect in his 
 generations." 
 
 A question now arises: Does heredity modify the aver- 
 age life? In other words, does it make aught of difference 
 to your grand-children or mine what our lives have been, so 
 far as heredity is concerned ? I verily believe it does; that 
 this has been true in all ages and in manifold ways. In 
 primitive times the workings of a law on this line can be 
 readily seen, but not as readily detected in the present gen- 
 eration. Methuselah, the oldest man of ante-diluvian days, 
 was the son of Enoch, who walked with God. Shem, aside 
 from his father the oldest man of post-diluvian days, was 
 the son of Noah, the perfect man of God. 
 
 If we carefully examine, I think histo^ will show that 
 not only do we inherit and transmit estates financial, but 
 
— 28- 
 
 intellectual, moral and physical as well. In Enoch and 
 Noah we see illustrated a law of retribution. The children 
 inherit, the parents transmit, a tendency to virtue, plus 
 length of days. 
 
 To formulate our view: A father shortens or extends 
 his days by vice or virtue. He transmits to his progeny a 
 tendency to vice or virtue, minus or plus length of days. 
 The same may be said of the mother. One parent being 
 vicious and one virtuous, gives parents and children an 
 equal footing in the race of life. Both parents being vicious 
 or virtuous, makes the law doubly sure. It follows as the 
 world becomes virtuous, longevity is increased, and vice 
 versa. Of course, we are speaking only of the law of hered- 
 ity or physical descent. 
 
 We hold, then, as in a vase, the treasures given us. 
 We add or take from as virtue or vice governs us. We 
 transmit — how often less than we receive ! 
 
 By heredity is meant prenatal inheritance, that which 
 one receives prior to birth. Tuberculosis is used in its most 
 comprehensive sense. Heredity in tuberculosis, then, 
 means prenatal inheritance of an intractable disease. 
 
 In all ages heredity has been recognized. This child 
 looks like his father, that child resembles her mother. 
 Physical resemblance to the biographer is heredity to the 
 biologist. 
 
 Physical resemblance is not alone, a mentality is trans- 
 mitted. How often we see a family of children with men- 
 tal traits or characteristics of their parents ! Yet this does 
 not always pertain. 
 
 Perhaps no better illustration can be given thar in the 
 world-renowned Beecher family. Edward, the scholar; 
 Harriet, the writer; Henry Ward, the orator — children of 
 the eminent divine. A clear case of heredity in mentality. 
 Yet today not one representative of that great family stands 
 an equal in intellect to any of the four named. 
 
 This brings us to a truth which I wish to indelibly im- 
 press on the mind of every one. That while physical re- 
 semblance and mental characteristic is transmitted, it is not 
 
—29— 
 
 transmitted, so to speak, in one continuous stream, as with 
 the river; there are water-falls and rapids and meanderings, 
 so in heredity. 
 
 Let no one claim that because heredity is not shown to 
 be continuous it is no longer heredity. Heredity flows in 
 no such perfect channel. On the principle of deviation in 
 heredity and selection of offspring, Darwin has the great 
 hold on the scientific mind. On this principle of deviation 
 and selection the florist or stockman select the prettiest or 
 best and make advances along this line. So in the thou- 
 sand and one things we see around us. Ever since man's 
 thoughts have been reduced to writing, perhaps before, 
 certain diseases have been regarded transmissible from par- 
 ent to child. Cancer, consumption and insanity belong to 
 this class. 
 
 Here is a field for the logician. If a healthy mentality 
 be transmitted, why not a diseased mentality? If facial 
 expression, why not other physical condition ? If tubercu- 
 losis be a constitutional disease — and we believe it is — why 
 not transmit the constitutional dyscrasia ? 
 
 Thus, to the logician arguing from probability, constitu- 
 tional disease is transmitted. Careful observation confirms 
 this probabilit3 T . Insanity has been traced through successive 
 generations in man} 7 families. Cancer sometimes shows 
 itself in the offspring of the first generation, but more often 
 in the second. 
 
 Children of consumptives, though the environment 
 be changed at birth, die oj this disease among other healthy 
 children, born of other parents. 
 
 We have already shown heredity travels in no perfect 
 channel. It is therefore seen that the proof of heredity is 
 complete. 
 
 But, sa} 7 some, tuberculosis is not a constitutional dis- 
 ease. It is a germ disease. The writer thinks differently, 
 but for the sake of meeting on a common ground we assume 
 you are right. 
 
 The microscope makes main- revelations. By its means 
 
—30- 
 
 scrofulosis and tuberculosis are declared one and the same. 
 This has been verified in Germany. We accept it. Scrof- 
 ulosis is modified by transmission, not so in tuberculosis. 
 Thus it is seen, if the latter statement be true, the diseases 
 which are declared one and the same are not one and the 
 same. If one and the same they would alike be modified 
 by heredity. 
 
 Let me illustrate: My friend and I are walking in the 
 country. I exclaim, ' 'What a lovely white house !" ' 'Yes," 
 says my friend, "but that house is also black." You don't 
 mean that same house is both black and white at one and 
 the same time? That is just what I mean. Well, I fail 
 to see it. My friend replies: "Were you ever in Germany ?' ' 
 "No sir, I never crossed the North Atlantic." Well, that 
 explains it. 
 
 Ladies and gentlemen, are you satisfied with the expla- 
 nation ? Would it not be wiser to call things one and the 
 same that agree in every particular ? 
 
 If these diseases be one and the same, heredity in tub- 
 erculosis is rendered stronger than probable. 
 
 Let us take another step. For many } T ears it was a 
 moot question whether living bacilli could be transmitted. 
 It is now universally agreed they may be carried by the cir- 
 culation to various parts of the body and through the fetal 
 circulation to the fetus itself. Ardent bacteriologists ex- 
 claim: "Why look for heredity ? Here are seeds of disease 
 carried to the prenatal offspring." 
 
 Please reflect one moment. Did it ever occur to you 
 that before a plant can take root there must be a suitable 
 soil or condition of growth? Which takes priority, the 
 plant or the soil in which it grows? Answer that question 
 honestly and you condemn yourself. 
 
 The moment you admit a growing bacillus at birth, 
 that moment you tacitly admit heredity in tuberculosis. 
 Heredity in tuberculosis is all we claim. 
 
 We must not stop here. Imagine before you five ladies 
 who gives intruction in painting on canvas. Your daughter 
 
— 3 i— 
 
 wishes to acquire the art. Before selecting an instructor, 
 s uppose you put a test question to each of these teachers. 
 You hold a fabric in your hand and ask severally the color. 
 Listen to the answers: Red, blue, orange, violet, indigo. 
 What ?rises in your mind? One of two things — either 
 these ladies are deceiving you, which is improbable, or else 
 they do not understand the business they profess. What 
 painter could instruct in blending three to five hundred 
 shades of color who could not distinguish a primary one? 
 
 You. have a son to send to college. You call before 
 you five leading clinicians in the state and put to each the 
 test question: What factor is heredity in tuberculosis? 
 Listen to the answers: Nothing, little, much, a great deal, 
 all. What arises in your mind ? One of two things — either 
 these teachers are deceiving you, which is improbable, or 
 el^e they do not understand the business they profess. 
 Who can instruct except they zt'/io know? 
 
 Ladies and gentlemen, have we been teaching error in 
 the past? Come, let us acknowledge our fault, or rise in 
 our place and refute what is said. 
 
 We have not reached the pinnacle as yet. There is 
 another step. With heredity in tuberculosis declared and 
 demonstrated, an herculean work must be wrought. 
 
 In marriage something more than minister or justice is 
 required. It needs: 
 
 i. General enlightenment in order to select. 
 
 2. A physician's certificate by both parties prior to the 
 marriage contract. 
 
 3. A secretary of forensic medicine, with a universal 
 marriage law. 
 
 Ladies and gentlemen of the profession, when we rise 
 to the occasion and demand these, they will be granted. 
 
—32- 
 
 THE PRECEDENT STATE. 
 
 When Robert Koch announced the discovery of the 
 tubercle bacillus, its invariable association with tuberculosis 
 and its consequent causative influence, the medical world 
 were ready to accept anything as a working theory. Tuber- 
 culosis had hitherto been an intractable disease. It was 
 argued that when we have greater light or insight into the 
 cause or causes of the disease, then we will be more success- 
 ful in treatment. 
 
 Some few physicians had anticipated the discovery. 
 Others could see no reasonable objection to the conclusion. 
 Figuratively speaking, the entire medical profession took off 
 their hats and hurrahed. 
 
 Had Koch discovered the same germ in health, deter- 
 mined its invariable association and declared the presence 
 of the germ the consequent cause of health, he perhaps 
 would not have awakened the enthusiasm, but the truth 
 uttered would have been equally clear. 
 
 Tubercle bacilli are ubiquitous; are found in both 
 health and disease. Growing bacilli are found only in dis- 
 ease. A soil must precede the .growing plant. Hence, 
 growing bacilli imply a precedent state. 
 
 What causes the precedent state ? The error of Koch 
 is a common one. Birds are seen on the growing plants. 
 They are the supposed cause of failure in certain crops. 
 The birds are killed. It is then found the birds were eat- 
 ing the enemies of the growing grain. Tubercle bacilli are 
 looked upon as the enemies of human kind. The prof ession 
 have been largely engaged in their destruction in toto. To 
 the writer it seems, should the extermination prove suc- 
 cessful, tuberculosis would still exist. 
 
 One thing should be plain to every observer: Health 
 and the tubercle bacillus do not constitute disease. Some- 
 
—33— 
 
 thing more is required, viz., the precedent state. 
 
 What is the precedent state ? It is the condition of the 
 individual that allows or encourages the growth of tubercle 
 bacilli in his system. The tubercle bacilli are present in 
 the bodies of every animate creature. They may be in the 
 saliva, the blood, the tissue, etc. 
 
 If the person be in health, or in other words, if there 
 be no precedent state, these germs remain, or come and go, 
 and cause no systemic disturbance whatever. 
 
 Should the person inherit or should he acquire the pre- 
 cedent state the living tubercle bacilli at once take root and 
 flourish, for the temperature of the body is favorable to their 
 development and growth. When these germs are found, 
 growing in the human body the person is said to have tub- 
 erculosis. Should one receive or acquire the condition fav- 
 orable to the growth of these germs, this person may be 
 said to have the precedent state. 
 
 What is the precedent state ? Incipient tuberculosis — 
 tuberculosis in the absence of tubercle bacilli. As elsewhere 
 stated, tuberculosis may exist, though infrequent, in the 
 absence of tubercle bacilli, but can never exist without the 
 precedent state. 
 
 In how many ways is the precedent state commonly 
 received? In two ways — heredity and abeyance of atmos- 
 pheric influence. 
 
 Please explain in what way one inherits the precedent 
 state? The precedent state is most commonly inherited 
 through a tuberculous ancestry. The same state may also 
 be inherited if one or both parents at conception, or the 
 mother during gestation, be suffering from suspension of 
 atmospheric influence, either from causes original or ac- 
 quired. This, to some, may seem strange, but must of 
 necessity be true. It is simply the violation of law on the 
 part of the parents the precedent state transmitted to the 
 children. 
 
 To secure a healthy offspring it is showm to be just as 
 necessary to live right as to marry right. A premium is 
 
- 34— 
 
 therefore placed upon correct living and the taking of 
 proper persons in marriage. To render this plain, let me 
 illustrate: A mother or father has tuberculosis at concep- 
 tion. Perhaps it is both parents who are afflicted with the 
 disease. The children born die of tuberculosis. This 
 seems plain. 
 
 In the above, instead of tuberculosis, place the prece- 
 dent state. The sentence then reads: One or both parents 
 have the precedent state at conception. What would one 
 reasonably expect as to offspring ? They would likewise 
 have the precedent state. With children thus born, how 
 easy to explain results. 
 
 Many obscure cases are rendered clear by this explana- 
 tion. We cite one by Austin Flint, Sr. ( "Practice of Med- 
 icine," 1873): 
 
 "Dr. Henry E. Paine, of Dixon, 111., illusirates a con- 
 genital tendency without the evidence of inheritance. Mr, 
 S. is fifty-seven years of age and in good health. His wife 
 is fifty-two and well. No progenitors have- been known to 
 die of tuberculosis. All the children, five in number, died 
 with this disease between 1853 and 1861; their ages respec- 
 tively being at the time of death twenty-three, twenty-five, 
 twenty-four, twenty-two and twenty-three." 
 
 In the absence of knowledge as to the occupation, mode 
 of living, previous history of disease, etc., of Mr. and Mrs. 
 S., the writer has the right to assume: 
 
 1. Mr. or Mrs. S., one or both, had pneumonia prior 
 to marriage. In common parlance, the)' were well, but 
 each had a bronchial difficulty, or perhaps an hepatized lung. 
 To what does this condition tend? Suspension of atmos- 
 pheric influence — the precedent state. 
 
 2. Mr. or Mrs. S., perhaps both, were engaged in an 
 unhealthy occupation. Mr. S. in a tow-mill or grinding on 
 an emery wheel ten hours per da}-, constantly spitting black 
 dust from his lungs. Mrs. S. making shirts in close quar- 
 ters fourteen hours per da}'. In either case to what would 
 this induce? Suspension of atmospheric influence — the 
 
CO 
 
 precedent state. 
 
 3. Their manner of living was unsanitary. Mr. S. 
 was a miser. He lived in one room and kept the door shut 
 to save fuel. Mrs. S. was a crank and afraid of night air. 
 She put the children to bed and covered their mouths to 
 keep,out the cold or heat. To what would this condition 
 of things tend ? Suspension of atmospheric influence — the 
 precedent state. 
 
 Under these circumstances the parents were well or in 
 good health, but their progeny received the precedent state 
 just as trul3 r as though both parents were suffering from 
 tuberculosis. Result — the children died of tuberculosis. 
 
 The result would have been the same had the parents 
 lived in our generation. They might have indulged in 
 present scientific fads — the injection of tuberculine to cause 
 sloughing of diseased tissue: the placing of sterilized gauze 
 over all apertures for ventilation to prevent the entrance of 
 microbes, so fatal to children; or, were they familiar with 
 present ideas in the fatherland: the securing of artificial im- 
 munity. The writer believes that under any or all of these 
 so-called cures or preventives the children would have died 
 as' the}' did, of tuberculosis. 
 
 It is not cure, but prevention, that will ultimately con- 
 trol the disease — prevention, not by injection, but by con- 
 trolling the -precedent state. 
 
 But hold ! Why not assume Mr. S. had a right in- 
 guinal hernia or Mrs. S. scarletina in infancy? The reason 
 is obvious. Nothing is assumed that does not naturally 
 lead to the precedent state. 
 
 Does it necessarily follow that one having the prece- 
 dent state must die of tuberculosis ? It does not necessarily 
 follow. It must be remembered the precedent state is the 
 first link in a great chain. If there be no first link the 
 chain will never be formed. If the first link be present, 
 others are readily added. In a typical case will other links 
 be joined. That depends. For the individual it must ever 
 be a constant battle. 
 
-36- 
 
 Let us endeavor to make this clear- Mr. A. has the 
 precedent state. The soil in his system is read}- for the 
 seed. The tubercle bacillus, the seed, is constantly present. 
 What is the probability ? The seed will at once take root. 
 
 How best to proceed ? There are three methods; 
 i. To get away from the germ. 
 
 2, To get away with the germ. 
 
 3. To leave the germ alone or rid one's self of the pre- 
 cedent state. To use terms more consonant with science; 
 ( 1) Germ exclusion; (2) germ destruction; (3) germ non- 
 intervention, 
 
 1. Dr. W. Van der Heyden, a bacteriologist of Japan, 
 has recently built a microbe-proof house. Its manner of 
 structure, dimensions, etc., are known to many. We 
 t\ ill not refer to these, Japan is young in science. Science 
 in theory and science in practice are two things. Suppose 
 the germs cause the disease; the house perfectly excludes 
 the germs. It is evident the doctor cannot always remain 
 in his house. He must be a live M. D. He must attend 
 to business. Will he take the house with him constantly ? 
 He has a field to cultivate. Will he kindly loan the house 
 to his servants while at work ? He has a large manufactory 
 in which thousands of hands are employed. Will he in- 
 clude this establishment in his microbe-proof house? If 
 not, why not? The doctor will find theoretical science is 
 not practical. 
 
 We now introduce another class. In this we have the 
 intellect of our land. Says an authority; Whenever I see a 
 case of incipient tuberculosis I exclaim: "Haste to the 
 mountains 7? Escape for thy life !" The writer asks why 
 so great haste. To get away from the germs. 
 
 "Come, let us reason together. " Suppose you stand 
 before two bare rocks, the one on the right hand, the other 
 on the left. On the one rock is placed one kernel of wheat. 
 On the other rock is placed one thousand kernels of wheat. 
 The conditions of growth, light, heat, moisture, etc., being 
 the same, which would germinate the sooner, the one kernel 
 
—37— 
 
 or the one thousand kernels ? The writer asks any man in 
 the land to show a difference in germination. Why do you 
 hasten your patients to the mountains ? To escape from 
 the germs of disease. What foolishness ! 
 
 Do not germs exist in the mountains ? They are not so 
 plentiful in the mountains. If germs cause the disease, if 
 the condition of the system be favorable to their growth, 
 are not a few germs all that is necessary ? 
 
 If absence from germs be all that is required, please be 
 consistent. Why not lease Dr. Heyden's microbe-proof 
 house? The truth lies here, the mountains do benefit, but 
 the benefit does not consist in absence of germs. It con- 
 sists in more perfect aeration of the blood. In other words 
 the more perfect aeration drives away the precedent state 
 and the germs do not grow. Let this be remembered. 
 
 To recapitulate: (a) Science has no practical method 
 of germ exclusion; (b) had science such method it would be 
 useless unless germs cause disease. 
 
 2. Germ destruction. It is true germs may be de- 
 stroyed. There are germicides in abundance, and some of 
 them very efficient ones. It is also true that science knows 
 no method of total germ extinction. Had we such method 
 it would be useless unless germs cause disease. The writer 
 thinks the latter stands not proven in tuberculosis. 
 
 3. Germ non-intervention. This is the author's own 
 method, and, he thinks, has the merit of being practical. 
 
■38- 
 
 WHOM TO MARRY. 
 
 . So long as medical men firmly believe the germ theor3 r 
 of tuberculosis, so long there will be no true progress in 
 prevention and control of this disease. 
 
 So soon as we grasp the idea of a precedent state or 
 condition in the individual prior to the advent of the bacillus 
 so soon we take the first step in prevention and control. 
 
 There can be no definite action until there is clear ap- 
 prehension. 
 
 If one only cares to look he can readily see the tubercle 
 bacilli do not grow in the normal or healthy tissue. It is 
 always in the abnormal or unhealthy tissue they take root 
 and flourish. 
 
 Tubercle bacilli, then, differ from the ordinary parasites 
 that infest the animal and vegetable kingdoms. 
 
 Again, a recognition of heredity in tuberculosis — a per- 
 ception that something is inherited other than an active 
 bacillus— likewise leads to investigation that will enlighten 
 and aid in controlling the disease. It is into a channel of 
 this character we desire to enter at this time. 
 
 We have elsewhere stated, "Abeyance of atmospheric 
 influence, in whatever way induced, causes a depraved tis- 
 sue or dyscrasia, through which the tubercle bacilli enter 
 and grow." In other words, a law underlies the formation 
 or creation of the precedent state or condition. 
 
 In heredity the precedent state or condition of the off- 
 spring is received direct by parental transmission at con- 
 ception, or more slowly, through the mother during intra- 
 uterine life. 
 
 At conception the father's work is complete. If the 
 father at this time have a constitutional dyscrasia, or if he 
 be violating a law of his being so as to impair his organism, 
 the fetus will certainly show this dyscrasia or violation at 
 
—39— 
 
 birth or in after years. The same may be said of the mother. 
 
 If both parents have this dyscrasiaor are violating law, 
 the result named to the fetus is doubly certain, or, perhaps 
 better, doubly strong. 
 
 At conception the work of the mother is incomplete. 
 During gestation, if the blood of the mother be impure or 
 impoverished, it will certainly cause the death or deteriorate 
 the health of the intra-uterine offspring. This statement is 
 confirmed by every -day observation. It is therefore seen 
 that the character of the offspring must be largely deter- 
 mined by the health of the mother. 
 
 If we are clearly understood, the precedent state or 
 condition is found in two classes: 
 
 i. Those who in any way, suspend atmospheric in- 
 fluence. 
 
 2. The fetus or intra-uterine offspring under the con- 
 ditions named. 
 
 Or perhaps it is rendered clearer by saying the preced- 
 ent state or condition is received in two ways: 
 
 i. Suspension of atmospheric influence. 
 
 2. Heredity. 
 
 While the law of formation or creation of the precedent 
 state or condition may be active in the ancestry, it is neces- 
 sarily inactive in the prenatal offspring, -per se ; hence a 
 question now arises: 
 
 How do you reconcile a condition induced by law and 
 the same condition induced by heredity in which this law is 
 held in abeyance? 
 
 An illustration perhaps will render this clear. Along 
 the ocean coast there are tides. These tides are governed 
 by law. A prevailing wind increases or diminishes the tide 
 at any point of the ocean shore. Heredity is a prevailing 
 wind. Heredity may increase or diminish the death rate 
 from tuberculosis. 
 
 Eliminate all disturbing elements and there would be 
 uniformity in tide. Eliminate disturbing elements in tub- 
 erculosis, of which heredity is one, and there is uniformity 
 of action in law. There is this difference: The tide may 
 
-40— 
 
 never be governed; heredity is, in many instances, controlled. 
 
 Having tried to make plain the conjoint action of law 
 and heredity in tuberculosis, showing that in some instances 
 heredity aids the action of law and in others militates against 
 its action, let us now proceed to discuss a topic in which we 
 all are directly or indirectly interested, viz., marriage. 
 
 A certain farm writer has compared marriage to the 
 garden of the farm—in many ways a beautiful and happy 
 comparison. The garden, a mere patch, highly cultivated/ 
 yields the choicest and most luscious fruits; marriage, a 
 fraction of duration, happily consummated, yields an off- 
 spring the joy and jewel of our lives. The garden returns 
 according to seed, soil and degree of cultivation; marriage 
 returns according to parents, mother and care in after years, 
 
 Let there be no mistake. Nature is not mocked. As 
 the seed, soil and cultivation, so the fruitage. 
 
 In marriage so many questions are involved that it 
 seems like complication to add other conditions to those 
 already known. But if the future welfare of a people de- 
 mand care in selection, it must be granted that no care is 
 too great. 
 
 From time immemorial the man has sought the woman. 
 It is the man who "pops the question." The woman 
 chooses in the negative — receives or rejects. Whether this 
 order should be changed, whether the change would be ben- 
 eficial, are questions we w T ill not discuss, but there is one 
 thing on which the writer expresses himself, viz., every 
 man or woman's family history should be a public record. 
 
 As one in the purchase of real estate goes to the public 
 record to examine the title, so every one should have the 
 right to examine a record of heredity when selecting a 
 partner for life. This may be deemed foolish, but it is a 
 foolishness beneficial to mankind. 
 
 Let me illustrate. You select a partner. Whether 
 guided by impulse or choice in the selection, she pleases you 
 and the union is joyous but for one thing — in a number of 
 years, more or less, usually less, the wife dies of tubercu- 
 losis. Yet more — the children have a history of tuber cu- 
 
—4i— 
 
 losis. Perhaps this is the record of a husband. The result 
 to him is just the same; not always so to the children. 
 
 All observers agree that tuberculosis travels most read- 
 ily through the mother. Why ? Because it is the mother 
 who sustains the fetus during gestation. A diseased condi- 
 tion of the mother if therefore more liable to be transmitted. 
 
 Father and mother are equals in conception, unequals 
 in gestation. 
 
 As social custom gives man the province of selec- 
 tion, observation should teach him to select wisely. As 
 social custom prescribes woman an acceptance or rejection, 
 she should be taught to accept or reject wisely. 
 
 WHOM TO MARRY. 
 
 Let no man propose to a woman who has a clear family 
 history of tuberculosis. Let no woman readily accept a 
 man with a clear family history of tuberculosis. 
 
 While the worn an, under certain conditions, as vocation, 
 environment, etc., ma} 7 accept a husband w T ith a hereditary 
 taint of tuberculosis, it is best for her not to do so. Under 
 no circumstances should one secure a wife w r ith a tubercular 
 history. The progeny in the former case is generally free 
 from the disease, but not always so; the progeny in the 
 latter case are seldom or never free from the disease. Of 
 course there are exceptions. 
 
 Intermarriage of tuberculous subjects should be pre- 
 vented by legal enactment. 
 
 What more can we say ? In prevention of tub erculosis 
 education and restraint should be the watchword. In all 
 theorizing, practical results should be the object or aim. 
 
— 4 2- 
 
 EDUCATION. 
 
 We must educate. We must educate. This has been 
 the watchword in our country since its early history. A 
 commendable watchword. Washington, Franklin and 
 others expressed the same in like words. 
 
 Some restrict education to the acquirement of knowl- 
 edge. It is more than this. Education has for its object 
 the development of the powers of man. This development 
 may be along many lines of work. It truly includes orig- 
 inal work. People must be educated even to think. 
 
 It does not follow, then, that he is best educated who 
 has the most information in store; the largest library. 
 Rather he is best educated who best reasons from cause to 
 effect; who, while having the requisite knowledge to in- 
 quire, has also the ability to. generalize. 
 
 We speak thus particularly, for many think education 
 and acquisition of knowledge are synonymous. There is a 
 distinction and of ttimes this distinction makes the difference 
 in mankind. _ 
 
 On no topic do we more clearly require education than 
 on the one before us. Our mental shelves are laden with 
 acquisitions, but in the writer's judgment little education is 
 present. False notions and ideas have become so blended 
 and intermingled with actual knowledge that much is taught 
 which lies in shadow-land, that cannot endure the test 
 of time. Education should lift us through or above the 
 shadows into the reality; open the veil before us to let the 
 sunshine of truth enter. We must educate, but we must 
 do so as to awaken latent thought, cultivate original re- 
 search, and teach every man to think independently. Then 
 education will be of value. 
 
 Today there is a germ theory of tuberculosis. Truly, 
 it is a theory. Is it anything more? We think not. Med- 
 
—43— 
 
 ical works are filled with disquisitions on the tubercle bacil- 
 lus, the so-called cause of tuberculosis; when, where and 
 how the germ is detected; its significance when found or 
 when not found; the procedure, if latent or growing; the 
 way to capture, isolate and cultivate; the best microscope 
 to look at, after or into the invader, etc., etc., etc. 
 
 This is all very well so far as it goes, but it seems to 
 the writer like superficial cultivation. We need occasion- 
 ally a subsoiler that will strike deeper and bring up that 
 below into the sunlight, 
 
 A number of years ago an enthusiastic agent was intro- 
 ducing a certain kind of honey bee. Among the many 
 points of excellence of this particular bee was its size, hard- 
 iness and qualities as a honey collector; so large no other 
 bee would quarrel with it; so hardy the climate had no 
 effect upon it; so great a worker it did not require feeding. 
 He dwelt on these points with a fervid oratory. A hive of 
 peculiar construction was then introduced. It excelled 
 every other in that the holes or exits were so small that no 
 enemy of the bee tribe could enter. The hive was abso- 
 lutely safe from all invaders. At this juncture an old 
 farmer arose and asked how so large a bee could enter so 
 small a hole. The agent was evidently master of the situa- 
 tion and blandly remarked this was no business of his what- 
 ever; this is the bee's look-out. 
 
 After so much talk on the tubercle bacillus, what it 
 does and what it does not, the writer is somewhat in the 
 position of the old farmer, and asks how the tubercle bacil- 
 lus enters the healthy organism. The reply is equally log- 
 ical: "This is the look-out of the tubercle bacillus." 
 
 This seems the only answer ever given by the bacter- 
 iologist. Is there no other? We think there is. The 
 fighting qualities of the tubercle bacillus, like the Span- 
 iards, is vastly over-rated. Each desires little to do and 
 plenty to eat. Neither would forcefully enter a harbor for 
 temporary or permanent rest. How, then, do the tubercle 
 bacilli gain a footing ? By falling as a seed by the wayside 
 and simply taking root; by eating the first food that pre- 
 
—44- 
 
 sents and satisfying a natural craving or hunger. The 
 tubercle bacillus is not seeking whom it may devour. It 
 never goes out foraging, but is everywhere present, and 
 wherever there is suitable soil, simply grows. It is evi- 
 dent that a soil must precede the growing organism. 
 Every biologist will acknowledge the accuracy of this state- 
 ment — first the soil, next the organism and lastly the 
 growth. 
 
 Say not, then, that the tubercle bacillus is a parasite. 
 It is not a parasite. It is a vegetable organism, taking root 
 in a fertile soil. The soil precedes, is prepared for and 
 nourishes the growth of the organism. What is the mission 
 of the organism ? That of a scavenger. It takes up the 
 old, useless and worn-out tissue that has no further virtue 
 in the economy. When this effete tissue is wholly taken 
 up the organism disappears. So long as this tissue forms 
 the organism thrives. 
 
 In tuberculosis an animal debris is continually present. 
 Suspension of atmospheric influence causes the debris or 
 worn-out tissue. Remove the suspension and you at once 
 remove the formative process. No formative process, no 
 tuberculosis. This information may seem strange; may not 
 be found in standard works; yet is nevertheless true. 
 
 The tubercle bacillus is not the cause of tuberculosis. 
 There is another cause, viz., suspension of atmospheric in- 
 fluence in whatever way induced. 
 
 With this truth clearly before us and ever in mind, no 
 fear need be entertained regarding the tubercle bacillus. 
 It is perfectly innocent and may be so considered by all. 
 We are living in troublous times. The outlook is brighter. 
 
 I^et us gird on our armor, fight the battle with courage 
 and take heart for the future. 
 
 A crisis is upon us. Men of science have laid out the 
 metes and bounds of knowledge in this disease. ' 'Thus far 
 thou shalt go and no farther." Men of observation, per- 
 haps equally wise, see no progress — rather decadence; ob- 
 serve a weakness or inefficiency in present methods. They 
 boldly ask why this educative empty nothingness. Men of 
 
—45— 
 
 the schools who hold place, perquisite and power ask why 
 this cadence of invective. Each in his way maintains his 
 right — a battle for supremacy. 
 
 It becomes every thinking medical man to use his in- 
 fluence for the right, whatever may betide. Disease stalks 
 rampant through the land. Servitude, if of value, is hon- 
 orable. Serfdom to a theory is dishonor. In this disease 
 the gall and bitterness of bondage are severely felt. Are 
 we thinking men ? Let us feel the chafing of a foreign yoke 
 no longer. 
 
 What is tuberculosis ? Says one: "An infective dis- 
 ease caused by a germ." Says another: "A systemic dis- 
 ease caused by violation of law." One says: "No tubercu- 
 losis without a germ of disease." Another says: "No tub- 
 erculosis without violation of law." One holds a vegetable 
 organism or plant growth as necessary. Another holds 
 violation of law or ill- ventilation as necessary. No tubercle 
 bacillus, no tuberculosis. No suspension of atmospheric 
 influence, no tuberculosis. One tries to catch or antagonize 
 a bacillus. Another tries to correct or modify present action 
 of law. One could prevent disease if no tubercle bacillus. 
 Another could prevent disease if no violation of law. One 
 says: "Give us more time; it is a question of science." 
 Another says: "Give us a hearing; it is a question of com- 
 mon sense. ' ' One stands entrenched with shield and banner 
 displayed. Another stands in the open, fearing no defeat. 
 What medicine can be more practical than preventive 
 medicine ? 
 
46- 
 
 FOOD PRODUCT. 
 
 No factor is more conducive to trie well-being of a peo- 
 ple than diet or food product. If we turn to history and 
 seek those nations which have secured the most lasting re- 
 gard or aggrandizement, we invariably find a people well 
 fed. Per contra, should we seek the tribe or race lowest 
 in the scale of existence, whose history — if so it may be 
 called — lies in the unwritten legend or tradition, whose 
 home is migratory and uncertain, we find an insufficient 
 diet, with alternate plenty and privation. 
 
 So true are these statements, that brawn and brain 
 work most harmoniously and efficiently when food product 
 is adequate to the animal economy; so true are these state- 
 ments that, other circumstances being equal, given the diet 
 for five consecutive generations f the condition of a people 
 may be fairly determined. 
 
 No better illustration can be given than in the exam- 
 ples of Great Britain and India. 
 
 Great Britain, synonym for strength, has fought with 
 nearly every nation of the earth, and today controls a do- 
 main on which "the sun never sets." , Great Britain, a 
 land of liberal diet. 
 
 India, synonym for weakness, vast in area, population, 
 resources and willingness to pay taxes; vast in little else, 
 controlled by a few thousand alien soldiers. India, a land 
 of restricted diet. 
 
 Exchange the food product for five generations, think 
 you their relative strength would remain the same ? 
 
 As with the nation, so with the individual, though less 
 marked. Show me the man or woman whose whole life 
 diet is scant or insufficient, and I will show you the intel- 
 lectual or physical weakling. Bone, brain and muscle are 
 built on food ample in quality, quantity and variety. When 
 little Oliver Twist calls for '"more" it is no idle, childish 
 
—47— 
 
 whim or folly, but is au urgent call of wronged nature. 
 The soup is too thin, the quantity too small, and the qual- 
 ity deficient. Are there any little children in this land of 
 plenty who are calling for more? Examine closely before 
 you say no. 
 
 Thus far we have spoken of normal or wholesome food 
 product. But at times a staple production fails, or is defec- 
 tive or diseased through climatic or other causes. A people 
 dependent on one production must then face starvation or 
 become enervated through diet. The famine in Ireland 
 through failure of the potato crop, or local out-breaks of 
 ergotism through eating black rye, etc., are familiar exam- 
 ples. Again, a food product may be defective in that it is 
 improperly cared for. Mouldy hay or musty grain must 
 impair the health of the animal that eats them. Over-ripe 
 fruits, partially decayed vegetables or meats improperly 
 kept must cause sickness to the consumer. In regard to a 
 food product there is only one royal way — to select only 
 the best. 
 
 Of food product there is only one with which we all are 
 perfectly familiar; only one that fulfills every indication, 
 meets every want, and in truth is ideal — pure milk. Per- 
 fect and familiar food as milk is, no article has been more 
 used and misused. Today it stands eulogized and con- 
 demned. One fact remains — -pure milk a -perj ect food. 
 
 The purity of milk is affected by intrinsic or extrinsic 
 causes. In other words, milk ma}' be changed during se- 
 cretion or after it is withdrawn. Of the various changes 
 that take place after milking we will not refer, but simply 
 state that they all may be prevented for a longer or shorter 
 period by roper sterilization. Various apparatus are on 
 the market and perfection in this regard seems to be reached. 
 
 While sterilization is thus regarded so favorably there is 
 one thing it can not do, as will shortly appear. 
 
 Of the various changes that take place at or during se- 
 cretion we wish to speak more particularly. 
 
 i. It is asserted by high medical authority that tuber- 
 culous animals secrete milk containing bacilli. So far as 
 
- 4 8- 
 
 known, no one argues their presence in the milk. Seeing 
 is believing. 
 
 2. That by sterilization the bacilli may be killed and 
 the resultant milk rendered a perfect food. 
 
 In the judgment of the writer this statement is as near 
 prevarication as is Bill Nye's description of a cyclone. It 
 contains some truth, but most of it is mythical. That 
 bacilli may be killed by sterilization or that there are cy- 
 clones, no one denies, That tuberculous milk may be ren- 
 dered perfect food by sterilization is as mythical as Nye's 
 description. 
 
 There are two things of which American physicians 
 can justly feel proud — practical ideas and good common 
 sense. Suppose during the famine in Ireland that the 
 Americans, instead of sending a ship-load of corn, had sent 
 a ship-load of sterilizers. Would the famine have been 
 staid ? Suppose during an out-break of ergotism some one 
 should suggest sterilization. My dear sir, we do not eat 
 uncooked rye. It is ground, made into loaves, and sterilized 
 in the oven. The* people still die. No sterilization will 
 render a diseased grain or a partially decayed potato perfect 
 food product. 
 
 Fondness of a bargain is likewise American. Suppose 
 I have five tons of mouldy hay. It is sterilized after the 
 most approved German method. Is there a physician in 
 the land who will pay a full market price for this hay ? 
 The hay is an imperfect food before a mould fungus starts. 
 Killing the mould fungi does not restore perfect hay, 
 
 Milk secreted by a ticbercu/otis animal is a diseased 
 product — a diseased -product before bacilli are found. 
 Killing the bacilli by sterilization does not restore a -per- 
 fect milk 
 
 Milk is a secretion — an elaboration — of principles from 
 the blood. If the blood be pure, the milk is pure and vice 
 versa. 
 
 It is known that nervous impressions increase, dimin- 
 ish or vitiate the milk flow. It is known that the milk of 
 a syphillitic is poor in quality, and should be nursed only in 
 
—49— 
 
 exceptional cases. 
 
 What shall we say of the milk of an animal suffering 
 from a constitutional disease ? To the writer, it seems a 
 fallacy is foisted unwittingly on an intelligent public. 
 
 Are there any little children in this land of plenty who 
 are calling for more ? Herein lies a secret of the fifty per 
 cent, of mortality under five years of age. Believing this, 
 could you conscientiously recommend condensed milk for 
 children, gathered as it is from unknown sources? 
 
 Poor as are all artificial infant foods — in that they do 
 not contain the elements of nutrition — they are superior to 
 commercial condensed milk, in that they do not contain the 
 elements of disease. 
 
 Some one may ask what is the chemical difference be- 
 tween diseased and healthy milk. Some one may likewise 
 ask what is the chemical difference between a diseased and 
 a healthy potato. Cook them and your three-year-old child 
 will see a difference. Use the two kinds of milk and you 
 will perceive a difference. 
 
 Have you ever said to a mother: "You must not nurse 
 your infant. You are in ill-health. The milk is a diseased 
 product." 
 
 In the moral as well as the phj^sical world no man 
 should find fault with present conditions unless he be able 
 to point out a better way. 
 
 If pure milk be the only perfect food, if the infant 
 human race must live on milk, the way to obtain pure milk 
 is the desideratum of the century. 
 
 i. We must have healthy animals. 
 
 2. Animals must conform to hygiene. 
 
 3. Every precaution must be taken to keep milk pure. 
 How shall we obtain healthy animals ? What says the 
 
 New York Health Board? "Use the tuberculin test and 
 kill all diseased ones." To the writer this seems like cross- 
 ing the valley of Lethe on the bridge morality. The bridge 
 — a very fine structure — stops in the ?niddle of the river . 
 In less than five years New York will again have to adopt 
 the scientific method. 
 
— 5o- 
 
 While removing the diseased animals would it not be a 
 higher wisdom to secure a healthy progeny by selection. 
 Animals must conform to hygiene. 
 
 It is astonishing how inconsistent we are. Mothers 
 must be very careful of diet, etc., etc., while nursing in- 
 fants. Cows are allowed to be crowded in filthy stan- 
 chions, eat mouldy hay, drink stagnant Water, without air, 
 exercise or sunlight; milked at all hours, the milk delivered 
 twenty-four hours late, is sterilized and pronounced perfect 
 baby food. 
 
 The man who sells rotten bananas and robs you of your 
 child is no more guilty than he who thus cares for bis cows 
 and spreads disease and death. They should alike be held 
 amenable to law. 
 
 Kvery precaution should be taken to keep milk pure. 
 Herein lies a field for sterilization. 
 
 Look over the able articles written during recent years 
 and you will readily glean a concensus of belief as follows: 
 (a) Diet causes tuberculosis; (b) diet cures tuberculosis; 
 (c) diet prevents tuberculosis; (d) the same article of food 
 taken in the same manner acts in the three ways mentioned; 
 viz : a, b and c, at the same time, (e) Statistics prove all 
 this. Our ascertained facts must be renovated. There is 
 certainly something wrong. 
 
 In what does the wrong consist ? We believe it con- 
 sists in a false conception of the nature of the disease, 
 tuberculosis. 
 
 We are taught tuberculosis is an infective disease 
 caused by the tubercle bacillus; infective in the sense that 
 one takes the disease from another; caused, in the sense 
 that growing bacilli are commonly found in the disease. 
 So long as these ideas entertain and hold there can be 
 little true progress. To progress there must be a radical 
 change or rather interchange of ideas. Take the common 
 food product, butter. No article of commerce is in more 
 common use or contains greater number of tubercle bacilli. 
 If present views be correct every time we partake of butter 
 we are infecting our system with tubercle bacilli or causing 
 
—51— 
 
 tuberculosis. 
 
 On observation it is evident: (a) That multitudes of 
 people eat butter who do not take tuberculosis; (b) that 
 tubercle bacilli do not take root in the health}' human 
 organism. Hence (c) butter does not cause tuberculosis 
 only in certain diseased conditions of the system. 
 
 It follows: (a) Those having this diseased condition 
 should not ed't butter; or (b) should eat butter free from 
 tubercle bacilli. 
 
 The question now arises, what is this diseased condi- 
 tion of system ? 
 
 How does it arise or how is it caused, and in what way 
 may we prevent it ? 
 
 On close observation it is seen only those animals allow 
 the entrance of growing bacilli who in some way have sus- 
 pension of atmospheric influence. If there be no suspension 
 of atmospheric influence there can be no tuberculosis. 
 
 It is then a question of suspension or non-suspension of 
 atmospheric influence, and not a question of eating or not 
 eating butter; not a question, -per se whether tubercle 
 bacilli be preseut or absent in said butter. If the reasoning 
 be correct, instead of a microscopial examination of butter 
 to determine the presence or absence of tubercle bacilli, we 
 should examine the family histor3 r or environment of the 
 party eating butter. 
 
 The same reasoning may be applied to milk. 
 
 No greater fallacy exists than that milk causes tuber- 
 culosis. Yet it will take years to teach the public to think 
 otherwise, because we are so imbued with the germ theory 
 of disease. The truth will at last prevail. Some time, sooner 
 or later, we will know better. In the accepted way, we 
 have spoken of diet as causing tuberculosis. Let us now 
 refer to diet as a cure of the disease. It is observed by all 
 clinicians that tuberculous patients recover most rapidly 
 who have good digestion and assimilation. They w T ho can 
 eat food and digest it, increase in flesh and put on a healthy 
 appearance. They are certainly getting better. Per con- 
 tra , the}' who are scant eaters, or they who have poor di- 
 
—52- 
 
 gestion gradually lose in flesh and become worse. They 
 lose in flesh from lack of nourishment and from the waste 
 constantly going on. Herein lies the secret, if there be 
 one, of the so-called cure. 
 
 Diet of food, rich in fat, if readily assimilated, restores 
 the waste constantly going on. Does it cure? 
 
 It is' certainly an efficient aid in cure. Should the 
 cause of the disease be steadily at work, np true cure is 
 affected by diet. 
 
 Does diet prevent tuberculosis ? That there be no mis- 
 apprehension we refer to one or two writers as expressing a 
 belief that it does. Is this true? "Next to a life in the 
 open air, perhaps even more than that, the question of food 
 is of the utmost importance in the prevention of tuberculo- 
 sis, as well as in the treatment of the disease." — Youth's 
 Companion, March 31. 
 
 Speaking of hygienic treatment: "Of equal importance 
 with pure air is the selection of proper food and its diges- 
 tion and assimilation," etc. — Lancet-Clinic, Feb. 5. 
 
 These writings are selected simply to show the trend of 
 modern instruction . They express what is being taught on 
 every hand: That proper food is equal to pure air as a pre- 
 ventive of tuberculosis. 
 
 The writer thinks not. Proper food or diet per se will 
 never prevent tuberculosis. Pure air per se will ever pre- 
 vent tuberculosis. Taken together there is no equality. 
 
 Improper or insufficient food causes inanition. 
 
 Impoverished or impure air causes tuberculosis. 
 
 In inanition there may be or there may not be tuber- 
 culosis. 
 
 In tuberculosis there is always inanition. 
 
 To briefly summarize: 
 
 Diet does not cause, cure or prevent tuberculosis. If 
 true, how can the action of a, b and c take place at one and 
 the same time? If true, are tubercular statistics of value? 
 
 What is tuberculosis? A constitutional disease, de- 
 pendent largely on the evils of civilization and governed by 
 the following law: The death rate from tuberculosis is in 
 direct ratio to suspension of atmospheric influence. 
 
—53" 
 
 THE CAUSE OF TUBERCULOSIS, 
 
 United States Indian Service, 
 Yankton Agency, 
 Greenwood, S. D., August 24, 1898. 
 
 Dear Doctor — I have read with great interest your 
 article in the last number of the Medical Record. I have 
 held your views for some time. I have in my experience 
 the best illustration imaginable. 
 
 I have attended the Indians both here among the Sioux 
 and in Idaho among the Bannocks. I have known many 
 Agency physicians and have talked with them. All agree 
 that the older Indians say they did not have consumption 
 among them when they lived in teepees and in the open air. 
 But as civilization advanced among them the government 
 has constructed log cabins and small frame houses for them, 
 and they have given up the teepee except a short time in 
 the hottest weather of summer. Now we have consump- 
 tion the most prevalent disease. More than half of the 
 deaths are from it. 
 
 In examining Indian children as to their physical 
 fitness for school it is almost the rule to find tubercular 
 glands in the neck or some evidence in the lungs. The 
 joints of Indians and mixed bloods are rarely attacked by 
 tuberculois. 
 
 These houses are mostly low, having one room; many 
 are log cabins with dirt floors, sealed as tightly as possible ; 
 the whole family living in this one room, and except in 
 summer, cooking there on a large cook stove, heating the 
 poorly- ventilated room to furnace heat, and after perspiring 
 freely, going into the cold air. They are in the transition 
 stage between savagery and civilization, mentally, morally 
 and physically. This may account in some measure for the 
 fearful hold this disease has on them, but I think tubercu- 
 losis came with the house and ' 'suspension of atmospheric 
 
-54— " 
 influence." 
 
 Would it be wise to embody these thoughts, rambling, 
 in a paper to help prove the great factor, suspension of at- 
 mospheric influence ? 
 
 I trust you may find some interest in these remarks, 
 and I thank you for the new light your valuable paper has 
 thrown on the subject for me. 
 
 Believe, me, I am, very truly yours, 
 Geo. F. Pope, M. D., Agency Physician. 
 
 The above letter is self-explanatory. The article re- 
 ferred to is found in the New York Medical Record of 
 August 20, 1898, and is one of a series now numbering 
 nearly forty. In these papers it has been the endeavor of 
 the writer to express a continuity of thought and establish 
 the law of tuberculosis. 
 
 The law and the proof of its existence may be found in 
 the Transactions of the Ohio State Medical Society (1893). 
 So far as known no writer has attempted to controvert this 
 fa ^ Its author stands its champion and advocate. 
 
 To some it may seem strange that disease obeys law. 
 Why not? Is not everything in this universe subject to 
 law ? Why not disease ? 
 
 Malaria, the writer feels assured, is governed by law. 
 He has so expressed himself in one or two published articles. 
 So that whatever view may be entertained as to the Plasmod- 
 ium of this disease, please remember there is a law of malaria. 
 
 Cholera, the writer has long thought, is governed by 
 law. The visitations of this disease are no mere chance 
 visitations. Law underlies them in every instance. 
 
 So we think in every disease there will be found a law. 
 Knowing the law, we can the more readily control the 
 
 disease. 
 
 Medicine of the future will be largely preventive. In 
 the past the effort has been to find a remedy that will suc- 
 cessfully combat the symptoms of disease. This is well. 
 We have a multitude of such remedies. In the future it 
 will be the desire to determine the law that governs dis- 
 ease. This will be better, in that we can the more readily 
 predict the time, place and extent of disease zones. Then 
 there will be less confidence in remedies and a greater con- 
 
—55— 
 fidence in means cf prevention. All hail this happy day ! 
 It will surely come. 
 
 Malaria is a disease whose treatment is fairly well 
 understood. In its worst type it is not considered a dis- 
 tinctly fatal disease. It is largely enidemic and its visita- 
 tions are under control. 
 
 Cholera belongs to other climes, and visits our land 
 only under certain conditions and {after the lapse of years. 
 With this disease we are not so much concerned. 
 
 With tuberculosis the case is different. This disease 
 is with us at all seasons and is extremely fatal. It takes 
 our nearest and dearest friends, and when once its grip is 
 felt its hold is seldom relaxed. It is a strangely fatuous 
 disease. The patient is ever having a slight relapse, never 
 worse, gradually improving all the time, and dies in this 
 belief. 
 
 There is another fact. No treatment is of lasting 
 benefit. The physician calls it a bronchitis, assures a cure, 
 receives a retainer, until he who runs may read tuberculosis. 
 
 Nor is this act of the physician a mere love of gain. 
 At first he believes what he says. He then modifies his 
 prognosis as the disease advances. At last, for fear of com- 
 petition, he holds his patient by mere force of will. He 
 says in his heart: "I know you cannot be cured, but you 
 must not be a patient of my competitor. ' ' What a shame i 
 Tuberculosis thus advances year by year without one 
 thought of cause or cure. Of course we are speaking of the 
 rank and file of the profession. What shall we say of them 
 whose title, dignity and rank but belittle the name they 
 bear? "Miserable comforters are ye all." The classic lore 
 still guilds the page, but blinds the intellect. When will 
 ye be wise ? 
 
 In the Medical Review, October 5, 1895, the writer 
 recalled the words of the Psalmist: "He brought them 
 forth also with silver and gold; and there was not one 
 feeble person among their tribes." The estimate being 
 variously given as from one to two millions, where could 
 we find such a people on the face of this earth today ? Cer- 
 tainly not among the civilized. 
 
 He also recalls the statement of the classic historian, 
 
Lossing. Speaking of the Indian tribes embracing the 
 greater portion of the north temperate zone, L,ossing says: 
 "Physical deformity was unknown, and there were few dis- 
 eases among them. ' ' Could tubercul osis have been present ? 
 We think not : 
 
 Prof. Osier is also referred to in the same article as 
 saying: "No race is immune. The Indians of this conti- 
 nent are very prone to the disease. Matthews, whose ex- 
 perience with the native race is large, states that the dis- 
 ease is on the increase among them. 
 
 The writer asks, how is the disease on the increase 
 among them? As they come iu contact with civilization. 
 
 Listen to Osier's own words, same page (Practice of 
 Medicine, p. 185, 1892): "The death rate in the older res- 
 ervations, as in New York, is three times as great as in 
 Dakota." That is, the death rate is three times as great 
 where the Indians are in contact with civilization three times 
 as long; or, in other words, the death rate is in a direct 
 ratio to contact with civilization. Could any testimony be 
 more conclusive ? 
 
 Carefully read the above letter, and you have the un- 
 asked testimony of one from the field. Is it not a satisfac- 
 tion to know we have reasoned correctly ? Is is not a 
 greater satisfaction to see medical men in authority endorse 
 the same view ? Would it not be a still greater satisfaction 
 to see the dread disease, tuberculosis, banished from our 
 midst? It certainly would. It shall be seen, but perhaps 
 not in our day. "The world do move." 
 
 Turn back the page of history and walk with me in the 
 streets of Ephesus. It seems but yesterday Diana, that 
 ancient goddess, blindly ruled a queen, Around her stood 
 the workmen and knelt the votaries at her shrine. Who 
 dare blaspheme her name ? The workmen saw that in their 
 craft was gain. They wildly cried, "Great is Diana, the 
 Bphesian god!" What now remains of this once lordly 
 queen ? Perchance a broken column proclaims the place 
 she stood. 
 
 The times have changed. We worship now around 
 
—57— 
 
 another temple. It is a German mosque. The worship is 
 as senseless as of old, the gain far greater, the maddening 
 cry of workmen yet more deafening. Who now dare speak 
 against this altar? Here and there a still small voice. 
 That voice will yet be heard. 
 
 Along the shores of time are wrecks of theories. Here 
 a broken rudder, there a mast, tell plainly of a palace in the 
 years gone by. It long has disappeared. So will it be 
 with this. 
 
-58- 
 
 THE GERM THEORY. 
 
 '.'And he sat in the tent-door in the heat of the day." 
 — Genesis 18:1 
 
 The text needs little elucidation. The one spoken of 
 is no less a personage than the patriarch Abraham. Of all 
 worthy historic characters none stand more prominent. 
 
 Born in Ur, of the Chaldees, about thirty-nine hundred 
 years ago, Abraham, under a providence, not his own, be- 
 came wealthy and the head of a numerous household. 
 
 We read : ' 'The Lord had blessed Abraham in all 
 things." 
 
 It is not the purpose of the writer to dwell in detail, 
 but his was a noble character, not perfect, but worthy of 
 emulation. 
 
 Two things are obvious : Abraham dwelt in a tent, 
 and he rested at mid-day. 
 
 The climate of Chaldea is such that life in the open air 
 was common. Plainly, yet warmly clad, they dwelt as did 
 their fathers, in tents and booths. Life to them was sweet 
 in simple joys, which knew no after pain. 
 
 Happy we, if in our race for greater joy had recognized 
 the pain thereafter ! 
 
 Man seeks greater closer habitations ; he builds a 
 house. In building, had he kept the ventilation as in the 
 tent or booth, all would be well. He builds regardless of 
 an inner air, and garners as he sows — a spurious joy in dread 
 disease — tuberculosis. In this we recognize a father's care 
 is greater than man's protection. This, we think, is wisdom. 
 
 Abraham rested at mid-day. Some think he idly sat, 
 while others worked. The writer does not think so. He 
 had been working, but at mid-day, while the heat was great, 
 sat resting in the tent. A lazy man can never rest. Some 
 may suppose he sat and slept ; the record does not say so. 
 "And he lift his eyes and looked and lo," etc., showing 
 
—59— 
 plainly he was wide awake — alive to duty. 
 
 Multitudes are sitting, idly dreaming of the castles in 
 the air, while the few are slowly moving upward, step by 
 step, the golden stair. Of this few was plain old Abraham. 
 
 Let us pursue the picture : 
 
 "And lo, three men stood by him, and when he saw 
 them he ran to meet them," etc. 
 
 May we not learn a lesson ? Abraham sat, and looked 
 and saw and acted. Let us imitate his example. 
 
 Perhaps to day no one thing is receiving greater atten- 
 tion from the medical profession than the germ theory of 
 disease. Hundreds of Abrahams are sitting in their tents. 
 Some, I verily believe, are resting. Many, wide awake, are 
 looking with powerful miscropes and troubled gaze. Is the 
 theory true or false ? 
 
 What is seen ? In diseased conditions certain germs or 
 microbes at the seat of lesion. At times, one kind alone ; 
 at others, more than one. 
 
 What is seen ? Myriads of bacteria or growing plants, 
 subsisting on diseased or worn-out tissue in frail, unhealthy 
 patients. 
 
 What is seen ? A growing vegetation in a fertile soil. 
 This is seen on every hand. Along the shores of lakes are 
 seen the shoals of many fishes. At times, one kind alone ; 
 at others, more than one. 
 
 What is seen ? Myriads of the finny tribe subsisting on 
 the food there placed, or propogating species of their kind 
 in favored places. This is seen. Abraham could have seen 
 the same and that without a microscope. 
 
 As the fish along the shore take up the food and prop- 
 ogate their kind, so bacteria in unhealthy tissue. 
 
 Do bacteria cause disease ? Another class are looking, 
 with microscope as fair and eyes as bright. They say, in 
 words our own, no microbe, -per se can cause disease, unless 
 said microbe be diseased itself. Wondrous knoweldge ! My 
 friend, good bye. How can we yet determine the sickness 
 or health of any microbe. 
 
 Let us pass on. In passing would it not be wiser to as- 
 sert that microbes are found in the environment most favor- 
 able to growth ? The seed is scattered everywhere. It falls 
 
— 6o- 
 
 in fertile places and takes root. Growing germs are found 
 where there is proper food ; where proper food they propo- 
 gate their kind. 
 
 Do they cause disease? Look again. "Bacteria in their 
 growth develop toxines." If by toxines is meant vegetable 
 poison or alkaloid ; if by develop is meant store up in their 
 substance, this statement is true. . 
 
 "These toxines are given off by the growing vegetable 
 organism." Abraham, where art thou? This, the writer 
 thinks, is far from the truth. He finds no such fact record- 
 ed in nature, giving plants do not give off their alkaloids 
 while growing. They give them up only by infusion or ex- 
 traction. Illustration : Strychnia, morphia, atropia, are 
 vegetable alkaloids. Do the plants give off these poisons in 
 growing? How utterly absurd ! This the writer endeav- 
 ored to make plain some two years ago, vide "Status of the 
 Bacillus." 
 
 In order to be clearly understood, let us make a simple 
 experiment. Put fifty pounds of rich earth in a box. Plant 
 poppy seed in this earth. Place under the most favorable 
 conditions of growth — light, heat, moisture, etc. The seeds 
 germinate, the plants soon grow and develop to maturity. 
 How do we obtain morphia ? Is there a physician in the 
 land unable to answer? Listen to the bacteriologist : 
 "Plants in growing develop toxines. These toxines are 
 given off in growth." 
 
 How do bacteriologists obtain morphia ? By collection 
 from air, earth or water? If not, why not ? Do not plants 
 in growing give off toxines? 
 
 The following bacteriological experiment is very com- 
 mon : Into a flask containing a small amount of bouillon, 
 put a number of living tubercle bacilli. Let them multiply 
 for several weeks. Filter out all the bacilli and inject a lit- 
 tle of the filtrate beneath the skin of a guinea pig. See how 
 quickly it succumbs. This, they say, is proof positive the 
 plants give out toxines to the fluid in growing. The writer 
 thinks not so. A plant in growing absorbs or inhibits the 
 soil in which it grows. If the poppies in growing take up 
 
— 6i— 
 
 one ounce of soil, there is just forty-nine pounds and fifteen 
 ounces left. If in growing they develop one ounce of opium* 
 this one ounce is found in the plants. No where else. As 
 the plant in the earth, so the plant in the bouillon. 
 
 Have we made this plain? If so, let us take another 
 step. 
 
 One suffers from tuberculosis. Tubercle bacilli are 
 growing in his system; How are the symptoms of the dis- 
 ease commonly explained ? Toxines are developed by the 
 growing organism or bacilli. These toxines are thrown off 
 by the bacilli in growing and continually poison the patient. 
 Reason says the proper way to treat the disease is to give a 
 remedy that will neutralize the toxines as thrown off by the 
 vegetable organism. 
 
 The writer smiles when he thinks of such foolishness. 
 He at the same time feels vexed that men high in authority 
 should make statements so erroneous. 
 
 What is tuberculosis? A constitutional disease depen- 
 dent largely on the evils of civilization and governed by the 
 following law : The death-rate from tuberculosis is in direct 
 ratio to suspension of atmospheric influence. 
 
 In other words, tuberculosis exists before the entrance 
 of the growing bacillus ; one has symptoms of the disease 
 before there is evidence of the growing germ. 
 
— 62 
 
 ARTIFICIAL IMMUNITY 
 
 The world in many ways is growing wiser. A few 
 centuries ago they little thought of the progress to be made 
 in the arts and sciences ; of the methods of travel, war, 
 commerce, etc., now in vogue. Could past generations rise 
 and view the strides taken we think they would truly be 
 illuminated. 
 
 Medicine, like other things, has been moving. While 
 here and there the movement is retrograde, the general 
 trend has been ahead. Should those ancient gods or myths 
 in medicine arise we think there are many things for them 
 to learn. But hold ! Some boldly assert the dead already 
 know more than the living. If true, they keep this knowl- 
 edge to themselves. 
 
 There is no reliable evidence to establish intercom- 
 munication. We have little sympathy for thinking men 
 who consult or worship dead medical heroes. The writer 
 believes a "live dog is better than a dead lion." The light 
 of these men went out in their death. It is seen only in 
 their works — "Foot prints on the sands of time." 
 
 In mathematics certain facts are so plain they need no 
 demonstration. Illustration: The shortest distance between 
 two points is on the straight line between them. 
 
 Other facts equally plain are based on an assumption. 
 Illustration: Two and two make four, i. e. 9 according to 
 our system of notation. 
 
 We assume one is one. If one be two, then two and 
 two make eight. 
 
 These two forms of truth we will designate as innate 
 and assumptive. The two forms are found in medicine. 
 
 There is this distinction. Innate truth is accurate 
 under all conditions. Assumptive truth may be or may not 
 be accurate in these same conditions. There is a wide dif- 
 
-6 3 - 
 
 ference in the meaning. The one is truth, the other 
 assumption. 
 
 One who reasons and uses truth and assumption as 
 synonyms may find fallacy in his conclusion. 
 
 Have we made this plain ? We believe that 'he who 
 claims a possible immunity from tuberculosis by the injec- 
 tion of an alkaloid of the plant tubercle bacillus is laboring 
 under the mistake named— taking an assumption for a 
 truth. 
 
 If the writer be correct, the reasoning is of necessity 
 fallacious. If assumption and truth be used synonymously 
 one has no moral right to ask acceptance of his teachings. 
 Let us be honest. 
 
 In discussion one is apt to be carried away by the heat 
 of argument and utter things which he would not in his 
 more sober moments. This is true in all controversy. The 
 fire which generates steam if too strong may cause an ex- 
 plosion. No explosion is desirable. Let honesty of pur- 
 pose and fervency of spirit be the motto. The subject de- 
 mands it. 
 
 With one-seventh of the death rate caused by this 
 dread disease, taken largely from a people in the prime of 
 life and otherwise well fitted for years of usefulness, let no 
 man stand by the death-bed of his fellow and trifle or de- 
 ceive. Rather let us be honestly in earnest. 
 
 "Tuberculosis is caused by the tubercle bacillus." 
 What evidence have we of this ? 
 
 (a) Tubercle bacilli are found in the disease tubercu- 
 losis. A murder is committed in a certain village. A, B 
 and one thousand others are found in this village. Is this 
 proof positive that the one thousand and two committed 
 the murder? Would any lawyer, judge or jury so regard 
 it? Tubercle bacilli are found in health. Is their presence 
 the cause of health ? 
 
 (b) Tubercle bacilli are found growing in tuberculosis. 
 Please examine this answer carefully. We desire it. 
 Rushes are found growing in a certain pond. Do the 
 rushes cause the pond ? Is not the pond a suitable place for 
 
-64— 
 
 the rushes to grow ? In tuberculosis a diseased condition is 
 present. The diseased condition is a suitable place for the 
 tubercle bacilli to thrive. Being found growing in this dis- 
 eased condition is no evidence these plants caused the con- 
 dition named. How utterly absurd? That no one think 
 the writer has gone daft on this subject, we herewith append 
 the following letter: 
 
 Colorado Springs, Col., October 8, 1898. 
 Dr. H. H. Spiers: 
 
 Dear Doctor: — I wish to say most positively that in 
 what you say regarding the cause of tuberculosis, etc., "I 
 am with you,'' and that it is only a question of time before 
 the whole truth will be known , I have studied consump- 
 tion now for sixteen years, both in laboratory research and 
 in a general practice among consumptives, and I have mai^ 
 facts to prove beyond question that the tubercle bacilli only 
 attack a tissue prepared for it. Flies only "blow" a dead 
 horse, as the cowboy says. 
 
 Hoping to meet you some day, I am, 
 
 Very sincerely, 
 
 C. F. Gardner. 
 
 With the above statement before us we trust no one will 
 henceforth talk of tubercle bacilli creating a soil in a healthy 
 subject. They do no such thing. In every case of tuber- 
 culosis the soil is prepared before the bacilli take root and 
 grow — prepared in one way — suspension of atmospheric 
 influence. Hence the law of tuberculosis : The death rate 
 from tuberculosis is in direct ratio to suspension of atmos- 
 pheric influence. This law the writer has advocated for the 
 past twelve years. If true, the disease tuberculosis can be 
 controlled. 
 
 (c) Tubercle bacilli or their pure cultures are injected 
 into healthy guinea pigs. In every case these animals die 
 of tuberculosis. This, says the germ theorist, is proof pos- 
 itive the tubercle bacilli cause the disease. Let us examine^ 
 Admitting the injection causes the result named, it is nec- 
 essary to show (1) the human race is a race of guinea pigs' 
 
-6 5 - 
 
 (2) the method of injection is nature's method. Neither 
 can be shown. 
 
 (d) Tuberculosis is infectious. Example: Mr. H.^ 
 aged twenty-five, is in poor health. He marries a healthy 
 girl. Two or three years later the husband is told by an M. 
 D. that he has tuberculosis. Mr. H. takes but little medicine, 
 confines himself almost wholly to the house, and the wife, 
 who is very much attached to him, stays long in the same 
 room and ministers to his wants. One year from his first 
 illness he dies of tuberculosis. His wife dies of the same 
 disease about six months later. The neighbors say, "She 
 caught the disease from her husband." 
 
 If one take the disease from another in what way is the 
 infection conveyed? In other words, if tuberculosis be due 
 to suspension of atmospheric influence, how can this sus- 
 pension be conveyed to another person? Do not be too 
 hasty in judgment. Let us hear a further recital. 
 
 Mr. B., of P., aged twenty- three, marries Miss T., of 
 K. His family history is decidedly bad. At the present 
 writing all the family — parents, children and grand-children, 
 nine in number — are dead. The family tree is extinct. 
 With but one exception all die of tuberculosis. One child, 
 I think an infant, died of diphtheria. 
 
 Mrs. B., his wife, aged twei^-one, is healthy, but 
 never robust. About two years after their marriage Mr. B. 
 dies of tuberculosis. His wife is very attentive in his sick- 
 ness and does everything possible for him in her power. 
 Eighteen years have elapsed. Mrs. B. looks older, but is in 
 as good health today as in those days of her marriage. 
 Will any M. D. in the land assign a reason why Mrs. B. did 
 not take the disease ? Do not be too hasty and we will 
 recite another case. 
 
 Mr. B., of E., aged twenty-two, of poor family history, 
 imperfectly recovers from typhoid fever. Two }< r ears later 
 he marries Miss H., of about the same age and of fair fam- 
 ily history. They settle in the township of R., and build a 
 new house. Two children are born of this union, the elder 
 still living, though delicate; the younger, an infant of six 
 
-66— 
 
 months, dies of tuberculosis. The father dies of the same 
 disease about six weeks later. Mrs. B. cares for both hus- 
 band and child during their illness. Eight years have 
 elapsed. A month or two ago I met this lady on the streets 
 of this village, the picture of health. Why did the second 
 Mrs. B. escape this disease? 
 
 In both cases, narrated from life, the reason is simple. 
 Need I explain ? It is these little things which tell me the 
 law of tuberculosis must be true. It cannot be otherwise. 
 How did they escape ? By having perfect ventilation in the 
 rooms occupied. There is no danger whatever of "catching' ' 
 or contracting tuberculosis if the ventilation be perfect. 
 Why ? Because the tubercle bacilli cannot create a soil in 
 the healthy individual. The soil is created by suspension of 
 atmospheric influence. Write this in your note book, I 
 solemnly declare it is truth. How, then, does a wife or 
 husband "take" the disease from a partner? By living in 
 the same environment, which is an improper one. This 
 truth was shown many years ago. We have referred to it 
 before. We refer to it again : 
 
 "From the statistics of the Brompton hospital, collected 
 by Drs. Cotton and Edwards, it has been shown that of the 
 many nurses and others engaged in that institution during 
 twenty-one years, but one nurse and one servant died of 
 phthisis. Especial care seems to have been taken in the 
 Brompton hospital in regard to ventilation and other 
 hygienic conditions. Dr. Cotton's expression is that 'a 
 residence in the consumptive hospital and long-continued 
 working in its wards is a very good way, indeed, not to 
 catch the disease." (Reynold's System of Medicine, vol. 
 II, p. 117, revised by Hartshorne.) 
 
 It is seen that especial care is taken in this hospital in 
 regard to ventilation, etc. What other hospital has taken 
 like care ? What other hospital has a like record ? It is 
 not that we know less than formerly, but is it not true we 
 have gone daft after a germ theory ; Is it not true our 
 present system of medicine is so Germ-amzed that we think 
 
-6 7 ~ 
 
 of little else except germs ? 
 
 It is therefore seen if a, b, c and d are trie valid reasons 
 why tubercle bacilli causes tuberculosis, the statement that 
 they do cause said disease is assumption. If assumption 
 be used as a synonym of truth, the conclusion is fallacious. 
 
 To return, if tubercle bacilli do not cause tuberculosis, 
 how can we rationally say their alkaloid affords immunity ? 
 
68 
 
 THE BICYCLE A PREVENTIVE. 
 
 The world moves on wheels. How rapid the pace. 
 
 "Art is long and time is fleeting." 
 
 As we look from our window and see the many swiftly 
 gliding by on wheels, the question arises, how will the race 
 be fitted for the "struggle for existence" in the years to 
 come. 
 
 On the good to result from the use of the bicycle, as of 
 other things, there is a diversity of opinion. Whether the 
 bicycle prove a benefit or a curse will largely depend on its 
 proper or improper use. Some, predict a future race of 
 humpbacks, with deflected spinal columns, etc. 
 
 The writer takes a more hopeful view. He thinks as 
 time passes the wheel will be made more specially adapted 
 to individual wants. Each person cannot wear the same 
 clothes. Why should wheels be made so nearly alike? 
 The tall and the stout, the lean and the obese should each 
 have a wheel adapted to his needs. The novelty in use .will 
 wear away. Each will learn while there is celerity in move- 
 ment and time saving in use, there is also a limit to physi- 
 cal endurance. 
 
 In the future we will be more conservative of our pow- 
 ers. Grace in riding will be sought in the future. We 
 cannot all be handsome. It should be the aim to ever ap- 
 pear at our best. So that taking all in all, we are inclined 
 to think many of the evils now existing in the use of the 
 wheel will pass away. 
 
 Beauty in the wheel will give way to grace in riding. 
 Rapidity in motion to comfort in using. Novelty to utility 
 and the world will be made better by its introduction. 
 
 There is a phase in its use on which we wish to dwell. 
 The wheel leads to out-door exercise. 
 
 The toiling millions have exercise enough, say some. 
 
-69— 
 
 Where is this exercise ? In the dusty shop or ill-ventilated 
 hall. Mechanics, merchants, orators, laborers, all breathe 
 an atmosphere absolutely impure. In this great world of 
 ours, with the vast oceans to purify the air, should we 
 breathe such vile stuff ? No ! A thousand times no ! 
 
 What are we doing in breathing impure air ? The 
 lodgment of dust in the air cells of the lungs causes sus- 
 pension of atmospheric influence from without. 
 
 The inhaling of impure or impoverished air causes 
 suspension of atmospheric influence from within. What 
 does suspension of atmospheric influence induce? The 
 precedent state or condition ; tuberculosis in its incipient 
 state. 
 
 What does exercise in the open air accomplish ? The 
 inflation of the air cells of the lungs and the inhalation of 
 volumes of pure air. 7 he -prevention of the precedent 
 state or tuberculosis 
 
 Who most readily take tuberculosis ? 
 
 They who have the greatest suspension of atmospheric 
 influence. 
 
 Who most readily convey tuberculosis ? 
 
 The mothers of our land. Mothers, let us have more 
 wheels. They prevent tuberculosis, the greatest evil of 
 civilization and the greatest foe to the human race. 
 
7o- 
 
 LEGISLATION. 
 
 A legislator should be argus-eyed. All feel the burden 
 of taxation, have ideas of just and unjust law, and recog- 
 nize the worth of public officials. Taxation should be equal, 
 laws just and officials honest. This the legislator should 
 know. He finds it difficult to place the burden of taxation 
 equally, to know at all times a just from an unjust law, to 
 be strictly honest on every occasion. The law giver may 
 strive to do his duty, fulfill all the necessary conditions, yet 
 be misunderstood or misrepresented by many rivals and fail 
 at the next election. 
 
 These are a few of the trials or tribulations which every 
 law giver meets. Truly, the legislator should be argus-eyed. 
 He should have great wisdom. Legislation is asked on a 
 subject of which little is known. This is an unjust de- 
 mand. Education should precede legislation. The legisla- 
 tor has the right to ask enlightenment. A subject is clearly 
 understood, yet there is a diversity of interest or opinion. 
 One party asking, another denying, legislation. Here great 
 wisdom or its opposite may be shown. 
 
 It is a function of the legislator to exercise tact and 
 judgment. In the exercise of these success or failure is as- 
 sured. Barring those cases of exceptional wisdom and tact 
 in the legislator, legislation can advance no faster than the 
 public sentiment which lies behind. In a republic we have 
 no moral right to ignore our laws. It is we, the people, 
 who make them. The legislator is only our instrument. 
 He should be wise. 
 
 We have spoken of honesty. Without this all other 
 traits or characteristics will fail. No matter how wise, per- 
 suasive or brilliant, if honesty be lacking, no worthy legis- 
 lation can be assured. It may be said if one be wise, he will 
 also be honest. Not necessarily so. There is a wordly wis- 
 
—7i— 
 
 dom without honesty; a love of office or power with evil 
 intention. "A devil's purpose with an angel's face." 
 
 If, then, we have correctly reasoned, three things are 
 essential in the legislator, viz, many eyes, wisdom and hon- 
 esty. 
 
 Having spoken of the essentials in a legislator, having 
 referred to the difficulty of always securing proper legisla- 
 tion, and the necessity of education preceding it, we now 
 take up a subject on which a great deal has been said, little 
 formulated, and less put into execution. We refer to legis- 
 lation on tuberculosis. 
 
 It is the concensus of medical belief that tuberculosis 
 can be controlled. The medical world is shouting this on 
 every hand. L,et the legislator ask the question, in what 
 way can tuberculosis be controlled? Many are silent, more 
 are indefinite, and a few continue to talk without ideas. 
 Some physicians have this latter faculty in an intense de- 
 gree. It is not a faculty to be sought in prayer. Our prayer 
 should rather be, not more words, but ideas. 
 
 It is evident the method of ridding ourselves of this 
 deadly disease will depend largely on its cause. If we have 
 a large vested interest in bacteria, having traveled and stud- 
 ied extensively at great cost, no doubt it will measurably 
 shock our sensibility and pride to be told that bacteria are 
 of little worth in tuberculosis, and may be ignored entirely 
 in the control of this disease. If the truth is to be spoken, 
 let not a vested interest swerve us to the right or left. Leg- 
 islators should be wholly disinterested. 
 
 Again, if we hold a chair in some school of medicine, let 
 not the emolument of office or the pride of power prevent the 
 discernment of right and wrong. Let our motto ever be, 
 learn to unlearn that which has been learned amiss. Knowl- 
 edge sought and won in this wa5^ is power. To the thinker, 
 no other knowledge is worthy a place. 
 
 If rightly understood, we now have a w 7 ise, honest and 
 disinterested legislator. He asks: "What is tuberculosis?" 
 We answer, a constitutional disease dependent largely on 
 the evils of civilization, and governed by the following law: 
 
-72— 
 
 The death rate from tuberculosis is in direct ratio to sus- 
 pension of atmospheric influence, Please observe, in this 
 answer no reference is made to the tubercle bacillus what- 
 ever. 
 
 According to the writer, then, the wise, honest and dis- 
 interested legislator will take no cognizance of the tubercle 
 bacillus in framing a law for the prevention of tuberculosis. 
 All laws framed will be against the evils of civilization; 
 none against the tubercle bacillus. 
 
 Says one: "Do we understand there will be no legal 
 notice taken of promiscuous spitting ?" None, whatever. 
 This, we think, is a proper subject for education, not legisla- 
 tion. People should be educated to be cleanly in their per- 
 son, habits and environment. We think one could no more 
 be legislated into cleanliness than into righteousness. Kach 
 is -a subject for education. 
 
 But says another: "Is it not true that tubercle bacilli 
 are continually floating in the atmosphere ? Must we not 
 prevent this?" Says the writer, it is true that tubercle ba- 
 cilli are found in every atmosphere, more prevalent in some 
 than in others. Two questions present: (i) Can we pre- 
 vent their presence ? (2) Would prevention be of value? 
 On the answers given these questions must hinge all law 
 against the germ. 
 
 In regard to the first, every medical man will agree that 
 it is absolutely impossible to destroy all microbes or bacteria 
 in the atmosphere. Why attempt the impossible ? Suppose 
 we could destroy all bacteria in the atmosphere, what would 
 it avail ? Bacteria are present in the food we eat and the 
 w r ater we drink. Suppose we could destroy all these ? If it 
 be shown the tubercle bacilli do not cause tuberculosis, of 
 what avail the destruction ? The wide-spread disease tub- 
 erculosis would still be prevalent. With the premises 
 before us, no other conclusion could be reached. 
 
 The reasoning of the germ theorist is somewhat as fol- 
 lows: Tuberculosis is caused by the plant tubercle bacillus. 
 The more plentiful the germ in the atmosphere, food or 
 drink, the more prevalent the disease, and vice versa. 
 
—73— 
 
 Could we in any way diminish the number of tubercle 
 bacilli, we could diminish the prevalence of tuberculosis in 
 the same ratio. Germicides, control of sputa, etc., dimin- 
 ish the number of tubercle bacilli per cubic foot of air space. 
 Therefore, germicides should be used and the sputa con- 
 trolled. These, therefore, are proper subjects for legislation. 
 
 This reasoning seems plausible, yet it is fallacious. 
 Let us examine. In the first place, the prevalence of tub- 
 erculosis is not in proportion to the number of tubercle 
 bacilli in the atmosphere. Some will say at once that this 
 is not true. It is true. 
 
 We have already referred to the observation of Drs. 
 Cotton and Edwards in the Brompton Hospital for Con- 
 sumptives. Conditions in hospital, ventilation and hygiene 
 good. Number of years in observation, twenty-one. 
 Number of attendants who died of the disease, one nurse 
 and one servant. Conclusion: "A residence in the con- 
 sumptive hospital and long-continued working in its ward 
 is a very good way, indeed, not to catch the disease. 
 
 Take the same conditions except ventilation. Think 
 you no attendants would have died ? All attendants would 
 have died of the disease. Why? Because imperfect venti- 
 lation is suspension of atmospheric influence, or a condition 
 in which the living tubercle bacilli enter the system and 
 grow. 
 
 In the two cases wherein is the difference? Opening 
 or closing a window or door does not alone determine the 
 absence or presence of tubercle bacilli in the atmosphere. 
 How foolish ! There must be something else. What is this 
 something else? It is the -perfect ventilation that renders 
 the system immune. Here is the immunity long sought, 
 not an injection. It is the imperfect ventilation that ren- 
 ders the system a fertile soil. Hence the law of tuberculosis. 
 
 The corrected proposition, then, reads: "The preva- 
 lence of tuberculosis depends on ventilation, not the number 
 of bacilli." This is an important consideration, one which 
 the biologist would do well to stop and investigate. We 
 hardly look for this at present, he is so thoroughly imbued 
 
-74— 
 
 with a germ theory. 
 
 In the second place, tuberculosis is not caused by the 
 plant tubercle bacillus. We have spoken of this in other 
 places. We endeavor to be brief at this time. 
 
 It is evident to any thinking mind that a plant cannot 
 precede the soil in which it grows. Please consider: The 
 tubercle bacillus is a plant, the soil is the being in which it 
 grows. The being in health does not have growing bacilli. 
 Why not? There is no soil. So soon as suspension of 
 atmospheric influence takes place in said being so soon a soil 
 is present and so soon the tubercle bacilli take root and 
 grow. Is this plain ? When the ventilation is perfect there 
 is no soil, and consequently no growing bacilli. This is 
 true, no matter how few or many tubercle bacilli are in the 
 atmosphere. If, then, the ventilation be perfect, there is 
 no danger whatever of catching the disease tuberculosis. 
 In this condition the tubercle bacilli are perfectly harmless. 
 
 We are writing to rational beings. How, then, ought 
 we to proceed ? Attempt to destroy the harmless tubercle 
 bacilli, or render the ventilation perfect ? Which view 
 ought to engage the attention of the wise, honest and dis- 
 interested legislator ? There can be but one answer, legis- 
 lation should be for better ventilation, l^eave the tubercle 
 bacillus alone; it needs no care. 
 
 In the course of events, as tuberculosis becomes less 
 prevalent, through a purer atmosphere, the tubercle bacilli 
 likewise become less. Whether few or many, it matters 
 little if the ventilation be correct. 
 
 What, then, shall we say of germicides and the control 
 of sputa ? Germicides are of little worth. It is not neces- 
 sary to use them. Tuberculosis can be controlled in a bet- 
 ter way. Every one should care for his sputa, but the care 
 of it is not a proper subject for legislation. "Cleanliness is 
 akin to Godliness." Cleanliness should be taught. 
 
 If the writer' s conclusions be correct the reasoning of 
 the germ theorist must be fallacious. What, then, is a 
 proper subject for legislation ? Ventilation. 
 
 In order to present this subject in a clear light perhaps 
 
—75— 
 
 one or two illustrations would be proper. In referring to 
 these it is not to condemn any particular system, but simply 
 to illustrate. The cases chosen are the ones which come 
 most readily to mind. 
 
 In the elevated railroad of New York a method of 
 rapid transit is in vogue that is unsurpassed in this country. 
 The trolley or horse car of other cities is excellent. All 
 these systems have one fault, viz., the ventilation of the 
 crowded car is poor. The writer has been on the New 
 York road when every inch of available space was occupied ; 
 no room to stand. The same may be said of the horse car 
 line on Broadway as it was a few years ago. This condi- 
 tion of things ought not to be. The situation seen in New 
 York is seen in many other large cities. Every seat in a 
 car should have a proper air space for its occupant. Every 
 occupant should be given a seat. Then the question of 
 ventilation is settled at once and forever. The ventilation 
 of the car should also be perfect. In short stops and fre- 
 quent changes this would be materially aided by frequent 
 opening and closing of the doors. In long runs the case is 
 different. Here the most perfect ventilation should be 
 secured. One source of annoyance in long distances in the 
 irritant dust. How to eliminate this and at the same time 
 secure perfect ventilation is a question for science. Its 
 present aim seems to be how best to catch, destroy or elim- 
 inate the bacillus. The writer thinks its field of action 
 should be changed. 
 
 But ill-ventilation is not seen in the car alone. It is 
 seen in the hall, church or shop; in truth, wherever people 
 congregate. It is also seen at the fireside in the home. 
 When will we learn wisdom? "Wisdom is the principal 
 thing; therefore get wisdom." 
 
 It may be said the question of legislation, in regard to 
 ventilation, is a complex one. It is complex, yet it is very 
 simple. Pure air is abundant. It is also free. Why 
 should there be difficulty in obtaining it ? The first ques- 
 tion to consider is one of desire. Do we, as a people, desire 
 pure air ? If it be best for us to have it, if it be abundant 
 
- 7 6- 
 
 and free, why should we hesitate ? It seems to the writer 
 it is a question of education alone. 
 
 There are many things we earnestly desire. They 
 cannot be obtained, or if received they spoil us or injure our 
 health. When a necessary is to be had at so little cost we 
 should reach out our hands and receive or demand it as our 
 right. This is American. 
 
 We are taking a journey. The car or boat or bus is 
 crowded. One passenger desires pure air; the rest are 
 satisfied as it is. The conductor or captain or cabman is 
 asked to open a window or door. Many at once object for 
 fear of taking a cold, and the window or door is closed. 
 All suffer from the closure. Do we not need education ? 
 A consumptive or one having a cough enters this crowded 
 car or boat or bus. He coughs or expectorates from neces- 
 sity. The one in authority says: "My dear sir, or madam, 
 you must not spit in this car." "Why not? Havel not 
 purchased a ticket?" "Your ticket is all right, but you 
 must not cough and expectorate while on this car." "My 
 dear conductor, why do you not give us pure air?" "You 
 talk to the authorities about that." The authorities are 
 investigated. "We are perfectly willing to conform to any 
 reasonable public demand. Scientists tell us there is great 
 danger from dried sputa. It becomes disseminated through 
 the air and causes consumption, etc. Scientists are silent 
 as to ventilation." 
 
 Do we not need education ? We certainly must edu- 
 cate before we can legislate. Legislation without public 
 sentiment behind it is a dead letter. Education and legis- 
 lation, like twin sisters, walk hand in hand. 
 
 What, then, shall a traveling public demand of its car- 
 riers ? Perfect ventilation, abundant air space and a seat 
 for all. 
 
 How shall we render our halls, churches, schools, etc., 
 less dangerous ? By having them more perfectly ventilated. 
 This can be accomplished in many ways: (a) I^ess seating 
 capacity or larger air space; (b) better heating apparatus, 
 in that less atmosphere of the room is impoverished, i. e. } 
 
—77— 
 
 by having greater heating surface and less intensity of heat 
 less oxygen is abstracted from the air in the room; (c) an 
 abundant supply of pure air partially warmed before enter- 
 ing the room; (d) an exit for all vitiated or impure air. 
 These taken collectively, with a proper construction of the 
 building or room, will fulfill all needs. 
 
 Many churches or halls are erected as to external ap- 
 pearance or acoustic properties. While these must not be 
 lost sight of, the ventilation of the building is of far greater 
 importance. The life of the audience is of more value than 
 the beauty of structure or voice of speaker. Architects, in 
 making designs, should think of this. 
 
 What shall we say of the home ? Our home is where 
 we live or abide. Where is the home? In the country or 
 city? Is it our own or another's? Or, rather, do we hold 
 or rent ? The answer to these must modify the answer 
 given. If in the country there, is greater opportunity to 
 breathe pure air. The same may be said if the home be our 
 own. In rented flats or rooms in the city we receive that 
 for which we pay. If able to pay we receive the best; if 
 unable to pay we must take that which we can get. With 
 the poor wage earners it is often take the poorest or none at 
 all. How comfortless are these ! How illy ventilated ! 
 Often, how short lived the occupants ! Cannot legal re- 
 straint give them better homes ? 
 
 We have often thought in visiting country homes, what 
 a field for cultivation ! How lovely and pleasant some of 
 these homes are ! What taste and munificence ! Yet oft- 
 times it is outward adornment like dressing the hair or 
 body, not that inner fitness so essential to worth or useful- 
 ness. Seldom does the architect or builder think of that 
 inner adornment — ventilation. What a pity ! In other 
 homes, how destitute and comfortless ! The home is a 
 mere hovel or shelter. 
 
 It is not the elegant home that confers health and 
 longevity. Frequently it is the poorest. One log cabin the 
 writer recalls, which contained a large family. It was so 
 open the stars could be seen through the wall on either side. 
 
- 7 8- 
 
 Yet that family lived in that home many years. Little sick- 
 ness, plenty to eat and do made that home a happy one. 
 The family grew to manhood and womanhood, separated 
 and organized homes of their home. How beautiful the 
 picture ! This is not seen in every home. 
 
—79" 
 
 CONTROL. 
 
 Of all historic diseases which have afflicted mankind, 
 no continuous disease has been less subject to control than 
 tuberculosis. There have been epidemics or endemics 
 that were more fatal or less subject to control for short per- 
 iods of time. But these have been only for short periods. 
 These diseases die out for want of fresh fuel, or their very 
 contagiousness has demanded great effort, which has re- 
 sulted practically in control. 
 
 With tuberculosis the case is different. This is a dis- 
 ease with which we all are practically familiar — one which 
 every medical man thinks he understands. The very clear- 
 ness of apprehension with which he thinks he sees leads 
 him blindly on in treatment or prevention. Hence no stop 
 or cure. 
 
 It is a common impression that tuberculosis is due to a 
 germ. If true, the germ being killed the disease would at 
 once cease. Methods of destroying germs are familiar to 
 all. It is plain to the ordinary observer they are of little 
 value. Germicides -per se being valueless, it enters the 
 minds of some that perhaps a condition of the system may 
 be induced that will prevent the entrance of germs, or — 
 may be better — will not allow their growth. Germ cul- 
 tures are procured and their alkaloids used to fortify the 
 system or render it immune. With a pains- taking accuracy 
 worthy a better result, these germs are isolated, cultivated 
 and the alkaloids injected for this purpose. 
 
 The result is before us. Is tuberculosis lessened by 
 injections of these cultures? There are many occupying 
 chairs in medical colleges who would be pleased to answer 
 in the affirmative, but facts do not bear out the assertion. 
 Instead of boldly saying no, which would be the writer's 
 course, the attempt is made to waive a direct answer to the 
 
-8o— 
 
 question and encourage a hopeful view for the future. 
 At the same time these teachers are continually instructing 
 in methods which have long since proved practically nil. 
 Is such instruction a benefit ? Finding it impossible to kill 
 the germs in the air or in the person without injury, rinding 
 immunity largely an imaginary quantit} 7- , men have in some 
 quarters advocated germ-proof houses. It is soon seen by 
 all except a few fanciful scientists that even these germ- 
 proof buildings could be of little value. 
 
 The question now arises: If present notions prevail, how 
 soon will tuberculosis be under control ? No one can clearly 
 answer,' for no one knows. Under the circumstances, would 
 it not be wisdom carefully to investigate the cause of dis- 
 ease and see if there be not some other connecting or under- 
 lying condition which allows the living tubercle bacillus to 
 enter one's system and grow? If such condition be found, 
 would it not be further wisdom to inquire if this condition 
 is always present in the growth of tubercle bacilli in the 
 human organism ? If always present, would it not yet be 
 further wisdom to ascertain if this condition cannot be re- 
 moved, and thereby prevent the entrance of a growing 
 bacillus in one's system ? If this condition exists, is always 
 present, is removable, we hold in our hands an effectual 
 weapon for the prevention of tuberculosis. 
 
 The writer claims that here is a succession of facts the 
 force of which cannot be weakened by any argument. In 
 other words, here lies a chain of reasoning on which the 
 law of tuberculosis is based. This law is based on facts as 
 immutable as is any law of Kepler or Newton. This law 
 must stand. What is the law of tuberculosis ? The death 
 rate from tuberculosis is in direct ratio to suspension of 
 atmospheric influence. 
 
 Having laid down a law of tuberculosis, let us now 
 critically examine the facts on which this law is based. 
 My attention was called to these many years ago. The 
 first published article bearing on the subject is found in the 
 December number of the Cleveland Medical Gazette, 1890. 
 Phthisis pulmonalis is here spoken of as a zymotic disease. 
 
Medical experts had so placed it, and this opinion was ac- 
 cepted without question. Upon investigation the contag- 
 iousness of the disease was in doubt. It was found there 
 are certain conditions of the system in which one apparently 
 takes the disease. There are other certain conditions in 
 which one does not take the disease. The question arose: 
 On what does the contagiousness or non-contagiousness of 
 tuberculosis depend? In answer to this, it is seen that cer- 
 tain animals are affected and the same animals are not 
 affected, according to the condition in which they are 
 housed or kept. Some in authority have lately asserted 
 that food or diet has as much to do in the origination or 
 starting of tuberculosis as has the atmosphere. The writer 
 thinks that in this statement there is a misconception. It 
 is not the atmosphere -per se, but suspension of atmospheric 
 influence that induces the condition or disease. Food or 
 diet, according to quantity and quality, may improve or 
 weaken the physical or mental condition. This, I think, is 
 about all. Suspension of atmospheric influence, whether 
 the animal be weak or strong, will produce a condition of 
 the system which allows the tubercle bacilli to enter and 
 grow. 
 
 While suspension produces a condition favorable to the 
 growth of a germ, food produces simply a strong or weak 
 condition of the system and has no relation to the germ's 
 growth whatever. This, I think, is a marked difference, 
 and one which even late observers have entirely overlooked. 
 Again, it is evident that if the basic facts be changed, the 
 law depending on those facts must be worded differently. 
 This accounts largely for the change made in the law. 
 
 Another fact may be referred to at this time. It is 
 very difficult for some to enter into a discussion or investi- 
 gation in which figures or mathematics are used. In order 
 to accommodate this class, the law is stated in the simplest 
 language possible. The writer feels assured that those who 
 impartially investigate the subject will find the conclusions 
 accurate. 
 
 With this simple law before us as demonstrated, with 
 
-82 — 
 
 the deadly disease before us as seen, it is the writer's hope 
 and belief that much may be accomplished in a practical 
 way by simply living in accord with the teachings of this 
 law; by avoiding in every possible way the suspension of 
 atmospheric influence. A deadly enemy is before us. In 
 every engagement thus far we have met defeat. Let us 
 train our guns to do the most effective work. Before enter- 
 ing an engagement it is always well to take an account of 
 the character of weapons to be used. One great difficulty 
 in the recent past has been that the bacteriologists have 
 taken upon themselves the entire work. This I think is a 
 mistake. Bacteriology is one arm of the medical service. 
 Its work along its own line is of great value; its work in 
 other lines of no value whatever. 
 
 To illustrate: We have many ships in our navy — bat- 
 tleships, cruisers, torpedo boats, etc. Suppose a captain of 
 a torpedo boat should say, "My boat will act as a battle- 
 ship." Or the captain of a battleship should say, "My 
 boat will act as a cruiser." Or the captain of a cruiser 
 should say, "My boat will do the entire work; the rest of 
 you may remain idle." What would be the condition of 
 the navy ? Any one could see that the service would be of 
 no practical benefit whatever. We might as well do with- 
 out a navy as to have one boat arrogate the entire service 
 to itself . Thus with bacteriology. Bacteriology has been 
 pushed forward to the exclusion of everything else. I 
 trust some of my contemporaries will see the force of this 
 assertion. 
 
 There is another insuperable difficulty which bacter- 
 iology has met in the battle with tuberculosis. It is as- 
 sumed that tuberculosis is a germ disease. If it were a 
 germ disease, rationally considered, it could be met with 
 germicides or the alkaloids of germs. It not being a germ 
 disease, rationally considered, germicides or alkaloids of 
 germs would be of no value. Whether the disease be due 
 to a germ or not, I leave to an intelligent profession; this 
 much is certain, bacteriology has thus far found no cure for 
 the disease. The same may be said of other methods of 
 
-8 3 - 
 
 treatment. The writer believes that the secret lies in 
 recognizing the cause of tuberculosis. It is plainly evident 
 if the cause of tuberculosis be suspension of atmospheric 
 influence, no line of treatment could cure without first 
 recognizing the cause and removing it. Even then, if 
 there be destruction of tissue, no treatment could restore 
 tissue lost. These facts must be taken into consideration 
 when talking of cure. So that he who asserts he has a cure 
 for tuberculosis either falsifies or is ignorant. 
 
 There being no cure for tuberculosis, it remains to be 
 asked : In what way can we arrange our forces most effect- 
 ually to battle with the disease ? To the writer it seems 
 clearly evident that the control of the disease must be large- 
 ly along the line of prevention. Now do not misapprehend. 
 The writer believes that open air and constitutional treat- 
 ment are of great value. In truth, in conjunction, they are 
 the best treatment of tuberculosis known to the science of 
 man. At the same time, to repeat a well-worn aphorism : 
 "An ounce of prevention is worth a pound of cure." There 
 is no cure for tuberculosis. There is prevention. If pre- 
 vention succeeds, there is no need of cure. Today this hy- 
 dra-headed disease exists on every hand. There is need of 
 prevention and there is also need of treatment. Insiduous 
 and deadly in its nature, say not to the afflicted that there 
 is no value in treatment. There is value in treatment. But 
 if cure be perfected, treatment must be given in the prece- 
 dent state or incipient stage of the disease. Then there is 
 cure. But, as said in a previous article, if there be disorgan- 
 ization or breaking down of lung tissue, this tissue can never 
 be restored. Yet even in this condition treatment is of value 
 and by its judicious employment life may be prolonged, 
 and aid and comfort given the afflicted. This elone is cer- 
 tainly worthy our consideration. 
 
 To speak directly of prevention, the first step to be 
 taken is to remove the cause of the disease. If the disease 
 be due to suspension of atmospheric influence alone, the 
 first step in prevention is to remove the suspension. With- 
 out this, nothing can be accomplished. With this, much 
 
-8 4 - 
 
 can be accomplished. If due to heredity in conjunction 
 with suspension, here the battle must continue as long as 
 life lasts. Heredity is an entity of the parents, and must 
 be controlled in the rising generation by proper marriage. 
 Let no one marry into a consumptive family, should he de- 
 sire healthy offspring. Evidently the marriage relation is 
 a serious one if we look at it in the light of transmission of 
 disease. Every one who asks in marriage should have a 
 clear health register and he should expect the same of his 
 partner. Without this, tuberculosis will remain a disease 
 in the human family to the end of time. With this, tuber- 
 culosis can be controlled. 
 
 In a recent session of our legislature some one intro- 
 duced a bill to regulate marriage. What became of the bill 
 the writer only conjectures. One thing is known — the way 
 in which the measure was received. Some spoke of it as 
 ahead of the times; others as visionary, unnecessary, ridic- 
 ulous, etc. It is not worth while to discuss the merit of 
 this particular bill. This much is certain: In the years to 
 come some measure of this character will be enacted to pre- 
 vent disease. Education must ever precede legislation. It 
 is education today, legislation tomorrow. In this way, step 
 by step, the human family has risen in civilization. The 
 laws of Ohio today could not be enforced in present China. 
 The laws of Ohio, it is hoped, will be changed for the better 
 in the years to come. True, it is difficult to legislate on 
 marriage. To say one must or must not is somewhat arbi- 
 trary. Is it not best to do so ? When one is educated to 
 select only the best in marriage, it is more largely a matter 
 of choice or judgment and less one of impulse or emotion. 
 Not long since a man of this city, pointing to a deformed 
 child, said: "If nature could give me no better body than 
 has that child I would ask to be shot/' Please reflect ! 
 What was nature's act other than the volition of the par- 
 ents ? Why not legislate ? 
 
 Reverting to suspension of atmospheric influence, this 
 may be induced in many ways. The following classifica- 
 tion presents the subject in the clearest light possible. 
 
SUSPENSION OF ATMOSrHKRIC INFLUENCE. 
 
 atmosphere { D1 ventilation > vocation,etc. 
 From without 1 T ., , j Over-heating rooms, im- 
 
 I atoolphere { Proper ventilation, etc. 
 
 From within 
 
 (Defective f 0ri S inal {Heredity. 
 
 Di< 
 
 ure, etc. 
 
 ) jjerecnve J ( 
 
 | lung tissue | Acquired> (Disease, expos 
 
 To explain more fully, suspension takes place in two 
 ways — from within and from without. 
 
 From within through original or acquired lung tissue. 
 Though the scalpel or microscope may detect no difference 
 in lung tissue, it is observed that children of consumptives 
 take the disease more readily than children of the healthy. 
 Why? Defective lung tissue — heredity. Such children 
 will tolerate no confinement. Confinement to them means 
 death from tuberculosis. These children die from the dis- 
 ease, while other children escape — ventilation, food, phys- 
 ical exercise, etc., being the same ; thus showing that there 
 is a difference in the organism or lung tissue. It is also ob- 
 served that those having stenosis of the air passages whether 
 congenital or acquired, are more subject to tuberculosis t 
 Why ? Suspension of atmospheric influe nee. In some of 
 these cases operation to remove the stenosis is beneficial. 
 In all, there should be perfect ventilation. 
 
 There are certain diseases which tuberculosis is pretty 
 sure to follow if precaution be not taken, viz., measles, 
 pertussis, etc. Why? Defective lung tissue— acquired. 
 Suspension of atmospheric influence due to thickened lung 
 tissue. What precautions are necessary ? Perfect ventila- 
 tion during sickness and recovery. 
 
 From without, through impure or impoverished atmos- 
 phere. Every observer has noticed that there are two classes 
 in particular who suffer much from tuberculosis — they 
 whose vocation or calling keeps them continuously in the 
 dust and they who suffer from confinement in ill- ventilated 
 rooms. In the first class there is suspension from lodgment 
 
-86— 
 
 of dust particles in the air cells of the lungs or from me- 
 chanical irritation of the same — one or both, commonly 
 both. What is the preventive ? Avoidance of the irritat- 
 ing dust, (i) Change of vocation; (2) wearing of adust 
 protector; (3) elimination of dust by a dust collector. 
 
 If heredity be a factor, the first method should be 
 adopted. No one should engage in or follow an unfavora- 
 ble pursuit if the subject of hereditary influence. Though 
 the usual precautions were taken, the probability is he 
 would die of tuberculosis. If the subject be vigorous and 
 have a good family history, he may follow the vocation of 
 his choice. In this case a dust protector is of service, but 
 unequal to a dust collector. In all shops where there is an 
 irritating dust these collectors should be obligatory. 
 
 We now reach the topic of impure or impoverished 
 atmosphere. This has been explained elsewhere, but a 
 word or two in this connection will not perhaps be out of 
 place. We, as Americans, are living in homes many of 
 which are warmed by furnace heat. In all homes there is 
 artificial heat for a part of the year. In these homes the 
 atmosphere is at times impoverished. As a result the occu- 
 pants suffer largely from respiratory and constitutional dis- 
 ease , Tuberculosis is of this number. It is prevalent and 
 deadly. Treatment is of little avail. Prevention is of 
 value. The preventive, the writer is inclined to believe, 
 consists in a stove or furnace of at least double the size or 
 capacity of the one ordinarily used. It takes no more fuel, 
 the heat is more constant and even, and the stove or fur- 
 nace lasts longer. There is, therefore, no greater expense 
 in the end. There is an assurance of better health. The 
 danger in cold weather is that too much oxygen is with- 
 drawn from the room to support combustion, and not enough 
 air is let in to replace the oxygen abstracted. Suspension 
 of atmospheric influence is induced. In this way plants 
 and animals alike suffer. 
 
 There is another factor which should engage our atten- 
 tion. I refer to the irritant dust of soft coal stoves and 
 furnaces. In the present arrangement of these, nearly all 
 
-8 7 - 
 
 give off an irritant dust, smoke or vapor. Irritation of the 
 throat, fauces and bronchial tubes commences soon after 
 their use. This should not be. The draught should be 
 perfect, so as to allow no dust in the room. If it is not 
 perfect, there is suspension of atmospheric influence because 
 of the irritant dust; also because of the lack of oxygen in 
 the air. Consequent tuberculosis. When these facts are 
 clearly understood and acted upon, the writer feels satisfied 
 the death rate from tuberculosis will be much diminished. 
 If true, this statement is worthy of consideration. In the 
 above I refer to the atmosphere as found in country homes 
 and villages. In large cities, as a rule, it is very much 
 more impure. Large cities are railroad centers, contain the 
 factories, workshops, etc. There are, of necessity, great 
 volumes of smoke. At times the outdoor air is almost un- 
 endurable. Science can and no doubt soon will remove this 
 smoke nuisance of cities. 
 
 There are other factors, not mentioned, in cities which 
 contaminate the air and render it unfit to breathe. I pass 
 over these. One or two others I mention which aid respir- 
 ation and whose absence makes breathing more difficult. I 
 refer to public baths and gymnasiums. 
 
 To conclude, if the person be kept clean, a certain 
 amount of physical exercise be taken, and pure air constantly 
 inhaled, there is no danger whatever from tuberculosis if 
 there be no heredity. Tuberculosis can be controlled. 
 
-88— 
 
 STATUS OF THE BACILLUS 
 
 "The bacteria are now admitted to belong to the veg- 
 etable kingdom and to constitute the lowest forms thereof." 
 — Dr. K. O. Shakespeare. 
 
 There is a law of vegetable growth. Rationally con- 
 sidered, the low form of organism or its microscopic nature 
 does not militate against or invalidate this law. In other 
 words, there are certain conditions which must be complied 
 with in the growth of perfect vegetation. 
 
 PLANT LIFE. 
 
 (a) Conditions of Growth. Heat, solar or artificial, 
 is necessary in the germination of every seed and in the 
 fructification of every plant. Without heat plant life or 
 plant growth lies dead as inorganic matter. 
 
 There must also be moisture. Heat may awaken a 
 latent energy in plant life, but if continued without mois- 
 ture the agency that awakens destroys. 
 
 Light is also a potent influence. Heat may awaken 
 life, moisture may continue life, light alone perfects and 
 thereby perpetuates the life begun. 
 
 In the continuation of plant life these three factors are 
 always present, and, so to speak, in an intense degree. No 
 one of the three factors can be ignored. The bacteriologist 
 with his culture media, etc., etc., recognizes these principles 
 and applies them more or less in his field of labor. We say 
 more or less. Heat is necessary; the temperature below a 
 certain point little change takes place in the culture media. 
 Moisture is necessary; no growth can develop without mois- 
 ture. Light is necessary; with a perfect action of the other 
 two, light is essential to fruition. 
 
 In the construction of the ordinary culture oven, if a 
 provision be not made for the generous admission of light, 
 will the vegetation be a perfect one ? At the end of an in- 
 
-8 9 - 
 
 definite series, a culture becomes attenuated. In what way ? 
 There are many things a flood of light would illuminate. 
 
 But hold ! The tubercle bacillus dies in the sunlight. 
 
 "The tubercle bacillus dies under sunlight, in thin lay- 
 ers in the course of a few minutes or hours, but perishes 
 under diffuse daylight only in the course of a week." — Dr. 
 Jas. T. Whittaker, Ohio Medical Journal, July, 1895. 
 
 One other condition is necessary — a suitable soil. This 
 will be referred to later on. 
 
 (b) Modified by Environment. — Observe trees in a 
 dense forest — tall, straight and without limb until near the 
 top, in the crowded fence row — fan-shaped, with limbs to 
 the earth; in the open — short, with branches extending in 
 all directions. 
 
 That a variable condition of the tubercle bacillus is due 
 to environment is shown in an article in the Cleveland Med- 
 ical Gazette, June, 1894, by Dr. C. W. F. Muenchehofe. 
 
 (c) Elective in Location. — Sitting in a wood in Wes- 
 tern Illinois I counted fourteen varieties of lumber trees on 
 less than two acres in area. This is remarkable. Seldom 
 do we see more than three or four varieties on so small a 
 space. There are forests of oak, pine, cypress, etc. Often 
 several kinds are intermingled, but usually one or two kinds 
 predominate. 
 
 The reason for this absence or predominance is prob- 
 ably plant dislike or affinity for certain soils. We know 
 from observation that native trees do not thrive equally well 
 in all localities. There are certain spots in w T hich native 
 trees refuse to grow. Change but a few 7 rods distant and 'at 
 once they begin to thrive. Seeds from forest trees are scat- 
 tered year by year in these waste places. They fail to take 
 root and flourish. The voice of plant life is the voice of the 
 maiden: I marry, but not w T hom I dislike; I grow but with 
 affinity. 
 
 In the distribution of bacteria man} T species are often 
 found in the same tissue. 
 
 "Different species of bacteria are so frequently asso- 
 ciated together in substances that afford them nourishment 
 
-go- 
 that some method of separation is essential for intelligent 
 study, etc." — Dr. Shakespeare. 
 
 At other times well nigh pure cultures are found. 
 
 ''The main habitat of, the tubercle bacillus is the lungs 
 and the sputum is sometimes almost a pure culture." — Dr. 
 J. T. Whittaker. 
 
 One of the greatest difficulties in the past has been to 
 isolate in order to cultivate. It is thought this difficulty is 
 now entirely overcome. 
 
 With the removal of one barrier another appears. It 
 is found the germ takes root in some soils and in some it 
 does not. The reason for this affinity or dislike can only be 
 conjectured. Instead of explaining in a perfectly natural 
 way by saying it is owing to drainage or chemical constitu- 
 ents of the soil, there arises the strange hypothetical doc- 
 trine of phagocytosis, which is in substance that on the part 
 of host and invader armed battalions are constantly on 
 guard. On the least provocation a free fight begins. As 
 neither party will yield, it is a war of extermination. 
 
 It is readily seen how such a theory could arise on the 
 continent. It is an every day picture.. It is not so clear 
 how such a theory could become established among intelli- 
 gent Americans. But it is simply wonderful the amount of 
 trans- Atlantic idol-worship that is present among us. 
 
 On this topic, as many others, revelations will arise. 
 It is to be hoped they will be more in consonance with rea- 
 son and common sense. 
 
 (d) Absorption. — This topic is taken up with a degree 
 of trepidation. Plant growth is shrouded in mystery. 
 What the vital principle, when enters it the plant, how 
 transmitted to the seed, death occurs in what way ? — these 
 and many other questions are as mysterious as life and death 
 in the individual. 
 
 The diversity in growth is involved in mystery. Two 
 children, born of the same parents, reared with the same 
 care, grow up together — the one virtuous, the other vicious. 
 Mysterious ? Not more so than the growth of plants. 
 
 Two seeds from the same tree are planted, the soil,, 
 
—9i — 
 
 moisture and sunlight alike to each, The one is straight- 
 grained, the other twisted. Mysterious ! Perhaps the 
 child, by bent of inclination, received the vicious tendency 
 and grew as moulded. Perhaps the embryo tree met some 
 obstruction and turned in growing, remaining thus as tree. 
 Mystery when made plain is mystery no longer. 
 
 The growth of plants indifferently from the same soil 
 is somewhat mysterious. The beech, the maple, the oak, 
 grow side by side. It seems there must be a difference in 
 the elements assimilated. 
 
 How diversity of labor is performed on the same food 
 is mystery. Three persons sit at the same table. One rises 
 an orator, another a hod-carrier, the third a nothingness 
 until the next meal. It seems there must be a difference in 
 the elements assimilated. 
 
 There is a difference. All living organisms grow by 
 absorption, or perhaps better, assimilation. 
 
 To the vegetable world the soil is the food. Suitable 
 soil means proper elements properly prepared. Whether 
 the soil be prepared by the care or folly of man it matters 
 not, nature [appropriates as found. This thought should 
 carefully enter the mind of every one seeking a cause or 
 cure for tuberculosis. 
 
 There is a difference. Each plant takes the element 
 best suited to its nature, leaves the rest. One has more, 
 another less. All must eat or die. 
 
 Example: Mr. R. plants a field to corn for eighteen 
 consecutive years. The field is occasionally fertilized as 
 others. Year by year the crop of corn becomes less and less. 
 On the eighteenth year there is a good growth of fodder, 
 but no corn. The soil for corn is exhausted. Without fer- 
 tilizer the same field yields a large crop of oats the ensuing 
 season. Here is a lesson showing the value of rotation in 
 crops. 
 
 No doubt each tree takes nourishment appropriate to 
 itself and leaves the rest. Another tree absorbs from what 
 is left. In this is seen a gathering up of all, or Nature's 
 providence. 
 
- 9 2 — 
 
 But, however rich a soil may be, it avails nothing to the 
 growing plant unless it be rich in assimilable elements. To 
 this subject my attention was early called in planting trees. 
 All things considered, those trees grew best which were 
 planted with the greatest care, in having all rootlets well 
 cared for and the earth well pulverized around them. This 
 much for soil constituents. 
 
 In two articles on malaria, published in the Cleveland 
 Medical Gazette, September, 1891, and April, 1895, the 
 question of plant absorption of an element extraneous to the 
 soil is dealt with. This must suffice for the present. 
 
 Much as is known of the life history of bacteria, their 
 growth is involved in mystery. Why arise these micro- 
 scopic organisms ? Is their office eliminative or destructive ? 
 Does their presence in disease constitute the disease fer sef 
 When once in possession of a soil, can the soil be reclaimed ? 
 These and kindred questions may be asked in all earnest- 
 ness, and yet the answer be a hollow mockery. 
 
 The presence of the bacteria in disease — causal — and 
 the presence 'of the same bacteria in health — harmless — is 
 mysterious. 
 
 Mystery made plain is mystery no longer. If we look 
 upon the bacteria as vegetable organisms — and the highest 
 authorities in the land view them as such — the way is clear. 
 As already stated, all organisms grow by assimilation. 
 The presence of a growing organism implies the presence of 
 assimilable food. The presence of assimilable food implies 
 a something before the organism takes root. 
 
 Which has the priority, the something or the organism ? 
 Will some bacteriologist please tell us in what this some- 
 thing consists ? Mark the issue, in this something exists 
 the cause of tuberculosis. Control this something and you 
 control the disease. 
 
 Can tuberculosis be controlled ? Per contra, the pres- 
 ence of a living organism — not growing — implies the con- 
 ditions are unfavorable for growth, for it is as natural for 
 organisms to grow under favorable conditions as it is for 
 the sun to shine or water to seek its level. If, then, other 
 
—93- 
 
 conditions be the same, in health as in disease, the growth 
 not being the same, the cause or causes must be sought in 
 the soil. Other conditions, light, heat and moisture, are 
 supposed to be the same. A fair deduction then, is, the 
 difference in growth is due to a difference in the soil. 
 
 If, then, we take this rational view of the question, it 
 is unnecessary to consider the hypothetical doctrine of 
 phagocytosis at all. In other words, the peace of Europe 
 does not demand an armed intervention. 
 
 But say some, "The tubercle bacillus is a parasite.'' 
 What is a parasite? We will let the Standard answer: (i) 
 "A living organism, either animal or plant, that lives on or 
 in some other organism from which it derives its nourish- 
 ment for the whole or part of its existence, as a louse, tape- 
 worm, mistletoe or dodder." Yes the tubercle bacillus is a 
 parasite, 
 
 One question please: Did you ever know of a person's 
 head being so healthy that a louse could not live on it ? 
 Does the mistletoe invariably grow most luxuriantly on the 
 tree half dead ? Look around you. Did you ever hear of 
 a tape-worm being found in a healthy -primes vice? Does 
 the potato beetle always select a sickly potato ? 
 
 "Come, let us reason together." 
 
 Why does the tubercle bacillus select a sickly subject ? 
 Why does the tubercle bacillus fail to grow in the health y 
 subject? 
 
 "Your reason, Jack, your reason." "What ! upon 
 compulsion ? 
 
 Yes, armed phagocytes at the portals. 
 
 The changes produced by the tubercle bacilli are mys- 
 terious. 
 
 "The body which we term a 'tubercle' presents in its 
 earh- formation nothing distinctive or peculiar, either in its 
 components or in their arrangement," — Dr. Osler. 
 i. £., before bacilli enter or are planted, "tubercle" is the 
 same wherever found. The bacilli enter. 
 
 "The bacilli then cause, in the first place, a prolifera- 
 tion of the fixed elements with the production of epithelioid 
 
—94— 
 
 and giant cells; and, secondly, an inflammatory reaction, 
 associated with the exudation of leucocytes. How far the 
 leucocytes attack and destroy the bacilli has not been defi- 
 nitely settled." — Dr. Osler. 
 
 The writer has a simple taste, but he thinks when a plant 
 takes root it begins to grow; that in growing it absorbs 
 nourishment from the soil; that whatever the plant gains 
 the soil loses. There must be change while the growth is 
 going on. Change can be detected. 
 
 All pathological talk has been on what is found in or 
 after growing. What is taken up by the plant ? What is 
 lost to the individual ? These are questions that should be 
 answered. 
 
 The "agreement" of modern pathologists is mystical. 
 Illustration : 
 
 "Modern pathologists have agreed in this r that only 
 such products, though histologically the same or similar, as 
 contain and result from the specific bacilli, deserve the name 
 of tuberculosis. Thus tuberculosis is defined an infectious 
 disease." — Dr. A. Jacobi. 
 
 Suppose the farmers of Ohio should agree that, inas- 
 much as a horse has so many excellent traits, he shall 
 henceforth and forever be called a man. As a result of this 
 agreement would the horse hereafter walk on two feet ? 
 
 While it is perfectly right and proper for the patholo- 
 gists or farmers to act as in the premises, their action or in- 
 action makes no change as to facts. The- horse still re- 
 mains a horse. Pathological agreements are not solid rock 
 against which the medical writer can indifferently place the 
 Archimedian screw. 
 
 This is a question of mal-absorption or assimilation. 
 
 Theological writers have been accused of cultivating a 
 third eyelid. Medical writers have, and use, only two: 
 Schliesze bcide Atiglein zu. 
 
 (e) Diffusion . — The earth teems with life in the 
 springtime, when plants drink the moisture and sunlight. 
 The air teems with life in the summer, when plants give the 
 world their fragrance. 
 
—95— 
 
 Plant Absorption and Diffusion . — Thus is taught a 
 great lesson in nature: Secure, give. Man has perverted 
 this lesson: Acquire, hold. 
 
 It is not primarily a lesson in charity we desire to teach; 
 the rather, to study plant diffusion and observe the lesson 
 therein taught as closely as we may. Perhaps this study 
 can be introduced in no better way than by an illustration; 
 
 The city of Ravenna, O,, has a water supply inferior 
 to none in the state. Drawn from Crystal lake, it is dis- 
 tributed through mains to various parts of the city* Being 
 soft, clear and pure, it is satisfaction to all who use. At a 
 certain season of the year, and for eight or ten da3 T s, usu- 
 ally in July and August, the water has a peculiar taste. 
 I am told this taste is due to vegetation in the lake, which 
 blossoms at this period. Since the intake has been supple- 
 mented by wells in the immediate vicinity of the lake the 
 taste of the water is not so marked at the period named. 
 At any rate, if my informant be correct, here is a clear case 
 of plant diffusion through water. The aroma of flowers, 
 of birch, pine, etc., is familiar to all. 
 
 Diffusion Through the Air. — If our senses were acute 
 enough to perceive them, no doubt constant change could 
 be detected in the soil, due to plant absorption and diffu- 
 sion. Our natural sense is too dull to perceive them, and 
 the chemist is bafBed in detection. 
 
 Query: If growing plants diffuse an entity to surround- 
 ing media, Cannot the same action take place within as 
 without, the body ? Or to put the question more directly 
 If growing plants diffuse to a fluid media, cannot living 
 bacteria diffuse to the fluids of the body ? 
 
 If yes, may not these diffusions markedly affect the 
 organism containing said bacteria ? 
 
 Let us examine. 
 
 "Recent chemical examinations of the contents of pure 
 cultures of various pathogenic and a few other bacteria 
 have shown the existence therein of certain peculiar poi- 
 sons, not only possessing specific physiological action, but 
 also having peculiar chemical properties and constitution.- 
 
- 9 6- 
 
 which ally them more or less closely to certain well-known 
 poisonous vegetable alkaloids. These chemical bodies have 
 been named ptomaines." — Dr. E. O. Shakespeare. 
 
 The willow is a native tree of North America. In the 
 United States many of these trees grow along the banks of 
 the smaller streams. As an anti-periodic the willow has 
 long been known. The medical properties are found in the 
 bark. In 1825 Fontana declared the active principle to be 
 salacin. Ptomaines and salicin are then similar in each 
 being developed in the living plant. 
 
 "Pathogenic bacteria have been killed in their pure 
 cultures by the action of heat. * * * The culture 
 medium then injected, produces a series of symptoms, etc." 
 
 — DR. SHAKESrEARE. 
 
 Willow trees may be boiled, /. <?., a decoction of willow 
 is made. Its administration, -per or em or injection, pro- 
 duces a series of symptoms, and acts as an anti-periodic. 
 Similarity is here closely allied. 
 
 "Again, these pathogenic bacteria have been removed 
 from the fluids of the pure cultures by means of filtrations. 
 The filtered fluid has been inoculated with similar results." 
 — Dr. Shakespeare. 
 
 A filtration of willow yields an anti-periodic. Listen 
 to the conclusion: 
 
 "From these reasonings it would seem probable that it 
 is the alkaloid developed by the growth of the bacterium 
 which is the specific active agent in the production of the 
 disease." — Dr. Shakespeare. 
 
 — i. e., the writer takes it, the alkaloid passes from the 
 growing plant into the fluids of the body and causes the 
 disease. 
 
 An Ideality. — John Smith, M. D., has long been a 
 delver of German medical literature. He owns a farm in 
 Ohio. Through this farm runs a small stream. Along 
 the stream are many clumps of willow. The banks of the 
 stream are shaded near its entirety. John has peculiar no- 
 tions. He drinks deeply of the fatherland. His reasoning 
 is as follows: "Salicin is made from willow. In order 
 
—97 — 
 
 to procure salicin the willow tree is destroyed. Why this 
 waste of timber? German medical literature says salicin is 
 continually passing from the willow to the soil. If to the 
 soil, then to the stream, for it cannot pass through the 
 underlying clay. Why not boil the water and procure sali- 
 cin from the stream? A perpetual annuity." John Smith 
 establishes a plant for the manufacture of salicin. We will 
 not speak of its capacity at this time. For some reason it 
 has not grown rapidly. The neighbors think John in the 
 borda'land of dementia. 
 
 What shall we say of our dear German brothers and 
 many American followers ? 
 
 A truth is impressed which should be known to every 
 observer. The fact that a plant develops or manufactures 
 and stores away an element or principle in its organism 
 while growing is no evidence this element or principle is of 
 necessity given out in its life to surrounding media. 
 
 As John Smith, M. D., is wrong in his reasoning that 
 salicin is given off by the growing willow, so is every one 
 wrong who assumes a living plant throws out its alkaloid 
 during life. The writer thinks it does no such thing. 
 That a plant which contains an element or principle may be 
 made to yield the same by some method of filtration is 
 plainly evident. That the plant tubercle bacillus does yield 
 such an element by heat and filtration is known to every 
 scientist. This element is the much vaunted tuberculin, 
 the so-called remedy for tuberculosis. The failure of this 
 remedy has been an ignominous one. Yet through all we 
 see the savant Koctr the least to blame \ He thought he 
 had secured a remedy for tuberculosis. Honest, though 
 mistaken, mankind is fallible. Let it pass. 
 
 John Smith, M. D., failed in the manufacture of sali- 
 cin. He at once converted the plant into one for the re- 
 moval of the willows. He reasons thus: "Tuberculin is 
 very efficacious in the sloughing of superficial tubercular 
 tissue. Tuberculin is the fluid extract of the plant tubercle 
 bacillus. Salicin is the alkaloid of willow. Salicin in solu- 
 
- 9 8- 
 
 tion ought to cause sloughing of superficial willow roots in 
 the soil." 
 
 Some people are always doomed to failure. John has 
 met success at last. He says the solution is efficacious, but 
 succeeds best if poured on the willow roots while very hot. 
 
 In the judgment of the writer, Dr. Shakespeare is right 
 in calling the ptomaine of bacteria an alkaloid; wrong in 
 supposing the alkaloid passes from the growing bacterium 
 to the fluids of the body. 
 
 Say some, if tuberculin is a failure in the treatment of 
 tuberculosis, it still remains the best agent known in the 
 diagnosis of the disease. A locksmith is working eight 
 years in the perfection of a burglar proof lock. He an- 
 nounces the lock ready for trial. A committee examine the 
 same and report the machine of no value as a lock, but 
 in the meantime find and add: // is an excellent -plaything 
 for the baby. 
 
 What do you think of the report as to the lock ? 
 
 So soon as treatment demonstrated tuberculin of little 
 value, one would naturally think the use of the vegetable 
 extract would wane. On the contrary, advocates rise in a 
 night, like mushrooms in a pasture, and the remedy sells at 
 fabulous prices. It is, then, not a plant diffusion, but a 
 diffusion of microscopes of high power. Money flows into 
 German coffers. 
 
 Ladies and gentlemen of the profession, in all sincerity, 
 is it not high time to call a halt ? Are we professional 
 thinkers, or are we incorrigible asses. 
 
 (f ) Diffusion . — Microscopy as a science[has done much 
 to increase medical knowledge. Its use is recognized and 
 its revelations regarded as of intrinsic worth. By its means 
 certain diseases are Jnow clearly diagnosed which were for- 
 merly obscure. Organisms have been discovered and de- 
 scribed which hitherto existed only in belief or imagination. 
 The road of the intellectual practitioner has been made 
 plainer and more perfect, the thoughts elevated to a higher 
 plane. No one today decries the use of the microscope. 
 It has come to stay. 
 
 Medical chemistry is also a welcome guest. During the 
 last two or three decades its strides in behalf of an advanced 
 profession have been great. It has opened a way by means 
 of which many urinary and other diseases are clearly recog- 
 
—99 — 
 
 nized and ameliorated. Its aid to the practical diagnosti- 
 cian in many cases has been immense. As medical practi- 
 tioners we are debtors and feel kindly for its guidance. 
 Like microscopy, no one fully educated speaks lightly of the 
 clearness of vision it gives in apprehending so complex a 
 subject as suffering humanity. 
 
 Microscopy and chemistry, as enlightened practitioners, 
 we welcome you. 
 
 But great as microscopy and chemistry enlarges our 
 field of usefulness, something more is required than these. 
 Microscopy or chemistry did not suggest gravitation to 
 Newton or the glacial theory to Agassiz. The clear per- 
 ception and description of animal life by Darwin was not 
 given by either. 
 
 Professional men are apt to forget and must be contin- 
 ually reminded that the field of medicine is a broad field. 
 He who reasons must reason from no narrow or special 
 premise. The premise must be broad as the conclusion. 
 The writer thinks the narrowness of the premise is a lack in 
 modern methods. With this breadth of reasoning there 
 must likewise be an acute observation. Without the latter 
 all reasoners are apt to fail. Broad education and acute 
 observation are two essentials in the advancement of medi- 
 cal science. The possession of these, with a love for the 
 work and an earnest desire to search only after truth, the 
 progress in medicine is assured. 
 
 There are at present two prevalent ideas. For the want 
 of better terms we will name them the specialist idea and the 
 generalist idea. The one is a specialist, the other a general 
 practitioner in medicine. Each reasons from his especial 
 field. Both claim accuracy. The specialist claims prestige 
 in his particular field. This is right. Work along par- 
 ticular lines ought to be better work. The generalist claims 
 a greater outlook. This is right. One looking from many 
 points has a clearer perspective. 
 
 Some one thing is sought in a certain field. Who best 
 to seek ? The specialist. Something is found requiring 
 determination. Who best to determine? The specialist. 
 Some one thing being found, who best to generalize and 
 assign its field ? The generalist. Something being deter- 
 mined, who best to name its systemic action? The gener- 
 
 L.cfC. 
 
— IOO — 
 
 alist. Thus each has his field of labor and each works best 
 in his especial line. 
 
 The microscope reveals a plant life in tuberculosis. 
 Had not this plant life been so revealed it might never have 
 been disclosed. Thanks to the specialist. This plant life 
 is proclaimed the cause of tuberculosis. By whom? The 
 specialist. Is he now in or out of his especial line ? If out, 
 how shall we regard his judgment? The plant tubercle 
 bacillus is analyzed. An alkaloid or ptomaine is discovered. 
 This alkaloid is declared the active cause of symptoms in 
 the disease. By whom ? The specialist. Is he now in or 
 out of his especial line? If out, how shall we regard his 
 judgment ? 
 
 With these facts before us we claim acute perception or 
 observation will do more in the solution of tuberculosis or, 
 if you please, will do more for a suffering humanity than all 
 speculations in existence. By observation it is seen (i) 
 that the plant tubercle bacillus grows in certain soils — none 
 other; (2) these soils are prepared for the natural reception 
 and growth of the bacillus in one way — none other — abey- 
 ance of atmospheric influence. Place these two proposi- 
 tions together and then ask, can tuberculosis be controlled ? 
 
 What has this to do with plant diffusion ? This is a 
 diffusion of plant ideas. 
 
 It is seen, then, that fitting or preparing a soil is all 
 that is necessary. If this be all, how does plant life come 
 into existence ? This may be answered in the simplicity of 
 Topsy in "Uncle Tom's Cabin"; "I spec's they growed. 7 ' 
 No one truly plants bacilli except the bacteriologist. He 
 plants when, where and how he pleases. Selects and fits his 
 own soil, cultivates or not as he deems proper, and reaps his 
 reward — a harvest of bacilli. The world is little wiser. 
 Did I say no one plants except the bacteriologist? Let me 
 correct this statement. Every one plants who fits a soil, 
 whether it be in his own person or the person of another. 
 There is this difference — the planting of the bacteriologist is 
 an artificial one; the planting as seen around us is a natural 
 one, induced by artificial life. The one is an artificial soil 
 
IOI — 
 
 Selected by man's care, the other an artificial soil induced 
 by man's folly, the one an artificial soil in that nature does 
 not lurk in wait with culture media and hypodermic needle, 
 the other an artificial soil in that natural soil has no growing 
 bacilli. Both are artificial in the sense of being either 
 selected or induced. 
 
 You say that preparing a soil is all that is necessary. 
 Can a natural soil be prepared ? Yes, in from one to twelve 
 weeks if the environment be favorable. What is meant by 
 environment? Illustration: Take monkeys from the forest 
 ■ — tuberculosis unknown among them since the days of 
 Adam. Place them in close rooms and examine them from 
 week to week. What do you find? They are dying of 
 tuberculosis. Perform the same with other warm-blooded 
 animals, as man. A similar result. How do you account 
 for it? Can you secure the same result by any other means 
 if you allow the animal free access to the open air? But, 
 says the bacteriologist, the close room means not only sus- 
 pension of atmospheric influence, but also the presence of 
 the bacillus. Eliminate the bacillus and will the animal 
 then die of tuberculosis? The reply must be similar in na- 
 ture. Are we not told the bacillus is ubiquitous ? Is it not 
 everywhere present ? Can we by any possible means control 
 its absence or presence ? What is the use for one to ask the 
 impossible ? If the tubercle bacillus truly causes the fatal 
 disease — if we cannot prevent its presence — what is the use 
 of being foolish ? What we cannot amend we must endure 
 We must abide the -presence of the bacillus and that which 
 it causes— tuberculosis . There is therefore no hope from 
 the ravages of this most intractable disease under present 
 teaching. 
 
 This seems probable from an examination of the death- 
 rate from the disease in Germany, the so-called medical 
 center of the universe. The American mind is pre-emi- 
 nently practical. ''The way to resume is to resume," 
 Why not practical in the management of tuberculosis ? It 
 is seen there must be a peculiar or particular soil before the 
 growth of the bacillus takes place. This soil must precede 
 
— 102 — 
 
 the advent of the germ. Why not control the soil and let 
 the germ care for itself. 
 
 Suspension of atmospheric influence being the cause of 
 the primary condition or precedent state, it is plainly evi- 
 dent the character of the soil is under control. The soil 
 under control, the disease is under control. This the 
 writer thinks, is the only effectual common-sense method of 
 controlling the disease. 
 
103— 
 
 ABEYANCE OF ATT10SPHERIC 
 INFLUENCE. 
 
 While attending lectures at Ann Arbor, Mich., in 
 1874-5, Prof. Ford clearly and forcibly demonstrated the 
 nature of lung tissue. Speaking of its tenuity, he com- 
 pared it to the finest tissue paper in existence. The paper 
 maker's art has advanced in twenty years, but normal lung 
 tissue remains the same. 
 
 Into and through this tenuous tissue courses the life- 
 giving principle, the blood; into and through this tenuous 
 tissue passes the life-giving principle, the oxygen. The 
 one surges from within at every heart-beat, the other surges 
 from without at every inspiration. 
 
 It is seen that in order to have perfect aeration there 
 must be a normal lung tissue, a heart-beat that sends a con- 
 tinuous stream of blood to every part of the lungs, an in- 
 spiration that renews continually the atmosphere of the air 
 cells — yet something more, the joint and harmonious action 
 of the two, or a correlation of force. If from any defect in 
 the organism, original or acquired, the blood or air does no fc 
 reach the lungs at proper times or in proper quantities, 
 aeration is defective, 
 
 Perfect aeration means more than this. It involves a 
 perfect machinery or organism plus a pure atmosphere. 
 Aeration in other words is ventilation of the blood as it 
 flows in the life current. As the river in its onward flow 
 receives the oxygen of purification, so likewise the blood. 
 The completeness of aeration is proportional to the com- 
 pleteness of ventilation. If, then, the writer clearly appre- 
 hends perfect aeration, it embraces primarily a normal lung 
 tissue, a correlation of force and a pure atmosphere. 
 
 While it is true digestion, circulation and aeration are 
 performed by separate organs in the economy, no organ can 
 
- 104 — 
 
 say its action is alone. Each is dependent on the other. 
 So with the lungs. A healthy organism is then presupposed. 
 
 The stomach, heart and lungs being supplied with the 
 same arterial blood, other circumstances equal, one would 
 rationally consider the function of each equally well per- 
 formed. The same is true of other organs. But the nerve 
 supply, which seems to designate or determine the work or 
 conditions of work for each organ, is very different. So 
 also is the work each organ is called to perform. 
 
 While the stomach, heart and lungs are supplied with 
 motor branches from the pneumogastric — a cranial nerve — 
 the organs of respiration are also furnished with sensitive 
 branches from the same nerve. In other "words, it seems a 
 design of creation that the brain should control respira- 
 tion. Yet not entirely, for it is seen that the three organs 
 named are also supplied with branches from the sympathetic. 
 But they are supplied in a very different manner, as one 
 would naturally infer from the nature of the work required. 
 
 While the stomach has a comparative paucity of plex- 
 uses and ganglia, the heart has an extensive system — a 
 complicated net- work — in this regard. The lungs are 
 marked by ganglia on all filaments extending to the bron- 
 chial tubes, and as stated, by a combined system of motor 
 and sensory nerves. 
 
 In looking over the nerve supply of the various vital 
 organs one is led to inquire who can interpret the nerve 
 factor of any. In attempting a solution, difficulties at once 
 arise. To interpret, all the organs must be taken into ac- 
 count. Imperfect knowledge of nerve supply and office, 
 imperfect interpreters, etc., are some of the difficulties we 
 meet. But this much is certain: The nerves are the lines 
 of communication, near or remote. Sever those lines and 
 communication is at an end. Suppose, instead of cutting 
 the lines, we so obstruct as to break the connection. The 
 result is the same, though slower. In the lungs there is 
 the motor and sensory fibers of the pneumogastric. We 
 inhale or exhale, forcibly or otherwise, as we choose. In 
 health it is a matter of volition. Sever or obstruct one or 
 
. —105 — 
 
 both of the nerves controlling respiration and the breathing 
 is laborious, or under control no longer. In disease of this 
 nerve, respiration is not a matter of volition. We may will 
 to breathe deeply or otherwise, but have no power to exe- 
 cute. The same or similar condition maintains if the brain 
 or ganglia on the nerve trunk be diseased. The telegraphic 
 connection is stopped or is not under perfect control. 
 
 Again, we inhale something that irritates our lungs. 
 We cough persistently, even though we desire to stop. No 
 doubt it is the little tell-tale ganglia on the nerve filaments 
 of the bronchial tubes that are kindly telling us of the irri- 
 tation. We are admonished in this way to remove it. If 
 the nerve filaments or ganglia be diseased the irritant may 
 be present, yet we are not conscions of it. But mark — the 
 injury entailed remains the same. 
 
 Having tried to make plain the central and peripheric 
 nerve influence, let us now consider the essentials to perfect 
 aeration, and at the same time study the defects that cause 
 abeyance of atmospheric influence. We do this the more 
 cheerfully, for on this topic, it seems to the writer, there is 
 gross ignorance and a degree of mental hebetude inconsis- 
 tent with civilization. 
 
 There is a period of growth or development in all exis- 
 tence. We see this on every hand. The human system is 
 no exception to this law of creation. The number of years 
 allotted to man has been variously estimated by different 
 writers. It seems that, while there is a general average of 
 life, there can be no law that will apply to every individual. 
 Each human being has a life distinctly his own. As no 
 chain is stronger than its weakest link, so no being is 
 stronger than his weakest organ. When we see a race, 
 family or individual prone to a certain disease, we can ac- 
 count for it on no other than rational principles. There can 
 be nothing accidental regarding it. It must be due to 
 heredity or causes external or internal. If due to heredity, 
 by following up certain family lines or connections, we find 
 the same disease. If, as we trace this disease back, we find 
 it more or less prevalent or malignant, we make deductions 
 
— 106 — • 
 
 accordingly. These are generally correct. 
 
 There is a tendency on the part of some to speak of 
 heredity as a sole causal factor in diseases showing trans- 
 mission. This seems a mistake — an error that needs cor- 
 rection. Should a parent have lung disease, should his 
 children to the latest generation have the same disease at 
 birth, one could reasonably attribute all disease of like na- 
 ture to heredity. Observation does not confirm this state- 
 ment. A parent with diseased lungs, or lungs of abnormal 
 tissue, may transmit weak lungs, or, probably better, lungs 
 of abnormal tissue. Observation shows this to be true. 
 Both parents having weak or diseased lungs this law is 
 doubly sure. Of either parent — the mother most certainly 
 — transmits the weakness as I have elsewhere shown. This 
 then, seems a law of heredity: Like transmits like. 
 
 Why certain mental or physical characteristics or con- 
 ditions, etc., are transmitted may never be fully explained, 
 but their transmission cannot be denied. 
 
 Is there another factor that aids heredity ? Suppose a 
 cause be shown for the lung disease already spoken of. Sup- 
 pose this cause is constantly at work. The following would 
 then prevail: Abnormal lung tissue from parentage plus the 
 common cause — nothing preventing — a -progression that 
 would de-populate the earth. 
 
 This, I think, is the exact condition we find in tuber- 
 culosis. Tuberculosis is a systemic or constitutional dis- 
 ease, due to a common cause, viz., abeyance of atmospheric 
 influence. A tuberculous parent transmits a tuberculous 
 tissue. A child of a tuberculous parent is prone to tuber- 
 culosis. Placed in a condition of enforced suspension of 
 atmospheric influence, he will assuredly die of tuberculosis; 
 placed in an opposite condition, he probably will die from 
 other disease. Tuberculosis has one cause — one alone — 
 abeyance of atmospheric influence. 
 
 What evidence have we of this ? The best evidence of 
 cognizable facts: The evidence of our senses — intellectual 
 perception. 
 
 In what does a subject of the tubercular dyscrasia dif- 
 
— 107 — 
 
 fer from the healthy or normal subject? In nothing, so far 
 as known; only in proneness to tuberculosis. The tubercu- 
 lar dyscrasia seems a systemic taint that weakens the entire 
 human fabric; a poisoned system in which a harmful ele- 
 ment is not eliminated; a system lacking in one essential — 
 the oxygen of the atmosphere; a system that may be re- 
 stored to the normal, through the generations by observing 
 natural law ; a system destined to premature disease and 
 death without invoking the aid of this law. 
 
 In the - whole realm of disease can an analogous one be 
 found ? Disease, like facial expression, is similar, yet dis- 
 similar. No two faces alike — a similarity in all. Syphilis 
 and tuberculosis have many similarities. 
 
 What is abeyance of atmospheric influence ? Simply 
 suspension of atmospheric influence, imperfect aeration, 
 lack of ventilation of the blood. Can it be made more 
 plain? This may arise from causes external or internal, or 
 combined. The air we breathe contains certain essential 
 elements in relative proportion. This is normal air. 
 Should one in health breathe air that deviates from this 
 standard it would eventually lead to disease. In other 
 words, the disease would be induced by suspension of atmos- 
 pheric influence. This suspension does not take place from 
 external causes alone. Should one with abnormal lung 
 tissue breathe normal air, the blood at the same time not 
 being perfectly oxygenated, it would be just as truly an 
 abeyance of atmospheric influence as in the former case. 
 The result would be the same, though the conditions be 
 changed. We have, then, abeyance of atmospheric influ- 
 ence from external and internal causes. 
 
 Now suppose, further— and this supposition is not an 
 imaginary one — that the two conditions be found at the 
 same time in the same individual, viz., abnormal lung tissue 
 and abnormal atmosphere. What would result ? Disease 
 doubly certain, and that, it may be, in the absence of the 
 bacillus. This disease would then be induced by combined 
 causes. In the opinion of the writer, the major part of tub- 
 erculosis is so induced. 
 
— io8— 
 
 Let us row consider severally some of the so-called 
 predisposing causes of tuberculosis. It will be seen that 
 whatever the ultimate result, abeyance of atmospheric in- 
 fluence explains the primary condition. By primary condi- 
 tion is meant the state of the patient before the entrance of 
 bacilli. 
 
 CONGENITAL. DEFECT. 
 
 Children are brought into this world by the vicious, 
 over- worked, etc., without object or aim. They are cast 
 upon society as helpless waifs, a burden to mankind. It 
 were better had they never been born. Without particular 
 disease, they fall an easy prey to any. This is the congen- 
 ital predisposition of some writers. It is seen where num- 
 erous children are born of the same mother in rapid succes- 
 sion. The parents may be healthy, but the period of rest 
 is so short the children do not receive a requisite vitality. 
 Children of this stamp readily succumb to any endemic or 
 epidemic disease. Is it a wonder multitudes of these child- 
 ren die of tuberculosis ? Would it not be a greater marvel, 
 that any lived with so unfavorable a birth and environment ? 
 Puny in development, with narrow and contracted chest 
 walls, the air space for perfect breathing is not sufficient. 
 Born perhaps of scrofulous or tuberculous parentage, the 
 lung tissue is abnormal, and, as shown, there must be a 
 consequent abeyance of atmospheric influence. Add to this 
 an unfavorable environment, meaning by this absence of 
 proper care, sunlight, clothing, etc.; add still further, an 
 impure atmosphere, and you have a condition favorable to 
 the entrance of bacilli. Do the bacilli cause the disease? 
 By no means. They simply enter the tissue as a feeding 
 ground. As the vulture and dead animal are found together 
 so likewise the bacilli and diseased tissue. It is the condi- 
 tion of the system that allows the bacilli to enter . 
 
 HEREDITY. 
 
 So much has already been written on this topic that it 
 seems superfluous to write further. This much is certain: 
 Parentage in the race of life does tell. The nearer perfect 
 
— log — 
 
 the health and environment of the parents the nearer per- 
 fect the child at birth. The greater the deviation from the 
 normal in parentage the greater the deviation from the nor- 
 mal in offspring. When writers tell us all are born alike, 
 and that the differences in mankind are wholly due to bent 
 of inclination, environment, etc., it seems the sanity of the 
 writer should be called in question. To think the child of 
 the debauche an equal competitor with the child of the up- 
 right it contrary to reason and common sense. 
 
 OCCUPATION, 
 
 Another predisposing cause of tuberculosis is found in 
 the vocation of the individual. In those trades or callings 
 where the rooms are crowded or where the air space is not 
 sufficient, the death-rate from tuberculosis is sensibly in- 
 creased. Here it is abeyance of atmospheric influence from 
 without — impure air. In those trades in which the air is 
 filled with an irritant dust, which comes in contact continu- 
 ally with the air cells of the lungs, the death-rate from 
 tuberculosis is largely increased. Here it is abeyance of 
 atmospheric influence from within, due to the irritant in the 
 air. The lung tissue actually becomes thickened and dis- 
 eased before the bacilli are found. Change of occupation 
 frequently effects a cure. Again, we sometimes see the two 
 conditions combined, viz., insufficient air space and an irri- 
 tant dust. In these cases the death-rate from tuberculosis 
 is still higher. Here we have abeyance of atmospheric in- 
 fluence from combined causes — lack of air space and the irri- 
 tant dust. Suppose the person so exposed be a subject of 
 congenital defect, or the tubercular dyscrasia. We would 
 then have the maximum death-rate from tuberculosis. In 
 all cases it is a suspension of atmospheric influence in the 
 primary condition. Thus in an enumeration of disease in 
 which tuberculosis seems to invade secondarily, it will be 
 found abeyance of atmospheric influence is always present. 
 
 To summarize: The requisites of perfect aeration are 
 normal lung tissue, correlation of force, and a pure atmos- 
 phere. The predisposing causes of tuberculosis are: Con- 
 
— no— 
 
 genital defect, heredity and occupation. The primary 
 cause of tuberculosis is abeyance of atmospheric influence, 
 induced by external, internal and combined causes. 
 
 It is seen that tubercle bacilli perform a secondary role 
 in the great tragedy of tuberculosis. This is the convic- 
 tion of the writer, after years of careful research and 
 observation. 
 
Ill — 
 
 ANNOTATIONS. 
 
 ''The tubercle bacillus not being inherited, but passing 
 into the body from the outside, how does it get there? 
 Under what conditions does it exist there? Under what 
 conditions does it pass from the outside to the inside of the 
 body ? Under what conditions does it live and propogate 
 there ? It is impossible to demarcate the answers to these 
 questions as clearly as the questions themselves." — (Jas. B. 
 Russell, B. A., M. D. LL. D., Senior Medical Officer of 
 Health, Glasgow. Republished by permission by the State 
 Board of Health of Massachusetts, 1896.) 
 
 As seen in the preface of the pamphlet from which this 
 extract is taken, "The subject is so clearly expressed and 
 so admirably treated that the State Board of Health, with 
 the consent of the author, has decided to reprint the prin- 
 cipal portion for popular distribution." 
 
 We have, then, an eminent health officer writing on a 
 subject which concerns us all, and asking under what con- 
 ditions the tubercle bacilli enter the system and propogate 
 or grow. At the same time he positively affirms no answer 
 can be made as clear as the question itself. The writer 
 thinks differently. 
 
 The scholiast recognizes five methods of obtaining in- 
 formation, viz., observation, reading, listening, conversa- 
 tion, meditation. Suffering has also been added. We 
 briefly call attention to two or three of these methods. 
 
 (a) Observation. Cast your eye over the field of ani- 
 mate nature. Observe closely they who have tuberculosis 
 and the}^ who have it not. All belong to one of two classes, 
 there is no middle state. Observe the manner of life of 
 these distinct classes. No nomad, no wild animal has the 
 disease. Among the civilized and the domestic animals the 
 disease is found in every case. 
 
— 112 — 
 
 Note yet further. All civilized people and all domestic 
 animals do not alike have the disease. Some take it while 
 others escape. Why do not all take the disease? Why do 
 any escape ? Observation again points the way. None 
 have tuberculosis except they in some way have suspension 
 of atmospheric influence. No suspension, no tuberculosis. 
 To apply this truth clearly it is observed there is more than 
 one way in which suspension of atmospheric influence takes 
 place. They who think suspension means simply breath- 
 ing an atmosphere in which there is less oxygen than nor- 
 mal have only a superficial view of the situation. Suspen- 
 sion means more than this. We use in brief a chart as 
 heretofore published: 
 
 {Impure j 111 ventilation, vocation, 
 
 atmosphere {etc. 
 Impoverished ( Overheating rooms, im- 
 atmosphere ( proper ventilation, etc. 
 
 {Defective I Original \ Heredity, 
 lung tissue J Acquired f Disease, 
 ^ \ exposure, etc. 
 
 Observe the inonkeys in the forest. Tuberculosis is 
 unknown among them. Place these monkeys in confine- 
 ment and suspend atmospheric influence in one of the many 
 ways, they die of tuberculosis. Avoid the suspension, the 
 monke) 7 S live. Observation affords a lesson. 
 
 In "Boots and Saddles," when Mrs. General Cutser 
 sees, in the great Northwest, the cabin and tepee side by 
 side — the one unoccupied — and asks the reason, the igno- 
 rant Sioux expresses a truth for all time: "I have a cough 
 when living in the cabin." The Sioux knows nothing of 
 germs, but he does know the cause of the cough and avoids 
 it. Did he know the virtue of ventilation he could live in 
 the cabin as tepee. The civilized man knows of the germ, 
 but regards nothing else and dies of the cough. Which is 
 the wiser? Civilization has many lessons yet to learn. 
 One lesson may be learned of the untutored savage. None 
 is more important! W T ill he learn it ? 
 
 To speak clearly, there is a condition of system which 
 
—ii3— 
 
 allows the entrance of the germ. This condition is pro- 
 duced by suspension, which is caused in many ways as 
 enumerated. In this there can be no mistake.. When Dr. 
 Russell declares it is impossible to demarcate the answer as 
 clearly as the question, he is mistaken. The mistake can 
 be shown by putting a test question, i. e., by taking a 
 healthy animal and causing suspension — the germ at once 
 takes root and grows. This test may be made in the many 
 ways of suspension. In this test the law of tuberculosis is 
 verified. This law is founded in fact. Of this truth the 
 writer is so assured he challenges controversy. 
 
 Why is the Indian in the ill-ventilated cabin subject to 
 cough, while the Indian in the tepee is immune? The rea- 
 son is simple. It is the condition of the Indian that allows 
 the bacilli to enter . This condition is produced, in his 
 case, by ill ventilation. Nothing is more certain. Could 
 it be otherwise ? 
 
 In the writer's judgment there is no question but that 
 the advent of civilization was the advent of tuberculosis. 
 Must we then go back to nomadic life in order to rid our- 
 selves of this dreadful scourge? By no means. All that is 
 necessary is to recognize the cause of the disease and remove 
 it. Nothing further is required. 
 
 (b) Reading. "When the bacillus obtains access to 
 the body of a warm-blooded animal, which it almost solely 
 does by the great main entrance, the mouth, passing thence 
 into one or other of the diverging channels, the windpipe 
 and the gullet, it is not yet in a physiological sense inside 
 the body. It must break through the mucous surfaces of 
 ' these passages. This is a most important stage in the ca- 
 reer of the bacillus from a preventive aspect," etc. (Dr. 
 Jas. B. Russell.) 
 
 When a fire on the hearth or in the furnace is kept 
 within its metes and bounds and its gentle warmth is dif- 
 fused to every part of the house there is no danger from 
 conflagration. The house is not yet on fire. The fire 
 must break through the roof and windows of the building. 
 This is a most important stage in the career of the fire from 
 
-114— 
 
 a preventive aspect, etc. There is a close analogy between 
 the bacillus and the fire. The bacillus in the windpipe or 
 stomach is as fire on the hearth or in the furnace. So 
 long as either remain there, no danger is experienced. 
 When either leave, the one to grow, the other to consume, 
 each becomes an element of danger. Neither can be dan- 
 gerous so long as the machinery is intact. The writer thinks 
 it becomes the good tenant in either case to attend to all 
 needful repairs. Herein he thinks the bacteriologist is at 
 fault. 
 
 The writer desires to be honest when he asserts that 
 all the bacteriologist attempts to prevent is the entrance of 
 the living germ into the healthy system. This is laudatory, 
 but unnecessary Living germs do not enter the healthy 
 system to harm or destroy. It is the unhealthy system alone 
 they harm. When a system becomes unhealthy from sus- 
 pension then the so-called germ enters and propogates or 
 grows. 
 
 The bacteriologist asserts, no germ, no tuberculosis. 
 The germ is wholly at fault. The writer says not so. There 
 is another fault which can be prevented, and in this way the 
 disease can be controlled. The fire is not at fault. The fault 
 is in a defective flue or fire-box. So, the writer believes, 
 the bacillus is not at fault. The fault lies in the defective 
 organism in which the bacillus thrives. As stated, this de- 
 fective organism is induced by suspension. This may be 
 shown at any time, by direct experiment. Why not make 
 it? 
 
 It seems our present knowledge is inaccurate or at fault. 
 The tubercle bacillus is spoken of as a parasite. It is a 
 parasite only in the sense that it propagates or grows in dis- 
 eased tissue. A true parasite attacks or attaches itself equal- 
 ly well to the healthy or diseased organism. Not so the tu- 
 bercle bacillus. To examine more closely the latter part of 
 Dr. Russell's statement — "This is a most important stage 
 in the career of the bacillus from a preventive aspect." 
 
 Two constructions may be placed on the above. Or, 
 perhaps, better, the above may be considered from two 
 
—ii 5 — 
 
 stand-points : 
 
 i. It is truly an important stage. It is the com- 
 mencement of the second stage of tuberculosis, and if the 
 disease be not controlled at this point in all probability it 
 will not be controlled at all. Certainly this is very im- 
 portant. 
 
 2. In another sense it is not so important as may 
 seem on first sight. The patient has been ailing for weeks 
 or months. The bacillus is now about to enter his system 
 and grow. Why wait these weeks or months ? Why not 
 pre\ T ent the disease during this long period ? Why wait un- 
 til the last moment ? Suppose the firemen of your village 
 or city should hear the alarm of fire. Would you have them 
 wait until the flame bursts from the roof and windows be- 
 fore attempting to extinguish the same ? Would it not be 
 better to stop the fire at the earliest moment? Why not 
 apply this truth to tuberculosis ? 
 
 Physicians are called poor collectors. Certain it is 
 many die in poverty after years of toil. Is not some- 
 thing else lacking ? Do not physicians lack common sense 
 in the application of truth ? The writer is inclined to think 
 so. If our reading is to be of avail in the betterment of 
 mankind, we must examine and digest what we read and 
 truly make it a part of ourselves. Without this we are the 
 mere puppets of erudition, nothing more. 
 
 (c) Meditation. "The bacillus is not inherited. As 
 regards pulmonary consumption, this statement may be 
 taken as absolutely true. The bacillus may pass from a 
 tuberculous parent into the body of the fetus, and be born 
 with it; and thus the offspring may carry into independent 
 life a tuberculous process, but this fact has merely an acad- 
 emic interest. Tuberculosis has been actually seen in the 
 fetus with just sufficient frequency and certainty to prove 
 that the inheritance of the bacillus is not impossible. For 
 all practical purposes, the hygienic administrator is bound 
 to regard every case of tuberculosis as caused by infection, 
 which has taken place, so to speak, in the open, within the 
 sphere of his control." (Dr. Jas. B. Russell.) 
 
-n6— 
 
 He who observes "must ponder or meditate, else his ob- 
 servations will be common as of the multitude. Apples had 
 fallen since the days of Adam, but it was Newton alone who 
 discovered the law of gravitation. He simply thought 
 about the falling apple. He who reads must digest or 
 assimilate, or his reading is of little avail. 
 
 The fact that a tubercle bacillus may pass from a tuber- 
 culous parent into the body of the fetus truly has academic 
 interest. The truth that tuberculosis or the growing bacillus 
 is actually found in the fetus is of greater interest and has 
 wider range of application. One can readily conceive of a 
 plant organism passing into the blood current of the mother 
 and thence to the fetus. The finding of a growing bacillus 
 in the same fetus is of wider significance. It is a thought 
 worthy of our closest attention. It is proof positive a soil 
 -preceded the growing -plant. How came that soil ? The 
 hygienic administrator see nothing in this. "He is bound 
 to regard every case of tuberculosis caused by infection." 
 This statement seems truly marvelous in the light of facts: 
 (i) No germ takes root in health; (2) in every case a soil 
 precedes the growing plant; (3) the tuberculous parent 
 transmits a soil. It is seen: No infection can take place 
 unless there be a suitable soil. But the tuberculous 
 parent transmits a soil, hence the hygienic administrator is 
 bound to regard every child of tuberculous parentage. 
 Yet more, he is bound to regard every tuberculous marriage. 
 When we consider a soil is produced in one way, and must 
 in every case precede the growing germ, it is high time the 
 hygienic administrator recognizes this fact and acts accord- 
 ingly. No such recognition or action will be taken so long 
 as he firmly believes the germ theory of tuberculosis. Let 
 us at once and forever discard this theory. Mankind will 
 receive a marked benefit. 
 
= — 1 17- 
 
 DUTIES OF THE HOUR 
 
 To see ordinary duties postponed from time to time 
 when they should be discharged at the moment is a sad 
 commentary on human life, but such is seen at man's best 
 estate. ''Procrastination is the thief of time." A worse 
 condition is often observed; Urgent work is neglected and 
 the time occupied with things of a trivial nature. 
 
 This procrastination or putting off the essentials while 
 superficialties engage the attention is a common fault and is 
 due to many causes. Foremost among them is a lack of 
 thought. The child at school who idles away the time 
 instead of getting the lesson is doing this very thing — a lack 
 of thought. In after years the thoughts come thick and 
 fast when there is little time for reparation. So in man- 
 hood we often take up those subjects which are truly least 
 beneficial, and find in old age we have wasted our time and 
 substance for naught. 
 
 The medical man is subject to the same fault and gives 
 way to the same weakness. How often we observe the 
 carefulness of procedure in seeking out a so-called germ, in 
 establishing its habitat and means of propogation, and then 
 giving way to a childish method of disease communication 
 and suppression. 
 
 In no disease is this seen more clearly than in tuber- 
 culosis. By erudition and a pains-taking accuracy it is 
 determined that a plant or bacillus is found in certain con- 
 ditions of the system, that in these conditions a disease is 
 commonly present, known as tuberculosis, Without fur- 
 ther care or thought it is at once assumed the diseased con- 
 dition is caused by the plant or so-called germ. Nothing is 
 more foolish. A plant growing in a certain condition is no 
 evidence the plant causes the condition named. It simply 
 shows a live plant has found a favorable soil. This favor- 
 
— lib- 
 able soil may be found or determined in two ways: (i) Nat- 
 ural selection or affinity; (2) transference. 
 
 Illustration: Mr. A plows a field and weeds spring up 
 in every direction — natural affinity. It may be one or more 
 particular kind of weeds are found growing. Mr. B plows 
 a field and sows one or more kind of grain. A transference 
 is here seen. In the two cases the soil is similar, the sow- 
 ing dissimilar, the fruitage or growth is like or unlike. 
 The distinction is in the method in which the plant or seed 
 becomes rooted in the soil, i.e., natural or artificial. In 
 other words, the distinction is the way in which tuberculosis 
 becomes seated in the system. The soil is alike in both 
 cases. 
 
 On this and on this alone hinge the worth or littleness 
 of our knowledge in tuberculosis. On this and on this 
 alone must be estimated the merit of infection or contagion. 
 Is tuberculosis infectious or contagious ? Is the soil favor- 
 able ? Weeds or seed do not grow unless the soil be favor- 
 able; neither do germs. 
 
 Disease extension in tuberculosis is seen on every hand . 
 Why ? Its cause is wrongly interpreted. Disease suppres- 
 sion is nowhere to be seen, or at best only in isolated cases. 
 Why? Present methods are utterly insignificant. First 
 grasp the true cause of tuberculosis, then act, not talk of 
 disease suppression. 
 
 It may be asked, is not tuberculosis less prevalent now 
 than it was a few decades ago ? The disease seems less 
 prevalent, but this is due not to our greater knowledge of 
 germs and avoidance of them, but rather to a better method 
 of living, in that we have more commodious dv^ellings, 
 take more exercise in the open air, etc., etc. Advance fur- 
 ther in this direction and the condition of the people will be 
 yet more marked. 
 
 Our knowledge of germs has done little if anything 
 -per se in combating the ravages of this disease. That this 
 statement is true every acute observer will plainly recognize. 
 We see a natural and a selective affinity in the daily voca- 
 tions of life. 
 
—ii 9 — 
 
 Milk, on standing in the open, becomes acid or sour. 
 We are told this is due to the presence of germs. Please 
 observe: Conditions of the atmosphere hasten the changes 
 that occur. May it not be that the condition of the atmos- 
 phere prepares a suitable soil ? Is this not probable ? 
 Must it not be so? If not, why should milk turn quicker in 
 some atmospheres than in others ? 
 
 If the milk be hermetically sealed no change takes 
 place. Science tells us this is due to the exclusion of germs. 
 Certain it is, the milk thus sealed is not subject to the 
 atmospheric conditions. It is seen there are two ways to 
 prevent the changing of milk: (i) Select the atmosphere; 
 (2) hermetically seal. The first is difficult. The second is 
 readily performed. Hence the sensible farmer or dealer in 
 milk adopts the second. 
 
 Take the lesson we learn from the action of milk and 
 apply to the human system. 
 
 In our daily rounds we meet multitudes of people who 
 have, in one form or another, the disease known as tuber- 
 culosis. Some have placed the proportion among the civ- 
 ilized as large as three-fourths of the entire number of peo- 
 ple. The writer thinks this an exaggeration, but it will be 
 admitted that the exact number who have the disease, 
 though large, is hard to estimate. 
 
 Present science says the disease is caused by a germ, 
 known as the tubercle baciHus. The writer denies this, but 
 admits that in many cases of the disease this germ is found 
 growing; in other cases the germ has not taken root. The 
 disease may be in an incipient state, and all that is lacking 
 is a favorable soil. So soon as the soil be favorable so soon 
 is found the growing germ. A person in this condition 
 may be compared to milk standing in the open. If the 
 atmospheric conditions be favorable the milk turns sour, or 
 the germ takes root. In the individual the growing bacillus 
 is added to the already serious disease. The ailment then 
 takes upon itself a two-fold nature, viz., the -prepared soil 
 and the growing -plant. Herein the germ theorist is sadly 
 at fault. He regards not the dual nature of the disease, 
 and directs his energies to the germ alone. 
 
— 120 
 
 The writer believes the average germ theorist to be 
 germ proficient and common sense deficient. Knowledge is 
 power, but common sense should be used in its application. 
 
 It will be remembered there are two ways to prevent 
 the change in milk. There are also two ways to prevent 
 the germ's entrance and growth in the system. To her- 
 metically seal the milk works admirably. Could we hermet- 
 ically seal all avenues of entrance of animal life no doubt it 
 would work equally well, so far as the germ's growth is 
 concerned, but this cannot be done. Neither can we prac- 
 tically build germ-proof houses in which to live. One 
 alternative yet remains. We can control the soil in which 
 the germ thrives. In other words, we can control the 
 atmospheric conditions which cause the favorable soil and 
 thereby control the disease. This is certainly worth know- 
 ing. Its attention is a duty of the hour, an essential which 
 should be regarded at once. Knowledge of this truth 
 makes it reprehensible in us if we do not take heed to its 
 teachings. 
 
 What is one of the superficialties ? The tweedledum 
 and tweedledee of germ infection and immunity. Immunity 
 is a myth, infection an impossibility with an unfavorable 
 soil. He zvho allows or causes a soil to become favorable 
 should be held criminal before the lazu. 
 
 This may seem serious talk, but in so insidious and 
 deadly a disease as tuberculosis there should be no white- 
 wash or red tape. All teaching should be plain common 
 sense. 
 
 An elective or selective affinity is seen by the good 
 housewife in making bread. Yeast is prepared and at a 
 proper stage of the proceeding is transferred and thoroughly 
 mixed with the flour dough. The ferment causes the dough 
 to rise, and in this way the enlarged or aerated loaf is ob- 
 tained. This measure is one of convenience. The dough 
 would naturally ferment or rise if the atmospheric condi- 
 tions be favorable, but the action would be slow, erratic or 
 irregular — hence the artificial transfer. What is the dough 
 at best ? Only a favorable soil. What is the yeast ? Mul- 
 
121 — 
 
 titudes of growing germs. The germs placed in a favora- 
 ble soil at once take root. 
 
 Here is a lesson in bacteriology. Certain cultures are 
 procured in a similar way. Starch solution or beef bouillon 
 is used as a media and germs are propogated in these. 
 Now because cultures may be obtained to the fourth or fifth 
 generation is no evidence the culture causes the media. 
 The media is procured. The germ is procured. They are 
 simply placed in continuity under favorable conditions, and 
 the one affords nourishment to the other. The germs de- 
 velop or grow. This is a simple but truthful explanation. 
 
 It is marvelous to what straits the germ theorist is 
 reduced in talking of these things. According to him the 
 germ is all in all. It is no such thing'. The germ is only 
 one factor, the media another, and the conditions a third. 
 The one who rationally talks of tuberculosis must bring in 
 three factors: Media, condition and germ. If he talk of 
 germ alone he is one of the foolish virgins, and will soon 
 borrow oil or be left in darkness. The present age is one of 
 advance. Let us march forward. Tuberculosis can be con- 
 trolled and the world should know it. Did I say can be? 
 It is controlled and the world should know the way. The 
 author endeavors to give it; accept in this spirit. 
 
 We see an illustration of selective or elective affinity 
 in the experiments made in the bacteriological laboratory. 
 Cultures as above made in beef bouillon are transferred to 
 the animal kingdom, as the guinea pig, dove or rabbit. 
 Upon inoculation with these cultures it is found, generally 
 speaking, that they continue to grow and the animal dies of 
 a disease similar or like the one from which the original 
 germ was taken. This is assumed as proof positive that the 
 germ so found is the cause of the disease. Let us not be 
 too hasty in our conclusions. Assumption in every case is 
 not found to be truth. 
 
 We stated three conditions are necessary in order to 
 have the transfer or artificial removal a success, viz., media, 
 condition and germ. The germ selected is, of course, a live 
 or proper one. The condition is of the live animal, warm 
 
— 122 — 
 
 and moist, the most suitable. The media must afford nour- 
 ishment, else the plant would not thrive. What more do we 
 wish ? What does the experiment prove ? Simply that 
 plant growth will thrive in the live animal, or under vary- 
 ing circumstances. Does it prove that the germ causes the 
 disease ? By no means. In the first place, live animals, in 
 their normal condition, in the open air, never have germs 
 growing in their system. The placing of them there is an 
 artificialty. If naturally, in health, they do not enter the 
 system and grow, how can we establish that the artificial 
 insertion is the natural cause of the disease ? Such reason- 
 ing is unworthy the school boy. Yet such reasoning passes 
 for science. 
 
 A short time since the writer was invited by his friend, 
 Dr. Dudley P. Allen, to walk through the various apart- 
 ments of the L,akeside Hospital Cleveland, O. Among 
 others he pointed out the rooms for microscopical and bac- 
 teriological experiments. I saw in little crates or cages, 
 doves, rabbits, guinea pigs, etc., and thought in passing, 
 here is an artificial condition for natural entrance of germs. 
 The transfer made in the laboratory, like the transfer made 
 by the good housewife, is an artificial one for convenience. 
 It is more speedy. But in either case it proves nothing ex- 
 cept germs thrive and propogate in a variety of media. 
 When will we learn wisdom ? Certainly we have not as yet. 
 
 For a natural entrance of growing germs there must be 
 a prepared soil. Whether we prepare the soil ignorantly or 
 wisely, the germ alike takes root and grows. If we prevent 
 the formation of soil, we prevent the growth. Here is the 
 true secret of all tubercular disease. 
 
 Tuberculosis is a disease of civilization caused by sus- 
 pension of atmospheric influence, in that the suspension 
 prepares the soil for vegetable growth. 
 
 The disease is governed by the following law: The 
 death-rate from tuberculosis is in direct ratio to suspension 
 of atmospheric influence. 
 
 What, then, are the duties of the hour ? To prevent 
 suspension in every conceivable way. 
 
123- 
 
 A CATECHISM 
 
 What is tuberculosis ? A constitutional disease depen- 
 dent largely on the evils of civilization, and governed by 
 the following law: The death-rate from tuberculosis is in 
 direct ratio to suspension of atmospheric influence. 
 
 Do not standard medical writings tell us tuberculosis is 
 caused by the germ tubercle bacillus? Yes, they so in- 
 form us. 
 
 Is not the consensus of medical opinion, as found in 
 those writings more likely to be correct and of consequent 
 greater worth than individual opinion ? Yes, this is true as 
 a general proposition. 
 
 Why, then, should one persist in saying tuberculosis is 
 caused by suspension of atmospheric influence ? Ever}- one 
 as a witness, should tell "the truth, the whole truth and 
 nothing but the truth." 
 
 We are witnesses. As such, must we agree with the 
 multitude or tell that we know? The upright judge 
 would say, *' Tell that you know.''' Again, no body of men 
 is infallible. Because the multitude say a statement is cor- 
 rect is no reason it is so. 
 
 Is not the presence or absenc e of tubercle bacilli in the 
 tissue an evidence of the presence or absence of tuberculosis? 
 Listen to an authority: "The tubercle bacillus is ubiquitous." 
 
 Is not a growing bacillus in one's system an evidence 
 of tuberculosis ? Yes, but the growing bacillus implies a 
 precedent state. Without this state the bacillus does not 
 grow. The tubercle bacillus is not found growing in the 
 healthy system. 
 
 The question now arises, which is the primal cause of 
 tuberculosis, the precedent state — suspension — or the tuber- 
 cle bacillus? Look around you ! Which takes preced- 
 ence, the growing plant or the soil in which it grows. 
 In every case, the soil. 
 
-124- 
 
 Which is, then, the primary cause of tuberculosis? 
 One answer: The soil — the precedent state — or suspension 
 of atmospheric influence. 
 
 Having determined the primary cause of tuberculosis, 
 let us now proceed. 
 
 Mr. A has tuberculosis. Mr. B has the precedent 
 state. Will the writer please tell us the difference in these 
 cases ? Mr. A has the precedent state plus the growing 
 tubercle bacillus; Mr. B has the precedent state. Messrs. 
 A and B each have tuberculosis. 
 
 Tuberculosis may exist in the absence of tubercle ba- 
 cilli, but can never exist without the -precedent state. 
 Herein lies the error of the savant Koch. He has mis- 
 taken the cause of tuberculosis. His attention has been 
 directed alone to the germ tubercle bacillus. 
 
 Tuberculosis is not caused by the tubercle bacillus. It 
 is due to suspension of atmospheric influence, is based on 
 law and can be controlled. 
 
 To be clearly understood, the writer makes tuberculosis 
 more comprehensive. The term includes: 
 
 i. All cases in which the growing bacilli are found. 
 2. All cases in which the condition of the system is 
 such as to allow the tubercle bacilli to take root. Should 
 we classify: 
 
 First stage, prior to entrance of bacilli — subject to 
 control. 
 
 Second stage, after entrance of bacilli — amenable to 
 treatment. 
 
 Third stage, breaking down of 'tissue — treatment of 
 little avail. 
 
 Having shown the plant growth is a secondary condi- 
 tion or modifying influence in this most fatal disease, we 
 would now call attention to modern treatment as directed 
 against this growth or supposed cause. We do this the 
 more willingly feeling assured this treatment must ever be 
 barren of permanent curative results, and at times danger- 
 ous to the patient. 
 
 What is tuberculin ? As first given the public, tuber- 
 
— 125 — 
 
 culin is a glycerine extract of tubercle bacilli cultures. 
 
 Judging from observation, of what use is tuberculin? 
 Largely commercial. 
 
 Has tuberculin value ? Yes. Illustration: Mr. A has 
 tuberculosis, as ordinarily defined, i. e. y the precedent state 
 plus growing tubercle bacilli. Here it has value. That 
 there be no mistake in this matter, we quote no less an 
 authority than Prof. Jas. T. Whittaker; "The value of 
 tuberculin in the diagnosis of the disease in cattle is univer- 
 sally accepted. According to the report of Salmon, thus 
 far we have yet to meet the first case which reacted and did 
 not show tuberculosis upon post mortem examination." — ■ 
 Lancet-Clinic, Sept. n, 1897. *"• e *i tuberculosis as ordi- 
 narily defined. 
 
 (a) Tuberculin determines the presence of growing 
 bacilli. 
 
 Today, as then, these words are true. All tuberculin 
 determines is the presence of growing tubercle bacilli. 
 Hundreds of cattle stand in their stalls with the precedent 
 state. Thousands may likewise stand in favorable condi- 
 tions to. produce this state. Of these tuberculin says nothing. 
 
 This leads to another question, has tuberculin value in 
 diagnosis? No. Illustration: Mr. B has the precedent 
 state, i. e. , tuberculosis as defined by the writer — no grow- 
 ing bacilli induced by suspension of atmospheric influence, 
 (Please observe Mr. B has the symptoms of tuberculosis as 
 found in the first stage of the disease.) 
 
 An injection of tuberculin is made; no reaction. What 
 does this injection determine? 
 
 (b) Tuberculin has no value in diagnosis. 
 
 But if there be stages in the disease tuberculosis, the 
 first designated by absence, the second by presence of grow- 
 ing tubercle bacilli; if tuberculin determine the presence or 
 absence of these, is not the extract useful ? 
 
 When the writer remembers the first stage is subject to 
 control, the second simply amenable to treatment, this fact 
 appears valuable should we possess an accurate means of 
 determination. It is known to every practitioner that tub- 
 
— 126 — 
 
 erculosis in its first stage is difficult to detect. The stage 
 being determined, the physician knows for a certainty the 
 result to expect from treatment — a very valuable acquisition. 
 
 Can we with certainty differentiate the first stage by 
 means of tuberculin ? No. Illustration; Mr. C is sick and 
 calls on his physician. The symptoms simulate malaria. 
 The blood is examined; no plasmodium found. A tenta- 
 tive injection of tuberculin is made; no reaction. What 
 does this determine? The absence of growing bacilli. 
 
 It has been shown that growing bacilli are absent in 
 health. They are absent in many diseases. The mere ab- 
 sence of growing bacilli does not determine the first stage 
 of tuberculosis; therefore: 
 
 (c) Tuberculin has no certain value in differentia- 
 tion of ffrst stage. 
 
 Is the use of tuberculin dangerous ? Yes and no. 
 Illustration: Mr. D is ailing. He has symptoms of incip- 
 ient tuberculosis, or the precedent state. He has reason to 
 fear tuberculosis in the first stage, for his occupation and 
 manner of life are such as to induce this state. He asks his 
 physician, who is a noted bacteriologist, if there be anyway 
 to determine whether he has tuberculosis or not. The doc- 
 tor replies: "The science of medicine has made rapid ad- 
 vances. When you were a boy this could not be deter- 
 mined. Now it is as simple as A, B, C. Dr. Koch de- 
 serves the gratitude of mankind. ' ' An injection of tubercu- 
 lin is made; no reaction. The patient is assured; "Your 
 fears are groundless; no tuberculosis whatever." (It must 
 be remembered the precedent state is the condition of the 
 system in which the living tubercle bacillus takes root.) 
 
 What is the actual result ? Mr. D passes rapidly from 
 the first to the second stage of tuberculosis — from a curable 
 to an incurable condition. 
 
 What is the actual result ? Mistaken diagnosis, loss of 
 confidence in the physician, death of the patient. 
 
 (d) Tuberculin is sometimes dangerous. 
 
 True, the patient is dead. Can it be shown tuberculin 
 is the cause of death ? Has not Prof. Whittaker told us he 
 
—127— 
 
 has used tuberculin every day in hospital and private prac- 
 tice for six years, in now nearly one thousand cases, and has 
 never seen any kind of evil result? Does not Prof. Koch 
 say in substance that tuberculin is perfectly innocuous ? 
 Why decry tuberculin ? 
 
 That there be no misrepresentation we quote from the 
 published writings of Koch, as translated by J. T. W. 
 ( Lancet- Clime, April 24, 1897); ''Only the most extremely 
 virulent cultures should be used in the preparation of TR 
 . . . They must be prepared as fresh as possible . . 
 . I consider it out of the question to produce TR in 
 large quantities with the hands .... At my sugges- 
 tion, apparatus for whoesale manufacture has been pro- 
 vided." 
 
 Listen to what follows concerning Prof. Koch's new 
 tuberculin: "In regard to TR, it has been subjected to 
 much criticism, both on account of the failure in some hands 
 to obtain hoped-for results, and on account of the impurity 
 of some of the samples that have been sent out by the firm 
 that have been allowed by Koch to manufacture this prod- 
 uct for the market.'' Again: "According to Trudeau and 
 Baldwin, some tuberculosis bacilli may be found in the 
 preparation." (Bulletin of the Pasteur Institute, July, 
 August and September. ) 
 
 After reading the above it seems further comment is 
 unnecessary. 
 
 Is tuberculin dangerous? No, if perfectly pure and 
 injected with proper precautions, 
 
 To summarize: The injection of tuberculin determines 
 the presence or absence of growing bacilli, is of no value in 
 diagnosis of tuberculosis, of uncertain value in differentia- 
 tion of first stage of the disease, and is sometimes dangerous. 
 
 It is seen from the above that the intrinsic value of 
 tuberculin is small, while, under existing circumstances, its 
 commercial value may be great. 
 
 What of tuberculin in treatment ? When Prof. Andree 
 launched his balloon in search of the pole he began a peril- 
 ous journey; result unknown. So when one promises cure 
 
-128 — 
 
 of disease not understood, he is traveling — no one knows 
 whither. 
 
 What is a constitutional disease ? The word constitu- 
 tional is significant. When that prince of cynics, Thomas 
 Carlyle, took a walk for the good of his health, he spoke of 
 it as a "constitutional" — conveying the idea, as the writer 
 thinks, that physical exercise in the open air builds up the 
 entire system. 
 
 When one speaks of a constitutional disease he means a 
 systemic ailment that primarily is taking away or destroy- 
 ing the life or vigor of the entire organism. 
 
 The word constitutional is used in contra-distinction to 
 local. Should one in the prime of life gradually decline in 
 physical and mental vigor, we properly designate this a 
 constitutional disease. Should one have an ailment in one 
 part or member of the body, we properly designate this a 
 local disease. 
 
 In medicine constitutional and local are relative terms 
 used to point out the extent of invasion. If applied to 
 treatment they respectively represent the whole or part of 
 the system for which the remedies are taken or applied. 
 
 From the very nature of the case, when one has a con- 
 stitutional disease he frequently has local symptoms. Per 
 contra, when one has local disease he frequently has con- 
 stitutional symptoms. 
 
 Our system is so connected and complex, one part be- 
 ing dependent on another, that when one member is dis- 
 eased the entire system suffers; when the system is diseased 
 individual members suffer in a greater or less degree. 
 
 These remarks may seem common-place. They are 
 common language used to make plain the nature of a con- 
 stitutional disease. 
 
 The writer takes it, a constitutional disease is a disease 
 of the entire organism, and that primarily. 
 
 Is tuberculosis a constitutional disease? On this, as 
 many other subjects, writers fail to be lucid. If we attri- 
 bute the diseased condition found in tuberculosis to the 
 action of the germ tubercle bacillus alone, as is the common 
 
— 129 — 
 
 sentiment of the medical profession today; if the tubercle 
 bacillus capture and kill its subjects, as a fox a lamb in the 
 open, tuberculosis may be regarded a local or infectious 
 disease. The writer is unwilling to accord so potent an in- 
 fluence to the plant. 
 
 We are told one takes tuberculosis as he takes measles, 
 etc. The inception of tuberculosis is a question of expos- 
 ure. As the majority of mankind have measles at some 
 period of their existence, so the majority have tuberculosis. 
 As some do not "catch" measles, so some do not 'take" 
 tuberculosis. This seems very simple. 
 
 Is this view strictly correct ? Let us examine this sub- 
 ject a little more closely. The tubercle bacillus is a plant 
 growth. Like all vegetable organisms, the plant must have 
 a soil in which to develop. True, the soil for the vegetable 
 growth is found in a living animal, but please observe the 
 soil -per se is a dead or partially disorganized tissue. Must 
 it not, of necessity, be so? 
 
 Science tells us that plant life can assimilate only the 
 simplest forms of food; that tissue of the living animal is 
 food not in its simplest form. Therefore, the living tuber- 
 cle bacillus -per se cannot take root in the living animal. 
 Hence, a soil must be prepared before the reception of its 
 host. 
 
 For an author to state that tuberculosis is caused by a 
 germ, and is received in the same way as measles, etc., is, 
 to say the least, an expression of ideas w T ith little reflec- 
 tion. The method of infection in measles and tuberculosis 
 is very different. Is it necessary to prepare a soil for the 
 inception of measles ? Can we in any way so prepare a soil ? 
 Is a soil prepared in every case of tuberculosis before the 
 bacilli can take root ? Yes, in every case. Can we so pre- 
 pare a soil? That we can must be evident to every ob- 
 server. 
 
 Illustration: Take a number of monkeys from the for- 
 est. In their natural state ^tuberculosis is unknown among 
 them. Place these monkeys in confinement, with poor ven- 
 tilation, for a few days. It will be found that not some but 
 
-130— 
 
 all have the precedent state or soil necessary for the growth 
 of tubercle bacilli. It will be found in a short time that 
 not some but all have tuberculosis. 
 
 In an exposure to measles some few escape; not so in 
 tuberculosis, if the soil be prepared. 
 
 It may be asked, does not confinement -per se aid in the 
 production of the precedent state ? This is answered most 
 emphatically in the affirmative. 
 
 We have shown suspension may take place from within 
 or from without. We have shown that exercise in the open 
 air prevents the precedent state. To now speak of confine^ 
 ment as an aid to the precedent state seems superfluous. 
 Confinement or lack of physical exercise must, of necessity, 
 be an aid in its production. 
 
 One writer says tuberculosis is a disease of the nervous 
 system. He reasons: In every case of tuberculosis the ner- 
 vous system is involved. 
 
 Another might say tuberculosis is a disease of the mus- 
 cles, for in every case the muscles are wasted. 
 
 A third might say it is a disease of the osseous system, 
 etc., etc. 
 
 The truth lies here: Tuberculosis is not a disease pri- 
 marily of any one isolated system, but is a constitutional 
 disease. As such it includes everything in the physical 
 make-up of the organism. The truth of this assertion can 
 be verified by any observer or pathologist. 
 
 L,et us for the moment lay aside the idea of germs and 
 calmly consider the pathological condition as found. One 
 has phthisis pulmonalis — tuberculosis of the lungs; another, 
 tabes mesenterica — tuberculosis of the mesentery; a third- 
 receives an injury, an amputation is performed, and tuber- 
 culosis develops in a partially healed stump, etc., etc. It is 
 seen the pathological condition is found in many organs of 
 the body. While one organ — the lung — has a preeminence 
 in this regard, yet the fact of finding tubercle in every organ 
 would lead one to suppose a constitutional dyscrasia pre- 
 ceded the pathological condition. In other \^ords, that tub- 
 erculosis is a constitutional disease before the formation of 
 tubercle. 
 
—i3i— 
 
 Why one organ is predisposed in one individual and 
 another in another is perhaps due to an innate weakness, of 
 that particular organ. 
 
 It is generally found that when tuberculosis of one 
 organ causes death, the evidence of the disease is not local, 
 but systemic, showing a condition of system preceded the 
 local condition. 
 
 But, say some, "How can these things be ?" Does not 
 the bacteriologist inject tubercle bacilli cultures into the 
 healthy living guinea-pig, and do they not grow? Why 
 should one say a soil must be prepared ? 
 
 Another question: "Do these bacilli naturally grow in 
 the tissue of the healthy living guinea-pig?" Is not the 
 method of injection an unnatural method? In seeking nat- 
 ural results why not use natural methods? For tubercle 
 bacilli to grow in a natural or spontaneous manner a soil 
 must be prepared. 
 
 Let every biologist in the land take this truth to his 
 laboratory and ponder it in his heart. Let him ponder with 
 the slide of his microscope intact. Then will he truly learn 
 the science of life. 
 
 What is meant by civilization ? 
 
 "An improved condition of man resulting from the 
 establishment of social order in place of the individual in- 
 dependence and lawlessness of the savage or barbarous life. 
 It may exist in various degrees; it is susceptible of continual 
 progress." — (Guizot', -translation by Hazlitt.) 
 
 Do we understand civilization has evils ? 
 
 As Guizot has put it, civilization is an improved condi- 
 tion. Let no one assume the life of the savage is equal to 
 the life of the civilized. A just comparison places savagery 
 far in the back-ground. Should any doubt this let him com- 
 pare the condition of woman in the two stages of existence. 
 In savage life she is the menial of man, subject to his ca- 
 price; in civilized life his equal in every regard. Nowhere 
 today do we see the savage exalted except perhaps in poet- 
 ical effusion. 
 
 The author quoted tells us civilization exists in various 
 
- 132— 
 
 degrees. For example, the civilization of the United States 
 in 1 897 is not the civilization of Spain for the same year. 
 There is an immense difference. 
 
 Again, civilization is susceptible of continual progress. 
 No nation or people have, as yet, arrived at an ideal of civ- 
 ilization. As the Methodist brother puts it, "We must go 
 on unto perfection." 
 
 If civilization be not yet perfect, evils must exist. To 
 what particular evils does the writer refer ? 
 
 Only to those which cause suspension of atmospheric 
 influence, or the precedent state. In other words, only 
 those which cause tuberculosis. 
 
 What is one of the most flagrant evils of civilization ? 
 
 Ill ventilation: (a) In the home; (b) in the work shop; 
 (c) in the public hall or conveyance. 
 
 (a) The writer's attention was called to the remarks of 
 some poor immigrants: "What lovely homes ! Do the peo- 
 ple own these? How did they get them ? In our country 
 no one owns homes except the rich." A sad commentary 
 on European civilization. Will it ever be so in America? 
 The bulwark of strength in our land today is the home. 
 Churches ma3^ rise and fall, nations come and go, but the 
 home is sacred and should remain. To the home we are at- 
 tracted and tied. 
 
 In building the home or temporal structure in which 
 we live, mankind is fallible. We build too large or small, 
 or not in accord with the laws of nature or of health. We 
 build each after his own model or ideal, and our houses dif- 
 fer as our judgment. "Each thinks his correct." As mis- 
 placed confidence in marriage wrecks the happiness of the 
 earthly home, so building ill-contrived or ill-constructed 
 houses wrecks the happiness and health of those who in 
 them dwell. 
 
 In obstetric practice we are often called into homes in 
 which the bedroom or sleeping apartment is the smallest 
 room in the house. This is a mistake; it should be the 
 largest. In close apartments the air is breathed and re- 
 breathed many times during the night. 
 
—133— 
 
 In the selection of a furnace or heating apparatus mis- 
 takes are made. Furnaces, in general, are too small. The 
 furnace should at least be double the capacity required in 
 cold weather. There is then no white or red heat of the 
 furnace to abstract oxygen. It has been already shown 
 that impure or impoverished air causes suspension of atmos- 
 pheric influence or the precedent state. Herein lies the 
 secret of the so-called infectiousness of tuberculosis. 
 
 Tuberculosis is never infectious in a pure atmosphere. 
 Tuberculosis is ever infectious in an impure atmosphere. 
 
 What is the lesson taught ? To ever keep the atmos- 
 phere pure. 
 
 To summarize: Each resident in America who builds a 
 home builds as best suits his judgment. In construction 
 little regard is paid to ventilation. This is perfectly natu- 
 ral, for present teaching seems to be how to render the 
 home germ proof. 
 
 (b) In one sense our work-shop is our home. One is 
 an attorney, another a merchant, another an artisan, etc. 
 Each is engaged in his vocation a certain number of hours 
 per day. For these hours his shop or office is his home. 
 The laws of health apply as in the home. The ventilation 
 and heating should be on the same principle — an abundant 
 supply of pure air. 
 
 To the artisan in his shop there is an element of dust or 
 vapor with which he must contend. This increases the 
 danger from tuberculosis in that it increases the suspension 
 of atmospheric influence from without. 
 
 Who has not observed the increased death-rate from 
 tuberculosis in the artisan ? Have you ever thought this 
 increase was due to excess of germs in the little shop in which 
 he works single-handed? In the writer's judgment, the 
 increased death-rate is not due to excess of germs, but to 
 suspension of atmospheric influence from without. The 
 germs then enter. 
 
 In the larger shops there are often three factors at 
 work at one and the same time: (i) Insufficient air space, 
 consequent rebreathing or air impoverishment; (2) poor 
 
-134 — 
 
 ventilation, to prevent draughts or to keep out the cold — 
 therefore, impure air; (3) the irritant dust or suspension 
 from without. Add to these, heredity,, low vital resistance, 
 etc. Is it any wonder multitudes thus placed readily suc- 
 cumb to tuberculosis ? 
 
 Please look at the question from a rational standpoint. 
 Would you think a disease thus caused could be prevented 
 or cured by other principles than those of common sense ? 
 
 What would be a teaching of common sense ? ( 1 ) 
 Abundance of pure air; (2) elimination of the irritant dust; 
 (3) all workmen, with an hereditary taint excused. 
 
 What is present teaching? (1) Artificial immunity — 
 injection of tuberculin; (2) prevention of infection — cupsi- 
 dors partially filled with water, into which, all workmen are 
 taught to spit. The comparative merit of the two methods 
 of prevention is left to an intelligent profession. 
 
 (c) The people who continuously dwell in close houses, 
 who assemble in close public halls and churches, are the 
 civilized. The people who continuously suffer most from 
 the dread disease, tuberculosis, are the civilized. These 
 two statements must ever be born in mind. 
 
 Of civilization and tuberculosis, which precedes the 
 other ? 
 
 In one sense there is no precedence. Where we find 
 the one, there we find the other also. Civilization and tub- 
 erculosis, like twin sisters, walk hand in hand. In point of 
 time there is precedence. 
 
 Civilization has evils. Civilization must exist before 
 evils develop. In this sense civilization precedes the evils 
 and the disease rapidly follows— cause and effect — the one 
 shrouded in the mysticism of the ages, the other plain as 
 the noon -day sun. 
 
 Can nothing be done to avert the calamity that has fal- 
 len upon us as a civilized people ? 
 
 So long as students in medicine are taught that tuber- 
 culosis is due to a germ; that immunity may be secured by 
 injection of tuberculin, so long there will be no true pro- 
 gress in prevention and control of the disease. So soon as. 
 

 5D~ 
 
 we grasp the true or primary cause of tuberculosis — susperr- 
 sion of atmospheric influence — so soon we take the first step 
 in prevention and control. There can be no definite action 
 until there is clear af prehension. 
 
 Perhaps no great nation of the earth has better inter^ 
 communication than the United States. A famine in our 
 land would be well nigh an impossibility. One wishes to 
 travel; he has only to select his route and trains pass and 
 repass by day or night at his very door. It seems perfection , 
 
 Did you ever think of the inconveniences of travel ? 
 We refer more particularly to the irritant dust or smoke of 
 the cars; of the close and vile air contained in them. Have 
 you ever experienced these? The same inconveniences of 
 travel are found on many crowded thoroughfares of our 
 large cities. Day by day we see every available space 
 taken. Standing room is at a premium, for in standing one 
 occasionally gets a breath of fresh air as the door is opened. 
 
 To what danger are we exposed in these closed coaches 
 and assembly halls ? Suspension of atmospheric influence — 
 the precedent state — incipient tuberculosis. 
 
 Does not the danger consist in infection from the germ 
 tubercle bacillus ? As already stated, infection cannot take 
 -place unless one has the precedent stat-e. This state is in- 
 duced by suspension, avoided by breathing pure air. 
 
 What, then, is the preventive? 
 
 An abundant supply of pure air. 
 
 The way to cure disease most speedily has long been 
 sought in the practice of medicine. Human judgment is 
 ever at variance as to method, a clear indication that nc 
 perfect wsy has as yet been found. 
 
 One thing the present generation has taught us: The 
 necessity of prevention. In this regard no century of his- 
 tory can show a brighter record. We are entering the por- 
 tals of a millennium. God hasten the illumination. 
 
 Truly, who can cure tuberculosis? No one. Who -can 
 prevent the disease? Only he who understands its cause. 
 The study of causal conditions in tuberculosis should there- 
 fore be our highest aim . Let us ever keep this thought in 
 mind. 
 
-136- 
 
 In how many ways is suspension of atmospheric influ- 
 ence induced ? Suspension may take place from within or 
 from without. From without through impure or impov- 
 erished atmosphere; from within through defective lung 
 tissue, original or acquired. 
 
 When is an atmosphere impure? An atmosphere is 
 impure when it contains a mechanical or chemical irritant. 
 In grinding on an emery wheel, or in certain vocations in 
 stone work, etc., the dust irritates the lungs, or collects on 
 the mucous surface, and thereby suspends atmospheric in- 
 fluence. The same suspension is found in vocations in which 
 the irritant is a gas or vapor, etc. 
 
 When is an atmosphere impoverished? When, from 
 over-heating of rooms, improper ventilation, etc., the oxy- 
 gen in the air is less than normal. 
 
 How does impoverished atmosphere produce suspension 
 of atmospheric influence ? A certain amount of oxygen is 
 necessary at each inspiration to properly aerate the blood. 
 If oxygen be deficient in the air the respirations must be 
 hurried, or else the blood is not aerated. Imperfect aera- 
 tion is suspension of atmospheric influence. 
 
 A careful study of the death-rate from tuberculosis will 
 show it is largely increased in cases of suspension of atmos- 
 pheric influence from without. 
 
 To what extent is the death-rate increased ? In pro- 
 portion to suspension of atmospheric influence. Let us see 
 if this be true. Here are two men doing like work in the 
 same room. One dies of tuberculosis, the other continues 
 at his work. Why this marked difference? 
 
 i. Heredity. If heredity and environment be the 
 same, like results could be anticipated, not otherwise. 
 
 2. Home life during nou- working hours. If the same, 
 like results. 
 
 3. Vital resistance. Mankind are not born alike in 
 power to endure; If so, there is inequality in vital resistance. 
 
 If heredity, home life and vital resistance be the same, 
 we should expect similar results. At the same time, what- 
 ever the comparison, it will be found that suspension of at- 
 
—137— 
 
 mospheric influence induced the precedent state. Without 
 this there could, be no tuberculosis. 
 
 What is meant by defective lung tissue ? The word 
 defective is used in its ordinary sense. If a limb be defec- 
 tive it is in some way weakened or deformed; if a fruit or 
 growth be defective it is not perfect. So in lung tissue. 
 Defective lung tissue is not perfect, does not perform its 
 normal functions. The function of lung tissue is to ensure 
 perfect aeration of the blood. If this tissue be inflamed or 
 thickened it is defective; if it be permanently thickened, or 
 if it be of abnormal tissue, its function is weakened or 
 destroyed . 
 
 A lung tissue may also be impaired temporarily or per- 
 manently. This impairment may be due to heredity or ac- 
 quisition. If to heredity, one is responsible for results only 
 as to using the one talent aright; one talent is all that is 
 granted. If to acquisition, one is responsible not only for 
 the right use of the talent remaining, but also for thelo^sof 
 the many talents bestowed. 
 
 Profit and loss are seen in life as in business. Should 
 we recklessly throw away our God-given faculties there is 
 no one to blame but ourselves. If we use and strengthen 
 those granted us, it is all a reasonable creator could ask or 
 creature desire. 
 
 To any who closely study disease it is seen that the off- 
 spring of defectives are defective. It is also seen that one 
 cannot recklessly throw away a treasure and at the same 
 time have it. 
 
 To those who study tuberculosis it is seen that children 
 of tuberculous parents are generally tuberculous. It must 
 also be seen that there are certain acquired conditions which 
 predispose to tuberculosis. In a tuberculous offspring there 
 is original defective lung tissue — suspension of atmospheric 
 influence, the precedent state. In other cases, as in measles, 
 pertussis, etc., there is an acquired defective lung tissue — 
 suspension of atmospheric influence, the precedent state. 
 
 To recapitulate: The precedent state or incipient' tub- 
 erculosis is caused by suspension of atmospheric influence. 
 
- 138— 
 
 Suspension of 
 
 atmospheric 
 
 influence. 
 
 From 
 without 
 
 From 
 within 
 
 f Impure f 111 ventilation, 
 
 | atmosphere { vocation, etc. 
 <J f Over-heating 
 
 Impoverished ■< rooms, improper 
 , atmosphere (ventilation, etc. 
 r { Original: Heredity 
 
 \ Defective f Disease 
 
 1 lung tissue j Acquired -j expos- 
 
 t (ure, etc 
 
 ' The law of tuberculosis expresses it more tersely: The 
 
 death-rate from tuberculosis is in direct ratio to suspension 
 
 of atmospheric influence. 
 
 There have been many solutions of the sphinx-like rid- 
 dle, tuberculosis. The writer thinks the above will stand 
 all tests. 
 
 Let us resume our catechism. Why should measles 
 and pertussis be placed in the category as causing acquired 
 defective lung tissue and pneumonia left out ? It is true, 
 tuberculosis sometimes follows pneumonia. The writer is 
 inclined to think pneumonia more often supervenes upon an 
 unrecognized incipient tuberculosis. The pneumonia runs 
 its course and then tuberculosis, at this stage, is diagnosed. 
 To answer the question more direct: in measles the rash 
 covers the entire surface, cutaneous and mucous. During 
 the eruption suspension of atmospheric influence must take 
 place. The eruption disappears,, but sometimes leaves an 
 inflammatory thickening in the lungs. This causes con- 
 tinued suspension of atmospheric influence, or the precedent 
 state. The bacillus then enters and takes root. 
 
 A double pneumonia is fatal. Isobar pneumonia usu- 
 ally involves but a portion of one or both lungs. While 
 this portion is involved the rest of the lung acts perfectly, 
 but, of course, respiration is quickened. Hence no suspen- 
 sion. The disease is of short duration and recovery is perfect. 
 
 In pertussis there seems to be a continued inflammatory 
 action,, which leads to thickening — suspension or the pre- 
 cedent state. 
 
 Observation shows tuberculosis often follows the above 
 diseases. The explanation given seems the most sensible 
 and comprehensive. 
 
—139— 
 
 It is fabled when Methuselah was 500 years of age, an 
 angel awoke him and said: ''Arise, Methuselah, get thee up 
 and build thee an house for thou art yet to live 500 years. ' ' 
 
 The reply of Methuselah is characteristic of a man in 
 the prime of life. Said he: "If I am to live but 500 years 
 why should I build me an house?" 
 
 Whether the age of Methuselah be taken in a literal 
 sense or not, this much is certain: Life at present is short- 
 ened in years. 
 
 Whether Methuselah lived in the open his entire so- 
 journ or not this much is certain: The present manner of 
 life shortens our years. 
 
 What is a common cause of tuberculosis ? Let us ex- 
 amine. If the animal kingdom be taken as a whole we find 
 two classes: They who roam at will and they who are sub- 
 ject to the will of another. Or perhaps better, they who of 
 necessity take physical exercise in the open air and they 
 who from choice, or otherwise, do not take such exercise. 
 
 Of the former class, w r e find all wild animals and all 
 nomadic tribes, as the aborigines of our country. 
 
 Of the latter class, all domestic animals and all civilized 
 people, as the Americans and Europeans of today. 
 
 Among the former, tuberculosis is unknown. Among 
 the latter no less than one-seventh die of the disease. A 
 marked contrast. Of the wild animals it is verily a ' 'struggle 
 for existence." 
 
 One animal is preying, on another, so each is on the 
 alert. If it be not the pangs of hunger that cause exertion 
 it is the fear of having to appease the hunger of another 
 animal. 
 
 So physical exercise is a matter of necessity. Activity 
 is life. 
 
 It is mainly so of an uncivilized people. The struggle 
 for existence is dominant. The females perform all man- 
 ual labor, the males are trained in war and the chase. War 
 and the chase are constant occupations. The tribes are 
 constantly moving and live in the open air. 
 
 As before stated, none die of tuberculosis. With 
 
— 140— 
 
 domestic animals the case is different. The pet cat or pug 
 sits quietly by the fire and lives wholly in the home. They 
 are fed as the family and ofttimes receive greater attention. 
 
 The domestic animal is fed and housed as the individ- 
 ual owner. The stabled cow, the penned sheep, the unused 
 horse are treated in like manner. 
 
 Is tuberculosis prevalent among them ? Yes, and please 
 note the prevalence is in accordance to the law of- tubercu- 
 losis. The death-rate from tuberculosis is in direct ratio to 
 suspension of atmospheric influence. 
 
 Did you ever know of a daily used race horse dying of 
 tuberculosis ? 
 
 Do not unused stable-fed horses die of tuberculosis ? 
 Why the difference ? Lack of physical exercise — suspension 
 of atmospheric influence. 
 
 This statement is also true of the work horse. A 
 horse constantly used in the open air seldom dies of tuber- 
 culosis. Why not ? Because physical exercise does not 
 permit continued suspension of atmospheric influence. Can 
 any one assign a logical reason why tuberculosis is more 
 prevalent in the. ox than in the horse? The difference lies 
 in a difference of physical activity. 
 
 All things considered, physical activity means preven- 
 tion of tuberculosis. 
 
 In these latitudes there are two conditions which com- 
 pel mankind to bestir themselves, viz., poverty and riches. 
 
 Both are blessings if rightly used. 
 
 He who has not the wherewithal to secure the next 
 meal is compelled to put forth effort either to work, beg or 
 steal. 
 
 He who has riches is compelled to care for them, or 
 "they take wings and fly away." 
 
 The effort put forth to attain these objects is physical 
 activity. 
 
 The student of history will observe the immense increase 
 in wealth in this country during the past few decades. 
 
 He will also observe this increase is largely in the hands 
 of a few. 
 
— Hi— 
 
 Immense wealth brings corresponding responsibility 
 ofttimes not rightly used. 
 
 Increase of poverty means increased dependence on 
 those who hold the wealth. 
 
 Ofttimes increased uneasiness or dissatisfaction that the 
 difference in the social scale is so great. 
 
 Both the rich and the poor need education and moral 
 restraint. They should ever strive to be more agreeable 
 one to the other. 
 
 Legislation should never widen the chasm between 
 them; the trend should rather be to close. 
 
 These facts are noted: 
 
 i. Increase of poverty and riches. 
 
 2. Entailed activit}^. 
 
 Upon whom does this activity descend ? 
 
 The following picture presents: The rich, few; the 
 many, poor; the anxious, careworn parent; the idle or vicious 
 child. 
 
 In the home of the rich — superfluit3 T , idleness, etc. 
 
 In the home of the poor — penury, vagrancy, etc. 
 
 What is idleness? 
 
 What is vagrancy ? 
 
 An answer for both — physical inactivity. 
 
 If physical activity prevent tuberculosis, what shall we 
 say of ph}^sical inactivity ? Does it not induce tuberculosis ? 
 
 What, then, is a common cause of tuberculosis? 
 
 Physical inactivity. 
 
 In what way is physical inactivity a cause ? 
 
 In that it allows suspension of atmospheric influence to 
 take place in the individual. 
 
 Suspension of atmospheric influence is tuberculosis. 
 
 What is lacking? 
 
 The incentive to labor. 
 
 The rich man's child asks, "Why should I labor? 
 There is no need." 
 
 The poor man's child asks, "Why should I labor? 
 There is no remuneration." 
 
 Physicians, pastors, educators — all, teach the wort hi- 
 
— 142 — 
 
 ness and necsssity of labor. It is life. 
 
 Say some, "A woman's work is never done." 
 
 She suffers most from tuberculosis. 
 
 Why educate woman to labor ? 
 
 Where does woman perform her work ? 
 
 Usually in the ill-ventilated home. 
 
 Does the work cause tuberculosis or is the cause of 
 tuberculosis to be found directly in the ill-ventilation ? 
 
 In every case in the ill-ventilation. 
 
 The work as exercise is the salvation of many a woman , 
 
 If then, the house in which we live — our home — brings 
 so much disease and death, Methuselah was wise in his gen- 
 eration when he said, "Why should I build me an house?"' 
 
 Is physical culture a requisite in the education of the 
 perfect man ? 
 
 When the Rt. Hon. W. E. Gladstone m his school days 
 sculled two miles up the river Thames with his college 
 friend, Hallam, he was developing that physical stamina 
 which served him so long and well in after years. 
 
 His friend Hallam, in being carried, enjoyed the com- 
 pany, ride and scenery, each in itself a benefit,, yet from 
 these alone he received no physical brace or vitality to resist 
 the inroads of disease. 
 
 The life of the one proved a monument of achievement 
 in deeds accomplished. The life of the other a monument 
 of worth so soon to pass from mortal view. 
 
 Here is a lesson to aspiring genius. Happy the one 
 who clearly reads. The young man or woman who starts 
 in life with a good physical and mental heritage, though 
 poor in purse, should remember in these alone he has a for- 
 tune. He should constantly bear in mind this fortune is in 
 his hands for a purpose. That a right use of this fortune 
 strengthens or increases it. A lack of use or abuse of this 
 fortune diminishes it in a like proportion. These truths 
 are seen on every hand. 
 
 Two persons of equal age and import start in the race 
 of life. The trysting time is now at hand. The one moves 
 «©& and accomplishes the cherished object of his life. The 
 
—143— 
 
 other speedily succumbs. Whence this difference? The 
 one has received physical training for the race; he is pre- 
 pared. The other has made no struggle and is unprepared. 
 
 The struggle of existence is the preparation and oft- 
 times determines the man. Physical training is assuredly 
 necessary, let none think otherwise. 
 
 In physical culture, what is the primary object? On 
 this, as other topics, writers may differ, but the author 
 takes it physical culture is for the development of the entire 
 man. 
 
 Physical culture is used in the training of certain mus- 
 cles. If life be a foot-race or boxing match the training of 
 certain muscles may be all that is required. But life is more 
 than these. I^ife is a complex entity in which there is 
 accumulation, conservation and diffusion of energy. Do not 
 misunderstand. No one of these factors work alone and of 
 its own free will. From infancy to manhood it is largely 
 accumulation. From manhood to old age it is largely con- 
 servation. It may be, or it may not be, diffusion all the 
 way. 
 
 The primary object in physical culture is to awaken, 
 hold in abeyance and give forth at the proper call. In other 
 words, physical training should include moral and mental 
 training. He who acquires much in youth has much to 
 diffuse in manhood or old age. He who dors not conserve 
 the energy received has no staying power in the continued 
 race, and falls by the wayside. He who best accumulates 
 and conserves has most to diffuse. 
 
 The Hie of each individual may be compared to a dy- 
 namo. Electricity is developed, stored and diffused. If 
 the generator be small there is little electricity to store or 
 diffuse. If the storage be small there is no need to develop 
 until ready to use. If the diffusion be faulty there is little 
 use to develop or store. The perfect dynamo has these 
 under Control. So the perfect man. Some men have strength 
 — development. Some have staying power — storage. Some 
 know when to give forth— diffusion. The perfect man has 
 each under control.. 
 
- 144— 
 
 The historical Samson had cumulation and diffusion- 
 no conservation. Failure. 
 
 The college student, Hallam, had conservation and 
 diffusion — no cumulation. Failure. 
 
 Gladstone had cumulation, conservation and diffusion. 
 Success. 
 
 Perhaps this may be illustrated in another way: Many 
 cannot resist temptation — cumulation and diffusion — no 
 conservation. 
 
 Moral training or physical restraint may be necessary. 
 Many, through heredity or defect, have conservation and 
 diffusion, no cumulation. If due to heredity the strong arm 
 of the law should assert its right for the benefit of future 
 generations. 
 
 Many have cumulation and conservation, no diffusion. 
 Among this number are the multi-millionaires in health and 
 strength, who acquire and hold but never give. Lazy lumps ! 
 What a shame ! 
 
 The primary object of physical culture should be to 
 render the circuit complete and under control, 
 
 Should physical culture be alike for all ? 
 
 As anatomy tells us the human body at all times has 
 essentially the same number of muscles, so one naturally 
 infers if one muscle needs training, then all. As the rela- 
 tive strength of these muscles varies with the individual, so 
 one naturally infers the exercise should be adapted to indi- 
 vidual capacity. The rule should be: No muscle to lie idle, 
 no muscle to be exercised above a healthy endurance. 
 
 Ought physical culture or training be continuous ? 
 
 The Christian might ask y ought prayer be continuous, 
 meaning ought the believer to pray once, twice or three 
 times per day during life. The answer would be, "Pray 
 without ceasing." Meaning that at stated intervals the 
 Christian should hold communion with God. The fre- 
 quency of these intervals must be determined by the needs 
 of the soul. So in physical training. The needs of one's 
 system must determine the frequency or duration of exer- 
 cise. In eating, one partakes of food wheu he is hungry. 
 
— 145— 
 
 The frequency of eating or amount of food must be deter- 
 mined by the needs of the system. Some people do not eat 
 enough; they starve the body at the expense of the intellect. 
 Others eat too much, so much, indeed, they scarcely know 
 the}' have an intellect. 
 
 With prayer and physical exercise the average man is 
 not apt to overdo. Yet it must be admitted with the physi- 
 cal wage earner there are many, many times when the sys- 
 tem becomes exhausted. This should not be. The wage 
 earner should have his periods of work and repose as others. 
 The brain worker should take a certain amount of physical 
 exercise each da}', preferably in the open air, the amount to 
 accord with the physical make-up of the system. If the 
 quantity of food ingested be large the exercise should be 
 more active or prolonged. If small, then less so. The 
 brain worker will hold out longer and accomplish more by 
 observing this simple rule. Work or physical exercise is 
 intended for all. There is no exception to it on this earth. 
 
 To briefly resume: All should engage in continuous 
 physical culture for perfect development. 
 
 What does perfect development bring ? Freedom from 
 tuberculosis. 
 
 Ought promiscuous spitting to be stopped ? 
 
 Under a repub lican form of government all its people 
 are free and equal. 
 
 Equal in that each has certain inalienable rights which 
 cannot be abrogated. 
 
 Free in that each does as he please, provided he does 
 not displease his neighbor. 
 
 As a people we are a nation of spitters. This arises 
 from two causes: The use of tobacco and the prevalence of 
 catarrh. 
 
 For the habitual user of tobacco, the writer has little 
 sympathy. For the sufferer from catarrh he has great 
 regard . 
 
 "Cleanliness is akin to godliness." 
 
 All tobacco users are filthy. It is impossible for them 
 to be otherwise. While there are grades of filthiness, from 
 
— 146 — 
 
 the esthetic smoker, whose breath at times emits perfume, 
 to the mendacious chewer and spitt er, who wallows in saliva, 
 all are filthy. 
 
 "Let him which is filthy be filthy still." 
 
 In one who suffers from climatic influence, or a consti- 
 tutional dyscrasia, the case is different. He, too, may be 
 filthy, yet ofttimes it is not a filthiness from choice. The 
 filthiness is thrust upon him. 
 
 We are a nation of spitters. 
 
 Let him who thinks otherwise enter the crowded church 
 or hall and examine. Let him move through the crowd 
 around the central stove of eating house or saloon, or glance 
 into the cuspidors of the more modern hotel. This, we 
 think, will convince. 
 
 Ought promiscuous spitting to be stopped ? 
 
 In attempting to answer this question there are two 
 things to be considered. 
 
 (a) Is spitting beneficial to the one so inclined? 
 
 (b) Is spitting injurious to the neighbor ? 
 
 On the answer given these questions must hinge the 
 oughtness of promiscuous non-spitting. 
 
 No tobacco user can swallow his saliva continuously. 
 He must, in some way, eject it. Spitting, then, in his case, 
 is beneficial to himself. If it be shown spitting is injurious 
 to the neighbor, the oughtness of it should be considered, 
 for no one in health is compelled to use the weed. Its use 
 is simply a habit. To the neighbor who wears long dresses 
 and asks, "Why should I be compelled to endure the nui- 
 sance of spitting ?" the user of tobacco may reply, "Why 
 should I be compelled to endure the nuisance of trains ?" 
 
 The one is as much a nuisance as the other. 
 
 Should one who views life from a practical or esthetic 
 stand-point ask the same question, no such reply could be 
 given. 
 
 The way, then, is plainly open to the tobacco fiend.. 
 To at once stop its use or care for his saliva. 
 
 On this subject the common law and the law of eti- 
 quette should be plain and harmonious.. 
 
—147— 
 
 There ought to be no mistake. 
 
 Having considered the status of the tobacco user, let us 
 now consider the rights of the afflicted. His rights, it 
 seems to the writer, have been flagrantly violated in all dis- 
 cussion of the past. At the outset, it may be asked, what 
 right has the afflicted that may not be granted to the healthy ? 
 If the healthy have no right to spit on the floor or carpet, 
 in the hall or home, why should this right be accorded to 
 the sick ? Let us be candid. 
 
 No such right is granted. 
 
 Whether in sickness or in health no man or woman can 
 claim the privilege of indiscriminately spitting. 
 
 It is a nauseating and filthy habit and should be so re- 
 garded by all intelligent people. 
 
 At the same time there are extenuating circumstances. 
 
 It is to these we would, at present, direct attention. 
 
 i. The patient is suffering from climatic influence. 
 He has recently taken cold, or has an influenza. He must 
 needs cough and hawk and spit. The patient and his 
 neighbor must bear these patiently. What we cannot amend 
 we must endure. But please observe in every case it is the 
 plain duty of the patient to care for his sputa. He has no 
 right to place this sputa in any way to inconvenience his 
 neighbor. If so placed, his neighbor has the right to object. 
 This much for the ordinary cold. 
 
 2. The patient is the subject of a constitutional dys- 
 crasia. The dyscrasia is a something, not of the patient's 
 volition. Perhaps it is due to marriage, or manner of life 
 of his ancestry — a thing beyond his control. It is the pa- 
 tient's duty, so far as in him lies, to ameliorate or remove 
 this dyscrasia. It is his duty to care for his sputa. Is this 
 all ? Has the public no duty to perform ? While the pub- 
 lic is asking so much of the patient, from a mere esthetic 
 point of view, ought not the public to discharge its plain 
 duty in securing a more healthy generation in the years to 
 come ? Why should the public demand so much of the in- 
 dividual, while it accords so little to the individual in return ? 
 
 3. The patient has tuberculosis. Laying aside, for 
 
the moment, the cause of tuberculosis— whether the germ 
 tubercle bacillus, or suspension of atmospheric influence- 
 laying aside the contagiousness of tuberculosis — whether all 
 or none in health take the disease — ought promiscuous spit- 
 ting to be stopped ? Yes, from an esthetic stand-point. 
 
 Assuming tuberculosis is due to the germ tubercle ba- 
 cillus, ought promiscuous spitting be discontinued from this 
 stand-point alone ? No. Tubercle bacilli are found in every 
 atmosphere. If the direct cause of tuberculosis, all would 
 have the disease regardless of sputa. 
 
 Assuming suspension of atmospheric influence to be 
 the primary cause of tuberculosis — that no tuberculosis 
 exists without first having this condition or precedent state 
 — ought promiscuous spitting be stopped? No. If sus- 
 pension of atmospheric influence must be present before 
 tuberculosis can exist — if the ventilation be perfect — what 
 matters it whether there be one or one thousand tubercle 
 bacilli per cubic foot of air space ? 
 
 In the contagiousness of tuberculosis the writer is in- 
 sistent. There must first be the precedent state before one 
 can take the disease. 
 
 It is not the number of tubercle bacilli in the air, but 
 the presence or absence of the precedent state that deter- 
 mines the contagiousness of tuberculosis. 
 
 When one insists that all sputa should be burned or 
 destroyed, from an esthetic stand-point, he is consistent 
 with the facts in the case. 
 
 When one demands destruction of sputa on the ground 
 of its becoming dried and mingled in the air, and thereby a 
 source of contagion to the healthy, he is asserting that 
 which the facts in the case do not justify, that which he 
 cannot maintain. 
 
 What leads to a belief there is other cause of tubercu- 
 losis than the germ tubercle bacillus ? The fact that only a 
 portion of human kind take the disease. If the tubercle 
 bacillus be the direct cause of tuberculosis, all should take 
 the disease, for all are exposed. 
 
 What other reasons can be assigned ? The tubercle 
 
—149— 
 
 bacillus is not found growing in the healthy individual. If 
 the direct cause, the growing bacillus would be found in 
 health. 
 
 Is there other reason to confirm this belief ? A period 
 of indisposition on the part of the patient, always precedes 
 the entrance of the growing bacillus. If the bacillus be 
 the direct cause, this period would be superfluous. 
 
 In what way can we determine the presence or absence 
 of this period ? By clinical observation and history. 
 
 In what way is this period of indisposition naturally 
 produced ? By suspension of atmospheric influence. 
 
 Can we induce an artificial indisposition which will 
 allow the living tubercle bacillus to enter one's system and 
 take root; if so, in what w T ay? By suspension of atmos- 
 pheric influence. 
 
 If one has this natural or acquired indisposition, or 
 precedent state, in what way can he rid his system of its 
 baleful influence ? By physical exercise in the open air. 
 The air is necessary, in that it supplies a long felt need in 
 oxygen restored. The exercise is necessary, in that it ex- 
 pands and contracts the lungs, thereby forcing the air into 
 the remotest cells. 
 
 Is, then, the open air treatment of tuberculosis cura- 
 tive? In every case, in the first stage of the disease, i. e., 
 before the tubercle bacilli take root. 
 
 Is this truth an important one? The most important 
 in the history of the disease. A knowledge of this truth 
 and its practical application would revolutionize treatment 
 and control the disease — tuberculosis. A truth of such 
 magnitude is w v orthy consideration. This truth is formu- 
 lated in the law of tuberculosis. 
 
 If, then, we rightly understand the writer, is the oxy- 
 gen treatment of tuberculosis beneficial? It is beneficial, 
 more especially in the first stage of the disease, i. e., before 
 the entrance of the tubercle bacilli. 
 
 Is the oxygen treatment curative? It is never curative 
 in that it does not remove the first cause of the disease, viz., 
 suspension of atmospheric influence. The treatment re- 
 
-ISO- 
 stores oxygen, ad interim, and thereby temporarily builds 
 up the system. The cause of the disease, being constantly 
 at work, gradually undermines the system and results in 
 the death of the patient. Oxygen treatment alone does not 
 cure tuberculosis. 
 
 You have spoken of the open air treatment. In what 
 way is this treatment curative ? The living tubercle bacil- 
 lus cannot enter one's system and grow unless there first be 
 the precedent state. The open air treatment is curative in 
 the first stage of the disease in that it drives awa3^ the pre- 
 cedent state and thus prevents the entrance of the tubercle 
 bacillus. With an hereditary taint this treatment must be 
 continuous in order to prevent the disease. Herein is shown 
 the ill influence, in treatment, of the tubercular dyscrasia. 
 An universal marriage law and correct living are the only 
 two metheds that will thoroughly eliminate this dyscrasia. 
 
 We have hospitals in this and other countries in which 
 the cure of tuberculosis, in all its stages, by the open air 
 treatment, is announced; are these statements reliable? It 
 is a sad commentary on human nature that statistics, like 
 many other things, are modified by the "almighty dollar." 
 But such is the truth. We have professors wdio are utter- 
 ing half truths in statistics year after year; men who have 
 not the vital stamina to tell what they truly know. While 
 we must recognize a difference between the teacher and the 
 thinker, at the same time please reflect — w r e are teaching a 
 future generation. Men and women are rearing an edifice 
 of knowledge that in future use will be cumbrous machin- 
 ery. So in the statistics we gather; many of these are 
 senseless verbiage. To return: Tuberculosis is caused by 
 suspension of atmospheric influence. To restore this influ- 
 ence would restore the patient to health, provided there be 
 no destruction of tissue, etc. There are in nearly all hos- 
 pitals tubercular patients with destruction of tissue, etc.; 
 therefore, but few of these p atients are restored to health. 
 Let us illustrate: Mr. A runs a circular saw; in its use he 
 loses a hand; can any hospital restore that hand as before ? 
 Mr. B has tuberculosis; cavities are discovered in his lungs; 
 
—151 — 
 
 can any hospital fill those cavities with normal lung tissue ? 
 The age of miracles is past. Why attempt to show the 
 present age a miraculous one? The age is not miraculous. 
 The attempt, if made, is simply a shield in order to more 
 effectually grasp the mighty dollar. Let us be honest. 
 
 In general terms, does the open air treatment benefit 
 tuberculosis ? Yes, in many ways (our own classification is 
 used.) In the first stage, as already shown, this treatment 
 is curative. In other words, tuberculosis is under control 
 in the healthy subject. In the diseased subject, as in hered- 
 ity, or in the second cr third stage of tuberculosis, it is dif- 
 ferent. In heredity, a soil is alread}- prepared; if the con- 
 ditions of life be favorable, the bacillus at once takes root; 
 not so in perfect health; a condition of life maybe favorable 
 to the growth of tubercle bacilli, and yet they do not grow. 
 Why ? Absence of the precedent state. Again, in the 
 tubercular dyscrasia as inherited, there must be a constant 
 battle to hold the condition of the system at the normal; not 
 so in perfect health. Man}' flagrant violations of law may 
 occur, and yet recovery is possible. Is the force of heredity 
 seen ? 
 
 In the second and third stages of the disease the pre- 
 cedent state is of necessity present. There are present the 
 growing bacilli, and, in many cases, abscess cavities. It 
 has been shown that the open air treatment cannot restore 
 lost tissue; lung tissue, broken down, has disappeared for- 
 ever. What can the open air treatment do in these cases ? 
 Prolong life and afford a small chance of recovery. In all 
 these cases there is still left a small amount of working lung 
 tissue. By the open air treatment this small amount of tis- 
 sue is placed at its best; by its proper use, with no incum- 
 brance other than the growing bacilli, the patient is kept in 
 better condition and life is prolonged. Constitutional treat- 
 ment in connection affords the best results. A good family 
 history with, open air and constitutional treatment will re- 
 store a share of these cases to health, and in every case will 
 prolong life. In truth, this treatment is the best known to 
 the science of man. At the same time it must ever be re- 
 
-152 — 
 
 membered prevention is the great field in which to labor. 
 Tuberculosis can be controlled. 
 
 Cannot exception be taken to the language used in 
 speaking of treatment? To the followers of Koch, perhaps, 
 TR will rank first; to those having hospitals at command, 
 other systems will continue in vogue. To the, one who 
 carefully examines causes and effects, the writer thinks 
 there is but one answer: The open air treatment is the most 
 potent, if not the only reliable therapeutic agent. The 
 writer has seen consumption recover under open air treat- 
 ment without the administration of any drug whatever. 
 
 On what is this answer based ? Careful observation — 
 to the readers who have carefully observed the old-time 
 homeopathist, of triturations and dilutions, you have seen 
 one thing: The great care used in selecting and arranging 
 the patient's room; the largest room, the one with the most 
 sunlight and best ventilation is the one chosen. The 
 homeopathist succeeds in the treatment of tuberculosis 
 where the regular has failed. Why ? Certainly not on 
 account of the medicine given, for flies sip copiously, night 
 and day, from the dilutions without apparent effect. Why 
 the benefit? On account of the oper> air treatment. 
 
 Is tuberculosis contagious? 
 
 This question is often asked by near relatives, friends 
 and attendants; those who directly minister to the wants of 
 the patient. As a question, it is a perfectly proper one and 
 should be answered in all sincerity. 
 
 Before directly attempting an answer, perhaps a pre- 
 liminary statement is necessary. 
 
 Among civilized nations, tuberculosis is found in nearly 
 every locality, is fatal in its nature, and is by some thought 
 to be on the increase. Since the advent of the germ theory 
 of the disease many worthy people have held tuberculosis 
 should be isolated as variola, etc., on account of its contag- 
 ious nature. These people have even invoked the aid of law 
 to prevent contagion — to protect the healthy. 
 
 Is tuberculosis contagious ? 
 
 The word contagious is used in its ordinary sense. By, 
 
—153— 
 
 is a disease contagious, is meant, is a disease catching ? 
 
 Can one take the disease from another while staying in 
 his house or rOom as nurse, or doing the ordinary work of 
 the household ? In other words, does one ordinarily take 
 tuberculosis while pursuing these vocations ? 
 
 Is tuberculosis contagious ? 
 
 John Smith is twenty-seven years of age , has a loving 
 wife with five small children and the disease tuberculosis. 
 No insurance. Mrs. John Smith is twenty-five years of 
 age, of nervous temperament; does the work of the house 
 but has heard of the germ tubercle bacillus. Mrs. S. thinks 
 dearly of John, but occasionally thinks of herself and fam- 
 ily. Very natural. She consults her family physician, 
 who is a germ theorist. 
 
 ''Doctor, I am afraid of catching this disease. Is tub- 
 culosis contagious?" 
 
 "Madam, your question is a very timely and pertinent 
 one. I have been in attendance on your husband now for 
 about one month. There is no question whatever as to the 
 nature of his disease. Had thought several times of telling 
 you to be more careful, but I have been busy, extremely 
 busy. . Mrs. S., you ought not to enter your husband's 
 room. There is great danger of the tubercle bacilli enter- 
 ing your system." 
 
 "But, doctor, what shall I do ?" 
 
 "You ought to hire a nurse at once. A competent and 
 thoroughly trained nurse; one who clearly understands the 
 situation." 
 
 "But, doctor, how shall I pay him?" 
 
 "Really, madam, I do not know. The law makes no 
 provision." 
 
 "Doctor, will the nurse not take the disease ? If the 
 bacilli enter my system, will they not enter the system of 
 the nurse as well ?" 
 
 "Madam, you do not understand. The nurse will take 
 proper precautions." 
 
 "Well, doctor, can you not give these precautions to 
 me ? Why hire a nurse?" 
 
- 154— 
 
 "You have thus far discharged the duties of nurse. 
 Your work has been done well, yet there are certain precau- 
 tions that should be observed. All sputa should be burned. 
 The object in this is two-fold: To prevent contagion on the 
 part of attendants and to prevent reinoculation on the part 
 of the patient." . » 
 
 "Doctor, since my husband's sickness I have burned all 
 sputa, as an act of cleanliness. ' ' 
 
 "As I said before, you must not enter your husband's 
 room. There is great danger." 
 
 "Doctor, in what does the danger consist ?" 
 
 "What a question ! In what does the danger consist? 
 The air is full of living tubercle bacilli. The danger con- 
 sists in these bacilli entering the system and causing tuber- 
 culosis." 
 
 "But, doctor, does not all air contain tubercle bacilli ? 
 Why should I be denied entrance to my husband's room?" 
 
 "True, the tubercle bacilli are ubiquitous, but they are 
 not so plentiful elsewhere as in your husband's room." 
 
 "Doctor, how many tubercle bacilli does it take to start 
 tuberculosis ?" 
 
 "Well, really I do not know, but I suppose one or two 
 would be all that is necessary." 
 
 "Doctor, I have read there are many microphytes in 
 the ordinary atmosphere. Now, according to your theory, 
 in order to prevent tuberculosis, one would have to stop 
 breathing." 
 
 "Madam, there are so many things you must learn from 
 experience. As I said before, you ought not to enter your 
 husband' s room. ' ' 
 
 "But, doctor, how shall I attend to his wants?" 
 
 "By means of a telephone. So far as I know, no ba- 
 cilli travel by wire." 
 
 "Doctor, shall I convey his food and clean linen and 
 arrange his bed by telephone ?" 
 
 "Certainly, madam, certainly." 
 
 "Doctor, ought. I to wear deceptive gloves while mak- 
 ing my husband's bed?" 
 
—155— 
 
 " Deceptive? You mean aseptic. There are so many 
 mistaken terms in science." 
 
 "Doctor, you say my husband's room is improper in 
 that it contains multitudes of tubercle bacilli. What would 
 you say to a larger room with more perfect ventilation ?" 
 
 ' 'Madam, this is not in accord with approved treatment." 
 
 "But, doctor, would not a larger room with perfect 
 ventilation lessen the number of tubercle bacilli per cubic 
 foot of air space ? Would it not render the room more fit 
 for a nurse to enter ?' ' 
 
 "Robert Koch, the greatest scientist who ever lived, 
 does not treat tuberculosis in that way. He huddles his 
 patients in small rooms. This is approved treatment." (Dr. 
 Hyndman, Cincinnati, O., speaks of the number of patients 
 in a small room.) — Lancet Clinic in Koch's hospital. 
 
 "It seems to me, doctor, that science could yet learn a 
 little common sense. However, so long as you are attend- 
 ing physician, I will obey orders." 
 
 "On one condition, madam, I will allow you to enter 
 your husband's room: Provided you wear a mask well 
 padded with cotton wool. The wool strains out the tuber- 
 cle bacilli." 
 
 "Yes, doctor; thank you. I can then look at my dear 
 husband." 
 
 "Yes, madam; but you must refrain from speaking." 
 
 "In regard to diet, madam, it matters little what you 
 give your husband to eat, provided it be served in the proper 
 manner." 
 
 "Doctor, what do you mean by proper service?" 
 
 "All food contains tubercle bacilli. The food and 
 dishes should be perfectly clean and all milk sterilized and 
 the dishes placed in the hot oven before and after use." 
 
 "Doctor, do you allow butter to your patients?" 
 
 "Butter in limitations is quite nourishing. It is used 
 with the usual precautions." 
 
 "What do you consider the best way to sterilize butter?' ' 
 
 "Butter should be boiled. It is best eaten while hot 
 through a sterilized tube. There is then no danger of in- 
 fection." 
 
- 156- 
 
 "Doctor, what shall I do in regard to my five dear 
 children?" 
 
 "Madam, I have not read the latest article by Count 
 Von Blaunerhasselt, but I am of the opinion you ought to 
 take unusual precautions." 
 
 "Doctor, what would you think of sending them to their 
 grandfather's? He lives on a farm far in the country. 
 The children could have abundance of exercise in the open 
 air and plenty of nourishing food." 
 
 "Madam, if you value their lives as anything at all, 
 you should do no such thing. To insure safety, your 
 children should be placed in a germ-proof house and the T. 
 R. treatment commenced at once." 
 
 "Doctor, of course I have a mother's fear, but is the 
 T. R. treatment dangerous?" 
 
 "The danger from the T. R. treatment is now at a 
 minimum, but of course in all cases there is danger." 
 
 "Doctor, what is the object of T. R. treatment ?" 
 
 "The primary object is to induce immunity." 
 
 "May I ask one other question, doctor? What is 
 meant by immunity ?" 
 
 "There are two forms of immunity, madam. Immun- 
 ity to tuberculosis and immunity to tubercle bacilli. It is 
 of the former kind I now speak." 
 
 "Doctor, do you mean by immunity to disease that one 
 has the disease all the time ?" 
 
 "No, madam; the very opposite. When one has im- 
 munity to disease he never has the disease; he never has 
 the disease so long as he is immune." 
 
 "How long does immunity last, doctor?" 
 
 "That depends. On an average something more than 
 two hours." 
 
 "Well, doctor, of course I am a woman, but this does 
 not seem like immunity to disease, but rather a continuation 
 of immunity." 
 
 "As I was about to remark,, there is another form of 
 immunity, viz., immunity to the tubercle bacillus. If one 
 should be so immune that the germ could not enter his sys- 
 
—157— 
 
 tern and grow, as this germ causes tuberculosis, the person 
 so immune could not take the disease if he desired to do so." 
 
 "Doctor, that is just the immunity I desire for my dear 
 children; please explain." 
 
 1 'Virulent living tubercle bacilli are injected into healthy 
 guinea pigs." 
 
 "Doctor, you do not mean to so inject my children, do 
 you?" 
 
 "If left alone, in every case, these guinea pigs die of 
 tuberculosis. ' i 
 
 "Doctor, my children are not guinea pigs." 
 
 "If these guinea pigs are injected with T. R. in time, 
 the animals do not die of tuberculosis." 
 
 "Doctor, you stated the guinea pigs are healthy. Why 
 have them die at all?" 
 
 1 'As I said before, the germs of disease must be injected. ' ' 
 
 "Doctor, as I said before, I am a woman. If my babe 
 takes tuberculosis, are the germs of disease injected? Does 
 not a condition of system allow the tubercle bacilli to 
 enter? Does the T. R. treatment or injection eliminate the 
 condition of system ? If not, does it or can it cure the dis- 
 ease tuberculosis ? Doctor, please answer my question: Is 
 there not always a condition of system that precedes the 
 natural entrance of the growing tubercle bacillus ? If yes, 
 theT. R. treatment cannot cure tuberculosis." 
 
 Is tuberculosis contagious ? 
 
 Yes, if you have the precedent state. 
 
 No, if you have it not* 
 
-158- 
 
 AN OUTLOOK. 
 
 To one who travels the northern portion of our country 
 and sees the boulders scattered here and there — some large, 
 some small, all rounded as if by gradual attrition and con- 
 tinuous movement — he is led to inquire, whence came these 
 and what cause can be assigned ? It was the observation of 
 these and similar data that led to the glacial theory, now 
 generally adopted by scientific men. But what caused gla- 
 ciers in this latitude? Evidently, it was change in climate, 
 but in the attempt to explain this man is baffled at every 
 step. 
 
 Thus it often is in the elaboration of any theory. In 
 science as in religion we see through a glass darkly, and yet 
 we see. To the physician who has sat by the bedside and 
 ministered to the wants of his patient in the dread disease 
 tuberculosis, and witnessed a decline more apparent day by 
 day, though steadily laboring to combat symptoms, he is 
 led to inquire, why this dark blot on present civilization and 
 just stigma to medical science? 
 
 It is this and similar observations which has led to var- 
 ious theories of the disease. One sees symptoms in tuber- 
 culosis which are distinctly nervous, and he declares it a 
 disease of the nervous system. Another, as he travels, be- 
 holds germs or vegetable growths in all tuberculous tissue; 
 to him these cause the disease; he at once formulates and 
 advocates the germ theory. 
 
 The writer plainly asserts he is not satisfied with either 
 theory. Perhaps it is because he has one peculiar to him- 
 self. Some people are built in this way. They are satis- 
 fied with nothing unless it conforms to their ideas. Be this 
 as it may, the writer gives his theory gratis, and the rea- 
 sons are accompanied therewith. What more can be asked ? 
 We speak plainly, it is not our purpose to unjustly judge 
 
—159— 
 
 any theory, but to give as best we may our reasons for dis- 
 carding the same. In doing this we do not arrogate all 
 knowledge to ourselves, but we speak in order to be clearly 
 understood* 
 
 If the disease tuberculosis be of nervous origin on ac- 
 count of the nervous symptoms, why not in the same breath 
 declare it of muscular origin on account of the muscle wast- 
 ing seen in every case ? It seems to the writer this would 
 be just as consistent. One thing medical men should know: 
 An attendant symptom is not necessarily a cause of disease. 
 Every disease has symptoms peculiar to itself. Symptoms 
 correctly observed render the diagnosis clear. But watch- 
 ing symptoms is not determining the cause of disease. 
 
 If germs alone truly cause tuberculosis, if the germ be 
 ubiquitous, as most writers claim, why do not all take the 
 disease ? Why do any escape ? If true, the result is mar- 
 velous in the extreme. Herein is the greatest fallacy of 
 the century. 
 
 It is assumed that the plant tubercle bacillus is a parasite. 
 It is a -parasite only in the sense of its growing on an an- 
 imal already diseased. It never grows on the healthy 
 animal. This was pointed out many years ago and has not 
 been successfully refuted. Where are our living germ 
 theorists ? Living germs are abundant. 
 
 One thing must be evident to every unbiased mind: A 
 plant cannot grow without a proper soil. Whence comes the 
 soil ? The germ theorist assumes the tubercle bacillus grows 
 indifferently in any soil. The writer thinks this is no such 
 thing. In every case the soil must be -prepared. Ofttimes 
 no doubt it is prepared unwittingly, but preparation, as the 
 seed, alike is requisite. This all must learn. 
 
 In many ways the soil is analogous to the soil of the 
 farm or garden. As is well known, all soils are not alike 
 productive. Some must be rendered fertile,- some need great 
 care in preparation; some are but waiting for the seed. 
 Each soil needs its particular care or attention. This the 
 wise farmer learns from sad experience. So, in tuberculosis 
 <as with greatness, some are born great, some achieve great- 
 
— i6o— 
 
 ness and some have greatness thrust upon them. Some in- 
 herit a soil, some acquire a soil and some have a soil thrust 
 upon them. In tuberculosis this may seem strange, start- 
 ling and discordant, yet it is nevertheless true. It is the 
 discordant note in this disease that renders the harmony 
 more complete. 
 
 My attention was early called to law in tuberculosis. 
 What is meant by law ? Plainly speaking, law is uniform- 
 ity of action. Wherever uniformity of action is seen there 
 must be law. Examples: A drop of water undisturbed 
 assumes a globular form — law; the moon revolves around 
 the earth, and the earth around the sun in regular periods 
 of time— law. In the higher mathematics should we dem- 
 onstrate that planets pass over equal areas in equal times we 
 prove a law. Law is an order of sequence. Should the 
 same thing occur year after year without variation, this is 
 law. My office rent is due every six months. This is the 
 law of the firm. Of this we are conscious. The physician 
 should adopt just such a law, only made monthly, some 
 think weekly. 
 
 Laws may be divided or classified as known or un- 
 known. Known laws are accepted without question, or 
 should they be questioned, may be verified. Unknown laws 
 are discovered like planets, and after discovery may be seen 
 by those having eyes or intellect. "Seeing is believing." 
 They then become known laws. 
 
 A word in this connection: To the average mortal 
 mathematics is dry and uninteresting. The writer has a 
 fondness for this particular study. At college in this branch 
 he was excelled by none. Some think mathematics of little 
 value. A distinguished language professor said to his class 
 this year: "All we need of mathematics is to be able to 
 break a five dollar bill properly and receive the correct 
 change." Is this true ? Would it not be nearer correct to 
 speak of language on this wise ? "All we need of language 
 is to be master of our own." But we confine our remarks 
 to men writing for the medical profession alone. Allison 
 Drake on "Twentieth Century Medicine a Liberal Educa- 
 
— i6i— 
 
 tion," in the Colorado Medical Journal, speaks of "the leger- 
 demain of algebra," and "the incapacity of professional 
 mathematicians for dealing with problems of mixed uncer- 
 tainties as notorious." 
 
 The writer thinks if we are truly dealing w ith problems 
 of mixed uncertainties, the legerdemain of algebra is just in 
 place. But where do we find such problems ? In that book 
 of formulas known as analytical geometry, which requires a 
 knowledge of algebra, geometry and trigonometry; no leg- 
 erdemain or mixed uncertainties are found. Remember, 
 these formulas are used in calculations, as calculus, etc., 
 which are very accurate. "Be not deceived." True, some 
 professionals are so merged in their calling they know little 
 else; this, however, is just as true of musicians, mechanics, 
 etc., as of mathematicians. Let no sane man decry the 
 accuracy of mathematics. Mathematics alone is the exact 
 science. 
 
 The truth of the matter appears to be this: Whatever 
 trains the mind to comprehend clearly and reason accurately 
 should be used in the preparatory education of the physi- 
 cian. Mathematics in the training of the reason is trans- 
 cendent; at the same time he who is most familiar with 
 other languages is most master of his own. In medicine 
 one should alike be master of language and reason. 
 
 We said our attention was early called to law in tuber- 
 culosis. We also said we are extremely fond of mathemat- 
 ics. In conning the authorities we find no one dies of 
 tuberculosis in the frigid zone. Why ? Do they all freeze ? 
 No one lives there? Please let this pass at present. We 
 are seeking law. 
 
 We put down at once what is given by standard medi- 
 cal authorities. It reads as follows: 
 
 TUBERCULOSIS. 
 
 Zone. Death-rate. 
 
 Frigid o 
 
 Torrid ^ Small 
 
 Temperate Great 
 
 We then seek reasons for the above and in so doing 
 
— l62 — 
 
 liberally consult the authorities. It excites one's risibility 
 to think of some of the reasons given. Take the frigid 
 zone in illustration. One author finds as a reason for the 
 zero death-rate in this zone that the people eat a vast amount 
 of fat meat. Hence, the remedy in any climate — cod-liver 
 oil, glycerine, cream, etc. Just reflect one moment. More 
 fat is eaten per capita in the temperate zone than in the tor- 
 rid zone, yet the death-rate is larger; so that in giving this 
 reason there is neither law nor common sense. 
 
 Another, a germ theorist, finds the reason very simple, 
 The climate is so cold the tubercle bacillus is frozen. Hence 
 the remedy is to cook the bacillus in situ and cure the dis-* 
 ease in any climate. The writer passes this man by by 
 calling him a very si?nfle reasoner. 
 
 After long consultation and many sleepless nights we 
 found a something that fills the vacancy. My readers have 
 probably heard of it before, viz., suspension of atmospheric 
 influence. We now fill this vacancy and ask all readers to 
 look: 
 
 TUBERCULOSIS, 
 
 Zone, Death-rate. Suspension. Ratio-. 
 
 Frigid ........ o o i 
 
 Torrid .Small Small ,, i 
 
 Temperate . . . .Great Great i 
 
 Please notice the regularity. Webster says whenever a 
 regularity is traced, law must exist. A law is formulated. 
 In tuberculosis the ratio between death-rate and suspension 
 of atmospheric influence is always constant. We prefer the 
 following construction: The death-rate from tuberculosis is 
 in direct ratio to suspension of atmospheric influence. Take 
 your choice:, they are the same. L,et us see if this law 
 holds good in its practical application. "The proof of a 
 pudding is in the eating.''' 
 
 The first column, under death-rate, is standard author- 
 ity, and, so far as the writer knows, has never been called in 
 question. The second,, under suspension, is our own, and, 
 of course, is debatable, L,et us see — no suspension in the 
 frigid zone. How da you- make this appear ? The houses 
 
-i6 3 - 
 
 or huts are made of snow or ice. Suspension in such huts 
 is an impossibility. In snow the interstices are filled with 
 air and where there is an abundance of air there can be no 
 suspension; ditto in ice, though not so great. The dry at- 
 mosphere of a cold climate keeps this air contained in these 
 meshes or interstices in constant circulation. Writers who 
 have lived in this zone tell us under these circumstances it 
 is impossible for one to take cold. Taking cold, 'I appre- 
 hend, is not clearly understood. 
 
 How about small or little suspension in the torrid 
 zone ? With few exceptions the life is wholly in the open air. 
 The climate is hot and arid as a whole and permits or allows 
 this. Were the inhabitants of this zone as cleanly, and, in 
 fact, as civilized as in the temperate zone, the writer sees 
 little reason why tuberculosis could not be eliminated entire. 
 
 What reason is assigned for the great death-rate in the 
 temperate zone ? In this zone the reasons are multifarious. 
 Our life, for the major part, is an in-door life, i. e., is in in- 
 closed buildings; these are ofttimes but illy- ventilated. Life 
 in the open, at best, is only for. a few days in the year. 
 While the fathers and sons live for the greater part in the 
 home, the mothers and daughters live almost exclusively in 
 the home. Vast numbers live in the shops and factories; 
 these are poorly ventilated and filled with dust and smoke. 
 This dust and smoke in the lungs prevents a perfect aera- 
 tion. Add to this the consumption of gas or fuel which ab- 
 stracts oxygen. These factors are constantly at work, viz. , 
 indoor life, impurities in the air, lessened amount of oxy- 
 gen. Remember, also, such factors as these: Thickened 
 lung tissue from changeable temperature, etc.; heredity, in 
 that there is deficient lung tissue, capacity, etc.; heedless- 
 ness, in that there is ignorance of the true cause of disease. 
 Hence, the great death-rate is caused by great suspension of 
 atmospheric influence. 
 
 In December, 1890, the author published an article in 
 the Cleveland Medical Gazette, in which occurs the follow- 
 ing: "Nature controls tuberculosis beyond the polar circles ; 
 nature controls in great measure tuberculosis within the 
 
— 164 — 
 
 tropics. Nature is doing all she can for us. Can we help 
 her? I believe we can; that the day is not distant when 
 tuberculosis will be banished from our midst." 
 
 A law is given in tuberculosis — as we prefer to call it, 
 the law of tuberculosis. The writer is aware this law is an 
 innovation. In medicine, as in kindred sciences, innova- 
 tions arise. We trust this one will lead to a more clear 
 comprehension of this most deadly disease. To the author 
 it is not distinctly new. Fourteen years ago it was written 
 on a blackboard and presented to the Portage County Medi- 
 cal Society. Some of the members of said society are yet 
 living; others have passed to the great beyond. The law is 
 presented in all sincerity. The writer knows whereof he 
 speaks. He is assured. 
 
 Notice the working of this law as seen in animate na- 
 ture around us. No wild animal has tuberculosis. Why ? 
 No suspension of atmospheric influence. Domestic animals 
 have tuberculosis. Why ? Suspension of atmospheric in- 
 fluence. Of animals dying of this disease which have the 
 greatest proportional fatality ? Those having the greatest 
 suspension. Which the least fatality? Those having the 
 least suspension. 
 
 Again, in treatment. What remedy is of most avail in 
 any stage of the disease ? A life in the open air — removal 
 of suspension. What can be said of incurable cases ? 
 The suspension cannot be removed. 
 
 Notice the law: The recovery in tuberculosis is in direct 
 ratio to removal of suspension. 
 
-165- 
 
 VAOARIES. 
 
 " 'But,' I sez, 'can you tell how the little seed of this 
 weed goes down into the earth and selects just what she 
 wants out of the great store-house below ? She never comes 
 out in a pink head-dress or a yellow gown. No, she always 
 selects what will make the blue. It shows that it has life, 
 intelligence, or else it couldn't think, way down under the 
 ground, and grope in the dark, but always gropin' just 
 right, always a thinkin' the right thing, never, never in the 
 hundreds and thousands of years makin' a mistake. Why, 
 you couldn't do it, Josiah Allen, nor I couldn't. And we 
 set and see these silent mysteries a goin' on right at our 
 door-step, day by day and year by year, and think nothin' 
 of it, because it is so common. But if anything else, some 
 new law, some new wonder we don't understand comes in 
 our way, we are ready to reject it and say it is a lie.' " — 
 (Samantha at Saratoga.) 
 
 The advent of the germ theory of tuberculosis brought 
 with it many vagaries. Some of these have become obselete, 
 while others are more modern — the old and the new. 
 
 The endeavor is made at this time to point out a few of 
 these whimsical notions, wild fancies or extravagant ideas. 
 The object is to touch upon nothing that has distinct merit 
 -per se without giving the same due credit. 
 
 Foremost among these vagaries is, perhaps, the notion the 
 plant tubercle bacillus is a bug, its extract a veritable bug- 
 juice. Who first gave loose rein to his imagination in this 
 regard is unknown. Whether he spoke of verities or un- 
 certainties is unknown. Certain it is, some editors and. 
 many writers still cherish these ideas. Associations linger. 
 
 The tubercle bacillus is not a bug, but is a plant, deriv- 
 ing its nourishment from the soil. As all vegetation re- 
 
— 166 — 
 
 quires a soil, so likewise the tubercle bacillus. 
 
 Perhaps this may be best expressed in postulates: 
 
 i. No vegetation can grow without a soil. 
 
 2, The soil must be peculiarly adapted to the plant. 
 
 Of the first, no question will be raised; it is self-evi- 
 dent. Of the second, it is known that certain soils are 
 adapted to certain plants; other soils will not raise them. 
 The wise planter selects the soil by direct observation or 
 experiment; otherwise he meets many failures. 
 
 A second vagary is, the tubercle bacillus will grow in- 
 differently in any soil; in other words, as parasites are found 
 indifferently on sickly and healthy animals, so likewise the 
 tubercle bacilli. The outgrowth of this second vagary is 
 due to the common belief that the tubercle bacillus is a 
 parasite. It is a parasite in the sense that it is found grow- 
 ing in 'the living animal; it is not a parasite in the sense 
 that it is found growing in all animals, regardless of their 
 condition. No tubercle bacilli are found growing in 
 healthy animals. A manifest distinction is here made. If 
 then, the tubercle bacillus be a parasite, it is a -parasite of 
 disease and the disease takes -precedence. 
 
 From observation the tubercle bacillus is found grow- 
 ing in a soil prepared by suspension of atmospheric influ- 
 ence. It naturally grows in no other. 
 
 By experiment a soil may be so prepared and the plant at 
 once takes root. Hence,, we conclude there is a law of 
 vegetable growth for this particular plant. As the seed of 
 this plant is everywhere present, as the soil is in various 
 stages of cultivation or preparation, so tuberculosis is seen 
 in various stages of development. 
 
 One who takes into consideration only the plant, re- 
 gardless of the soil, is like the farmer who cares only for the 
 seed. From him the soil receives no attention. To this 
 farmer a small or large crop is equally satisfactory. The 
 ordinary farmer is not so constituted. So we think one 
 should take into consideration the condition of the animal 
 as well as the plant. Certain it is, unless the soil be correct.. 
 
— 167 — 
 
 there will be no growth. 
 
 Vagary three: The tubercle bacillus is dangerous. An 
 early experience in hospitals where operations were per- 
 formed under a continuous spray, a later experience where 
 patient and instrument were injured by so-called germicides. 
 a still later where no care was taken except cleanliness, 
 makes us somewhat sceptical of injurious germs. But, as 
 the heading shows, we confine our remarks to this particu- 
 lar germ, and assert, if the reasoning thus far be correct, 
 no tubercle bacillus can be dangerous unless the subject of 
 injection have a favorable soil. The observation and rea- 
 soning along this line has been somewhat curious: 
 
 (a) Historical. — Many observers of the past have re_ 
 garded tuberculosis as infectious or contagious. Else why 
 so many cases in one family or community, or nation? 
 Why so universal a disease ? Per contra, others have re- 
 garded the disease simply as a decline, and as attributable to 
 many causes, the family, community or nation being sub- 
 ject to said causes. Some trust statistics. 
 
 (b) Statistical. — At various times statistics have been 
 compiled. The reader can judge of their value. They are 
 gleaned somewhat as follows: Drs. A, B, C, etc., to the 
 number of five hundred, are written and asked to answer the 
 following question: "Do you consider tuberculosis contag- 
 ious?" One hundred pay no attention to the letter, one 
 hundred and fifty-seven answer in the affirmative, one hun- 
 dred and forty-three in the negative and one hundred are in 
 doubt. The compiler concludes: "The majority believe in 
 contagion; great care should be exercised." Then follow 
 rules for guidance — when, where and how to spit, etc., etc., 
 etc. Others use reason alone. 
 
 (c) Rational. — If it be true the plant tubercle bacillus 
 naturally grows only in a soil produced by suspension of 
 atmospheric influence; if it be true we can control, in the 
 majority of cases, the soil so produced, it follows we hold in 
 our hands a method of effectual control of tuberculosis, and 
 that without germ intervention. This is the writer' s belief . 
 
— 168- 
 Th e germ theorist reasons as follows: If the plant 
 tubercle bacillus causes tuberculosis, there is danger. We 
 must escape or destroy the germ if we would be safe from 
 the disease. Cotton wool, germicides and serums are in 
 demand. 
 
 These same theorists might claim, if tuberculosis be 
 caused by suspension, why shun the danger? One can no 
 more catch suspension that he can catch a broken limb or 
 a shooting star. The writer claims: True, one cannot catch 
 a suspension, but he can avoid a suspension and thereby 
 avoid the disease. This leads to another method which we 
 call: 
 
 (d) Synthetical. — We may hang our harp on the wil- 
 low of imagination, yet the most skillful player brings forth 
 only a weird and hollow sound. We are in a strange land. 
 In all logical reasoning we must deal with facts. Let 
 us try to give them : 
 
 (a) Tubercle bacilli are everywhere present and cannot 
 be eradicated. 
 
 (b) They take root and grow when there is a favorable 
 soil. 
 
 (c) The soil is produced by suspension of atmospheric 
 influence. 
 
 (d) Suspension of atmospheric influence may be con- 
 trolled. 
 
 This means the control of tuberculosis — nothing more 
 nor less. 
 
 But suspension is already present: 
 
 (a) From ignorance or neglect. 
 
 (b) Heredity, for which we are not responsible or 
 reprehensible. 
 
 (c) Disease, to which we are all subject and some time 
 must yield. 
 
 Therefore, we must deal with facts as they are, and not 
 as we ideally wish them to be. 
 
 We have, then, two entities ever present, viz., suspen- 
 sion or the soil, and the tubercle bacillus or the seed. The 
 
— 169 — 
 
 soil and seed determine the harvest. 
 
 "What shall the harvest be?" The seed cannot be 
 sensibly limited. The output is constant. The soil cannot 
 always be governed. It is sometimes beyond control. 
 
 Mankind are truly frail creatures, yet when we once 
 clearly recognize the true cause of tuberculosis and the 
 means of prevention, I am satisfied the above vagaries will 
 be forgotten and the dreadful scourge tuberculosis will be 
 sensibly diminished — the lessening not attributable to any- 
 thing except a higher knowledge of the disease. Let us 
 labor for this happy consummation, It will abundantly 
 reward us. 
 
— 170- 
 
 MEDICINE. 
 
 The field of medicine is an extensive one. Bach prac- 
 titioner, from his particular angle, views to the extent of 
 vision. As when one looks on the lake or ocean he sees as 
 far as he can see, so when one introduces or examines a 
 system of medicine his field is commensurate to the percep- 
 tives exercised. No two people see exactly alike. No two 
 have the same perceptives. Hence, the diversity in vision 
 and perception. 
 
 As in a coast survey many angles are taken before a 
 complete map is made, so in medicine each should assume 
 many angles before establishing a system. Many of us are 
 extremely narrow. A system should be like the ocean, 
 comprehensive and deep — so comprehensive as to include all 
 knowledge, so deep as not to be readily sounded. A system 
 of similar magnitude demands attention today. 
 
 Nothing is more evident than that present medicine is 
 beyond the comprehension of any! To some it is neither 
 here nor there — a veritable ignis fataus. 
 
 Competent men have declared there is no such thing as 
 medicine, and, to their own satisfaction at least, have proved 
 it. "When Bishop Berkeley said there is no matter and 
 proved it, 'twas no matter what he said/' So when the 
 medical nihilist says there is no medicine and proves it, 
 there is no medicine in what he says, and ordinary mortals 
 believe it. A practitioner who gains this idea had better 
 drop from the race. Honestly, he has nothing to do — a 
 disease, but no remedy. 
 
 Others declare medicine is uncertain. What is not un- 
 certain in this life ? To strike out the uncertain things 
 would not only root up medicine, but law and theology as 
 well. Medicine is far more certain than either. In truth, 
 what could exist ? The farmer would no longer till the soil, 
 
—I7i — 
 
 crops are so uncertain. The merchant would not cross the 
 ocean or venture in trade, it is uncertain. It is said noth- 
 ing is certain in this life except death and taxes. These are 
 uncertain in time and magnitude. If we hold fast only to 
 the certain things, poverty would soon be the lot of all. 
 
 Say some: Medicine is empirical. The first treatment 
 of disease must be empirical. We know as yet absolutely 
 nothing. We gain our information from observation and 
 experiment. Human nature is full of ailments. Nature's 
 store-house is full of remedies. We seek to determine what 
 will alleviate distress or aid nature in removing disease. 
 Various ingredients, singly or combined, are tried and the 
 results made known. This is empirical. When like results 
 are obtained by a consensus of observers this is then called 
 science in medicine. How else could the value of a remedy 
 be determined than by experiment ? How else the worth of 
 a medication than from observation? Experiment or ob- 
 servation at the first must ever be empirical. 
 
 As the world becomes older, as disease and remedies 
 become known, we have not only all past experimentation 
 and observation, but also a large field for original research. 
 In this field we are placed as at the first. It is one of un- 
 known disease and untried remedies. So that so long as 
 human nature remains as it is, subject to sickness; so long 
 as the world remains as now, full of the untried, so long 
 there will be the two distinct fields — experimental and prac- 
 tical. These will be taken up respectively by parties best 
 adapted to the work. The separate fields will not long re- 
 main fallow or barren. Each will be cultivated and abun- 
 dant harvests secured. 
 
 For the past few years there has been a decadence along 
 this line. This may be attributable to three or more causes: 
 
 i. The desire of some to shine in medical literature 
 before a proper standard of refinement is attained. The}- 
 who closely follow these writers do not see the same results 
 as shown. We must then unlearn what is learned amiss. 
 This retards progress. 
 
 2. Experiments on animals are assumed to give iden- 
 
— 172 — 
 
 tical results as the same experiments made on man. As- 
 sumption is not always truth; many times it is the opposite. 
 This we all learn sooner or later. 
 
 3. Another fault should be readily seen. Experi- 
 ments made on the healthy animal are assumed to produce 
 the same result as if made on diseased man. How a 
 rational being could make so illogical an assertion is past 
 finding out, yet such seems to be. That similar statements 
 are made may be ascertained by consulting the ordinary 
 text-book in medicine. So many grains of calomel, etc., 
 produce a certain condition or result in healthy dogs, rab- 
 bits, guinea pigs, etc. If given to diseased man we expect 
 similar results. We may expect, but, as a matter of fact, 
 we do not see. Any practitioner knows that Messrs. A and 
 B may be alike diseased and a remedy given to the one will 
 not always produce the same result if given the other. 
 Mankind differ in susceptibility both in health and disease. 
 How, then, could we rationally compare the action of reme- 
 dies in health and disease, much less in animals diverse in 
 nature and habits ? 
 
 These are among the irrational things found in medi- 
 cine. There are many others equally as flagrant. 
 
 4. As a small observer of the times and seasons, we 
 must also think this decadence is due in part to the drop- 
 ping of the old and tried remedies and the grasping for the 
 new. This is seen more particularly in the adoption of the 
 various serums in the treatment of disease. It is observed 
 in certain conditions that germs or microbes are found grow- 
 ing. Why they are thus found is not asked, but the con- 
 clusion is at once reached that they cause the condition or 
 disease named. How to eliminate or dislodge the microbe 
 is the question for solution — no other. The various meth- 
 ods proposed would baffle the forest hunter in his search for 
 game. A trap, snare or gun would constitute the hunter's 
 outfit. Not so the germ-hunter. He proposes to secure 
 the invader by means of his own extract — a novel method. 
 What is also remarkable, the extract must be of a certain 
 brand, usually foreign. This certainly appears dishonest. 
 
—173— 
 
 The writer thinks all dishonest methods should be shunned, 
 even though they assume the guise of novelty. Wrong is 
 wrong. 
 
 This method of treatment being so contrary to reason, 
 some have tried to rule it out by means of ridicule. But 
 ridicule is not argument. It does not convince. There is 
 one way in which the inconsistency can be properly shown, 
 and that is by comparison. Suppose you discover a drove 
 of hogs in your neighbor's potato patch. What is your 
 first honest impulse? To inform the neighbor. What is 
 the neighbor's impulse ? Perhaps to swear, then to remove 
 the hogs, repair the fence and ask for damage. What is 
 the future action ? To keep the fence in repair. This is 
 an order of sequence. As a physician you discover growing 
 tubercle bacilli in a patient's lungs, or perhaps, better, a 
 condition of system in which the bacilli will soon enter and 
 grow. You are paid for the discovery. What should be 
 your honest impulse ? Should you spend the entire time at 
 the expense and danger of the patient in trying to trap, en- 
 snare or kill the growing bacilli by means of an extract ? 
 Should you not act as well, as sensibly, as honestly, by a 
 patient as by a neighbor ? If not, why not ? Should one 
 spend the entire golden hours of the precedent state, and 
 while tuberculosis can be controlled, in vainly endeavoring 
 to secure a possible immunity to the germ ? This is what is 
 being done. 
 
 When one looks about him and sees the inconsistency, 
 the foolishness, the dishonesty of his fellows in medicine, he 
 is led to exclaim: "Great God ! Can it be possible man is 
 created in Thy image?" Brethren, repair the fence ! 
 
 Medicine not subject to law ! We are accustomed to 
 see things move with regularity and precision. The sun 
 and moon rise and set at regular intervals. Mankind are 
 born, they grow and die. Waters run, smoke ascends, the 
 tide rises and falls. These things we are accustomed to 
 and of them we take but little note. In medicine things are 
 different. Here there is no regularity. For pain or sick- 
 ness one takes nothing, another medicates, a third prays. 
 
-174— 
 
 and all complain. Each thinks his the proper way. Why 
 this diversity ? Why not more unanimity ? Why not a 
 universal method ? 
 
 How in regard to theology ? One believes in God and 
 prays, another believes in God but not in prayer. A third 
 believes in neither God nor prayer, etc. , etc. In truth, we 
 find many peculiar beliefs. 
 
 Note this connection in medicine and theology: Nearly 
 all bel : eve in something; the lack, if any, is in unanimity cr 
 method. This lack, in medicine, is the one thing of all 
 others which makes the field so extensive. Each has a 
 field. No two fields are alike. A system must compre- 
 hend or include all fields. There seems to be no other or 
 better way. I>et us enlarge our borders. 
 
 
— 175 — 
 
 DEEP BREATHING VS. TUBERCULOSIS. 
 
 One-half of the earth's people are poorly fed. The 
 reason is obvious. It is not that Mother Earth fails to 
 yield her sixty or one hundred fold, but that the hand has 
 been negligent or slothful in preparing the soil or planting 
 the seed. 
 
 Prosperity and effort are closely allied. "The hand of 
 the diligent waxeth rich." Indolence has no incentive to 
 labor. As a rule, famine stalks rampant in its fields. India, 
 today, is an illustrious example. We note also famine and 
 its twin sister, pestilence, thrive most among the heathen or 
 half-civilized. Christian civilization knows nothing of fam- 
 ine and little of pestilence from personal experience. They 
 are practically driven from its borders. 
 
 While we thus exalt civilization of this generation we 
 must also note some of its faults or defects. Foremost among 
 these is imperfect aeration of the blood. A vast majority of 
 the civilized are consuming less oxygen than they should. 
 The reasons are multifarious. 
 
 One would naturally think the primary cause for this 
 fault, defect or wrong consists in ignorance of the value of 
 oxygen. The writer is inclined to think this view an in- 
 correct one. The civilized are well informed. That it is 
 not ignorance alone is certain from the fact that physiology 
 is taught in all the public schools. The laws of the land 
 allow or compel attendance at these schools, so no plea of 
 ignorance can be raised. 
 
 But why is it assumed there is imperfect aeration among 
 the civilized ? What is aeration ? Aeration is ventilation 
 of the blood as it passes on in the life current. Aeration 
 takes place through the lung tissue. It naturally occurs in 
 no other way. The lungs of man, as the gills of fish, per- 
 mit the oxygen to enter the system. If the lung tissue be 
 
— 176 — 
 
 imperfect, thickened, or in any way defective, aeration i^ 
 incomplete, i. e., insufficient oxygen enters the system. 
 
 Should one consume less food than is required by the 
 system, or should the food be of imperfect quality, there 
 is a starvation of the body. The same may be said of oxy- 
 gen. One who takes in or consumes less oxygen than he 
 should, either from ignorance, perversity or inability, the 
 system must suffer. In one sense it is oxygen starvation or 
 famine. 
 
 Should one by deep breathing or inhalation take in 
 more oxygen, or should one breathe a purer air and thereby 
 receive a larger supply, every want in the system is met and 
 the famine is declared off. This is what deep breathing 
 does in certain states of the system. It removes the famine. 
 
 But first, why is it thought there is imperfect aeration 
 among the civilized? One-seventh of all deaths are due to 
 consumption or phthisis pulmonalis alone. If we add to 
 this number others who die of distinctly lung disease, as 
 pneumonia, etc., the proportion seems abnormally large. 
 No such proportion is seen among native tribes remote from 
 civilization. To the writer, the reason seems obvious: 
 They have a more perfect aeration. The perfect aeration of 
 native tribes secures a practical immunity from lung disease. 
 Civilization can show no such immunity. 
 
 What does aeration accomplish ? As the oxygen enters 
 the lung tissue it comes in contact with the venous blood 
 and changes it to arterial. The impure blood is thereby 
 rendered pure. The body, by this means, is kept in a 
 healthy condition. This of itself is one of the essentials to 
 long life. In order to have pure blood our food must be 
 ample in quantity and quality. The oxygenation of the 
 blood is just as essential. 
 
 We look on famine-stricken India with hearts of pity 
 and sorrow. Pity, there is so much suffering; sorrow, the 
 people are so unwise and improvident. India could look on 
 us with the same commiseration. The Americans and 
 Europeans are so talented; they have every resource of art., 
 science and literature, yet they are actually dying of starva- 
 
—177— 
 
 tion— an oxygen famine. The East India men should help us. 
 No doubt they would had they the zeal and knowledge. 
 The zeal, perhaps, could be attained by a better food supply, 
 the knowledge by the exercise of an acute observation, cer- 
 tainly not by consulting standard authors, who tell us so 
 much of disease germs and their action. 
 
 What else does aeration of the bloo d accomplish? The 
 food we eat sustains us or builds up our system as we digest 
 or assimilate the same. Without digestion and assimilation 
 there can be no true growth or strength added to our frame. 
 To every student of physiology it is known that the lacteals 
 empty the chyle, for the greater part, into the thoracic duct 
 and from thence it is poured into the venous circulation. 
 All chyle passes into this current. It here becomes subject 
 to aeration in its round of the circulation. What does area- 
 tion do to this new current which enters the channel for the 
 first time ? It seems this is the last creative act, if we may 
 so speak, in the formation of the new blood corpuscle. If 
 so, it must be a very important one in the animal economy. 
 New blood corpuscles are being formed, while at the same 
 time the old are revivified. These two actions are con- 
 stantly going on during aeration, are imperfectly performed 
 during imperfect aeration, and stop when aeration ceases. 
 It is seen that if every part of the human machinery be in- 
 tact except aeration there is here found sufficient cause for im- 
 purity of the blood and scantiness of the red blood corpuscles. 
 We may give eliminatives, we may ingest a better food sup- 
 ply, we may order / err urn redactum ad libitum, but we do 
 not reach the true cause of the difficulty until we establish a 
 more perfect aeration. 
 
 Herein lies a secret in the treatment of many diseases. 
 The disease tuberculosis, which is caused, we are told, by 
 the germ tubercle bacillus, originates in this way. The 
 first stage of tuberculosis is simply a faulty aeration. The 
 bacillus enters secondarily — is never a cause of the disease. 
 The faulty aeration may be due to many causes, but the re- 
 sult is one and the same — tuberculosis sooner or later. The 
 -remedy lies in the correction of this fault. It may take 
 
-178- 
 
 years to teach this simple truth, but it will eventually be 
 accepted, and we will look back at the amazing folly of hav- 
 ing once thought an infinitesimal germ caused the serious 
 disease tuberculosis. Colorado's burden will then be les- 
 sened and the world will breathe freer and easier, with a 
 purer blood supply and an enlightened conscience. It is this 
 field of original research that has remained so long fallow 
 that is destined to yield an abundant harvest on proper cul- 
 tivation. Let us each, with God-fearing assiduity, sow and 
 reap as best we may and patiently await our reward. It will 
 assuredly come and that with thanksgiving and joy. 
 
 We stated the quality and number of the red corpuscles is 
 dependent on the perfection of aeration. Let us see if this 
 be correct as to its practical workings. Take, for example, 
 the ordinary student life at college. Of course, we are 
 aware there is great difference in the student life of today 
 and that of twenty years ago. There has been improvement 
 on the social side, larger physical culture, more out-door 
 exercise, etc. In fact, there has been a constant change, 
 and that for the better. Yet, after all, student life is stu- 
 dent life — a host of duties, incessant cramming, and for the 
 studiously inclined, but little exercise. Many students are 
 constantly tired, easily exhausted, nervous and irritable. 
 What is lacking? A pure blood supply. Of this there can 
 be no question. What is the remedy? Physical exercise 
 in the open air, more perfect aeration of the blood or hema- 
 tosis. In the writers judgment there is no question but that 
 mental and physical training should be conjoined. All 
 schools should be conducted on this basis. 
 
 For further illustration take the ordinary housewife, 
 who does, for the greater part, her own work. What is her 
 life ? A constant round of duties in her household, never 
 fully done. From early morn till latest eve it is constant, 
 never-ceasing work. "A woman's work is never done." 
 What are her cares? For family, home and self. Self usu- 
 ally comes last. Her wants are many, but her greatest is 
 pure oxygen in her own home, or time and opportunity for 
 out-door exercise. She regards neither, but toils on , a poor 
 
—179— 
 
 weak, anemic creature, and dies, most often, of phthisis 
 pulmonalis. Could her untimely death have been avoided ? 
 Is civilization in any wise to blame ? These are questions 
 the twentieth century will be called to answer. Is not their 
 consideration proper now ? 
 
 But perchance the woman's sphere is not among the 
 toiling millions. Her life is one of so-called social joy and 
 gaiety. It is calls, balls, parties and receptions, of late 
 hours, untimely meals of indigestibles, society's loud call 
 for dress improper, etc. The life, ill-ventilation, etc., 
 cause rising with languor and the noon day sun. Envy, 
 jealousy and rivalry enter this life, but not more often than 
 imperfeet oxygenation of the blood. Society has yet im- 
 portant lessons to learn. Who would dare dictate to fashion ? 
 
 May be the life is that of a wage earner, and who is 
 not ? If so, it is so much work for so much remuneration. 
 We enter not the vexed question whether the pay be suffi- 
 cient for the labor. This is left to others. The question 
 with us is, is the ventilation ample. Workmen are often 
 crowded; the air space is insufficient and the room is dusty, 
 or perhaps the lights are consuming too much oxygen. 
 The remedy must meet the requirement. 
 
 In all these cases systematic deep breathing in the open 
 sir will overcome the difficulty if taken in time, provided the 
 fault be remediable. It will benefit the patient even though 
 the cause be continued. But the benefit in the latter case 
 will not, of course, be permanent. Permanent benefit means 
 freedom from tuberculosis. 
 
 A question now arises: What faults are and are not 
 remediable? If the fault be not enough oxygen in the 
 room, if an irritant dust, gas or vapor, if a use of the upper 
 air passages of the chest only, due to tight lacing or other 
 cause removable, these are remediable. If by heredity we 
 receive a lung tissue incapable of perfect aeration under the 
 most favorable environment, if from continued exposure, 
 taking cold or other cause we acquire a thickened lung tis- 
 sue incapable of perfect aeration, these, of course, are not 
 remediable. Deep breathing cannot alter permanently an 
 hereditary or acquired lung tissue. Deep breathing calls 
 into exercise the healthy lung tissue we possess, and aids 
 
— i8o— 
 
 the patient in his effort to secure a better blood supply. 
 This alone places him on a higher plane of health and enables 
 him to more effectually resist the encroachments of disease. 
 In other words, one who so acts keeps his system in a con- 
 dition in which the germ tubercle bacillus does not enter and 
 grow. He who so acts has a -perfect immunity to the dis- 
 ease tuberculosis. The number of germs in the atmos- 
 phere is of little moment provided there be a perfect aera- 
 tion of the blood. 
 
 Now please understand we do not advocate deep breath- 
 ing as a cure-all for every disease. Systematic deep 
 breathing, if the lung tissue be healthy, will insure a pure 
 blood supply in so far as oxygenation of the same is con- 
 cerned. Oxygenation of the blood, it will be found, is the 
 essential element in the prevention of the precedent state, 
 or first stage of tuberculosis. If true, how essential is per- 
 fect aeration in the prevention of the disease. If true, the 
 law of tuberculosis stands demonstrated: The death-rate 
 from tuberculosis is in direct ratio to abeyance of atmos- 
 pheric influence. 
 
 Deep breathing does more than the oxygenation of the 
 blood. As a preventive to taking cold or the ordinary 
 catarrh it perhaps has no equal. Deep breathing, then, not 
 only prevents tuberculosis directly, but it also prevents the 
 very causes which lead to the same. How essential is deep 
 breathing ! 
 
 It seems to the writer this article is incomplete until a 
 relation between deep breathing and physical exercise is 
 shown. In one sense deep breathing is physical exercise. 
 In another sense physical exercise is deep breathing. Yet 
 it must be evident to all they are not one and the same. 
 One may breathe deeply with little exercise. One may exer- 
 cise violently yet breathe shallow. Physical exercise should 
 be such as to cause perfect inhalation and exhalation. 
 
— 181- 
 
 AN AHERICAN NEED. 
 
 "A just observation and reflection upon men and things 
 give wisdom; these are the books of learning seldom read." 
 — Wm. Penn. 
 
 The Americans as a people are well educated. Many 
 things conduce to this end. Foremost among them a sys- 
 tem of common schools prevail throughout the length and 
 breadth of the land — the pride and joy of the nation. The 
 children, when grown, have vivid recollections of these 
 schools. Not only do they remember, but the habit of 
 thought then and there formed follows them in after years. 
 Early life is a period of inhibition; not only so, we also re- 
 tain what we see or hear. 
 
 The child at school may be compared to a sponge. 
 Whatever is presented is readily absorbed, so that, squeeze 
 whenever you will, the child or man gives out that he has 
 absorbed or inhibited. This is a sequel to the present sys- 
 tem. Whether it be regarded a fault or not, this much is 
 certain: There is not that in us which tends to a vigorous 
 growth or development. As writers and teachers we lack 
 originality and force. The writer believes this a fault, 
 one that should be corrected, or in some way avoided. It is 
 our life. Wherein does the wrong or fault consist ? In 
 this: We take in or assimilate as presented; we memorize 
 and give out just as we receive. Such teaching or instruc- 
 tion develops no originality. It is a parrot-like acquire- 
 ment and delivery. Ages come and ages go and we roll on 
 forever so. 
 
 It is a similar system which has brought the Chinese 
 empire where it is today. No people on this earth are bet- 
 ter educated than the Chinese. Yet in true progress and 
 clear ideas where are they ? One thousand years behind 
 the age. May it never be so said of America. 
 
It is not the object to find fault with a system of edu- 
 cation the like of which is not elsewhere to be seen— the 
 rather to commend it. At the same same time it must be 
 remembered that all human systems are faulty. To elimin- 
 ate a fault is to improve the system. Do we desire improve- 
 ment ? Why object to an- elimination ? 
 
 As before stated, in early life the receptive faculties are 
 open. This is as it should be. The child imitates, receives 
 and retains. As yet there is no cultivation of the percep- 
 tives. The child sees nothing except through his teachers. 
 As he grows why not occasionally let him look for himself ? 
 He passes from grade to grade, and, if studious, becomes an 
 encyclopedia of information, yet destitute of originality — a 
 mere book worm. 
 
 As the best pastor endeavors to find work for each of 
 his parishioners, and thus adds to or improves his talent, so 
 the most capable teacher strives to develop in each pupil his 
 powers of perception or originality. This is wise. Ency- 
 clopedias are common. Book- worms are unnecessary. 
 What the world wants is original thinkers for its advance- 1 
 ment. The sooner we discover this truth the better for 
 mankind. No discovery is probable by one who has been 
 educated under the present system. The system itself blinds 
 one to original research. It is a continual memorizing of 
 what others have passed on or determined. 
 
 That the writer is not giving vent to an hallucination 
 may be seen by observing the high school graduate as he 
 leaves his alma mater. Watch him ! His unaided ability 
 to secure a position and adaptability to gain a footing in the 
 "struggle for existence" is child-like. He is a mere tyro. 
 Place him on his feet, tell him what is to be done and how 
 to do it, show him what is expected of him, and if he be 
 faithful he learns more of practical wor th in one year than 
 in the many years previously. The world's book of prac- 
 tical suggestion and infor?nation is now o-pen to him for 
 the first time. Is he educated to read this book ? W& 
 ihiuk not. 
 
-i8 3 - 
 The same may be said of the ordinary college graduate. 
 Note the length of time before he finds a place adapted to 
 his abilities. When out of school he is like a landsman at 
 sea. Perhaps he begins with some menial employment much 
 to his distaste, if none^other offer. By diligence he rises 
 step by step and from his chaos of information he discovers 
 there is little available at present. The bent of inclination, 
 or more often the solicitations of friends, determines his vo- 
 cation. All may go well. Very often everything goes ill, 
 or it is rough sailing from the start, and the voyage proves 
 uneventful. 
 
 The great trouble is we are made too dependent on some 
 one else. Teachers are not always present. There are 
 some things we must observe for ourselves, else we do not 
 know. Birds and flowers and trees, etc., do not grow with 
 names stamped on them. 
 
 To be familiar with these objects we must learn them 
 from nature in nature's school. So in science; science of 
 today is not the science of yesterday or tomorrow. It is 
 changing. He who reads science truly must walk as in the 
 day, with both eyes open, recognizing all men, -paying 
 deference to none. He alone can read wisely. 
 
 "A just observation and reflection upon men and things 
 give wisdom; these are the books of learning seldom read." 
 Give us more self-reliance and greater originality; these are 
 potent factors in the world's evolution. 
 
 After the classical course in the schools comes the fit- 
 ting of oneself for professional life — a great w T ork. It is 
 said the major part of our great men are college bred. This 
 at best, is saying but little, for all of our children must have 
 more or less of college training. If, then, w T e have distin- 
 guished men at all they must of necessity be from this class. 
 
 The question under consideration is, do our strictly 
 college-bred men show marked traits for original research ? 
 Are they distinguished along the lines of acute observation ? 
 Do they not work in channels or grooves in which they have 
 
— 184— 
 
 been taught? Do they not hold and reverence the authori- 
 ties ? Are they not, as a rule, inferior in wisdom to the so- 
 called self-made men? 
 
 Our greatest .artists have ever copied from nature. 
 Why should we, the students of nature, ever be following 
 the scholastic method ? 
 
 Let us think wisely, but let us think for ourselves, re- 
 membering there are "Sermons in stones, books in running 
 brooks and good in everything." 
 
 
-185- 
 
 THE DAWNING 
 
 Within memory of the present writer a health officer 
 declared one dying of consumption should not be carried in 
 a public conveyance unless the casket be hermetically sealed. 
 Reason: The danger from germs is so great the public de- 
 mands precaution and protection. 
 
 Germs, in some localities, are yet considered dangerous 
 — dangerous in that their true action or condition of growth 
 is not clearly understood. We must live and learn. 
 
 Thanks to an enlightened public sentiment, the above 
 order is obselete. Other orders will be obselete ere long. 
 The light is gently breaking, and soon we will behold the 
 sun in his effulgence. The writer thinks he will bring heal- 
 ing in his wings. Give us the light ! 
 
 For the past tw T o decades we, as a people, have been 
 harassed by the announcement that milk and its products — 
 cheese and butter — are full of tubercle bacilli. We have 
 also, during the same period, been studiously taught that as 
 tubercle bacilli cause tuberculosis, these products are dan- 
 gerous and should be inspected. A government inspector, 
 as in Germany, has been urged. They say the people 
 should be taxed and microscopists should pass sentence on 
 all milk products placed upon the market. In this way 
 tuberculosis could be controlled. In the meantime, until 
 such inspection, we are advised to avoid cheese, boil butter 
 and sterilize the milk, some even going so far as to counsel 
 the eating of butter while hot through an aseptic tube. 
 
 The writer, in his weak way, at various times has de- 
 nounced these statements as fallacious. In the first place, 
 he argues that tubercle bacilli do not primarily cause tuber- 
 culosis. Tuberculosis is a constitutional disease, is based 
 on law and the bacilli enter secondarily. The constitutional 
 disease allows the natural entrance and growth of the 
 
-i86— 
 
 germ. On this topic the author challenges controversy. 
 
 If tuberculosis be a constitutional disease, the disease 
 preceding the germ's growth, milk is a diseased product 
 before the entrance of the growing germ, therefore, kill- 
 ing the germ by sterilization would not render it a perfect 
 milk. This was shown by the writer in 1894, {vide Tran- 
 sactions Ohio State Medical Society.) 
 
 If the milk be imperfect, milk products are also imper- 
 fect, and no microscopist could detect this imperfection by 
 the presence or absence of tubercle bacilli in said product. 
 Microscopical inspection is therefore a useless expense. We 
 pay taxes enough in this direction already. 
 
 As stated, the writer has attempted to clear the way for 
 microscopical entities. The replies have not been numer- 
 ous; in truth, as a rule writers have stood aloof. Is there a 
 reason why ? From the hills of New Hampshire we receive 
 the following: 
 
 DANGER FROM MILK OVER-ESTIMATED. 
 
 "Experiments as well as observations made in the last 
 few years lead us to believe that tuberculosis is much less 
 often communicated to man through milk than was former- 
 ly supposed." — New Hampshire Sanitary Bulletin, January 
 1900. 
 
 A closer observation, we feel assured, will lead to the 
 conclusion that tuberculosis is not conveyed in this way at 
 all, only under certain conditions. These will be spoken of 
 later on. 
 
 But who are making these experiments and observations 
 and what is their intrinsic worth ! The professors of the 
 United States agricultural experimental stations are largely 
 doing the work. The reports are of value according to the 
 ability, honesty and common sense of the ones making them. 
 Honesty we naturally expect. Some men are down-right 
 liars. Common sense and ability, like twin sisters, walk 
 hand in hand. Sometimes they are found alone, but only 
 for short periods of time. They soon come together. They 
 think so much of each other that they are close companions; 
 nothing can separate. So far as we can ascertain, these 
 
ir en, for the major part, are germ theorists. 
 
 For convenience, we divide them into theorists of the 
 first and second waters. Theorists of the first water believe 
 the germ -per se is all in all. Prof. Robt. Koch and his con- 
 geners belong to this class. Men of this stamp believe 
 germs are veritable Napoleons, carrying devastation, disease 
 and death. Theorists of the second water believe there are 
 germs and germicides; also a few other things worthy of 
 notice. Dr. Russell, of Glasgow, Scotland, and Prof. Rus- 
 sell, of the Wisconsin station, are men of this class. They 
 believe germs have a mission, but it is inferior to the mis- 
 sion of the being they infest. In other words, _, men are 
 superior to microbes. 
 
 It is a common impression that first- water men are 
 graduates cf German schools, while second-water men have 
 not crossed the North Atlantic. This is a mistake. Many 
 first-water men are found who never crossed their state line, 
 while some second- water men have visited many cities of 
 Europe, and vice versa. Where one has traveled is of little 
 worth. What does he know? This is what the world is 
 "asking. This it will ultimately find. One may deceive 
 himself forever. He can deceive the vast intelligence of 
 mankind but for a short time. Deception is short lived. 
 
 From the Storrs Agricultural Experiment Station of 
 Connecticut, eleventh annual report, we find experiments 
 were made by feeding eight calves with milk from tubercu- 
 lous cows, and that without infecting the former. These 
 calves were fed for periods varying from three months to 
 sixteen months without developing the disease. The report 
 is closed in brief, from which we extract the following sen- 
 sible words: "We kmfw comparatively little regarding the 
 ■conditions which favor the spread and development of tub- 
 erculosis among animals or man.''' Evidently, the above 
 was penned by a germ theorist of the second water. The 
 second water theorist knows but little in his own estimation; 
 the first-water theorist knows it all. When one rises to the 
 admission he knows but little, he is in position to take the 
 first step to obtain more.; when ©ne knows it all there is no 
 
incentive. He is practically dead and only needs burial. 
 
 That little is known, as yet, regarding the condition s 
 which favor the spread and development of tuberculosis 
 among animals, may be seen by consulting Bulletin 108, 
 June, 1899, issued by the experiment station located at 
 Wooster, O. Ohio as a state is in many regards a leading 
 one. The presumption is our men at Wooster are as com- 
 petent as others. Why not ? 
 
 "The herd of cattle at this station was established in 
 1894, by the purchase of a bull and two or three cows, each 
 of the Jersey, Guernsey, etc. . . . At the time these 
 purchases were made the idea was prevalent that the tuber- 
 culin test might be injurious to the health of the animal. 
 
 . For this reason the test was not insisted upon, etc., 
 etc. On the station farm they were, of course, given good 
 care, etc. All the increase was retained and by the spring 
 of 1897 there were about eighty animals in the herd, all 
 apparently in perfect health except two — a short horn cow 
 and a Jersey bull, which had begun to show evidences of 
 disease; the cow by rapid loss of flesh and the bull by the 
 growth in the throat of a visible lump, which caused diffi- 
 culty in breathing. At the beginning of June both of these 
 animals were killed, after having been subjected to the tub- 
 erculin test. The cow was found to be in the last stages of 
 generalized tuberculosis, and the lump in the bull's throat 
 was found to be due to the same disease. A supply of tub- 
 erculin was then procured and in December and January 
 further tests were made, and on June 8, 1898, fifteen cattle 
 were slaughtered." — An Outbreak of Bovine Tuberculosis 
 at this Station, p. 295. 
 
 Then follow temperature before «and after these injec- 
 tions, and the result as found after death — a very interesting 
 report. 
 
 These gentlemen should be congratulated. But the 
 writer is not satisfied, in that the report is incomplete. It 
 is incomplete in that the same number of animals were not 
 chosen by the tuberculin test and placed under similar con- 
 ditions. We would then have two lists of animals, one 
 
— 189— 
 
 chosen by general appearance or inspection and one by the 
 tuberculin test. Should the first lot develop tuberculosis 
 we could say, as in this case, it is lack of the tuberculin test 
 in selection. Should the second, "after the test, develop tub- 
 erculosis, what could we say ? Either the test is inefficient 
 or there is other cause of tuberculosis. Which would it 
 be ? The writer asserts that after the tuberculin test tuber- 
 culosis will develop, though more slowly. Why? 
 
 In an article (Lancet-Clinic, November 20, 1897,) the 
 writer held these conclusions: 
 
 (a) Tuberculin determines the presence of growing 
 bacilli. 
 
 (b) Tuberculin has no value in diagnosis. 
 
 (c) Tuberculin has no certain value in differentiation 
 of first stage. 
 
 (d) Tuberculin is sometimes dangerous. 
 
 The writer holds these conclusions tenable. But our 
 method of experimentation would be along a different line. 
 We claim the precedent state is the first stage of the disease 
 tuberculosis; that this state is caused by suspension of at- 
 mospheric influence and is based on law; that suspension 
 takes place from within and from without. Our questions 
 for answer would be as follows: 
 
 1 . Does suspension of atmospheric influence cause a 
 condition of system that allows the tuberele bacilli a natural 
 entrance and growth ? Take a healthy animal and subject 
 it to this test. Answer, yes or no. 
 
 2 . Is there more than one method of suspension ? 
 Experiment on an animal. Answer, yes or no, 
 
 3. Is there an anatomical difference in the lung tissue 
 of health and of heredity, or of acquired influence ? Sub- 
 ject the lung tissue of each to rigid microscopical examina- 
 tion or other scientific test. Answer, yes or no. 
 
 4. Is there a test, chemical, microscopical or other- 
 wise, which will determine the difference in the blood cf 
 health and that of suspension of atmospheric influence ? 
 Has science a delicate test ? Apply this test to the livirg 
 animal. Answer, yes or no. 
 
 When these experiments have been made and correctly 
 answered the law of tuberculosis will read as follows: The 
 death-rate from tuberculosis is in direct ratio to abeyance of 
 atmospheric influence, 
 
290— 
 
 MATHEflATICS IN MEDICINE. 
 
 In my boyhood days I taught a winter school in the 
 
 village of R . On entering the school building early 
 
 one morning I found written on the blackboard the following: 
 
 x }y *z 
 x y =* z 
 The value of z, please? 
 
 A question at once entered my mind. Who wants a 
 
 solution ? Several weeks later I learned a Mr. , who 
 
 had taught in the village , desired one. 
 
 Algebra is used but little in medicine, yet the writer 
 thinks its introduction would lead to more accuracy in defi- 
 nition, solve many hard problems and clear up some points- 
 now obscure. 
 
 In illustration, take the word heredity. What is meant 
 by heredity ? The author defines it a prenatal inheritance. 
 Whatever one receives in bone, blood, muscle, etc., prior to 
 birth is by heredity. 
 
 Let us see if this be true. Suppose one or both parents 
 have a constitutional disease. Does the definition hold ? If 
 not there is a mathematical inaccuracy. If true, there is hered- 
 ity in every distinctly blood disease, etc. We quote from 
 "Tuberculosis or Consumption" as follows: ^ You have a 
 son to send to college. You call before you five leading 
 clinicians in this state and put to each the test question : 
 What factor is heredity in tuberculosis ? Listen to the an - 
 swersr Nothing, little, much, a great deal, all. What arises 
 in your mfctd ? One of two things— either these teachers 
 are deceiving you or else they do not understand the busi- 
 ness they profess. If/w can instruct exceft they who 
 know?''' 
 
 But, replies, a germ theorist, if tuberculosis be caused 
 fay a germ,, which we have every reason to believe; if the 
 growing germ be not transmitted,, as experiments seem to 
 
 i 
 
—I9i— 
 
 show, what matters it whether heredity be much or little ? 
 Let us see: "It would seem much easier to formulate a co- 
 hesive and rational theory of the propogation of tubercular 
 disease by infection than to account for it by heredity." 
 (Ohio Agricultural Experiment Station, 1899, Bulletin 108, 
 page 364.) 
 
 The writer thinks this statement manifestly unfair. 
 Remember, it is a public document, paid for by the great 
 State of Ohio. The present writer has no motive other 
 than the advancement of medical science. He has a right to 
 ask fairness. In what does the unfairness consist ? In the 
 ambiguous word heredity. Does heredity mean [nothing, 
 little, much, a great deal, all? Much depends on the an- 
 swer. The majority of germ theorists claim heredity is 
 nothing. In place of heredity put nothing, and then read: 
 "It would seem easier, etc., to formulate, etc., by infection 
 than to account for it by nothing.' * Not only would it seem 
 easier but it would be easier. Of this the ^ writer feels 
 certain. 
 
 Who claims heredity is all ? Perhaps, all told, about 
 five persons in the United States. To whom, then, is the 
 committee of this experiment station talking ? To these 
 five. What does the great majority of the medical profes- 
 sion hold? That heredity is a factor in tuberculosis — a 
 variable factor. In some cases more, in other cases less. 
 Refer to history. We will attempt to explain this later. 
 
 Now look at the unfairness of the above statement in 
 the light of mathematics. To compare a factor or part with 
 an entity or whole as to the formation of a theory. Mani- 
 festly unfair ! One thing should be required of all public 
 servants, viz., accuracy of statement, mathematics in defi- 
 nition. 
 
 Says the same authority on next page (365): "In dis- 
 cussing the question of heredity we should keep clearly in 
 mind the biological meaning of the term," Exactly. This 
 is just what the germ theorist does not do. The germ 
 theorist claims the germ grows indifferently in any soil, i. e. , 
 the germ tubercle bacillus is the cause of tuberculosis. The 
 
— 192 — 
 
 writer says not so. A soil must be prepared, i. e. y the soil 
 must precede the growing germ . The germ theorist says that 
 heredity is practically zero. The spread of the disease is 
 from the germ alone. The writer says not so. Heredity is 
 a factor. A soil may be transmitted. This soil aids in 
 spread of disease. What is the order of the biologist ? Soil, 
 plant, growth or fruitage. Who keeps the biological mean- 
 ing most clearly? Mathematics in statement is required. 
 
 Why is heredity a variable factor ? Simply because it 
 does not occur in two cases just alike. I^et me illustrate. 
 A father has tuberculosis; his partner in life is in good 
 health; heredity in the child is one factor. Both parents 
 are in good health; heredity in offspring of these parents is 
 another factor. Both parents have tuberculosis; the child 
 in this case is still another factor. The mother has tuber- 
 culosis, the father is in good health; the offspring are other 
 factors. And so on ad libitum in as many conditions as the 
 parents may be found. 
 
 Again, the parents' occupation, environment, etc., 
 cause a variable condition of blood due to perfect or imper- 
 fect aeration, and this continued in the parents and trans- 
 mitted to an offspring cause variation in heredity as a factor. 
 
 The great body of physicians in America are as honest 
 and as competent as any physicians on the face of this earth. 
 In saying heredity is a factor in tuberculosis they express a 
 great truth. It is a factor. But we must look yet further. 
 Heredity is not the cause of tuberculosis. The cause is 
 suspension of atmospheric influence. Heredity as a factor 
 aids this cause in the extension of the disease. 
 
 Moral: In the prevention of tuberculosis heredity must 
 be regarded in connection with suspension. 
 
 A question is now presented to the germ theorist, viz.: 
 Why the diversity of opinion, past and present, in regard to 
 heredity if the germ theory be true ? In heredity what is 
 transmitted ? If there be transmission at all there must be 
 an entity. 
 
 In order to understand this rightly, one must first clear- 
 ly comprehend the law of tuberculosis. What does this law 
 
—19 
 
 teach or show ? In every case of suspension from whatever 
 cause, there is first an impurity of the blood due to imper- 
 fect aeration. This, if continued, leads to a condition of 
 tissue favorable to the growth of tubercle bacilli. The 
 tubercle bacilli ma}' be ubiquitous, but the} 7 are not omnis- 
 cient. They grow, but they grow as all plant life — in a soil 
 prepared. 
 
 Now take this truth and use it in connection with hered- 
 ity. What is the entity transmitted in heredity ? A pre- 
 pared soil. We have, then, in heredity an identical condi- 
 tion as in suspension at the first. Suspension creates a soil 
 and heredity transmits a soil and they (the soil) are one and 
 the same. 
 
 Illustration: Mrs. A. has poor ventilation in her home. 
 She becomes pregnant. During the months of gestation 
 the imperfect aeration continues and it induces an impurity 
 of the blood and a condition of the system or tissue favora- 
 ble to the growth of the tubercle bacilli. The fetus receives 
 the same blood and the same condition of tissue. Is this 
 clear? This is heredity in the child. 
 
 Should tubercle bacilli be found growing in the mother 
 they may sometimes be found growing in the child. In 
 either case, the mother or child alike allow the growth. 
 
 Or, perhaps better, let the illustration be taken from 
 life. Mrs.T., of E., has tuberculosis. She becomes preg- 
 nant, and in due time is delivered. (I often wonder if abor- 
 tion in some of these cases would not be justifiable.) The 
 mother having suspension, there is suspension in the child, 
 for, according to the author, in every case of tuberculosis 
 there is suspension. Here, then, we have a babe ready for 
 the growth of tubercle bacilli. In some few recorded cases 
 the bacillus is found growing at birth. Dr. Jacobi, of Xew 
 York, mentions such a case. Dr. Russell, of Glasgow, says: 
 "These cases have an academic interest," thereby acknowl- 
 edging their authenticity. The author thinks they have a 
 greater interest than this. They have a world-wide inter- 
 est. They prove a soil may be transmitted by heredity 
 alone. Yet there are men in high places who deny to hered- 
 
-194— 
 
 ity a value, and that before large classes. What astounding 
 effrontery in the light of observation, reason and common 
 sense. 
 
 We now hasten to discuss another phase of this ques- 
 tion. When a soil is induced by heredity, can it ever be 
 changed back to its original condition? That depends, as 
 in suspension, assuming there be simply a blood change or 
 slight change in the tissue — yes. If the change be to dis- 
 organization — no. Destroyed tissue cannot be restored. 
 Again, should there be disorganization with immense num- 
 bers of tubercle bacilli, as there usually is, all effort to re- 
 store health is in vain. The patient dies. Should enough 
 sound lung tissue remain to insure fairly perfect aeration, 
 under favorable conditions, health may be restored, though 
 not normal. 
 
 In what way may this change for the better be brought 
 about ? Just reflect one moment. What causes the dis- 
 eased condition? Suspension of atmospheric .influence. 
 What removes the condition? Removal of suspension. 
 The remedy is a simple one: Breathe pure air. 
 
 Illustration: We stated Mrs. T., of E., is delivered of 
 a child. What is its condition ? One of suspension. The 
 writer stated plainly to the parents the method to pursue. 
 Remove the child at once from the/breast, feed it cow's milk 
 and let it have abundance of pure air. The mother said no 
 — "If I die let the child die with me." Dr. W., of R., is 
 called. He approves my opinion. The mother still says 
 "No." An uncle, Dr. C, of C, is called, and he, holding 
 the same belief, takes the mother to his home and leaves the 
 child under the writer's supervision. In three or four 
 months the mother is covered with the clods of the valley, 
 but that child, today a man grown, is in perfect health. 
 At the time of removal it was thought by the trio of physi- 
 cians that the child would live but a few days. It had high 
 temperature, colliquative sweats and hurried respiration. 
 
 This history is but a counterpart of hundreds of others 
 seen in every civilized land. Do all receive equally favora- 
 ble results ? The writer thinks not. 
 
—195— 
 
 Let us now return to our analysis of bulletin 108, same 
 page. "The fact that the child of tuberculous parents de- 
 velops tuberculosis is by no means conclusive evidence that 
 it has inherited the disease in the sense that it may have 
 inherited physical conformation or mental characteristics." 
 The writer confesses he does not clearly understand what 
 the author of the above means. That his own view on this 
 most important topic be clearly understood, the writer again 
 quotes from ' 'Tuberculosis or Consumption:" "Children of 
 consumptives \ though the environment be changed at birth 
 die of this disease among other healthy children born of 
 other far ents" 
 
 Example: Mr. B. marries Miss T. Result of union, 
 one child. Mr. B.'s family history is unique. Of the en- 
 tire family, nine in number, consisting of grandparents, 
 children and grandchildren, all die of tuberculosis, except 
 one child of three, of diphtheria. Miss T. is of good family 
 history, but is delicate. Knowing th£ above history, the 
 child is taken and reared among other healthy children, yet 
 dies of tuberculosis, aged twelve; the writer being the last 
 attending physician. It seems to the author that in this 
 case an entity was transmitted. Who can determine ? 
 
 Another question bearing on the above now comes to 
 view. Is physical conformation or mental characteristic 
 transmitted ? Common observation shows that it certainly 
 is. This child looks like her father. That child acts like 
 his mother, etc. A likeness, similarity or entity is here 
 seen. 
 
 To be more explicit, is the entity of facial expression, 
 etc., as seen in heredity, one and the same as the entity of a 
 prepared soil by suspension ? It is not. In the former case 
 it seems to be the result of a natural law or unfolding, 
 whereas in the latter it is the result of a law violation or 
 suspension. Each is an entity, and each comes under the 
 head of heredity, but neither, so far as known, is controlled 
 by a germ. This may appear strange, but "truth is strang- 
 er than fiction." 
 
 And now for a bit of experience. "The experience at 
 
— i go — 
 
 this station with tuberculosis in swine, given on another 
 page, gives a forcible illustration of the manner in which 
 the disease may even skip a generation, to reappear in full 
 force in the next and yet not come under the law of heredity 
 as above defined." 
 
 Benjamin Franklin was pre-eminently a practical man. 
 He said to England, in 1776, that the proper way to eat a, 
 large cake is to commence at the edge. The above is a 
 large cake, and we propose to take Franklin's advice. Our 
 nibbling is only at the edge. If the law of tuberculosis be 
 true — and we think it is, ideally, at least — we can skip not 
 only one generation, but five or six generations in succes- 
 sion — ad libitum — and reinstate the disease in any genera- 
 tion in less than eight weeks. This may also seem strange, 
 but this in mathematics is called a corollary. 
 
 "Again, there is a possibility of prenatal infection from 
 either parent, previously referred to, which would be quite 
 a different matter from constitutional heredity." This is 
 the same old story of the germ theorist. Infection without 
 a soil. How could there be "prenatal infection?" Can a 
 plant grow without a soil ? If there be growth there must 
 be soil — ask any biologist. If there be prenatal soil, this is 
 heredity — the condition of growth. 
 
 We now give the algebra of the germ theorist. We 
 wish to be strictly fair. 
 
 a - Health. 
 
 b - The tubercle bacilli. 
 
 c - Tuberculosis. 
 
 The formula reads as follows: 
 a ~ b = c. 
 
 I^et us examine. Mr. B., what is your age? Twenty- 
 five. Are you in perfect health ? Never better; just took 
 out a policy for twenty thousand dollars; examined by three 
 physicians and all say first-class risk. Please step this way 
 one moment, Mr. B., I want to examine your sputum. A 
 microscopical examination is made. Tubercle bacilli are 
 found. Mr. B., did you eat butter for breakfast ? Yes, sir. 
 Please examine the butter. Tubercle bacilli are found. 
 
—197— 
 Mr. B., where have you been this morning? Walking in 
 the open air. Please examine the air. Tubercle bacilli are 
 found. Let us examine the formula: 
 
 a + b '- c, 
 i. e. y health -J- tubercle bacilli = tuberculosis. (Mathemat- 
 ics don't lie.) This man has got tuberculosis. Bring in 
 tuberculin and let us make a test. If there be a reaction he 
 has got the disease without doubt. Tuberculin confirms. 
 
 Ladies and gentlemen of the medical profession, this is 
 medical science as taught today. Millions of our fellow- 
 beings are hastening to eternity. Is it not time to call a 
 halt? 
 
 Let us proceed. "It is true that either of these forms 
 of transmission of the disease given would be in one sense 
 a hereditary transmission, but it would be transmission of 
 infective material, not of actual disease nor of diathesis. 
 The difference may at first sight appear to be hair-splitting, 
 but, in fact, this difference is of fundamental importance," 
 etc. 
 
 The above is rather a singular statement. Please ob- 
 serve—it is hereditary transmission, yet it is not hereditary 
 transmission. It seems like hair splitting, yet it is of fun- 
 damental importance. To the writer it appears like — it 
 either rains or it don't rain, for it is very evident if it don't 
 rain it must rain. 
 
 We now open a field for controversy. "Because there 
 can be no hope of overcoming this dread scourge until the 
 fatalistic idea that it is a constitutional disease can be dis- 
 placed by a clear conception of its contagious character." 
 The writer thinks if we wait until "the fatalistic idea that 
 it is a constitutional disease can be displaced' ' we will wait 
 until Mother Earth lays by for re-pairs and receives a new 
 axle-tree. In our judgment the constitutional will remain. 
 But we leave this for the future to determine and talk of 
 other things at this time. 
 
 If the view herein be clearly unde rstood or correctly 
 interpreted, it is seen an attempt is made to show a law in 
 tuberculosis — an inviolable law; that heredity is a factor 
 
— 19» — 
 
 aiding this law in an extension of the disease; that all dis- 
 ease of this nature of whatever character is governed by 
 this law. 
 
 THE LAW OF SUSPENSION, 
 
 The first stage in each case of tuberculosis is one of 
 suspension. This creates a condition of tissue which allows 
 the growth of tubercle bacilli. The tubercle bacilli do not 
 cause the disease, but in many cases render it more fatal — 
 fatal in that they cannot be removed — as a rule, they con- 
 tinue to grow; fatal in that their growth consumes the air 
 which should be taken up by the system; fatal in that their 
 growth renders the lung tissue incapable of perfect aera- 
 tion, etc. 
 
 If in the stage of suspension before a growth takes 
 place or while there is yet a feeble growth, perfect aeration 
 be established or re-established — according to this law — the 
 disease disappears and health is restored. In other words, 
 if a perfect being — meaning by this one free from heredity 
 as a factor — maintain a perfect aeration there can be no 
 tuberculosis. Tuberculosis is, therefore, a disease of ill- 
 ventilation or imperfect aeration. What, then, is the alge- 
 braic formula for tuberculosis in the various stages of the 
 disease ? 
 
 a - Health. 
 
 b = Suspension. 
 
 c - Heredity. 
 
 d - The tubercle bacilli. 
 
 e - Tuberculosis. 
 
 e' - more fatal. 
 
 e" - most fatal. 
 
 a -f b - e (formula i) 
 i. e., health with suspension added means tuberculosis. 
 Or transpose b: 
 
 a - e — b (formula 2) 
 i. <?., health is suspension taken away from tuberculosis. 
 
 a -fb jc-e' (formula 3) 
 i. e., health with suspension and heredity is tuberculosis of 
 a more fatal type. 
 
—199- 
 
 a -p b -p c 4- d - e" (formula 4) 
 i. e. } health with suspension, heredity and the tubercle ba- 
 cilli added means tuberculosis of the most fatal character. 
 This, the writer thinks, is the mathematics of tubercu- 
 losis. Other formulas can be given — 
 
 a -j- b -p c - e' (formula 3). 
 Transpose b -~ c. 
 
 a - e' — b — c, but a - e — b (formula 2). 
 Things equal to the same thing are equal to each other. 
 Therefore — 
 
 e — b = e' — b — c cancelling e = e' — c (formula 5). 
 i. e., tuberculosis is rendered less fatal by the removal of 
 heredity. 
 
— 200 — 
 
 THE NECESSITY OF A ITORE PERFECT 
 AERATION. 
 
 We are told in Genesis the Lord formed man of the 
 dust of the ground, breathed into his nostrils the breath of 
 life and he became a living soul. Whatever the belief as to 
 the genetic account of creation , this much is certain : In the 
 race of life man excels. The swallow of today is the swal- 
 low of the first century. The lion and tiger eat the same 
 food and procure it in the same way. Not so with man. 
 He alone of all animate creation has shown wisdom and 
 skill in environment. 
 
 We rightly feel proud of this, yet there is reason for 
 humility. 
 
 To him who reflects and compares man's estate with 
 the domestic mammal, it is evident: 
 
 ist. The number of still-born to man is vastly in ex- 
 cess to the mammalia. 
 
 2d. The number of deformed or abnormal births to 
 man is vastly in excess to the mammalia. 
 
 3d. Of normal births toman, the number who die nat- 
 ural deaths before maturity is vastly in excess to the 
 mammalia. 
 
 If, then, the writer observes correctly, man presents the 
 majority of still-born, deformed and of premature deaths. 
 Should the comparison be made with the wild mammal the 
 divergence is more marked. 
 
 The conclusion follows: Man with a living soul, or in 
 the exercise of reason, shows physical deterioration. 
 
 Per contra, the animal without soul or reason has 
 physically held its own. If true, these statements are 
 worthy our careful consideration. Let us try to consider 
 comprehensively and wisely. 
 
 The word child nood is used as the period from concep- 
 
tion to maturity. This, as will be seen, is the word in its 
 most comprehensive sense. 
 
 At conception the factors that enter the life of the em- 
 bryo are largely the health and vigor of the parents. The 
 purity of blood, strength of organism, predisposition, etc., 
 all must enter. 
 
 During gestation the blood of the mother is the blood 
 of the fetus. The life and health of the fetus is the life and 
 health of the mother. This follows of necessity. From 
 birth to maturity the life and growth of t!ie child is mainly 
 of his own volition, assuming there be proper food and care. 
 If at conception the blood of one or both parents be 
 impure, if during gestation the blood of the mother be im- 
 pure, if after birth the environment or food of the child be 
 improper so as to render its blood continuously impure — we 
 have the condition of impure blood from conception to ma- 
 turity or for the entire period of childhood. Nor is the 
 condition shown an anomalous one among the civilized. 
 
 Multitudes of such cases are seen in every generation. 
 Being so common and so easily recognized the only wonder 
 is that its true value is not duly weighed. 
 
 For illustration: Should impure food be given the 
 mother during gestation, or to the child during infancy, it 
 is readily seen the health is soon impaired. It is impaired 
 through impure blood. We have spoken of this elsewhere. 
 But improper food is not the only means of blood impair- 
 ment. There are many other ways. One of the most prev- 
 alent is non-oxygenation. In other words, improper venti- 
 lation of the blood as it flows in the life current leads to its 
 impurity. It leads to its impurity in two ways. 
 
 i st. The venous blood needs oxygen to change to 
 arterial. 
 
 Venous blood must not circtilate in the arteries. 
 Venous blood is impure blood and oxygen alone restores its 
 purity. 
 
 2d. The chyle poured into the venous current needs 
 oxygen to complete its elaboration or formation into blood. 
 Chyle must not circtilate in the arteries. Chyle is imper- 
 
— 202 — 
 
 feet blood and oxygen alone completes its perfection. 
 
 In defective aeration we have these two faults: An 
 arterial blood containing venous blood from the veins and 
 chyle from the lacteals. What is the result? The subject 
 whose life depends on such blood becomes physically weak. 
 The age of the subject makes no difference as to the fact of 
 impurity — only as to power of resistance. 
 
 The fetus in utero, the infant in arms, the child in the 
 home are all subject to like influence. A fetus in utero 
 may absolutely be killed by impurity of the mother's blood. 
 Likewise an infant in arms or a child in the home in so far 
 as they have the same powers of resistance. These facts are 
 worthy of notice and must be taken into account in the con- 
 sideration of the dread disease tuberculosis of which we 
 speak later on. 
 
 We said one who receives such blood becomes physi- 
 cally weak. In what way? He is improperly nourished 
 and a foreign element in his blood must of necessity act as 
 an irritant. Let me illustrate. Suppose a healthy individ- 
 ual eats food that is indigestible and that does not contain a 
 requisite amount of nourishment. He may pariake of the 
 food as often as he please but his system constantly grows 
 weaker. '-Aall any one ask how he may become strong ? 
 So in imperfect oxygenation. The blood contains an irri- 
 tant and does not contain a requisite nourishment. The 
 subject constantly grows weaker. He may become strong 
 by a change of aeration. In the adult this change should 
 take place. The adult has reason for a guide. Not so with 
 the child. The fetus in utero, the infant in arms has no 
 such monitor. He is subject to the whim or caprice, as it 
 may be, of another. During the infant's minority his life 
 and well-being are but as clay in the hands of a potter — 
 moulded at his will. Should this potter be an ignorant 
 crank the child must everlastingly suffer. 
 
 Such is the condition or history of thousands in our 
 land. These waifs who come into existence without thought 
 or care on the part of the parents, become the future men and 
 women to populate and repopulate the country. Is there 
 
— 203— 
 
 wonder at degeneration ? Could it be otherwise ? In this 
 connection the question may be asked, does not nature make 
 an effort to reclaim her own ? True, nature makes an effort 
 to secure more oxygen by a hurried respiration in the child, 
 and in a measure and in some instances secures it. Many 
 times it is like the one who tries to gain strength by eating 
 food more often. 
 
 If the nourishment be not in the food the rapid eating 
 does no good. So in aeration. Rapidity of breathing ouly 
 makes the irritant more apparent. It does not increase the 
 amount of nourishment. While this is true in regard to the 
 child, it does not apply to the fetus. The fetus has no res- 
 piration of its own. The oxygen of the fetus is from the 
 mother's blood. If the blood of the mother contain but 
 little oxygen, the fetus can secure but little and vice versa. 
 
 The mother, then, during gestation, has it in her power 
 to give or withhold oxygen. Does she in every case clearly 
 understand this ? If so, does she so act ? 
 
 Thus it is seen that the child or fetus is hedged in, in a 
 peculiar way in regard to an essential of existence. The 
 mother wrongs her offspring through ignorance. The off- 
 spring must suffer the wrong through an inability to rectify. 
 Since civilization began it has been so, and so it must re- 
 main until by a clear recognition of facts we change the 
 conditions. Should a child be denied food the public at 
 once cries out. The wrong must be righted. Should an 
 imbecile be born in the home the state provides for its care. 
 Should a child become wayward reformatories are at hand. 
 Should a child be still-born — from want of oxygen — no man 
 in the land has courage to raise his voice. "God moves in 
 a mysterious way, His wonders to perform. He plants His 
 footsteps in the sea and rides upon the storm." Thus the 
 major part of the deaths in childhood are providentially ex- 
 plained. How consoling to the bereaved, "The Lord has 
 given, the Lord has taken away, blessed be the name of the 
 Lord." This, it seems to the writer, is a perversion of 
 Scripture in the present instance. But there are other per- 
 versions. 
 
— 204 — 
 
 W£ stated that during gestation the mother has power 
 to give or withhold oxygen from the fetus. In health this 
 is true. In disease, more particularly of the lungs, this 
 statement should be modified. A woman who has diseased 
 lungs marries. The disease is so extensive it is difficult for 
 her to properly aerate her blood. The field for aeration is 
 so small. She becomes pregnant. A double work must 
 now be done. Not only must she aerate the blood for her- 
 self, but also for the fetus. If the field were formerly 
 small, how is it now ? Either the mother or the child, or 
 more commonly, both must suffer. 
 
 It seems to the writer that one who maintains heredity 
 is not a factor in the transmission of disease, does not clearly 
 understand the situation. 
 
 Heredity is a factor not only in the transmission of sim- 
 ilarities, but also in disease itself wherever aeration of the 
 blood is concerned. It must be true. So that whatever 
 the view as to the intermarriage of consumptives — weak 
 lungs beget weak lungs and weak lungs beget an infant 
 with imperfect aeration of the blood — the primary step in 
 the advancement of tuberculosis. Without this primary 
 step the disease is unknown. 
 
 In corroboration of what has already been stated we 
 herewith present the following typical cases: 
 
 Case i. Mrs. G. , aet. about 37 — in good health — has 
 had two confinements. On both occasions her children 
 were weak and purple in color on delivery. For several 
 weeks prior to confinement she staid closely in the home and 
 took but little exercise. Her husband is several years her 
 senior and is in poor health. At the third pregnancy — her 
 last, I was notified of the above facts and ordered light 
 exercise during the last weeks and small doses of chlorate of 
 potassium three times a day. Child was more vigorous 
 and less purple. 
 
 The ages of the children range about two years apart 
 and the following is the present history twenty years later: 
 
 The eldest is delicate, but is able to act as a clerk in a 
 dry goods store. The second died at nine or ten years of 
 
—205— 
 
 age of asthenia. The third is now about twenty — the pic- 
 ture of health — and graduates the coming season. 
 
 The writer thinks a supply of oxygen during intra- 
 uterine life has done thus much for him. 
 
 Case 2. Mrs. S., set. about 30, in delicate health and 
 has weak lungs. Has had three confinements. The child- 
 ren's ages range as follows: Between the eldest and second, 
 four years. Between the second and third, two years. 
 
 During gestation of second child the mother's health 
 is unusually poor; indigestion, cough and abscesses on var- 
 ious parts of the body. At confinement instrumental deliv- 
 ery is used owing to the size of the child — ten and one-half 
 pounds. The father's health is good. Soon after the birth 
 of this child it is observed the breathing is rapid and at 
 times irregular. The child is fretful and nervous and sel- 
 dom gives the mother a full night's rest. Every tooth a 
 pang, every cold a burden. Treatment is instituted early, 
 but is of little avail. Continued on these lines for upwards 
 of tw r o years. Dr. W. , Sr. , of R , one of the best phy- 
 sicians of Northern Ohio, is called in consultation and after 
 a careful examination, said, "It is my firm belief this child 
 car not be reared." 
 
 What is the treatment henceforth? A walk or run 
 around the house once or twice each morning after being 
 dressed. Result: The child begins to improve and contin- 
 ues to do so until he wants to be out of doors the entire 
 time. Fourteen years have elapsed. 
 
 What is the present status at nearly sixteen years of 
 age ? Last year this boy w r as captain of a foot ball team 
 that w T on in nearly every encounter and this year he throws 
 the sixteen pound iron ball in a forthcoming athletic contest. 
 Other cases could be given. In the face of these truths who 
 can deny the value of a more perfect aeration ? 
 
 Dr. F. N. Otis, in his classical work on "Genito-Uri- 
 nary Diseases," '83, says in substance as follows: In gonor- 
 rhoea, if the purulent discharge come in contact with a 
 healthy mucous membrane it causes the disease. He 
 further adds,, this is not true of syphilis. In this disease 
 
— 2o6— 
 
 there must be contact and also an abraded mucous surface. 
 The writer has long held and \et maintains that a healthy 
 or abraded mucous surface and the contact of the living 
 tubercle bacillus does not constitute tuberculosis. There 
 must be something more, viz.: The precedent state. With- 
 out this state there can be no transference of the disease or 
 contagion. With this state the disease is readily transferred 
 in the conditions named. 
 
 Herein is a radical difference of belief which must be 
 settled before a clear light can be diffused. Let us endeavor 
 to make this still more plain. Dr. Russell says— we quote 
 his writings for they have been scattered over the land by 
 the Health Beards in various parts of the country — Dr. Rus- 
 sell says: "The tubercle bacillus, not being inherited, but 
 passing into the body from the outside, how does it get 
 there ? Under what conditions does it pass from the outside 
 to the inside of the body ? Under what conditions does it 
 live and propogate there ? It is impossible to demarcate the 
 answers to these questions as clearly as the questions them- 
 selves."— (Dr. Jas. B. Russell, B. A., M. D., LL. D., Sen- 
 ior Medical Officer of Health, Glasgow. Republished by 
 permission by the State Board of Health of Massachusetts, 
 1896.) 
 
 The writer answers these questions briefly. The tub- 
 ercle bacillus gets there by simply growing in a soil prepared. 
 It passes and grows under the conditions of suspension of 
 atmospheric influence. It lives and propogates under the 
 same conditions of suspension. In other words, if there be 
 imperfect aeration of the blood from any cause and for 
 ary length of ti?ne, all the conditions named will be found. 
 On the accuracy of this statement the writer pledges his 
 ideal reputation and challenges controversy. What greater 
 assurance can be asked ? We read in current medical liter- 
 ature that of the births in Massachusetts fifty per cent die 
 before they are fifteen years of age. The deaths are largely 
 due to tuberculosis. How sad a commentary on present 
 civilization ! The burden of rearing children is prior to fif- 
 teen. This burden falls largely and heavily on the elder part 
 
— 207 — 
 
 of every community, the part that practically needs sup- 
 port. Think of it ! A child who has grown to near matur- 
 ity and is educated to a point of self-support is ruthlessly- 
 taken away. Can this condition be averted ? 
 
 After twenty years of close study and accurate research 
 the writer answers this question in the affirmative. 
 
 Give us the method at once. By legal restraint in mar- 
 riage, by careful watching of the mother during gestation, 
 by physical culture in the child, by accurate ventilation in 
 the home and elsewhere, in a word, by a perfect aeration 
 thousands of these youths may be annually rescued to years 
 of usefulness. Is it worth the labor? The writer thinks 
 it is. 
 
 In conclusion, with due deference to education, do not 
 tie yourself too closely to the germ theory of tuberculosis, 
 for rest assured in the near future it will be shown that 
 germs have little value. 
 
 Tuberculosis is a constitutional disease, induced by im- 
 perfect aeration, is based on law and can be controlled. 
 
 The mathematics of the situation is as follows: The 
 death rate from tuberculosis is in direct ratio to abeyance of 
 atmospheric influence. 
 
-208 — 
 
 THEORY OF THE PRODUCTION OF 
 TUBERCULOSIS. 
 
 DES DEUT5CHEN VATERLAND. 
 
 1 'Was ist des Deutschen Vaterland ? 
 Ist's Preuszenland, ist's Schwabenland ? 
 Ist's wo am Rhein die Rebe blukt? 
 Ist's wo am Belt die Move zieht ? 
 
 O nein ! Nein ! Nein I 
 Sein Vaterland musz groszer sein. 
 
 * * * 
 
 "Das ist des Deutschen Vaterland 
 Wo Eide schwort der Druck der Hand, 
 Wo Treue hell vom Auge blitzt, 
 Und Liebe warm in Herzen sitzt, 
 
 Das soil es sein ! 
 Das, wackrer Deutscher, nenne dein I 
 
 "Das Ganze Deucsthland soil es sein 1 
 O Gott ! von Himmel sich darein !■ 
 Und Gieb uns rechten deutschen Muth, 
 Das wir es licben treu and gut I 
 
 Das soil es sein I 
 Das Ganze Deutschland soil es sein," 
 
 We have elsewhere stated, and again affirm, tuberculo- 
 sis is a constitutional disease dependent largely on the evils- 
 of civilization and governed by the following law: The 
 death rate from tuberculosis is in direct ratio to abeyance of 
 atmospheric inflnence. Suspension of atmospheric influ- 
 ence is, then, the primary cause of tuberculosis,, not the 
 germ tubercle bacillus, as commonly believed. 
 
 In a former article we attempted to show that deep 
 breathing, in so far as it removes suspension, removes the 
 primary cause in the same ratio, and is thereby curative. 
 We now try to set forth more clearly the true cause or na- 
 ture of this most serious disease, and in so doing to give as- 
 best we may our theory of its production. 
 
 
— 209 — 
 
 In the first place, please bear in mind that tuberculosis 
 is a constitutional disease. Medical writers of this genera- 
 tion are somewhat at variance on this important topic. Some 
 classify the disease as constitutional and then define as local 
 and infectious; this seems contradictory. Others believe it 
 a specific infectious disease, yet fail to state the condition 
 under which the infective germ or cause enters. This 
 essential is omitted — an unwarrantable fault. Still others 
 recognize a condition or state of the system as necessary for 
 its natural transfer; but boldly assert this condition or state 
 cannot be named. The fallacy of this position is shown in 
 "Tubercular Annotations." 
 
 Nor is the diversity of belief confined to this alone. It 
 is just as great on the question of heredity in tuberculosis. 
 Ask the eminent German medical scientist of today if scrof- 
 ulosis and tuberculosis be one and the same, and he will an- 
 swer yes. In the same breath he will affirm heredity is a 
 factor in scrofulosis, but not a factor in tuberculosis. Such 
 teaching is illogical, and, we think, immoral. The emi- 
 nence of the teacher ofttimes blinds the intellect. Let us 
 endeavor to use logic and truth at the same time. If scrof- 
 ulosis and tuberculosis be identical they are identical in 
 transmission. The writer claims tuberculosis a constitu- 
 tional disease — constiturionBl from the moment of inception; 
 that scrofulosis and tuberculosis are not only alike in nature 
 and manner of inception, but also alike in transmission. 
 
 The time has come for medical men to assert with posi- 
 tive earnestness that which they know. The air is full of 
 skepticism and unbelief: The medical world is running 
 wild after the sheerest fads. 
 
 Do I speak the exact truth in saying the scientist is 
 largely to blame? It is time, high time, to utter truths and 
 stand by them in argument. What the world wants more 
 than all else is men, high-minded men, who, knowing what 
 is right, dare assert and maintain the same. The medical 
 policy for the last few decades has been one of vacillation 
 and inaptitude. In no line of work is this more clearly seen 
 than in the management of tuberculosis ! The land of science, 
 
— 2IO — 
 
 germs and serums shows its ravages most clearly. When 
 will we control ? 
 
 These and kindred topics could be presented indefinite- 
 ly. Why prolong the discussion? It is not that we wish 
 to demolish the structure that has been reared with so much 
 painstaking, but rather to notify the residents of danger. 
 The foundation is unstable. The building will ultimately 
 be removed and rebuilt with greater care. At present we 
 are reprehensible if we do not notify. 
 
 It was an ancient belief that the life of the animal is in 
 the blood. There is much in this statement to meet accept- 
 ance and commendation. As the blood deteriorates the 
 health declines; as' the blood flows out the life departs. 
 There is a health standard, so that, as a rule, show the char- 
 acter or composition of the blood and the stamina or vitality 
 of the individual is seen. 
 
 Much may be said in extenuation of this belief. Yet 
 on reflection it is seen many things must enter in the com: 
 position of the blood; or, perhaps better, many factors are 
 essential in the production or formation of the blood in its 
 perfection. We enumerate some of the more important. 
 As a rule, the richness of the blood depends on the quality 
 of the food. The quantity of food determines more the 
 amount of blood. Yet there are exceptions. A rich food 
 may secure a large blood supply or a plain food a rich sup- 
 ply. There is something strange in this provision of nature. 
 Each animal seems to adapt itself to the food ingested. We 
 see well-nourished people who live on plain food and illy- 
 nourished people who live on rich food. The richness or 
 plainness of the food does not always alone determine the 
 quality of the blood. Other factors enter in its production. 
 
 One of these is digestion. It is not alone the quality or 
 amount of food ingested, but the amount digested, that goes 
 to restore an impoverished blood. At all ages a constant 
 waste is going on in the system. In youth there must be 
 also a supply for growth. This waste and supply must be 
 met. It is met by ingestion and digestion of food. But 
 digested food is not blood. Before it becomes blood it must 
 
■211 — 
 
 be taken up and poured into the proper channel, conveyed 
 to the lungs and aerated. It is then blood, and can be used 
 or utilized by the system in its growth or development. 
 This seems very simple, but the latter, or aeration, has ap- 
 parently been ignored by many of the profession. 
 
 Today there are leading lights in practice who prefer 
 to call in a microscopic germ to account for a faulty aera- 
 tion. To the writer this seems absolutely silly. Germs do 
 not naturally grow in hea-thy tissue. Imperfect aeration 
 prepares the soil for the so-called germ of tuberculosis. 
 Change the aeration in this early stage and there is no tub- 
 erculosis, or, if you prefer — germ growth. This is certainly 
 worth knowing. 
 
 But is not the idea of germ growth recent medical 
 science ? Is not the germ theory adopted by all scholars of 
 eminence ? Can we set aside so great an array of evidence ? 
 What would be the ultim ate outcome should we discard the 
 germ theory of tuberculosis ? Would we not again go back 
 to our forefathers and start anew? In reply to this we ask, 
 what would the world miss today should all knowledge of 
 tubercle bacilli be cast into everlasting disuse ? The writer 
 speaks candidly and upon reflection when he asserts the 
 germicidal or serum treatment of tuberculosis is no better 
 than former treatment. If modern treatment is of no avail, 
 why should we cling to it with so death-like a pertinacity ? 
 Echo answers, why? It should ever be the aim of the 
 scholar to learn to unlearn what has been learned amiss. 
 We have been learning amiss. Let us correct the error and 
 mend our way. 
 
 Two theories, in particular, have been held in the past 
 as explaining the presence of tuberculosis. Let us consider 
 these for a moment: 
 
 i. Altered condition of blood originating in a perver- 
 sion of nutrition, or tubercle, an exudation. 
 
 2. Increased cell development and multiplication of the 
 included nuclei, or tubercle, a new growth. 
 
 The second or cell growth was held by the world-re- 
 nowned Virchow, but repeated investigations by careful 
 
— 212 — 
 
 histologists have failed to find said growth. The support- 
 ers of this theory have therefore been few. 
 
 The perverted nutrition as found in the first theory is 
 said to be owing to many causes, viz., vitiated air, imperfect 
 assimilation, hereditary taint, etc. 
 
 Please notice that vitiated air, imperfect assimilation, 
 hereditary taint, etc., bring in a large field of disease. It 
 seems to the writer that when so many causes are assigned 
 as producing one and the same thing, viz., tuberculosis, we 
 should carefully scrutinize, for such occurrences are rare. 
 It is something as with the vender of medicine who has a 
 remedy for the nomenclature of disease. One is apt to be 
 suspicious of its intrinsic worth. 
 
 The writer believes faulty or imperfect aeration pro- 
 duces an altered condition of the blood. It is altered, first, 
 in that the venous blood is not properly charged to arterial; 
 second, in that the chyle is not properly transformed into 
 blood corpuscles. This blood flowing to every part of the 
 system causes or induces the constitutional disease known 
 as tuberculosis. For mark, as already stated, tuberculosis 
 is never a local disease. 
 
 (a) Vitiated air may produce this same condition of 
 blood or system. 
 
 (b) Heredity may allow this faulty aeration or condi- 
 tion of the blood. 
 
 (c) Imperfect assimilation, etc., etc., we think have 
 nothing to do with the condition named. 
 
 We also take the liberty at this time to state that what- 
 ever destroys or hastily eliminates the red corpuscles re- 
 maining in the system hastens the progress of the disease, as 
 child bearing, excessive venery, etc. The reason is ob- 
 vious. Perfect blood is being formed slowly. The hasty 
 destruction of red corpuscles from any cause leaves the sys- 
 tem in a state of famine, which is slowly overcome. It is in 
 this state the tubercle bacilli naturally enter the system and 
 grow. I ask any fair-minded and candid man, do they cause 
 the disease ? Is not the soil prepared before the vegetation 
 takes root ? If so, should we control the soil do we not 
 
—213— 
 
 control the disease ? Herein lies the secret of the control 
 of tuberculosis. Herein lies the secret of the ameliorated 
 condition of mankind during the last decade. Our life has 
 afforded a better aeration of the blood. Afford a still bet- 
 ter aeration and the disease tuberculosis is more fully con- 
 trolled. Can we control perfectly ? Knowledge in this in- 
 stance is power. Power gained in an avenue of life means 
 greater insight in future trials. I«et us take courage and 
 press steadily on. 
 
 The question may be asked, what change takes place, 
 in perfect aeration ? It is known in the change of venous 
 blood to arterial, the dark red becomes a bright red. Gray, 
 the anatomist, tells us this change is due to the oxygena- 
 tion of the iron in the blood. Spectrum analysis shows 
 this. In regard to the change that takes place in the chyle 
 in the formation of red corpuscles we have little definite 
 information. It is thought at present the white corpuscles 
 are formed in the lymph ducts or glands, while the red are 
 formed direct from the chyle. Certain it is, chyle is not 
 blood; certain it is the fluid is still chyle when it enters the 
 venous circulation. Passing directly to the lungs, it leaves 
 them as blood. The change or conformation takes place 
 during aeration. In the absence of further light we assume 
 aeration changes chy le to blood. It is when an imperfect 
 blood is formed, or, in other words, it is when there is an 
 imperfect aeration, that the bacilli take root and grow. The 
 imperfect aeration in every instance precedes the vegetable 
 growth, or the soil precedes the growing plant. The veg- 
 etable growth, then, may modify the disease, but is not the 
 caasr- of it. 
 
 The construction of the thoracic duct in being single, 
 while many organs are placed in pairs: the plan of discharge, 
 in that it commonly empties its contents into the left vein 
 and not into the right, or both, are among the anatomical 
 peculiarities of this alone. The commingling of the chyle 
 with blood already devitalized and with the bulk of the 
 body's lymph; the passing of the united stream to the lungs 
 to combine with the oxygen of the air. shows a wisdom of 
 
- 214 — 
 
 construction seldom seen. The exact change that takes 
 place is not known, but the combined stream continually 
 flowing gives life and vitality to the whole organism. We 
 feel assured that when any change occurs in this current 
 either by man's device or folly, the entire system must suf- 
 fer. 7/ is no local disease. In point of fact, this is what 
 is seen in surgery. Remove a tuberculous mass from any 
 part of the body — does the wound heal readily ? Is the dis- 
 ability removed entire? In no case is this true — plain evi- 
 dence to the writer that tuberculosis is not a local disease. 
 Treat the subject constitutionally; give him, in so far as 
 possible, a perfect aeration of the blood, and I pledge you 
 the patient in every case will receive a benefit. 
 
 It is these little things which tell us plainly the law of 
 tuberculosis must be true. 
 
—215- 
 
 INTROSPECTION. 
 
 By introspection or the introspective method is meant 
 the studying of mental phenomena by means of one's own 
 consciousness. Everything about us or within is a subject 
 of consciousness. We are conscious of one's presence or 
 absence, of an opinion or belief, etc. We study or grasp in 
 its entirety as we lay hold of the mental phenomena con- 
 nected therewith. So that the introspective method pre- 
 supposes a rational being in its exercise. Mird is neces- 
 sary to reason. 
 
 The introspective method is used at this time not so 
 much to look into or examine the individual as to search 
 out or investigate theory. Medicine is full of theory — 
 theory as to cause, prevention and cure of disease. Some 
 are true, many are false. The wise physician discriminates. 
 He distinguishes the true from the false. How better to do 
 this than by the exercise of reason in the introspective 
 method ? 
 
 Today we have a theory of the disease tuberculosis. 
 On what is it based ? Evidently, not on reason or analogy. 
 It is based exclusively on microscopical examination. Cer- 
 tain microscopic organisms are found in certain locations at 
 certain stages of the disease tuberculosis. These are 
 assumed to be the direct cause. The writer thinks this 
 wrong. He has his reasons for so believing. Microscopic 
 organisms do not naturally grow in health or induce disease. 
 
 (a) Microscopic organisms, like all plant life, grow 
 where the soil is properly prepared. 
 
 (b) The preparation of the soil, in every case, precedes 
 the growing plant. 
 
 (c) The soil is, then, the first stage or cause of tuber- 
 culosis. 
 
 How is a soil prepared ? By suspension of atmospheric 
 
— 2l6 — 
 
 influence. What does suspension of atmospheric influence 
 induce ? A faulty aeration or impure blood. What are 
 common methods of suspension ? 
 
 (a) Heredity, in that an imperfect lung tissue aerates 
 the blood in an imperfect manner. 
 
 (b) 111 ventilation, in that an impure or impoverished 
 atmosphere fails to furnish the requisite amount of oxygen. 
 
 (c) Occupation, in that there is a mechanical obstruc- 
 tion to aeration. 
 
 In these and other ways a soil is prepared in the indi- 
 vidual which allows the entrance of the growing bacillus, or 
 so-called cause of tuberculosis. This growth, if cause at all, 
 as already shown, must be a secondary one. 
 
 Based on the same assumption is a theory of the pre- 
 vention of tuberculosis. If the tubercle bacillus be the pri- 
 mary cause of tuberculosis, and all germ theorists believe 
 this, the prevention of the disease in theory is very simple. 
 It is simply to prevent the entrance of the growing germ. 
 
 In -practice prevention is found a very different matter. 
 In truth, the germ naturally enters the system and grows 
 without the rational aid of man. To prevent its entrance 
 and growth, or in other words, to prevent tuberculosis where 
 there is a favorable soil, according to present notions, is not 
 in the power of man. Prevention of tuberculosis is, then 
 ■practically a dead letter. 
 
 Look around you and see if this be not true. The eyes 
 of the profession are slowly opening. Give us more light \ 
 
 Based on this assumption, that tuberculosis is a specific 
 infectious disease, is a theory of treatment. In the writer's 
 judgment, in no phase of medical literature is common sense 
 and intellect more perfectly held in abeyance. 
 
 (a) Tuberculosis is caused by the tubercle bacillus. 
 
 (b) The bacillus, in growing in the healthy system, 
 gives out or throws off ptomaines, leucomaines, etc., which 
 poison and ultimately destroy. 
 
 (c) The extract of these same bacilli, grown under 
 other circumstances, injected into the diseased system pre- 
 vents their normal action or is cura-tive, Wondrous thought ! 
 
—2i7 — 
 
 Suppose 3 r ou give a healthy man an ordinary dose of strych- 
 nine. Suppose your neighbor practitioner injects another 
 ordinary dose. Is there a sane man in the universe who will 
 argue the one dose counteracts the other ? The germ theorist 
 has been teaching this the last two decades. Ladies and 
 gentlemen of the medical profession, are we professional 
 thinkers or are we incorrigible asses ? 
 
 On the same line of assumption is the theory of immun- 
 ity. To claim in one breath that a plant growth throws out a 
 poison which causes a disease and in the next to claim the 
 same poison injected secures an immunity ! Rationally con- 
 sidered, how could one and the same poison both cause and 
 prevent a disease ? What shameless folly ! But, in this 
 case, we leave out reason entirely, and ask: Does it do it? 
 
 We stated suspension of atmospheric influence causes 
 an imperfect aeration or impure blood. That this condition 
 is found in all cases of tuberculosis we candidly affirm. 
 That others now recognize this truth is plainly shown. Prof. 
 Osier says: "The arrest or cure of tuberculosis is a question 
 of nutrition entirely, and that the essential factor is to im- 
 prove the resisting forces of the body so that the disease 
 cannot make further progress or is eradicated. Fresh air 
 and good food are the most important means by which 
 the nutrition may be increased. (Maryland Medical Jour- 
 nal.) Please remember these are the words of a renowned 
 germ theorist. Please note Prof. Osier claims tuberculosis 
 a specific infectious disease, yet treats it a s a constitutional 
 one. The writer claims tuber culosis a constitutional disease, 
 based on law, and treats it as such. Which is the more 
 consistent ? We leave this to others. 
 
 But mark, there is something of more practical worth 
 to the living than the treatment of tuberculosis. Need I say 
 prevention ? So soon as we clearly understand the cause of 
 disease so soon are we able to see clearly a method to pre- 
 vent the same disease. So long as we teach one thing and 
 practice another so long the great mass of the world's peo- 
 ple will remain in blissful ignorance. 
 
 By a proper use of the introspective method we may not 
 only examine our own theories, but those of others, and the 
 world is thereby made wiser. 
 
— 218— 
 
 INCIPIENT TUBERCULOSIS. 
 
 "The forces of the universe are in league against a lie." 
 — Emerson. 
 
 Definition : A constitutional disease dependent largely 
 on the evils of civilization, and governed by the following 
 law: The death rate from tuberculosis is in direct ratio to 
 suspension of atmospheric influence. 
 
 Speculation has been rife whether tuberculosis is trans- 
 mitted. Some have said yes, others no, and a vast host of 
 the profession are as yet undecided. 
 
 That the author's statement appear not biased, con- 
 temporaneous writers are quoted: 
 
 "Consumption is caused by a germ known as the tub- 
 ercle bacillus, etc. This germ is not inherited, but is always 
 contracted from some other case," etc. (State Board of 
 Health of New Hampshire.) 
 
 This statement, coming from so high a source, has the 
 merit of being definite. There is only one fault we at pres- 
 ent observe, viz., the forces of the universe are in league 
 against it. 
 
 "It is an admitted fact that no child is born with tub- 
 erculosis, yet they do inherit that peculiar lymphatic, anaemic, 
 poorly-nourished constitution which gives them but little or 
 no resistance when exposed, "etc. (Jas.A. Burroughs, M.D.) 
 
 "In 1 86 1 I attended a phthisical woman in her first 
 confinement. She belonged to a consumptive family, had 
 suffered herself before she got married, and died in the third 
 week after confinement. The fetus was born at the end of 
 the seventh month of utero-gestation, and lived a few min- 
 utes only. There were numerous gray miliary tubercles in 
 the tissue of the liver near the surface, a few in its perito- 
 neal covering and the spleen, and on the pulmonary pleura." 
 (A. Jacobi.) 
 
I 
 
 —219 — 
 
 Please observe, the one says "No child is born with 
 tuberculosis;" the other says "I have seen tuberculosis in a 
 a seven month's fetus." Does the fetus invariably die be- 
 fore viability? If not, of what value is the "admitted 
 fact?" 
 
 The truth is, many children are born "with that pecul- 
 iar, lymphatic, anaemic, poorly-nourished constitution," but 
 only a proportion of them have tuberculosis. Why not all? 
 To the writer the reason seems plain. The proportion who 
 take the disease, in some way, have suspension of atmos- 
 pheric influence; the others do not have said suspension. 
 
 "The prevention of tuberculosis by prohibition of mar- 
 riage of consumptives will remain an Utopia until human 
 nature changes and the reason exerts a greater influence in 
 such matters than the emotions." (St. Louis Medical Re- 
 view.) 
 
 If we clearly apprehend, there is a brighter future for 
 humanity when reason has full sway. In other words, mar- 
 riage can be regulated to diminish tuberculosis. This, if 
 true, should be clearly understood by all. The minister, 
 justice and judge alike need enlightenment. 
 
 "Tuberculosis unquestionably may be inherited, but in 
 what way and how often are unsettled problems." (Osier's 
 Practice.) 
 
 The writer, in his weak way, attempts to render mat- 
 ters more clear and simple. In order to do so the germ the- 
 orist is taken on his own ground. It is said tuberculosis is 
 due to a germ, or rather tuberculosis is germ growth in the 
 system. The writer thinks differently. He believes tuber- 
 culosis is an induced state or condition under control, and 
 germ growth simply secondary. His reasons for so believ- 
 ing are as follows: No plant life can take root and grow 
 without a suitable soil. The tubercle bacillus is plant life. 
 Therefore the tubercle bacillus, in growing, has a suitable 
 soil. If found growing in one's system a suitable soil is 
 found in said system; otherwise it does not grow. No 
 growing tubercle bacilli are found in a healthy organism. 
 
 It is seen the soil must -precede the -plant grozvth. To 
 
— 220 — 
 
 this rule or law there is no exception. Herein lies the fal- 
 lacy of the germ theorist: He assumes the plant tubercle 
 bacillus causes the disease tuberculosis because it is usually 
 found in every typical case. 
 
 As in creation primeval the sun came into existence 
 before vegetation, so in tuberculosis suspension of atmos- 
 pheric influence ever precedes the advent of the germ. 
 Flood the earth with sunlight and vegetation at once starts. 
 Suspend atmospheric influence in the individual and the 
 same condition prevails — the germ grows. Withdraw all 
 sunlight and vegetation ceases to exist. Sunlight to the 
 earth's vegetation is as pure atmosphere to earth's people. 
 Perfect ventilation means freedom from tuberculosis. 
 The knowledge and application of this simple truth will rid 
 us of the most deadly disease known to the human race. Is 
 not such knowledge worthy attention ? The writer so con- 
 siders it. Let us proceed. 
 
 Much time and labor have been spent in determining 
 how the tubercle bacillus enters the circulation and grows in 
 various parts of the body, how the germ enters the mother's 
 blood-current ard by means of the fetal circulation is con- 
 veyed to the fetus. By some this is thought to be truly 
 marvelous. When the view entertained by the writer is 
 closely examined he thinks the inexplicable is rendered more 
 plain. The condition precedes the growth in every instance. 
 It has been shown this must invariably be the esse. A 
 child or person has the condition or precedent state. It 
 matters not for illustration how obtained — by heredity or 
 suspension in the individual. He has the condition or soil. 
 All that is requisite is the presence of the germ. These so- 
 called germs are everywhere present. Is there anything 
 mysterious in their growth ? Yes, but the mystery is as 
 the growth of a blade of grass or kernel of wheat. ' 'Simply 
 this and nothing more." 
 
 At times much ado is made because certain meats con- 
 tain tubercle bacilli. Has it ever entered the mind of the 
 scientist that meats may be tuberculous in the absence of 
 tubercle bacilli ? The writer has the temerity to assert that 
 
—221 — 
 
 sometimes, though infrequent, this may be the case. Sup- 
 pose these germs are thus found in said meat ? Is there 
 any general outcry when these same germs are found in the 
 food we eat and the water we drink? If not, why not ? 
 .Is not the major portion of our food and drink taken cold — or 
 not sterilized — before eating? Are not our meats sterilized 
 in the cooking? "Consistency, thou art a jewel." 
 
 Again, we are told so much about a "former case," as 
 if no case of tuberculosis occurred unless there be a preced- 
 ing case in the same house or neighborhood. This seems 
 absolutely silly. If tubercle bacilli cause the disease tuber- 
 culosis; if tubercle bacilli be everywhere present, w T hat is 
 the use to everlastingly harp on the "former case ?" 
 
 If the germ truly causes the disease, and germs contin- 
 ually float in the atmosphere, rationally considered one germ 
 would cause the disease the same as the germs in a "former 
 case." Hence, we have illustrated cases like the following: 
 
 Mrs. K. is sixty years of age and has an infant grand- 
 son living at her house. Mrs. K. has had a chronic cough 
 for years. The grandson is losing flesh and having night 
 sweats. He at times has a slight cough. After several 
 weeks he dies. No autopsy. Physicians assert this little 
 fellow had tuberculosis, and that he caught the disease from 
 his grandmother. Are you satisfied with the inception of 
 the disease? The writer claims a soil is first prepared. 
 When prepared, the tubercle bacilli, from whatever source, 
 readily grow. 
 
 For a writer to assert that every extension of the dis- 
 ease is due to a "former case" would be to assert that germs 
 must be fresh in order to infect new victims, i. e. } the infec- 
 tious material is carried with the fresh germ, or, in other 
 words, is external to itself. No true germ theorist could 
 accept this. We are therefore led to believe it is the germ 
 alone that grows, but it grows in a soil already -pre-pared* 
 The germ does not prepare the soil. 
 
 The fundamental principle involved is not how recent 
 the germ, not from whence derived, but how is the soil pre- 
 pared in which the germ thrives. Do we hold in our hands 
 
— 222 — 
 
 the preparation of the soil ? Can we prevent its forni3tion? 
 If answered in the affirmative, we can control tuberculosis. 
 
 Take, for instance, the case presented by Dr. Jacobi. 
 The mother is tuberculous, t. e. y has suspension of atmos- 
 pheric influence. The soil is prepared and tubercle bacilli 
 are growing in her system. Like produces like. The fetus 
 in utero has the soil of the mother. If bacilli grow in the 
 mother they likewise grow in the child. They are thus 
 growing when observed by Dr. Jacobi. 
 
 Another mother is healthy. The fetus in utero is also 
 healthy. While tubercle bacilli may be found in the tissue 
 or blood of both mother and fetus, they are not found grow- 
 ing in said systems. Why not ? There is no soil, no sus- 
 pension of atmospheric influence. Hence, freedom from 
 tuberculosis. 
 
 Another case presents. The father is in the last stage 
 of tuberculosis — so feeble he is unable to walk but a few 
 steps. His wife is in fairly good health and becomes preg- 
 nant at this time. A miscarriage shows tubercular devel- 
 opment in said fetus. How explained ? It will at once be 
 admitted this is an unusual method of transmission. Tub- 
 erculosis usually descends from parent to child through the 
 mother. Not always so. The fa'Jiermay also transmit the 
 disease. All conditions must be favorable for this consum- 
 mation. What are the conditions? The germ theorist ex- 
 claims it is readily explained: "The seed of disease is in the 
 semen of the father." The writer asks: "My dear sir, or 
 madam, how can a seed grow without a soil?" True, the 
 tubercle bacillus may be in the semen. It may also be in 
 the blood of the mother or fetus. 
 
 Why does the so-called germ grow in the fetus ? Let 
 us attempt an answer. The mother, apparently, is in good 
 nealth. She takes little or no exercise. What of this ? 
 Her very inactivity causes suspension of atmospheric influ- 
 ence in herself and fetus, and allows the tubercle bacilli to 
 grow. Hence, growth and consequent miscarriage. The 
 same condition prevails if suspension occur in any other way. 
 
 This, we think, a correct interpretation of facts. 
 
 After twenty-five years of active practice the writer 
 recalls abortion and miscarriage enough times to recognize 
 the certainty of heredity in tuberculosis. Knowing this, 
 he thinks he has a clear idea of the inception of the disease. 
 
■223— 
 
 AS OTHERS SEE US. 
 
 <c O wad some power the giftie gie us 
 To see ourse?s as others see us ! 
 It wad frae monie a blunder free us 
 And foolish notion." — Burns, 
 
 Colorado Springs, Col., August 27, 1898. 
 Dr. H. H. Spiers, Ravenna, O. 
 
 Dear Doctor — Allow me to congratulate you on your 
 article in the Medical Record, "The Control of Tuberculo- 
 sis." I was much interested in the article and am in strong 
 sympathy with you on many points mentioned in it. 
 
 I cannot, however, entirely agree with you as to the 
 fact that if a person is kept clean, takes daily exercise, in- 
 hales pure air, that such a person cannot develop tuberculo- 
 sis if heredity is thrown out, as I have seen cases that ful- 
 filled all these requirements to a most perfect degree and yet 
 did develop tuberculosis, possibly through milk as a child, 
 the germ lying dormant for years. 
 
 I send you a reprint of some of my work. 
 Yours truly, 
 
 C. F. Gardiner. 
 
 The above is one of many letters in our possession. It 
 is difficult for us to answer or take note of all. 
 
 In the first place, we ask no one to entirely agree with 
 us. In truth, we do not expect this. The fact that one 
 differs in some minor point is prima facte evidence he has 
 ideas of his own. When one accepts ideas, style, language, 
 etc., of another, and swallows it, however crude, it is 
 marked evidence that person lacks individuality. We try 
 to be broad ourselves and allow the same latitude to others. 
 At the same time a law must not be set aside to attend 
 minor details. The law should have precedence, 
 
 We fear our able contemporary does not clearly com- 
 prehend the nature of tuberculosis. We are led to believe 
 this from the "reprint of work" sent us. The author seems 
 to be grappling with the germ theory of this disease. L,eave 
 
the germ theory alone. Set it aside for the present and 
 carefully examine the law of tuberculosis. What is tuber- 
 culosis ? A constitutional disease dependent largely on the 
 evils of civilization, and governed by the following law; 
 The death rate from tuberculosis is in direct ratio to sus- 
 pension of atmospheric influence. 
 
 Two things are noticeable: (a) Tuberculosis is a con- 
 stitutional disease; (b) tuberculosis is governed by law. 
 
 In each of our articles we have endeavored to make 
 these facts clear. The one quoted in the Medical Record is, 
 we think, no exception. 
 
 So that if our friend, Dr. Gardiner, fails to take in 
 these truths he fails to properly appreciate our effort, though 
 he congratulate. For this we feel sorry. 
 
 The error of Dr. Gardiner is not uncommon. This 
 mistake is seen on every hand. 
 
 Why are we so dull of apprehension ? This is certainly 
 un-American. Americans have perceptives and use them. 
 Why so dull in this ? Two reasons can be readily assigned: 
 (i) Education; (2) authority. 
 
 In one sense it is true: we believe what we are taught 
 to believe. Europeans have saddled upon us a germ theory 
 of tuberculosis. This theory is taught in the schools. We 
 are educated in this belief. Germs there must be, for we 
 can see them. Seeing is believing. Cause the disease they 
 must, for they are found with the ailment. No further 
 questions need be asked. If one ask why these germs are 
 found in certain conditions he is regarded an heretic. If 
 one suggest there may be the condition in the absence of 
 germs he is regarded as a lunatic. If one speak of the con- 
 dition prior to the entrance of growing germs he is asked if 
 he studied bacteriology in Heidelberg. Bacteriology and 
 high-power microscopes are at a premium. Reason and 
 common sense are excluded. 
 
 Does the writer express a truth ? If so, is not this 
 j udgment manifestly unfair ? Education — school learning — 
 is one thing, and education — progression — another. The 
 one is memorizing dry statistics; the other the use of the 
 
—225 — 
 
 intellect in the higher sense. Which shall it be ? 
 
 Again, there is reverence of authority. A young fresh- 
 man, on being asked what he thought of the professors in 
 the school he was attending, replied: "They are foine men, 
 but they have no hids." Now herein is a fault with many 
 authorities: They have no "hids." A professor in medi- 
 cine who sits down and deliberately compiles statistics week 
 after week, then quotes them in his lectures as law and the 
 gospel has no "hid." He may be pre-eminent in science; 
 he is only eminent in common sense. 
 
 Can we improvise "hids" for them so situated? This 
 is a question not only for the near future, but for all time. 
 
 We travel in ruts. If one step from the beaten track 
 he is regarded an heretic or lunatic. Yet mark, it is these 
 side-steps that make progress in science, literature and the 
 arts. 
 
 To return: "If a person is kept clean, takes daily ex- 
 ercise, inhales pure air, that such a person cannot develop 
 tuberculosis if heredity is thrown out." If heredity be 
 thrown out we take it for granted the subject is perfectly 
 healthy so far as tuberculosis is concerned. The sentence 
 then reads: If a healthy person be kept clean, takes daily 
 exercise and breathes pure air he cannot develop tubercu- 
 losis. 
 
 Keep clearly before you the proposition. What is it to 
 develop tuberculosis? "Answer ye who will." Tubercu- 
 losis has been denned a constitutional disease, etc. If one 
 develop tuberculosis he must develop or acquire a constitu- 
 tional disease. How does one develop or acquire a consti- 
 tutional disease? This one disease, tuberculosis, is devel- 
 oped or acquired in one way — only one — suspension of at- 
 mospheric influence. If there be no suspension of atmos- 
 pheric influence there can be no tuberculosis. If the healthy 
 person be kept clean, takes daily exercise, etc., there is no 
 suspension. Therefore there can be no tuberculosis in his 
 case. 
 
 "But," says Dr. G., "I have seen cases that fulfilled 
 all these requirements to a most perfect degree and yet did 
 
— 226 — 
 
 develop tuberculosis," etc. The writer asks, "How can 
 these things be?" Various explanations may be given. 
 The one most probable is that Dr. G. is mistaken in his 
 cases. 
 
 In this connection perhaps another conversation will be 
 allowed. Some time ago, on meeting my frier d Dr. X. C. 
 Scott, of Cleveland, O., he congratulated me on a paper read 
 at a certain society. His language was somewhat as fol- 
 lows: "Doctor, it is seldom I listen to papers outside my 
 specialty, but yours was an exception — one of the best I 
 ever heard. But, by the way, your theory of suspension 
 don't work. Why, this very summer I traveled all through 
 Mexico, and I saw many cases of tuberculosis. The climate 
 is warm, the people live in the open air, and if you are right 
 there ought not to be any disease of this kind. You are 
 evidently mistaken." He continued: "Oh, by the way, 
 doctor, do you know of a peculiar custom of sleeping in 
 Mexico ? They always wrap their head and face in a 
 blanket. 
 
 Is it clear why there is tuberculosis in Mexico ? 
 
 Suppose some one should tell you that Dr. Gordon, of 
 Mexico, committed suicide by drowning. How can it be 
 possible ? There is but little water in Mexico. How much 
 water does it take to drown when one is so disposed ? So 
 suspension of atmospheric influence ma) be produced by 
 simply covering the month during sleep. 
 
 It requires but little suspension to produce a diseased 
 constitution. A diseased constitution so caused allows the 
 tubercle bacilli to enter and grow — so-called tuberculosis. 
 
 With due credit to Dr. Gardiner for his honesty, wis- 
 dom and acuteness of perception, is it not probable he is 
 mistaken? Have any of these patients — referred to as 
 healthy — had stenosis of the air passages ? If so, suspen- 
 sion of atmospheric influence. Have they had measles or 
 pertussis ? If so, was recovery perfect ? If not, suspension 
 of atmospheric influence. Did any of these healthy patients 
 ever work at an unhealthy vocation, as stone-cutting, etc.? 
 If so, suspension of atmospheric influence. Did any of these 
 
— 227 — 
 
 parties, at any time, have a history of slow recovery from 
 typhoid fever, with lung symptoms ? If so, suspension of 
 atmospheric influence. Tuberculosis frequently follows 
 after the lapse of years. 
 
 One other question : Who in any land can say in any 
 case that heredity is excluded? Heredity, like the sun's 
 influence, is felt in every land where a race exists. I^et no 
 one assert the contrary — I knovfthis is true. Hereditary 
 influence no man can measure. When one asserts heredity 
 is left out he only 'approximately determines this truth — 
 nothing more. Dear doctor, the writer feels assured you 
 are mistaken. 
 
 We close with an extract from a letter referring to 
 State regulation of marriage. 
 
 Fall River, Mass., August 24, 1898. 
 H. H. Spiers, M. D., Ravenna, O. 
 
 My Dear Doctor — I have just read your article in the 
 Medical Record of August 20th, and wish to thank you for it. 
 As to the question of State regulation of marriage I think 
 you might have gone a step further than you did. The bill 
 introduced into the Ohio Legislature was certainly a step in 
 the right direction, and, as you say, in the years to come 
 some measure of similar character will be enacted for the 
 protection of the body politic. 
 
 I am at present at work along the same lines and may 
 have something to send you one of these days. State regu- 
 lation of marriage is as important and as much a function 
 of the State as regulations covering vaccination, contagious 
 diseases, boards of health and the like. 
 Very truly yours, 
 
 Geo. L. Richards. 
 
— 228 — 
 
 INDEX. 
 
 PAGE 
 Artificial Immunity 62 
 
 Abeyance of Atmospheric Influence 103 
 
 Annotations ,..111 
 
 An American Need 181 
 
 As Others See Us 223 
 
 Bicycle a Preventive 68 
 
 Cause of Tuberculosis 53 
 
 Control *. . 79 
 
 Catechism 123 
 
 Duties of the Hour 117 
 
 Deep Breathing vs Tuberculosis 175 
 
 Dawning 185 
 
 Education 42 
 
 Food Product , 46 
 
 Germ Theory 58 
 
 Heredity , 26 
 
 Introspection 215 
 
 Incipient Tuberculosis 218 
 
 Law in Tuberculosis 15 
 
 Legislation 70 
 
 Medical Theories 11 
 
 Marriage 19 
 
 Medicine 1 70 
 
 Mathematics in Medicine , 190 
 
 Necessity of a More Perfect Aeration 200 
 
 Outlook 158 
 
 Preliminary Statement 9 
 
 Precedent State 32 
 
 Status of the Bacillus 88 
 
 Theory of the Production of Tuberculosis 208 
 
 Vagaries 165 
 
 Whom to Marry 38 
 
FEB 9 1903