1
757 the value of the F. R. C. S, I. Perhaps some of your readers I might care to confirm or deny the accuracy of I I Eriiiensis. " I am. Sirs. vours faithfullv. Dublin, Sept. 7th, 1901. S. WESLEY WILSON. THE CONTAGION OF TUBERCULOSIS. To the Editors of THE LANCET. &eacute; SIRS.&mdash;Anything which throws any light on the probable < sources of infection or contagion of tuberculosis is just now i of interest to the medical profession, hence my reasons for &eacute; reporting the following circumstances. I was called about ] six weeks ago to attend a child, about 14 months old, whom I found to be suffering from tuberculous disease of the bowels ; it had been quite healthy and strong up to the beginning of May, when it commenced to suffer from diarrhoea and to lose flesh. The parents thinking it due to teething did not call me in until they became alarmed at its general appearance. The parents are both strong and healthy, as well as are three other children, aged about six. four, and two and a half years respectively, and there is no history of phthisis in the family. The patient is .a typical " marasmic child." Quite by accident I discovered the following circumstances connected with the milk-supply. Last February a new tenant came into the farm where my patients have obtained their milk-supply for years and which is next door (about 200 yards away), whose wife, aged 36 years, has milked the cows and daily night and morning delivered milk in a separate vessel at my patients’ house ; the separate vessel had been used as the house is not in the milk round ; all the rest of the milk had been taken straight away to a large town for delivery. On visiting the house last Sunday I was told that the farmer was in trouble, as his wife, who had been ailing ever since they came, was in bed with phthisis and could not recover. Here is a member of a perfectly healthy family (as far as can be ascertained) developing tuberculosis after drinking milk which has been handled by a dairymaid suffering from tuberculosis. I state these facts simply for what they are worth and leave your readers to form their own opinion upon them, and if any of them are making any investigations on this subject and would like more details I shall be glad if they will communicate with me. I am, Sirs, yours faithfully. Victoria-park, Shipley, Sept. 3rd, 1901. D’ARCY B. CARTER. " LEGISLATION AGAINST NATIONAL INTEMPERANCE." To the Editors of THE LANCET. SIRS,&mdash;My note in Nature (August 8th) was intended to draw the attention of biologists, as such, to this question, not a purely medical one, which has been advocated some- what too strenuously on one side by some of your correspondents. They have been driven back upon a time- worn biological line of defence, the non-proven " doctrine of Weismann, and there "left fighting" in a somewhat languid manner. It seemed desirable that the venue were changed and some expression on the purely biological basis of this discussion were given. Hence any lack of contro- versial directness on my part. I hope I have not misunder- stood the tenor of this correspondence when I ask-(1) Have there not been two contrary opinions maintained throughout as to the expediency of legislation against national intem- perance, the opinion of one side being based upon the impossibility of effectual legislation ? (2) Have not the two parties expressed or implied directly opposed views as to the import of alcoholism-one that it is a selective agent in the improvement of a stock of a nation by its weeding-out processes, and the other that alcoholism is only evil from the national point of view, and that continually, and largely because of its effect upon the offspring of drunkards and (3) Has not the ultimate justification for disregarding the last point rested upon Weismann’s doctrine? Dr. Reid asks me who stated that "alcoholism was a selective agent of value in the evolution of man which ought not to be interfered with by legislation," and then tells us he stated that it could not be interfered with. May I ask him, has he not the courage of his own convictions, and will he not allow that, if it cannot be interfered with, it ought n01 to be interfered with ? ’! And, further, does he not consider alcoholism a valuable selective agent ? If he does, it does not follow that he holds the "atrocious doctrine" to which he refers, but certain other rather serious conse- quences are involved. Not having access to my copies of THE LANCET containing this correspondence I cannot do more than refer to mv recollection that there have been "advocates of the view that alcoholism is a selective agent of value." Dr. Reid may not be one of them. As to the technical point in "Hair on the digits of man I I did not challenge Dr. Reid to refute me ; I referred him to it as the protagonist of the extreme Weismannian position, as I asked the biologists in Nature, to consider it on its merits. How comfortable it would be to be so sure, either way, as Dr. Reid is when he can say, ‘&deg; Doubtless man is the child of the monkey." " But we may at any rate assume that it is so for present purposes. The passage beginning ’’ its descendants" and including the two following lines is difficult to follow and contains a mis-statement which per- haps is an oversight. The monkey has not worn down the hair on its ungual phalanges more than man, but a good deal less on these and all phalanges of foot and hand. I have never heard of anyone who has satisfactorily explained how it is that the man has lost most of his hairy covering and it has been looked upon as rather a crux for the evolu- tionist. But one may assume, for the sake of argument, that the monkey has retained his because it suited his require- ments. The only indication I can see of any refutation of my sug- gested Lamarkian interpretation of a particular fact is the allegation : ’’ The disappearance of hair on the ungual phalanges is only part of a general phenomenon." The infer- ence is that, because I wearing-down " of hair on the phalanges is put forward as the only feasible interpretation f; this area, one is bound to account for the disappearance of hair from the whole of man’s body except from the head, face, armpits, and pubes, in the same way. In passing, one may note that it was a little incautious in Dr. Reid to men- tion the only four regions of the body where wearing down" does not occur and in which hair is abundant and persistent. But I will not claim this from him-he may deal with it as he likes. My modest little contention is only part of a great theory held by eminent biologists which Dr. Reid on August 10th called " wildly incredible " and now considers to be a "hypothesis so wildly improbable" and endeavours to alarm one at one’s own temerity in considering that the wearing down of hair on the ungual phalanges so affects the germs situated in the far-distant testicle or ovum that the organisms which spring from them tend to reproduce the peculiarity the parent acquired." It is no more deserving of scorn in this than in the greater cases seriously held as parts of a great whole which desires from selection no more than to " live and let live." Much more has yet to be learned and said as to the bearing of hair-direction on this much-debated doctrine. I am. Sirs. vours faithfullv. August 24th, 1901 WALTER KIDD. " HARVEST BUGS." To the Editors of THE LANCET. , SIRS,-I notice that some of your correspondents are interested in the matter of "harvest bugs," and as I have had personal experience of their blandishments my account may be not without value. Some years ago in the island of Grenada, West Indies, and the month November, being neither in the know" nor cautioned, I spent a forenoon writing letters, sitting at a table on the grass under a tree, and wearing trousers and thin socks, but no "pants." The next day I was sorely troubled with itching all over the legs, particularly about the ankles ; a few days later my whole body except face and hands was covered with minute pimples, or papules, which itched distressingly. This lasted for many days ; I used to get a friend to rub me hard with the roughest towel procurable, and a considerable quantity of clear, probably serous, liquid came from the papules when the tops were rubbed off. I lost several nights’ sleep and was feverish, and in fact far from well. I found the insect on my body and was told that it was well known in the island and was called the b&ecirc;te rouge. It was also pointed out to me actually hanging in great clusters of red colour from the noses of mules. I took specimens and on my return home made preparations of them and then identified them as harvest bugs (Trornbidium auturmnale).

THE CONTAGION OF TUBERCULOSIS

  • Upload
    darcyb

  • View
    213

  • Download
    0

Embed Size (px)

Citation preview

757

the value of the F. R. C. S, I. Perhaps some of your readers Imight care to confirm or deny the accuracy of I I Eriiiensis. "

I am. Sirs. vours faithfullv.Dublin, Sept. 7th, 1901. S. WESLEY WILSON.

THE CONTAGION OF TUBERCULOSIS.

To the Editors of THE LANCET. &eacute;

SIRS.&mdash;Anything which throws any light on the probable <

sources of infection or contagion of tuberculosis is just now iof interest to the medical profession, hence my reasons for &eacute;reporting the following circumstances. I was called about ]

six weeks ago to attend a child, about 14 months old, whom Ifound to be suffering from tuberculous disease of the bowels ;it had been quite healthy and strong up to the beginning ofMay, when it commenced to suffer from diarrhoea andto lose flesh. The parents thinking it due to teethingdid not call me in until they became alarmed at its

general appearance. The parents are both strong andhealthy, as well as are three other children, aged aboutsix. four, and two and a half years respectively, andthere is no history of phthisis in the family. The patient is.a typical " marasmic child." Quite by accident I discoveredthe following circumstances connected with the milk-supply.Last February a new tenant came into the farm where

my patients have obtained their milk-supply for yearsand which is next door (about 200 yards away), whosewife, aged 36 years, has milked the cows and dailynight and morning delivered milk in a separate vessel at mypatients’ house ; the separate vessel had been used as thehouse is not in the milk round ; all the rest of the milk hadbeen taken straight away to a large town for delivery. On

visiting the house last Sunday I was told that the farmer wasin trouble, as his wife, who had been ailing ever since theycame, was in bed with phthisis and could not recover. Hereis a member of a perfectly healthy family (as far as can beascertained) developing tuberculosis after drinking milkwhich has been handled by a dairymaid suffering fromtuberculosis. I state these facts simply for what they areworth and leave your readers to form their own opinion uponthem, and if any of them are making any investigations onthis subject and would like more details I shall be glad ifthey will communicate with me.

I am, Sirs, yours faithfully.Victoria-park, Shipley, Sept. 3rd, 1901. D’ARCY B. CARTER.

" LEGISLATION AGAINST NATIONALINTEMPERANCE."

To the Editors of THE LANCET.

SIRS,&mdash;My note in Nature (August 8th) was intended todraw the attention of biologists, as such, to this question,not a purely medical one, which has been advocated some-what too strenuously on one side by some of yourcorrespondents. They have been driven back upon a time-worn biological line of defence, the non-proven " doctrineof Weismann, and there "left fighting" in a somewhatlanguid manner. It seemed desirable that the venue werechanged and some expression on the purely biological basisof this discussion were given. Hence any lack of contro-versial directness on my part. I hope I have not misunder-stood the tenor of this correspondence when I ask-(1) Havethere not been two contrary opinions maintained throughoutas to the expediency of legislation against national intem-perance, the opinion of one side being based upon the

impossibility of effectual legislation ? (2) Have not the twoparties expressed or implied directly opposed views as to theimport of alcoholism-one that it is a selective agent in theimprovement of a stock of a nation by its weeding-outprocesses, and the other that alcoholism is only evil fromthe national point of view, and that continually, and largelybecause of its effect upon the offspring of drunkards and (3)Has not the ultimate justification for disregarding the lastpoint rested upon Weismann’s doctrine?

Dr. Reid asks me who stated that "alcoholism was aselective agent of value in the evolution of man whichought not to be interfered with by legislation," and then tellsus he stated that it could not be interfered with. May I askhim, has he not the courage of his own convictions, and willhe not allow that, if it cannot be interfered with, it ought n01

to be interfered with ? ’! And, further, does he not consideralcoholism a valuable selective agent ? If he does, it doesnot follow that he holds the "atrocious doctrine" towhich he refers, but certain other rather serious conse-

quences are involved. Not having access to my copiesof THE LANCET containing this correspondence I cannotdo more than refer to mv recollection that there have been"advocates of the view that alcoholism is a selective

agent of value." Dr. Reid may not be one of them.As to the technical point in "Hair on the digits of man I Idid not challenge Dr. Reid to refute me ; I referred him toit as the protagonist of the extreme Weismannian position,as I asked the biologists in Nature, to consider it on itsmerits. How comfortable it would be to be so sure, eitherway, as Dr. Reid is when he can say, ‘&deg; Doubtless man is thechild of the monkey."

" But we may at any rate assume thatit is so for present purposes. The passage beginning ’’ itsdescendants" and including the two following lines isdifficult to follow and contains a mis-statement which per-haps is an oversight. The monkey has not worn down thehair on its ungual phalanges more than man, but a gooddeal less on these and all phalanges of foot and hand. Ihave never heard of anyone who has satisfactorily explainedhow it is that the man has lost most of his hairy coveringand it has been looked upon as rather a crux for the evolu-tionist. But one may assume, for the sake of argument, thatthe monkey has retained his because it suited his require-ments.The only indication I can see of any refutation of my sug-

gested Lamarkian interpretation of a particular fact is theallegation : ’’ The disappearance of hair on the ungualphalanges is only part of a general phenomenon." The infer-ence is that, because I wearing-down " of hair on the

phalanges is put forward as the only feasible interpretationf; this area, one is bound to account for the disappearanceof hair from the whole of man’s body except from the head,face, armpits, and pubes, in the same way. In passing, onemay note that it was a little incautious in Dr. Reid to men-tion the only four regions of the body where wearing down"does not occur and in which hair is abundant and persistent.But I will not claim this from him-he may deal with it as helikes. My modest little contention is only part of a greattheory held by eminent biologists which Dr. Reid on

August 10th called " wildly incredible " and now considersto be a "hypothesis so wildly improbable" and endeavoursto alarm one at one’s own temerity in considering that thewearing down of hair on the ungual phalanges so affectsthe germs situated in the far-distant testicle or ovum that the

organisms which spring from them tend to reproduce thepeculiarity the parent acquired." It is no more deserving ofscorn in this than in the greater cases seriously held as partsof a great whole which desires from selection no more thanto " live and let live." Much more has yet to be learned andsaid as to the bearing of hair-direction on this much-debateddoctrine. I am. Sirs. vours faithfullv.

August 24th, 1901 WALTER KIDD.

" HARVEST BUGS."To the Editors of THE LANCET.

, SIRS,-I notice that some of your correspondents are

interested in the matter of "harvest bugs," and as I havehad personal experience of their blandishments my accountmay be not without value. Some years ago in the island of

Grenada, West Indies, and the month November, beingneither in the know" nor cautioned, I spent a forenoonwriting letters, sitting at a table on the grass under a tree,and wearing trousers and thin socks, but no "pants." Thenext day I was sorely troubled with itching all over the legs,particularly about the ankles ; a few days later my wholebody except face and hands was covered with minute

pimples, or papules, which itched distressingly. Thislasted for many days ; I used to get a friend to rub me hardwith the roughest towel procurable, and a considerablequantity of clear, probably serous, liquid came from thepapules when the tops were rubbed off. I lost several

nights’ sleep and was feverish, and in fact far from well.I found the insect on my body and was told that it was wellknown in the island and was called the b&ecirc;te rouge. It wasalso pointed out to me actually hanging in great clustersof red colour from the noses of mules. I took specimensand on my return home made preparations of them and thenidentified them as harvest bugs (Trornbidium auturmnale).