Page:Popular Science Monthly Volume 59.djvu/472

462 small number of medical men was inadequate to the conflict with a disease so deeply rooted in our habits and customs. Such a conflict requires the cooperation of many, if possible of all, medical men, shoulder to shoulder with the State and the whole population, and now the moment when such cooperation is possible seems to have come. I suppose there is hardly any medical man now who denies the parasitic nature of tuberculosis, and among the non-medical public, too, the knowledge of the nature of the disease has been widely propagated. Another favorable circumstance is that success has recently been achieved in the combating of several parasitic diseases and that we have learned from these examples how the conflict with pestilences is to be carried on. The most important lesson we have learned from the said experience is that it is a great blunder to treat pestilences according to a general scheme. This was done in former times. No matter whether the pestilence in question was cholera, plague, or leprosy, isolation, quarantine, useless disinfection were always resorted to. But now we know that every disease must be treated according to its own special individuality and that the measures to be taken against it must be most accurately adapted to its special nature, to its etiology. We are entitled to hope for success in combating tuberculosis only if we keep this lesson constantly in view. As so extremely much depends just on this point I shall take the liberty to illustrate it by several examples.

The pestilence which is at this moment in the foreground of interest, the bubonic plague, may be instructive to us in several respects. People used to act upon the conviction that a plague patient was in the highest degree a center of infection, and that the disease was transmitted only by plague patients and their belongings. Even the most recent international agreements are based on this conviction. Although, as compared with formerly, we now have the great advantage that we can, with the aid of the microscope and of experiments on animals, recognize every case of plague with absolute certainty, and although the prescribed inspection of ships, quarantine, the isolation of patients, the disinfection of infected dwellings and ships, are carried out with the utmost care, the plague has, nevertheless, been transmitted everywhere, and has in not a few places assumed grave dimensions. Why this has happened we know very well, owing to the experience quite recently gained as to the manner in which the plague is transmitted. It has been discovered that only those plague patients who suffer from plague-pneumonia—a condition which is fortunately infrequent—are centers of infection, and that the real transmitters of the plague are the rats. There is no longer any doubt that in by far the majority of the cases in which the plague has been transmitted by ocean traffic the transmission took place by means of plague among the ship rats. It has also been found that wherever the rats were intentionally or