DISEASES FROM THE ENTOPHYTA AND EPIPHYTA, ALGAE, FUNGI, MYCRODERMS.
Disease connected with Leptothrix Buccalis. Leptothrix is an alga affecting the month. It has been discovered in concretions on the teeth, and on the tonsils. It is not a known cause of any serious local disease.
Disease connected with Oidium Albicans and Torula. The filaments and spores of Oidium Albicans are always found in the eruptions of thrush in children, and are always attended with an acid secretion of the mouth, a fact which leads Dr. Leonard Sedgwick to consider the parasite as a cause of fermentative change in the mouth.
This minute parasitic vegetable growth has been assigned as a cause of other diseases. M. Collin reported to the Academy of Medicine, in the year 1s64, that three persons who were cutting vines, by an accident cut themselves, and were poisoned by the oidium. They all suffered after a few days from loss of appetite, shivering, and fever. Their wounds, which originally were slight, became gangrenous, and their limbs swollen. In all of them there was "muguet " of the mouth, which consisted of a cryptogamous product called the " oidium " of the mouth.
That the parasitic cryptogamic oidium albicans may, by in oculation, become a cause of disease in the human subject, was an hypothesis already advanced in May, 1s5s, by Professor Laycock, the late distinguished professor of medicine in the University of Edinburgh, on his discovering the Oidiuin in a pellicle or false membrane that had formed in the throat in a case of diphtheria.
It has been inferred that disease may be taken from the use of a flour containing a similar parasitic fungus —" Oidium This fungus was discovered by the late Dr. Robert Dundas Thompson in a specimen of bread made from an inferior kind of flour which easily becomes acid when exposed to moisture, and which emits the well-known sour smell, even after it has been turned into bread, if it be for a short time exposed to moist air.
The spores of the Torula Cerevisix or yeast plant have been discovered in the secretions of the body, and were at one time believed to be connected with choleraic disease. The hypothesis has not been sustained.
Disease from Sarcina Ventriculi.
The parasite called Sarcina, and which is made up of a series of rods held together in square-shaped masses, has been found in the secretions of the stomach, in some excretions, and in the fluid of the ventricles of the brain. It is most commonly found in the secretions of the stomach, and hence the common name Sarcina Ventriculi. When present there it develops with great rapidity, and keeps up an incessant irritation which causes vomiting of a peculiar sour fermenting fluid. In one instance of this kind, which was under my own care, the irritation lasted for months owing to the presence of the parasite, and as the digestion of food was almost stopped death itself became imminent. At that crisis the symptoms suddenly ceased, and recovery was completed in a few weeks.
Sarcina has been detected in the fluid vomited in pyrosis or water-brash, and the late Dr. Tilbury Fox believed that he had discovered the parasite on the skin. Its precise mode of into the body is not as yet understood.
Disease in Connection with Bacteria and Bacilli.
At the close of the last chapter a list is given of the various uses assigned to the terms bacteria and bacilli, and of the diseases which are assumed to spring from these parasitic organisms.
Bacterian and bacillian parasites are now found to be present, but not always present, in the secretions of many contagious dis eases, and in those of some other diseases which are not ordinarily considered contagious. The reader may, therefore, turn to the chapter on diseases which run a definite course, and attach a par asitic growth to many of them, as well as to phthisis, ague, and leprosy. I do not propose here to enter into the controversies which have arisen in relation to the presence of these organisms in the diseases named, or in regard to their position as causes or effects, because I must refer to that subject later on when treating on the causes of zymotic affections. But I add one remarkable instance of a disease attended with a bacterial parasite in the blood, as a good typical illustration.
Spipillum, in. Famine Fever.
In the relapsing or famine fever of India, Dr. Vandyke Carter has discovered that the vegetable unicellular parasite described as spirillum is found in the blood of the affected persons.
Respecting this fever it is admitted by Dr. Carter that no precise information was procurable as to the origin of the epi demic disease, in the Bombay Presidency, from which his obser vations were made. But as, in the country districts, the fever seemed to appear simultaneously with famine, he alludes to the possibility of an independent origin of the Supposing that the blood spirillum in some way represents the blood poison, it becomes conceivable, he thinks, that in certain impaired states of the frame, the result of starvation and bad hygiene, it might originate by a spontaneous variation of the spiro-bacterium of the saliva. Or the organism might be derived from the of impure water, which in a similar impaired state of the body finds an effective entrance otherwise debarred to it under healthy states. Possibly, he adds, germs of the spirillum are commonly present, but remain inert from absence of a nidusin the normal blood, but which find a suitable soil for some stage or degree of their development in an impoverished blood. Such germs produced during previous illnesses might long lie dormant in the earth or a building, e. g. as "lasting spores" until a return of the conditions adapted to their growth; this would account for the seemingly independent origin of some fresh epidemics.
The whole of the evidence brought forward by this laborious investigator tends to show that in the epidemic he witnessed the parasite spirillnm was present, as a rule, in the blood of the affected. At the same time he affords no proof that this was the primal cause of the fever, while he proves, incontestably, thj such primal cause is essentially related to poverty and famine. In a word, a certain diseased condition of the blood and tissues must be present for either fever or spirillum to be manifested. The precise part played by the parasite in the disease has yet to be demonstrated, together with the fact of its presence in all epi demic visitations of the same affection.
Disease Connected with the Parasite Actinomyces.
Recently Professor Ponfick of Breslau has described a disease which is contracted by man from the ox. The ox is attacked, sometimes, with a tumor affecting the jaw, usually the lower jaw, from which the infection is assumed to be directly or indirectly conveyed to the human subject. In the diseased person fistulous openings occur in the skin of the neck and back, ending with sup puration and phlegmon, or with pneumonia, pleurisy, or perito nitis. The discharges from the openings contain yellow millet-like seeds of fatty character resembling what is present in the ox. The millet-like seed consists of a number of small elementary bodies of Mycelium or fungus which Bollinger had found in the ox, and called actinomyces. The disease in the ox is called in man Actinomycosis hominis.
On the Parasitic Origin qf Phthisis Pulmonalis or Consumption of the Lungs.
We have already seen that a bacillus may be found in the expectoration and in the contents and walls of cavities of the lungs of persons who are suffering from phthisis. This observa tion was first made by Professor Koch, and from his experiments on the communicability of symptoms of phthisis to inferior animals it has been inferred that the bacillus is the cause of this disease. The subject has excited the keenest interest in the med ical world. From the controversy which has been elicited, and which I have followed with the closest attention, I gather that in the enthusiasm of the controversy, conclusions have been arrived at which are far too comprehensive to be even near the expected realization of truth.
In order to prove the origin of phthisis from the bacillus of tubercle it has been all at once assumed that phthisis is one dis ease. Constitutional tubercular phthisis; alcoholic phthisis, which need not be constitutional; syphilitic phthisis, and every other variety, have been thrown into one. This is entirely opposed to the facts of experience relating to the history of the disease.
To support the speculation still further it is insisted on that the disease is always communicated from one person to another by contagion. This view is of course essential to the hypothesis. But there is no evidence that the disease is ever carried by con tagion. I was for fourteen years physician to a hospital for dis eases of the chest, and in the large public experience there gained, together with that obtained in private practice, I have treated over three thousand cases of the disease. In that large field of observation, extending over thirty years, I have noted no ques tion more carefully than that which relates to contagion, and I cannot recall a single instance in which I could trace, in a clear and satisfactory manner, that the affection was communicated from one person to another.
I have known persons who were susceptible to the disease exposed to what would have been the extremest peril if there had been contagion, but have never known contagion to result under such circumstances. I have known three members of the same family die of phthisis, the first affected being in closest with the others, without any communication of the disease at the time. Yet years afterwards those same persons, on the mere accident of taking cold, have contracted the disease. I never knew a nurse, a doctor, or any other attendant on the con sumptive take the affection from contagion, nor anything that at all resembled such relationship.
The supporters of the bacillus hypothesis, in their anxiety to make it true, ignore the overwhelming evidence of hereditary tendency to phthisis. If all were susceptible to the disease all would take it, and the fact of taking by infection or contagion would be obvious to every observant mind: But, in truth, few if any suffer from the commonest form of consumption, that which attacks the young, except they are born with the proclivity to it. In the cases I have seen over ninety per cent. were hereditarily disposed to the malady and became stricken with it, as an all but universal rule, while living with other persons, and under the same conditions as other persons who were not affected with it.
Once more, in order to give credit to the hypothesis, the pe culiar condition of body of those who suffer is practically set aside as of no moment.
Such facts at first seem, truly, to give some countenance to the parasitic hypothesis, and if they stood alone they would be forcible if not demonstrative. As it is, they can only be taken in combination with the other facts above stated, upon which they are found to tally so completely with the constitutional and neuro pathological theory of origin that they need no other explanation. The confined and devitalized air acting as a depressing influence on vital action favors predisposition, and enables any disturbing cause to set up the first series of nutritive changes in the lung from which the rest proceed.
On the whole, then, all that it seems to me can be honestly admitted in respect to the parasitic nature of phthisis pulmonalis, is, that in certain instances of it, perhaps in many instances of it, a vegetable parasite is found in the affected structure, and in the expectoration. But even this requires still further proof.