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Victorian Blogging
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A collection of digitised nineteenth-century pamphlets from Conway Hall Library & Archives. This includes the Conway Tracts, Moncure Conway's personal pamphlet library; the Morris Tracts, donated to the library by Miss Morris in 1904; the National Secular Society's pamphlet library and others. The Conway Tracts were bound with additional ephemera, such as lecture programmes and handwritten notes.<br /><br />Please note that these digitised pamphlets have been edited to maximise the accuracy of the OCR, ensuring they are text searchable. If you would like to view un-edited, full-colour versions of any of our pamphlets, please email librarian@conwayhall.org.uk.<br /><br /><span><img src="http://www.heritagefund.org.uk/sites/default/files/media/attachments/TNLHLF_Colour_Logo_English_RGB_0_0.jpg" width="238" height="91" alt="TNLHLF_Colour_Logo_English_RGB_0_0.jpg" /></span>
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Conway Hall Library & Archives
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2018
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Conway Hall Ethical Society
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The extinction of war, poverty, and infectious diseases: containing essays on Home rule and federation; Can war be suppressed?; State remedies for poverty; and The extinction of infectious diseases by a Doctor of Medicine [George R. Drysdale].
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Drysdale, George
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Place of publication: London
Collation: 157 p. ; 18 cm.
Notes: Printed by A. Bonner, Chancery Lane, E.C. Sold by R. Forder, Stonecutter St. E.C.
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Geo. Standring
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1904
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G4999
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Social problems
Health
Poverty
Rights
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<a href="http://creativecommons.org/publicdomain/mark/1.0/"><img src="http://i.creativecommons.org/p/mark/1.0/88x31.png" alt="Public Domain Mark" /></a><span> </span><br /><span>This work (The extinction of war, poverty, and infectious diseases: containing essays on Home rule and federation; Can war be suppressed?; State remedies for poverty; and The extinction of infectious diseases by a Doctor of Medicine [George R. Drysdale].), identified by </span><a href="https://conwayhallcollections.omeka.net/items/show/www.conwayhall.org.uk"><span>Humanist Library and Archives</span></a><span>, is free of known copyright restrictions.</span>
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English
Home Rule
Home Rule-Ireland
Infectious Diseases
Malthusianism
Poverty
War
War;Poverty
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NATIONAL SECULAR SOCTPTV
STATE MEASURES
FOB THE ABOLITION OF
wig, War, and
Containing
three Articles, (the two last reprinted from
the “ National Reformer”) :
STATE REMEDIES FOR POVERTY;
CAN AVAR BE SUPPRESSED?
AND
THE EXTINCTION OF INFECTIOUS DISEASES.
BY
A DOCTOR OF MEDICINE,
Author of the “Elements of Social Science''
SIXTH THOUSAND.
LONDON:
E. TRUELOVE, 256, HIGH HOLBORN.
REMOVED FROM TEMPLE BAR.
1886.
�“Poverty, in any sense implying suffering, may be completely extin
guished by the wisdom of society, combined with the good sense and provi
dence of individuals.”—John Stuart Mill.
“ In civil society, either law or force prevails.”—Lord Bacon.
“ Man has it in his power to cause parasitic diseases to disappear off the
surface of the globe, if, as we firmly believe, the doctrine of spontaneous
generation is a chimera.”—Louis Pasteur.
�2-3 S’
no ,95
STATE REMEDIES EOR POVERTY.
I would here add, to what has been said in previous editions,* a
few remarks on a subject of the utmost possible importance. It
is a subject which has hitherto been little discussed, but on which
many have doubtless, like myself, thought long and anxiously,
BUd which seems to me urgently in need of an earnest considera
tion. However strongly opposed to the prevailing opinions
and sentiments, it will sooner or later, I believe, become the
most momentous of practical questions in every country of the
World. I refer to the endeavour to extinguish poverty by direct
legal enactment in the only way in which this could possibly be
done, namely, by means of a statute limiting the size of families,
and forbidding anyone, whether rich or poor, to have more than a
certain small number of children.
Mr. John Stuart Mill, the great thinker whose loss we deplore,
Was strongly in favour of such a measure. He says in his Political
Economy, “ It would be possible for the State to guarantee em
ployment at ample wages to all who are bom. But if it does this,
it is bound, in self-protection, and for the sake of every purpose
for which government exists, to provide that no person shall be
born without its consent.” In another work, in a vindication of
the French Revolution of 1848, he says, “ The practical result of
the whole truth might possibly be, that al] persons living should
guarantee to each other, through their organ, the State, the ability
to earn by labour an adequate subsistence, but that they should
abdicate the right of propagating the species at their own dis
cretion and without limit; that all classes alike, and not the poor
alone, should consent to exercise that power in such measure only,
and under such regulations, as society might prescribe with a
view to the common good. But before this solution of the problem
can cease to be visionary, an almost entire renovation must take
place in some of the most rooted opinions and feelings of the
present race of mankind.” And, again, he says in his Political
Economy, ‘‘ If the opinion were once generally established among
the labouring classes that their welfare required a due regulation
of the numbers of families, the respectable and well conducted of
the body would conform to the prescription, and only those would
exempt themselves from it who are in the habit of making light
*.These remarks were first inserted in the edition of the “Elements of
Social Science,” which appeared in 1878.
A 2
�4
STATE REMEDIES FOB POVERTY.
of social obligations generally ; and there would be then an evident
justification for converting the moral obligation against bringing
children into the world who are a burden to the community into
a legal one; just as in many other cases of the progress of
opinion, the law ends by enforcing against recalcitrant minorities,
obligations which to be useful must be general, and which, fro®®
a sense of their utility, a large majority have voluntarily c<M«
sented to take upon themselves. There would be no need, how^
ever, of legal sanctions, if women were admitted, as on all other
grounds they have the clearest right to be, to the same right of
citizenship with men. Let them cease to be confined by custom
to one physical function as their means of living and their source of
influence, and they would have for the first time an equal voice
with men in what concerns that function ; and of all the improve
ments in reserve for mankind, which it is now possible to foresee,
none would, in my opinion, be so fertile as this in almost every
kind of moral and social benefit.” I venture to think that even
if women were admitted to the suffrage, and other just rights and
privileges of citizenship, there would still exist the most weighty
reasons in favour of legislation on this subject.
The great reasons for such an enactment seem to me to be that
a law to regulate population, if duly carried out, could of itself with
certainty remove poverty and overwork ; that no other law, or laws,
could do this, and that the force of public opinion, and the con
science and self-interest of individuals are not strong enough,
without the aid of law, to accomplish so vast an object. What is
indispensably needed for the extinction of poverty is a restraint
on population so powerful and general as to riww the excessive
pressure on the soil; in other words, by diminishing the demand
for food, to enable the margin of cultivation to recede to a suffi
cient extent, the worst soils to be thrown out of tillage, and the
land altogether to be less highly and expensively cultivated. In
this way the productiveness of labour would be increased, and
wages would rise, while at the same time there would be a reduc
tion in the working hours, and in the cost, and, therefore, the
price of food. The country would then be placed somewhat in
the position of a new colony, for the essential difference between
an old country and a new colony is that in the former population
is pressing too heavily on the productive powers of the land. Now
it appears to me that a reform of such vast extent and difficulty
as this, requiring the co-operation of the whole of society, will
never be adequately carried out without the assistance and de
liberate sanction of the Government. When the increase of
population is left solely to the discretion of individuals, th#
moderation and self-restraint of some are counteracted by the
recklessness and improvidence of others, and thus the overcrowded
state is constantly kept up. Even in France, where prudence is
most general in this respect, there is still immense over-popula
tion ; as may be seen by the miserably low rate of wages in many
�STATE REMEDIES FOR POVERTY.
D
employments, and the high average price of provisions. It is a
fact, thoroughly established by science, that large families are the
real cause of low wages and dear food in old and civilised coun
tries, and there can be no doubt that Government has the power,
if it only has the will, to suppress the source of the evil, and
thereby remove the effect. Anything else which Parliament can
&> to raise wages must be merely indirect, and can only attain its
object by the circuitous means of acting on the general intelli
gence and independence of the people, and inducing them to limit
their numbers. Why then should we always be content with
indirect and inadequate measures? Why not go at once to the
root of the matter, and grapple with the main cause of poverty
and pauperism, with the earnest resolution to put an end to them ?
It seems to me that this question is sure to be asked before long
by the working classes and social reformers, when the chief cause
of poverty becomes widely known, and is no longer a matter of
dispute. The great idea lying at the root of the socialist and
democratic doctrines which have spread so widely of late years,
■especially on the Continent—an idea which I believe to be pro
foundly true—is that mankind form a community whose interests
are bound up together, and who should mutually aid one another,
and insure one another, as far as possible, against the ills of life ;
that society should have an equal care for the happiness of all its
members, and should see that all are duly provided for ; that
therefore it is the duty of society, through its organ, the Govern
ment, to take energetic steps for the removal of poverty, and to
guarantee to every individual who is willing to work, an ample
Subsistence in return for his labour. Now, a law to regulate
population is in reality the only law by which it is possible for the
State at once and directly to do away with poverty, to shorten the
hours of labour, and to raise wages to a satisfactory amount ; and
If it be true, as was maintained by the Provisional Government of
France in 1848, and was inscribed in the project of a constitution,
that the State ought to guarantee subsistence and employment to
ail who are willing to Work, such a law is the only means by which
the object could be effected. Ought not then the State to adopt
this one and only means for ensuring to all a comfortable subristence ? Should we not choose the most direct and certain path
to deliver our society from the fearful evils of poverty and
pauperism? For my own part, I cannot but entertain a deep
conviction that such a law is quite legitimate in the extraordinary
difficulties arising from the population principle. I think that it
would, if enacted, be the most important to human happiness of
all possible laws, and that it will sooner or later be laid down as
the very foundation and corner-stone of society, in all the civilised
countries of the old world.
It will be said that a measure of the kind described is far too
Sweeping an innovation, and too despotic an interference with
personal liberty to be ever seriously cont«mplated. But those
�6
STATE REMEDIES FOR POVERTY.
who rely on sueh objections would do well to consider attentively
the actual state of the facts The truth is, that population is
already so powerfully restrained by prudential motives in this and
many other countries, that a little more or less of restraint is a
matter of much smaller importance, and would be far less felt,
than is often supposed. Immense numbers of people, perhaps the
majority of society, are obliged at present by their circumstances
to exercise so much caution in regard to marriage and offspring,
that it would not make the slightest practical difference to them
whether a Malthusian statute were in existence in the country ot
not. To those who are forced to lead a life of celibacy, the change
would bring a positive increase of freedom, for if there were no
excessive families, a much greater number could marry. The only
persons whose liberty would really be interfered with are those
who have large families, and in their case the operation of the law
would for the most part be the greatest possible blessing to them
selves as well as to the rest of society. It is no one’s real interest
in an old and over-peopled country to have a large family.
Children, when too numerous, are a source of intolerable diffi
culties and anxieties among the rich quite as much as among the
poorer classes ; and it is a remarkable fact that in France and
many other countries it is the rich, and not the poor, 'who most
carefully limit the number of their offspring. We see, therefore,
that the question does not really lie between liberty and restraint,
but between two degrees of restraint, one of them unjust and
partial in its action, inefficient, and attended by the most wide
spread sufferings, and the other, which would be just and efficient,
and which would not be practically felt by most people as any
increase of restriction, but only by those who would themselves be
immensely benefited by the change. I believe that the abolition
of poverty, the mightiest of all social revolutions, could be quietly
and peacefully effected by this means, with only such an amount
of interference with personal liberty as would be comparatively
little felt as a positive evil. Moreover, poverty cannot possibly be
got rid of without an increase in the preventive check to popu
lation. It is in vain to wish that there were no poor, and yet
object to a further limitation of the size of families ; if we will
the end, we must will the means to attain it; and if, therefore,
society must of an absolute necessity submit to an increased
restraint in order to effect this grand purpose, what real difference
does it make whether the restraint comes from law, or from public
opinion, or from the conscientious feelings, or the interests, or the
circumstances of individuals ? Another very important matter
to be taken into account is, that legal restrictions on population
actually exist at present in many continental countries, and even,
in England. Mr. Senior, as quoted by Mr. Mill in his Political
Economy, says that in the countries which recognise a legal right
to relief, “ marriage on the part of persons in the actual receipt of
relief appears to be everywhere prohibited, and the marriage of
�STATE REMEDIES FOR POVERTY.
7
those who are not likely to possess the means of independent sup
port is allowed by very few.” In Norway, Wurtemberg, Bavaria,
Frankfort, several Swiss Cantons, and some other parts of the
Continent, no one is permitted to marry unless he can show that
he has a fair prospect of being able to maintain a family ; while
in England, by a provision of the poor-law, husband and wife are
separated in the workhouse. Now these laws, however excellent
their intention, and however efficacious they may have been in
diminishing poverty, do not seem to me strictly in accordance with
justice, for two reasons : in the first place, because they prohibit
marriages, instead of prohibiting (what alone, it appears to me,
the Legislature can justly restrict) large families; and, secondly,
because they apply only to the poor, and not to all classes of
society alike. The existence of such enactments shows that a
statute to regulate population would not introduce any new prin
ciple (since restrictions on marriage are really restrictions on
population), but would merely be the extension to the community
at large of a law which exists in this and other countries in regard
to certain classes, and which, in my opinion, is unjust so long as it
is confined to them, and is thus only a law for the poor and not
for the riqh. Is it just that all the restrictions should be laid on
the poor or the paupers, when the whole of society has a share in
the production of poverty and pauperism ? Again, as to the objec
tion that such a statute could never be enforced, we must remem
ber that it could not possibly be enacted without an immense
deal of discussion, and till the majority of the nation were strongly
in its favour, and that the majority would not seek to impose any
obligations on others which they were not ready to submit to
themselves. It may, perhaps, be added that it would be possible
to make the limit of families rather a high one—perhaps four
children as the maximum—since very many would not reach it, and
the penalty could be slight, as the great object of the law would
be to guide and strengthen public opinion, and the dictates of
individual prudence and conscience, and not by any means to
supply their place. The mere discussion of the subject would be
of incalculable value, and would spread a knowledge of the popu
lation truths over the whole country.
Had the population question been openly discussed, so that all
Blight understand it, we should never have seen that perversion of
justice by which two of the most gifted of English citizens have
Been sentenced to fine and imprisonment for seeking to benefit
the poor—for earnestly considering the cause of low wages, as
laid down by political economy, and pointing out the means by
which, in their belief, poverty could be removed from society. It
is the duty of all to meet, and not evade, this question. More
especially is it incumbent on those who prosecute others to state
plainly their own views on the subject. When a remedy for
human miseries is put forward, not as a good in itself, but as the
least oj several alternative evils, one or other of which is necessary
�8
STATE REMEDIES FOR POVERTY.
and inevitable, those who condemn it are bound to say which of
the other alternative evils they think preferable. As there must
always exist a most powerful check to population, either positive
or preventive, in old countries, the question to be determined is,
which of the various forms of the check is most consistent with
the happiness and well-being of mankind ? This is the real point
at issue, and opponents are bound to consider it most carefully,
and to show, if they can, that some other mode of dealing with
the terrible difficulty of population is better than the one pro
posed. Now there are several different ways in which the popu
lation difficulty may be dealt with by those who disapprove of
preventive measures. People may either ignore it altogether, as
the vast majority do, and go on blindly striving to remove from
society all the checks to population, or permanently to diminish
any one of them without a proportional increase of some of the
others-—objects which Mr. Malthus, eighty years ago, showed to
be quite unattainable by human effort. Or they may deny the
truth of the law of population, and contend that man’s choice is
not limited to one or other of the checks to increase, and that
poverty is not the result of too rapid multiplication. Or they
may hold that the existing checks, poverty, prostitution, and celi
bacy, are preferable to preventive means ; or maintain, with Mr.
Malthus, that all the other checks ought to be superseded by an
enormous increase of celibacy or sexual abstinence. Or, finally,
they may see nothing wrong in the preventive measures—nay,
may themselves adopt them—but yet hold that the subject ought
not to be spoken of or discussed in writing ; an opinion which is,
I believe, very common, but which cannot be sustained ; for if it
be morally right to use these means, they must be carefully con
sidered by physicians and others, so as to learn their influence on
human health and happiness, and to free them, as far as possible,
from any injurious consequences. One or other of these views
must be held by opponents, and they are bound to state clearly
and openly which of them they do hold. This, however, has not
been done by the prosecutors or their counsel, and hence those who
honestly meet and try to solve the greatest of human difficulties
are attacked and threatened with legal penalties by those who
evade it altogether, and therefore do not give any real grounds to
justify their condemnation. For the moment the attempt has
been defeated by the heroism and eloquence of Mr. Bradlaugh and
Mrs. Besant, and the heart of every true friend of the people is
with them, and with Mr. Truelove, in their steadfast defence of
the population doctrines and the liberty of the Press—one of the
greatest services ever done in any country to the poor and to
humanity at large.
�CAN WAR BE SUPPRESSED?
Hs>w long is war with its countless list of horrors and miseries to
continue among us? Every one must feel that war is an appalling
evil and blot on civilisation, and must earnestly desire that means
<fould be taken to put an end to it. War is lawlessness ; it is an
appeal to might instead of right, in which parties decide their own
quarrels by force of arms, instead of submitting them to an im
partial tribunal to be decided according to reason and justice ; and
hence it is utterly opposed to civilisation, which seeks to bring all
actions under the dominion of law. War stands out alone, as an
exception and a fearful remnant of barbarism in the midst of
modern civilised life. But war is not merely lawlessness, it is
murder. We can see this from the parallel case of duelling, which
absolutely prohibited and treated as murder by the law of
England. “ According to the law of England,” said Sir John
Holker, in a recent trial, “ a man who kills another in a duel is
a murderer and liable to be hanged.” No matter what the merits
of the quarrel may have been, whether a man be aggrieved or
aggressor, if he fights a duel and kills his opponent he is punished
by the law as a murderer. But if duelling be murder, what else
is war ? War is simply duelling on a vast scale, and with this
aggravation, that the crime of robbery, in the shape of annexations,
indemnities, and other kinds of pillage, is usually added to that of
murder. Moreover, in duelling the principals fight their own
battles, and an attempt is made to put them, as far as possible, on
a footing of equality ; whereas in war, the rulers who give the
command for it do not usually themselves fight, and every advan
tage is taken of superiority in number, skill, and military resources
between the combatants. Is it not monstrous that now, after all
the progress in humanity, one nation is allowed to attack another,
perhaps a much weaker nation, to kill the people and seize their
land and their goods ? How can the people of England, who
have shown their respect for law and for human life in putting
down the duel, tolerate war ?
Few of the great movements of the age are of such extra
ordinary importance as that for the suppression of war. The
most noble efforts have been made of late years for this end by
Mr. Bright, M. Victor Hugo, Mr. Henry Richard, Mr. Bradlaugh
gnd others, and the Peace Societies in England already number
Several hundred thousand members. Various plans have also been
put forward for superseding war and supplying its place by inter
�10
CAN WAR BE SUPPRESSED ?
national arbitration, and these plans cannot be too carefully con
sidered and discussed ; for it is not merely by the general advance
of commerce and enlightenment and the growing abhorrence of
war among thinking minds, but also, and above all, by the adoption
in time of peace of active practical measures to prevent war, that
we shall ever be able to free human society from this terrible and
immemorial evil.
The more deeply the subject is reflected on, the more clearly I
think will it be seen that the real cause of wars is the want of a
supreme and irresistible authority, which could force the nations to
conform to law in their dealings with one another and to settle
their disputes by peaceable arbitration. The only effectual remedy
for war, as has been well pointed out, is the introduction of law
—or in other words, of positive rules of conduct, applied by a
court of justice, and enforced by a competent authority—into the
mutual intercourse of nations. At present international relations
are in an essentially lawless state; there is no code of laws govern
ing nations like that which governs individuals ; for what is called
“ international or public law ” or “ the law of nations,’’ as all
writers on the subject admit, is not really law at all, in the legal
sense of the word, but merely custom or usage, or else engagement
by treaty. Nations may disregard these customs, or break their
treaties in particular instances, if they choose to incur the risk of
so doing, and they have what is called the “right of making war ”
on one another and deciding their quarrels by violent means—a
right whichis utterly subversive of the very idea of law. The essence
of law is the compulsory adjudication of disputes by an impartial
tribunal, and if parties are allowed to dispense with a tribunal
altogether and settle their differences for themselves by the sword,
it is evident that law doesnot exist between them. But wherever,
in any department of human affairs, law is absent, or cannot be
enforced from weakness of the executive, the most fatal conse
quences are sure to arise. Thus in the Middle Ages, before govern
ments were strong enough to coerce the barons and feudal chiefs,
private wars between them as well as national contests were so
common that, as Mr. Buckle says, “ there was never a week with
out war.” Even in our own day, when opinion is so much more
advanced, if there were no laws regulating the succession to pro
perty, the fulfilment of contracts, &c., and if people were allowed
to fight for their rights instead of having them determined by a
court of justice, society would be a scene of continual bloodshed
and confusion. War is the natural and inevitable result of the
present lawless state of international relations, and the one and
only remedy for it is to extend to nations, as well as individuals,
the inestimable benefits of law. But how is this to be done ? If
we examine the matter attentively we shall find that the element
which is wanting to constitute a true legal system between nations,
is a supreme authority with adequate executive force. There
exists already a code of rules or usages commonly called inter-
�CAN WAR BE SUPPRESSED ?
11
Rational law, which has gradually become better defined and more
binding, as well as juster and more humane, in the course of
ages ; an international tribunal could be established, consisting
of judges skilled in public law, and chosen from the different
States ; but the grand difficulty to be overcome is the want of a
supreme authority, to approve and, when necessary, add to the
code, and strong enough to compel the nations, however powerful,
to carry their disputes before the tribunal and abide by its de
cisions. It is a sanction, or enforcing authority, of this kind that
the international code really needs. “ The independent societies
of men, called States,” says Mr. Wheaton, in his work on Inter
national Law, “ acknowledge no common arbiter or judge, except
such as are constituted by special compact. The law by which
they are governed, or profess to be governed, is deficient in those
positive sanctions which are annexed to the municipal code of
each distinct society.” If there were such sanctions, war between
nations could be crushed out with the same certainty and com
pleteness as the civil wars between the feudal nobles have been
extinguished by the growing power of the law courts. The
question, How is war to be suppressed, seems to me, therefore, to
tasolve itself mainly into this other question—How is a sufficient
Sanction, or executive authority, to be obtained for the law of
nations ?
We may now turn to the various practical proposals which have
been brought forward with a view to the prevention of war, and
of which the most important seem to be the following : a general
reduction of armaments ,* a confederation of States, and international
armies. The first of these would be an immense boon if it could
be obtained, as it would lighten an intolerable burden on the
nations, and also make war less probable, since governments would
no longer be so fully prepared for it. But there are evidently
most formidable difficulties in the way of carrying out this pro
posal. The disarmament would need to be general, for if any of
the great Powers refused to reduce their forces, it would be dan
gerous for others to do so ; and some governments would be
particularly averse to disarm, either from unwillingness’ to give
up cherished schemes of ambition or revenge or from the vast
size of their dominions and fear of disaffection among their sub
jects. But even if these difficulties were overcome, disarmament
Would be only a palliative, and not a cure for present evils. It
Would still leave arbitration optional, whereas the object to be
aimed at is that it should be compulsory, or, in other words, that
law should be introduced in international affairs. “We hold,”
says Professor Cliffe Leslie, “ that only a law of nations in the
* A resolution in favour of a general disarmament by the European States
was proposed in Parliament by Mr. Cobden in 1849, and again recently in
1880 by Mr. Henry Richard. The latter also, in 1878, moved a resolution,
which was adopted by the House of Commons, in favour of the arbitration
of international disputes.
�12
CAN WAR BE SUPPRESSED?
strict sense of the term, can terminate war.” Without law, there
is not only no guarantee for peace, but no provision for securing
justice, between nations. Disputes between nations, as between
individuals, arise on questions of contested right, or in conse
quence of injuries received ; and if one party refuses to arbitrate,
the other must either tamely submit to what it considers an
injustice, or go to war to enforce its rights. But war, like the
barbarous “ trial by combat ’’ in use among our ancestors, can
never be a proper test of justice or of right, for a war does not
show which cause is just, but only which of the combatants is the
stronger. So long, therefore, as Governments may refuse arbi
tration and may go to war, injustice and lawless force are the final
umpires in international disputes, and this must have a profoundly
demoralising effect on mankind and their rulers. In order to have
either peace or justice it is necessary to introduce law, which would
compel arbitration, and secure, even to the weakest among the
nations, its rights and redress for its injuries. This, too, is the
only sure means for bringing about a disarmament, for the real
cause of the enormous armies (amounting at present in Europe
alone to about ten millions of men) is the state of general inse
curity and licence arising from the absence of law. As there is
no law to protect or restrain them, nations arm partly to protect
themselves and partly to carry out secret projects of conquest
and aggrandisement; and we can scarcely hope to see any satis
factory reduction of armaments till there is a real and effective
international law.
How, then, can such a law be obtained? We have seen that
what is mainly needed for this purpose is a supreme authority,
with adequate executive force to give effect to the present inter
national code, which, as Mr. Cliffe Leslie observes, has the features
of law “in its inchoate or rudimentary form.” Now there is
evidently only one way in which an authority of the kind can be
established, namely, by means of a combination between different
States. Nothing but the combined strength of many States can
force single States to obey the law and to keep the peace. The
real sanction of the law between individual and individual is the
general community of individuals, and in like manner the sanction
of the law between nation and nation can only be the com
munity of nations. It seems to me the clearest and most urgent
duty of nations to take measures for introducing positive law
between them and putting an end to war. Until provision can
be made for the legal settlement of international disputes, the
responsibility for war with all its horrors rests in great part on
the nations generally ; and this leads to the utmost confusion of
ideas with regard to the criminality of war. One. of the most
frightful of crimes is not generally seen to be a crime at all.
Thus at present wars are commonly divided into just and unjust,
because, in the absence of law, it is sometimes necessary, and
even an act of the most heroic virtue in a nation to fight for its
�CAN WAR BE SUPPRESSED ?
13
rights and liberties; but if law were once firmly established,
and means of legal arbitration afforded, war would simply be a
crime, to be repressed and its chief authors punished, as in the
case of other heinous offences. There would then be only one
kind of lawful and justifiable war, namely, that which is analogous
to the action of the police, and consists in putting down by force
any resistance to the orders of the supreme authority. . Not only
can and ought the nations thus to put down war as a crime, but it
is their most vital interest to do so. At present any nation is
liable at some time or other to be involved in war, and even
neutrals during a war often suffer most severely ; for their.com
merce and communications are interrupted by blockades, sieges,
and other military operations ; and, besides, war has a great ten
dency to spread, and the best efforts on the part of neutral States
are often unavailing to prevent their being dragged into it. Why
should neutrals submit to these fearful evils and dangers at
the hands of belligerents, who are morally bound to arbitrate
their disputes, and are therefore committing a crime in going to
war?
These considerations are so immensely important that they
■lust, I believe, before long lead to a combination among civilised
States for the purpose of preventing war. But States may com
bine in different ways, either by alliance or by a more or less inti
mate confederation ; and the great difficulty of the question is to
decide which kind of combination is at once suited to effect the
object in view and also capable of adoption by existing States.
^Professor Seeley, in a lecture delivered before the Peace Society,
Bias held that nothing short of a close federal union, like that sub
sisting between the States of North America, who are all under a
common government, would be sufficient; and a similar view seems
to be taken by those who advocate, as a remedy for war, the for
mation of what they term “ the United States of Europe.” It
geems to me, however, that so vast a change as this is neither
©raoticable nor necessary, and that the form of union to be aimed
at is one which, while binding the nations very strongly together,
would interfere as little as possible with the sovereignty and inde
pendence of each. This could best be done, in my opinion, by
means of an alliance, with mixed or international armies; a proposal
which was brought forward some time ago by Mr. G-lasse, in the
columns of the National Reformer, and to which I had myself
independently been led on thinking on the subject. The means
which I would venture to suggest as best adapted for the pre ven
tton of war are the following :—-That two or more nations should
enter into a close alliance together, unite their armies, and invite
other nations to join them, with the declared intention of arbi
trating their own disputes in future, and also of putting an end to
war throughout the world and compelling all disputes to be settled
by peaceable arbitration, as soon as the alliance was strong enough
to effect this. The object of such a league would be to sanction
�14
CAN WAR BE SUPPRESSED ?
and enforce international law, and compel all disputes between
nations to be settled by it, and not by war; and if only two or
three powerful States were thus to ally themselves, it would pro
bably be sufficient in great measure to effect the object, since the
alliance could often prevent a war by threatening, in the event of
a quarrel between two States, to assist in hostilities against either
party which acted illegally—or, in other words, which either re
fused to arbitrate, or, having arbitrated, refused to submit to the
judgment of the tribunal. It is to be hoped, however, that in time
all civilised nations would join the alliance, so that it would
become irresistible, and that single States would as little dare to
defy its authority as individuals now think of setting themselves
against the civil powers. In this manner war would not merely be
suppressed, if it occurred, but, what is infinitely more desirable,
would be entirely prevented from occurring.
A league of the kind here suggested would bind the nations
very firmly together by uniting their armies, and yet would not, as
it appears to me, interfere materially with their existing rights of
sovereignty and independence. One part of the mixed forces
could be kept in each country, and would be subject to the national
government, as armies now are ; while in all operations external to
the country the troops would be under the joint command of the
allied powers, and would never be used except against those who
refused to settle their differences in a legal and peaceable manner.
This, I submit, is the only true function of an army—namely, to
defend and enforce the law, and not merely, as hitherto, to carry
out the arbitrary will of individual governments. An army should
be the guardians of international law, as the police are the guardians
of the municipal law. Like the police, too, an army should be
strictly impartial, having nothing to do either with the merits of
quarrels or with the parties concerned in them. It should be as
culpable for a soldier to show partiality to his own country, at the
expense of international law, as for a policeman illegally to favour
his personal friends. This impartiality, so indispensable in all
officers of the law, would, I think, be best secured by having
armies of mixed nationality. Another great advantage of the
league would be that the allies could, if they pleased, at onep
reduce their forces, without waiting for other nations to do the
same, and without dangerously diminishing their strength ; for
they would be able to draw upon the combined armies and re-*
sources of two or more countries, instead of one only, for their
protection against foreign or domestic foes. It appears to me that
in this manner, or by some similar means, a sufficient executive
authority could be obtaiued for the international code ; while any
difficult question that might arise, or amendment that might be
needed in the code itself, could be discussed and settled, as is now
the practice, by conferences or congresses between the different
States.
The extension of law to nations as well as individuals, and th®
�CAN WAR BE SUPPRESSED?
15
abolition of the barbarous “ right of making war,” seem to me
beyond all comparison the greatest improvements which could be
effected in international politics, and would be a glorious triumph
of statesmanship. If statesmen of different countries, and among
them Mr. Gladstone, who has already done so much for the cause
of international arbitration, and who speaks in one of his works of
“ the rising hopes of a true public law for Christendom,” could do
something towards the realisation of these hopes, it would be a
priceless boon to a world sick of war and bloodshed, and longing
for the advent of a new era of settled peace, law, and real brother
hood among mankind.
[The momentous change in our Constitution which has lately
been proposed—the setting up, namely, of a Parliament in Ireland,
separate from that of Great Britain—is a change in the opposite
direction to those suggested above, and would, I cannot but think,
be a calamity and great danger to both countries from the clashing
of the legislative wills. It seems to me that the object of re
formers, all over the world, should be to strengthen and not to
relax the legal ties which now bind nations together. Why not
rather do our utmost to conciliate the Irish people and to satisfy
their legitimate aspirations, while at the same time enforcing
obedience to law and maintaining inviolate the Union ? a union
which has been the source of incalculable benefits to England and
Scotland, and also, I am firmly persuaded, to Ireland itself, in spite
of the confiscations and hateful penal laws of bygone ages.]
�THE EXTINCTION OF INFECTIOUS DISEASES,
Of all the doctrines recently brought forward in medicine, none
seems to me so extremely important as that which has been gain
ing ground with regard to infectious fevers, and has been earnestly
urged by the highest medical authorities, in particular by Sir
James Simpson and Sir Thomas Watson. I allude to the momentous
and startling doctrine that by taking proper measures to prevent
them, all the purely infectious or contagious febrile diseases might
be, and ought to be, completely and finally extirpated. The diseases
in question have more and more occupied the attention of Parlia
ment and sanitary reformers of late years, and were a leading sub •
ject of discussion at the International Medical Congress held a few
years ago in London. They form a peculiar class of affections,
having the following very remarkable characters in common.
They are fevers of a specific kind, most of them attended with an
eruption on the skin ; they are propagated by infection from one
person to another, usually by breathing the exhalations from the
sick, and they occur, as a rule, only once in a lifetime. In all of
them the minute poison which communicates the disease is im
mensely multiplied in the body of the patient, and as in this and
some other points the fevers have a resemblance to the action of
a ferment, they are often called zymotic, or fermentation-like
diseases.
The late Sir Thomas Watson, in an article on “ The Abolition
of Zymotic Disease,” which was published in the Nineteenth Cen
tury lieview, for May, 1877, and has since been re-issued with
others in a separate form, expresses his firm belief, that these
diseases “ might be finally banished from this island,” and ob
serves, that with regard to them, “it is of vast importance that
the public, no less than the medical profession, should have the
fullest attainable knowledge.” He thus enumerates the diseases to
which he refers :—“ They are not numerous,” he says, “ these
zymotic diseases. There are not more than nine or ten of them.
Small-pox, chicken-pox, typhus fever, typhoid or enteric fever,
scarlet fever, the plague, measles, hooping-cough, mumps—these
belong to, and, I think, constitute, the group of diseases now to
be considered.” Two of the number, chicken-pox and mumps
are slight affections, but the others are among the most ter
rible and fatal maladies that afflict the human race. If we
think of the prodigious amount of suffering and death these
diseases have caused and are causing yearly—the millions they
�THE EXTINCTION OF INFECTIOJS DISI A.SES.
17
have slain, and the panic they spread around them, the danger
which a person affected with one of them becomes to his fellow
features, and the broken constitutions and disfigurements they so
often leave behind even when they spare life, we can form an idea
of the immense and incalculable blessing which their extinction
Would be to mankind.
The great fact which warrants us in believing that these
diseases might be entirely extirpated, or “ stamped out,” is, that
whatever their primary origin in past ages may have been, they
never norv-a-days arise spontaneously, but are invariably propagated
ig infection. They are not merely infectious diseases, but have no
other source than infection. “ They are communicated from
person to person by contagion,” says Sir Thomas Watson, “and,
a® I venture to maintain, arise in no other way ; and this quality,
with their non-recurrence, forms the key to their supreme in
terest.” Small-pox, for example, never arises except by contagion
from a pre-existing case of small-pox, measles from a pre-existing
case of measles, scarlet fever from scarlet fever, and so on with the
rest. Moreover, they always, to use a common expression, “breed
tea®/* propagating their own kind, and no other, and maintaining
their characteristic type and features unchanged from generation
to generation. Thus measles always breeds measles, and never
scarlet fever or hooping-cough ; typhus breeds typhus, and never
typhoid fever; and each disease runs the same course in the
present day, has the same average duration, and presents the same
symptoms as it did when first clearly described by the earlier
physicians. In the above respects the infectious fevers bear a close
and most, striking resemblance to the different species of plants and
animals. We do not know how these species at first came into
existence (though we believe them to have been gradually deve
loped from lower forms), but we know that at the present day the
individuals belonging to each species always descend from parents
like themselves, and never spring up spontaneously. We know,
top, that they propagate their own kind and no other ; and that,
although admitting of some modifications, they adhere tenaciously
through the ages to their distinctive form and characters. From
their remarkable resemblance to species in these respects, the
infectious fevers are often called specific diseases ; that is, diseases
which are Like species in their constant characters, and in the fact
that they never originate spontaneously.
Sow it follows as a necessary consequence from this single and
definite mode of origin, that both the infectious fevers and the
different species of plants and animals are liable to extinction if
certain conditions be fulfilled. As they never arise in any other
way than by continuous succession, the fevers from diseases like
tbemgelves, and the plants and animals from parents like them
selves, if the line of descent be entirely broken through at any
time, the race perishes and can never re-appear. Many animal and
vegetable species have thus perished in the world’s history, as the
B
�18
THE EXTINCTION OB' INFECTIOUS DISEASES.
geological records show us, and some races hurtful to man have
been intentionally exterminated over large tracts of country, as,
for instance, wolves have been exterminated in England. In order
to extirpate a living species all that is needed is to destroy at any
given time every individual belonging to it ; and, in like manner,
to extirpate a form of infectious fever, it would be sufficient that
every existing case of it should be prevented from spreading to
others; if this can once, and once only, be accomplished, the
species, or the fever, ■will become permanently extinct. We see,
therefore, that as regards their preventibility, no less than their
mode of origin, the contagious fevers are a peculiar class of dis
orders, separated by a broad line of demarcation from others.
They are often called “ the most preventible of diseases/’ but the
truth is, that their preventibility is of a very different kind from
that of other affections. They are not merely preventible, in the
ordinary sense of the word, but extinguishable, or abolishable
diseases. Other diseases cannot be extinguished, and for this
reason, that we cannot destroy the causes that produce them. We
can only avoid their causes by the exercise of constant care and
vigilance, and if our efforts were relaxed at any time, the diseases
would appear again ; but in regard to the contagious fevers, as
they never arise but from other fevers of a similar kind, it is pos
sible to destroy the only causes known to be capable of producing
them. Thus, if every existing case of small-pox, typhus, scarlet
fever, and the rest, could be prevented from propagating itself to
others, these fevers would be definitively extirpated, and no im
prudence on the part of mankind, nor any other circumstance, so
far as we have reason to believe, could ever revive them. They
would then be extinct forms of disease, like the extinct species of
plants and animals, and only the memory of them would remain
to posterity.
The two assertions here made—that the infectious fevers have no
other source than infection, and that therefore, unlike other dis
eases, they might be finally extirpated—are among the most mo
mentous conclusions ever brought forward by science, and should
be thoroughly known to every one. The first of them is the
foundation of the other, and has a bearing on human health and
happiness whose importance cannot be exaggerated. If it be true
that these diseases have no other source than infection, then we
may hope by vigorous sanitary measures to stamp them out com
pletely, so that no further anxiety on their account would ever
afterwards be needed ; but if, on the other hand, besides being
infectious, they can also arise spontaneously, or de novo, as it is
often expressed (that is, from any other cause than infection), not
only would their prevention be far more difficult, since we should
have to guard against two or more modes of origin instead of one,
but we could never hope permanently to extinguish them. The
great question, therefore, is—Have these diseases no other cause
than infection ? This is a point on which the present medical
�THE EXTINCTION OF INFECTIOUS DISEASES.
19
opinion has been slowly and gradually arrived at. In former times
the infectious fevers were very commonly confounded together,
and their mode of origin was not clearly understood, but they
were often supposed to be due to some unknown atmospheric
influence ; as may be seen from the fact that even in the seven
teenth century the celebrated Sydenham, who was the first to
draw the distinction between small-pox and measles, did not know
that small-pox is infectious. Afterwards their infectiousness
became recognised, but it was thought that they might also pro
ceed from other causes ; and lastly, increasing experience and
careful observation and reasoning, especially since the publication
of Dr. Bancroft’s essay in 1811, have led to the modern view that
they never in any single instance arise but from infection. This
is now the prevalent medical doctrine on the subject, and with
regard to many of the diseases above enumerated it is rarely, if
ever, disputed.
Thus Sir Thomas Watson says: “ As life springs only from
preceding life—as, according to the verdict of exact scientific
experiment, there is no such thing as spontaneous generation, so,
under similar testimony, there is, now-a-days at least, no spon
taneous origin of any of these specific disorders.” In like manner,
in a “ Proposal to Stamp out Small-pox and other Contagious
Diseases,” published in the Medical Times and Gazette for January
4th and 11th. 1868, the late Sir James Simpson says, speaking of
small-pox: “We would no more expect this known species of
disease or poison to originate de novo at the present day, under
any combination of circumstances, than we would expect a known
species of animal or plant—as a dog or a hawthorn--to spring up
de novo and without antecedent parentage.” Dr. Aitken, also, in
his “Science and Practice of Medicine,” 7th edition, 1880, says,
in discussing the origin of scarlet fever: “ On this point Dr.
Ballard writes most distinctly (and with him I fully agree) that
‘ thus much is certain, it does not arise spontaneously—no disease
of its class ever does.’ ”
The most convincing argument against the spontaneous origin
of any of these diseases is the great length of time during which
they may be entirely absent from a district, a country, or even a
whole continent, until they are introduced from some external
source. Indeed, the contagious fevers, like the animal and
vegetable species, seem at first to have arisen in certain parts of
the world only, and thence to have gradually spread to others,
with the progress of human intercourse and the increased facilities
of communication, so that in most countries they are not indigenous
but imported diseases. Sir Thomas Watson observes that small
pox, though existing from remote antiquity in China and Hin
dustan, “does not appear to have been known in Europe till the
beginning of the eighth century,” and that “ there was no small
pox in the New World before its discovery by Columbus in 1492,
In 1517 the disease was imported into St. Domingo. Three years
b 2
�20
THE EXTINCTION OF INFECTIOUS DISEASES.
later, in. one ot the Spanish expeditions from Cuba to Mexico, a
negro covered with the pustules of small-pox was landed on the
Mexican coast. From him the disease spread with such desolation
that within a very short time, according to Robertson, three
millions and a half of people were destroyed in that kingdom
alone.” As to scarlet fever, Dr. Aitken says that “ the earliest
source of the poison is distinctly traceable to Arabia,” and adds
that “ measles was first noticed at the same time and in the same
country as scarlet fever, and the two diseases have subsequently
followed nearly the same course. They now prevail all over the
world.” Of hooping-cough -(which is not, like the others, afever)
he says that “ its origin is not beyond 1510, when it was endemic
in Paris ; but its epidemic character was not determined till 1580.
That most fatal of all epidemic maladies, the plague, had til'/
within the last forty years its chief home in Egypt and other
countries bordering on the Levant, from which it repeatedly
spread to different parts of Europe, committing fearful ravages.
In the middle of the fourteenth century it is computed to have
carried off, under the name of the “ Black Death,” from a fourth
to a third of all the inhabitants of Europe ; and in 16G5, the date
of its last appearence in our country, the “ Great Plague of
London” was fatal to 68,596 persons out of a population amount
ing at the time to about half a million. The prolonged absence
of a contagious fever is best seen in islands, and isolated places on
the mainland, to which infection is less readily carried ; and
among many remarkable instances of ths kind on record, there is
one which has often been cited in the recent history of measles.
There was no measles in the Faroe group of islands on the north
of Scotland, for sixty-five years previous to 1846, at which date
it was imported into them by a man affected with the disease.
It spread from him with vast rapidity (as usually happens when
measles or small-pox is introduced among a population, few or
none of whom are protected by having had it before), so that
within six months, out of the 7,782 inhabitants of the islands,
more than 6,000, old and young alike, suffered from the com
plaint.
Now, if any of these contagious fevers were capable of arising
spontaneously, why did they not show themselves during the
long periods just referred to? Why was there no small-pox in
Europe till the eighth or in America till the sixteenth century ?
Why has the plague been unknown in England since 1665, or,
since 1844, even in Egypt, which was formerly looked upon as
its peculiar home? Why was measles entirely absent from the
Faroe islands between 1781 and 1846? It cannot be said
that surrounding circumstances were unfavourable—on the con
trary, as events proved in regard to measles and small-pox, they
were extremely favourable to the existence and propagation of the
diseases. Why, then, did the latter not make their appearance ?
The answer evidently is, that they did not appear because there
�THE EXTINCTION OF INFECTIOUS DISEASES.
21
was no antecedent case present to produce them by infection, and
these diseases are as little capable of arising from any other cause
than injection as a plant can spring up except from a seed, or an
animal except from an egg.
I The argument against the spontaneous origin of the infectious
fevers, drawn from the great length of time during which they
®»ny be absent from particular countries or localities, until intro
duced from an external source, is so convincing that, when taken
®fong with the results of daily experience, it has led to a very
general agreement among medical men with regard to many of
these diseases. Thus, of the six principal kinds of infectious
fever now existing among us—namely, small-pox, measles, scarlet
fever, hooping-cough, typhusfever, and typhoid or entericfever'—the
first four are almost universally admitted never to arise spon
taneously at the present day, but to be propagated solely by
infection. On this point I may quote, in addition to the high
authorities already given, the opinion of Dr. Karl Liebermeister,
who says, in his introductory essay on Infectious Diseases, in
Stanssen’s “Cyclopaedia of the Practice of Medicine” (1875):
“ The spontaneous origin of small-pox, measles, and scarlet fever
could scarcely find a defender now.” Mr. Jonathan Hutchinson
observes also, in his article on Constitutional Syphilis, in Reynolds’
** System of Medicine
“ Like small-pox, scarlet fever, measles,
and the others in this group, syphilis is communicable from the
diseased to the healthy, and can be produced by no other means.”
One of the few who still advocate the doctrine of a spontaneous
origin is Dr. Charlton Bastian ; but he admits nevertheless, in
•peaking of “ hooping-cough, measles, scarlet fever, and small“ the knowledge we possess concerning the mode of
origin of these, otherwise than by infection, is almost nil."
With regard, however, to the origin of the two remaining
fevers, typhus and typhoid, and especially the latter, there is, un
fortunately, not yet the same general agreement; and as these
fevers are exceedingly important from their frequency and
fatality, they deserve particular attention. In their outward
appearance the two diseases are very much alike, being long
continued fevers, with obscure, though different eruptions, and
attended with great prostration and delirium—typhus lasting from
two to three weeks, and typhoid fever about a week longer.
Owing to their external resemblance, they were always confounded
together till within the last thirty or forty years, and were thought
to be merely modifications of the same disease, as other fevers
had been previously ; but the labours of several eminent observers,
among whom Sir William Jenner holds a conspicuous place, have
shown them to be quite distinct. In the Registrar-General’s
Imports of the causes of death in England they were first sepa
rated in 1869. The chief difference in their symptoms is, that in
typhoid fever there is always present an inflammation and ulcera
tion of some of the intestinal glands, accompanied by a peculiar
�22
THE EXTINCTION OF INFECTIOUS DISEASES.
and copious diarrhoea lasting for several days, which intestinal
affection is not found in typhus. For this reason, and also to
avoid the confusion arising from the similarity of the namM
typhus and typhoid, the latter disease is now more suitably called
enteric, that is, intestinal fever.
But the difference between the two diseases which is most
important with a view to their prevention is in the mode of their
infectiousness. Typhus fever, like small-pox, scarlet fever,
measles, and hooping-cough, is propagated directly from person to
person by breathing the air which surrounds the sick; but enteric
or typhoid fever is very little, if at all, communicable in this way.
It is spread, as it were, in an indirect manner by means of the dis
charges from the bowels, not in their fresh state, but some time
after they have left the body of the patient, and when they are in
the form of sewage, undergoing decomposition or putrefaction.
These discharges, by oozing from drains or cesspools, find their way
through the soil into the drinking water, and are swallowed, or else
the effluvia rising from them are inhaled, and thus the disease is
communicated. Another terrible epidemic disease, Asiatic cholera,
is also held, on carefully considered grounds, to be propagated
mainly in this indirect manner by means of the decomposing bowel
discharges of the sick. From the obscurity attending its mode of
propagation, the infectiousness of typhoid fever, as of cholera, was
long doubted or denied, and is difficult to trace in large towns,
where the houses are connected together by a network of drains ;
but in country places it is much more evident. Cases have again
and again been observed in which typhoid fever has been imported
by persons affected with it into country villages where it had not
previously been known for years, perhaps not within human
memory, and the disease has spread from them as from a centre—
facts which conclusively demonstrate its infectious nature.
Few, if any, now deny that typhoid fever is infectious ; but the
question has of late years been repeatedly debated, whether infec
tion is its only cause, or whether it can also arise spontaneously or
de novo, that is to say, from any other cause than infection ? Dr.
William Budd has urged with particular force and ability the
former doctrine, and his conclusions have been very widely accepted
among the medical profession. He holds the view just explained,
that typhoid fever is usually due to poisoning by sewage, but
that, whenever sewage acts in this virulent and deadly manner,
the reason is that it contains the stools of typhoid patients.
Ordinary sewage not containing typhoid stools has, he contendsf
no power whatever to produce the disease. On the other hand,
the doctrine that typhoid fever is sometimes generated spon
taneously has been advocated by the late Dr. Charles Murchison, in
an elaborate and most valuable work on “ The Continued Fevers of
Great Britain” (2nd ed., 1873). Dr. Murchison gives numerous
cases showing that typhoid fever is communicable from the sick to
the healthy—a conclusion which, he says, “with such facts before
�THE EXTINCTION OF INFECTIOUS DISEASES.
23
us, it is impossible to deny but he also holds that the disease is
BOmetimes produced afresh by a poison derived from ordinary
sewage not containing any admixture of typhoid stools. He says :
“It may be generated independently of a previous case by the fer
mentation of fsecal and, perhaps, other organic matter and this
is an opinion which is shared by many other medical men. Accord
ing to Dr. Murchison, moreover, the poison of typhus fever, a
highly and unmistakeably infectious disease, is sometimes “genefated de novo in the exhalations of living human beings, by over
crowding and bad ventilation,” especially in circumstances of great
poverty, dirt, and insufficiency of food ; but this view has, I think,
met with comparatively few supporters in this country.
In his article in the Nineteenth Century, Sir Thomas Watson
vigorously combats Dr. Murchison’s views on these two points,
and endeavours to show that neither typhus nor typhoid fever
has ever any other source than infection. The extreme importance
of this question can be readily understood. Our power to prevent
a disease depends on our knowledge of its cause, and it seems to
me that the question whether infectious disorders can also arise
spontaneously is in reality the most important of all questions
Relating to the causation of disease, from the vast practical conse
quences involved in it. In all efforts to prevent and eradicate
infectious diseases, the question of their spontaneous origin presents
itself, and few subjects in medicine have been so long and so
vehemently debated. It was discussed several hundred years ago
With reference to the plague, and within the present century the
controversy has been renewed again and again, not only in regard
to every one of the contagious fevers already enumerated, but also
to many other contagious maladies, among which I may mention
Asiatic cholera, yellow fever, relapsing fever, diphtheria, syphilis,
hydrophobia, glanders, and malignant pustule. The very same
question has been often discussed as regards the principal con
tagious diseases of the domestic animals, namely, rabies, glanders,
anthrax or splenic fever (which produce respectively, when inocu
lated on man, the very fatal affections of hydrophobia, glanders,
and malignant pustule), the cattle plague, pleuro-pneumonia or
infectious lung disease, sheep-pox, swine plague, and foot and
mciith disease. If we take these eight diseases in man, along
With the six infectious fevers prevalent among us, and also the
plague, which still exists in some countries, they form together
fifteen affections of the utmost gravity, besides eight most destruc
tive disorders of the domestic animals, the cause of almost all of
which is held very widely, and of many of them nearly universally,
by the best medical and veterinary authorities, to reside in con
tagion alone, while our hopes of preventing and extinguishing them
are inseparably bound up with the question whether or not they
can also arise spontaneously. If they are propagated by contagion
alone, their prevention is much easier, and their extinction is pos
sible ; but it) unfortunately, they can also arise in other ways,
�24
THE EXTINCTION OF INFECTIOUS DISEASES.
their prevention is far more difficult, and we cannot hope to
extinguish them. A few years ago, Professor Tyndall, as chair
man at a lecture delivered by Dr. Corfield, pointed out the extra
ordinary importance of the doctrine that infectious fevers “ breed
true,” and never arise spontaneously. He said that “ he entirely
agreed with all that the lecturer had stated as to these diseases
‘ breeding true,’ for they never found the virus of small-pox pro
ducing typhoid, or vice versa. The subject was one of the most
important -which could engage the attention of the scientific
physician, for in the whole range of medical art and science there
was not a subject of equal importance. But in applying to daily
practice this question of infectious diseases, the physician must
not stand alone—he ought to be aided by the sympathy of an
enlightened public.” On another occasion Professor Tyndall
quoted on this subject the words of the famous French chemist
and experimenter, M. Pasteur, who says, “ Man has it in his
power to cause parasitic diseases to disappear off the surface of the
globe, if, as we firmly believe, the doctrine of spontaneous genera
tion is a chimera.” The question as to the spontaneous origin of
infectious diseases has been so long under discussion, without being
yet decided, that there must evidently be something very difficult
in its settlement; and as it is a question of such vital interest to
human happiness, I may perhaps be permitted here to refer very
briefly to the arguments which Dr. Murchison brings forward
in favour of the spontaneous origin of typhus and of typhoid
fever.
I may remark, in the first place, that in order to prove an in
fectious disease to be capable also of arising spontaneously, it is
necessary to show one of two things—either that in a certain case
or cases infection cannot be the cause of the disease, or else that
some other influence, such as overcrowding or bad drainage, has
produced it. In other words, it is necessary to prove either the
negative proposition that the disease in some cases does not arise
from infection, or the positive or affirmative proposition that it
does arise from some other given cause.
Now in seeking to establish the first or negative proposition, the
main argument which Dr. Murchison uses is that several cases of
typhus and of typhoid fever, whose circumstances he relates, could
not, on careful enquiry, be traced to any exposure to infection as
their source. There was, he says, “ no evidence of infection ” to
be found in the history of these cases. But this argument, which
has always been the one most strenuously urged in such discussions,
is admitted by Dr. Murchison himself to be quite fallacious in
regard to small-pox. He recognises the well-known fact that in
certain cases of small-pox, as indeed of all infectious disorders, no
evidence of infection can be found, and yet he holds that small
pox never arises spontaneously at the present day. Speaking of
infectious diseases, he says: “ Some of them, such as Variola
(small-pox), are not only extremely contagious, but at the present
�THE EXTINCTION OF INFECTIOUS DISEASES.
25
day can nev yr be traced to any other cause than contagion. Whole
continents, such as America and Australia, have remained exempt
from them until they were introduced by an infected person. It
is true that now and then we cannot trace even these diseases to
contagion.” If then the argument is admittedly of no avail to
prove that small-pox can arise spontaneously, why should it be
relied on in other infectious complaints ? How can that be a good
argument for typhus or typhoid fever which is allowed to be a bad
one for small-pox ?
In answer to this obvious question, Dr. Murchison says that
there are mr.ny more cases of typhoid fever than of small-pox
which cannot be traced to contagion. This, however, is probably
to be accounted for by the very obscure and indirect mode of pro
pagation in the former disease, and there is reason to believe that
the number of unexplained cases will diminish as we gain a fuller
knowledge of the different channels or vehicles by which the in
fection may be conveyed.
We can easily see how unreliable is any argument founded
merely on negative grounds like the above when we consider the
extremely subtle and insidious nature of the poisons that give rise
to the infectious fevers. These poisons are invisible, they can be
carried long distances and kept, under favourable circumstances, for
an indefinite time, and moreover they can be communicated, not
only by the patient himself, both during his illness and his conva
lescence, but by everything that has been in his neighbourhood. A
person suffering from an infectious fever exhales constantly into
the air a multitude of extremely minute infectious particles, which
cling tenaciously to all the surrounding objects and persons, and
can be transmitted by them. There are thus three ways in which
these fevers can be communicated: either by the patients, by
tainted or contaminated objects, or by tainted persons ; the tainted
objects, or “ fomites,” as they are often called, acting simply as
©atriers of the poison, while the “tainted” or “suspected” persons
act not only in this way, but also as themselves perhaps infected
with the disease and already suffering from it in its latent or incu
bative stage. When we add to this that the little infectious
particles can be transported to a great distance in clothing, bedding,
furniture or other goods, drinking water, milk, etc., as well as by
persons, and that if kept from the air or dried, they may long
retain their virulent properties—a cloak, for instance, having been
known to give scarlet fever after being laid by for eighteen months,
and the poison of anthrax or the splenic fever of cattle having
been found active after keeping for four years—we can understand
how little warrant there is for inferring positively from the mere
fact that we cannot trace infection in a particular case that there
fore infection does not exist. The argument would be wellfounded if the case were a solitary one, and occurred in an island
or other locality having no communication whatever with adjacent
parts; but in a populous country where there are always many
�26
THE EXTINCTION OF INFECTIOUS DISEASES.
other cases of the same disease to he found, and where more or
less intercourse takes place, even with the remotest districts, it is
rarely possible to exclude entirely the chance of infection, and
unless this can be done the reasoning is evidently inconclusive.
In seeking to prove that typhus and typhoid fever, besides
being infectious, can arise spontaneously or de novo, Dr. Murchison
relies not only on the negative evidence afforded by our inability
to trace infection in particular cases of these diseases. He holds
that there is also positive evidence to show that typhus fever may
be produced by overcrowding and deficient ventilation, especially
among squalid, dirty, and ill-fed persons ; and that typhoid fever
is sometimes generated, independently of infection, by the fer
mentation of sewage and perhaps other organic matters. The
third kind of infectious disease described in his very able work
on “ The Continued Fevers of Great Britain ” is relapsing fever
(a less dangerous affection, always attended by a relapse, and
occurring from time to time in epidemics, especially in Ireland);
and this disease also he holds to be sometimes generated afresh by
famine or prolonged scarcity of wholesome and nutritious food.
The reason which he gives is that in cases where infection could
not be traced, the above influences were present, and appear to
him to have produced the diseases.
Now the causes here assigned by Dr. Murchison are the very
ones which have at all times been popularly believed to have a
power of breeding infectious fevers. Overcrowding and bad ven
tilation, dirt and squalor, the concentrated exhalations of numerous
uncleanly human beings pent up together in close and ill-smelling
rooms, prisons, or ships ; the foul effluvia rising from sewers and
cesspools, from graveyards, and other collections of putrefying
animal or vegetable substances; war, with its sieges and battle
fields. and its multitudes of unburied bodies polluting the air and
the water; and famine with its wasted victims—to these causes,
either singly or combined, it has been usual to attribute outbreaks,
not only of typhus and typhoid, but of nearly every other kind
of infectious fever, including the plague, scarlet fever, and small
pox. Even the best medical authorities commonly held such
views before the publication, in 1811, of Dr. Bancroft’s invaluable
work treating on febrile contagion. “Most writers on the subject
of contagious fever,” says Dr. Bancroft, “ have either inculcated
or believed that it might be generated—first, by an accumulation
of those disgusting matters commonly denominated filth ; secondly,
by the offensive vapours emitted by corrupting dead bodies, or by
other matters in a putrid state ; and, thirdly, by crowding persons,
even when healthy, in ill-ventilated and unclean places.” Dr.
Bancroft maintained that, although these causes greatly favour
the diffusion of a contagious fever when once it has been intro
duced by a person suffering from it, yet of themselves they are
utterly unable to generate a single case ; and his reasonings, with
those of others, had so powerful an effect, that this immensely
�THE EXTINCTION OF INFECTIOUS DISEASES.
27
important conclusion has been more and more widely received as
the true medical doctrine on the subject. “Never,” says Dr.
Murchison, “ has any work effected a greater revolution in pro
fessional opinion in this country. The doctrine of Bancroft was
generally adopted.” The chief argument used by Dr. Bancroft
was the one to which I have already referred—namely the complete
and prolonged absence of the contagious fevers till introduced by an
infected person, though the other causes alleged to be capable of
producing them are in full operation.
Thus Dr. Bancroft showed that, among the Esquimaux and
Greenlanders, in slave-ships, and in Continental prisons, there was
no typhus, in spite of over-crowding and bad ventilation together
with filth, hunger, and squalor, often in the most aggravated
degree. Typhus fever, it may be remarked, is the disease which
has been popularly known by various names, such as “camp fever,”
“ship fever,” or “gaol fever,” from the frequency with which it
has decimated armies in the field, and used formerly to infest
emigrant ships and the English prisons. Epidemics of typhus
have repeatedly occurred in most parts of Europe, especially when
imported into them by war ; but at ordinary times the disease is
not so widely spread as enteric or typhoid fever, which is a pre
valent affection in almost all countries. Typhus, on the other
hand, has its peculiar abode in some of the large towns of Great
Britain, and, above all, in Ireland, where it has always been fear
fully common and destructive; while in the rural districts of
England, throughout the whole of France, and in many other parts
of the Continent, it is very little known. “ In the country districts
of England,” says Dr.Murchison, “typhus is a rare disease ; almost
all the examples of 1 typhus ’ reported as occurring in small country
towns and villages are really cases of enteric fever.” He says
also : “ The disease is at all times so rare throughout France
that few French physicians have ever seen it;” and adds : “ It is
especially to be noted that in many parts of the Continent of
Europe where typhus never occurs in time of peace, it becomes
epidemic in time of war.” But over-crowding and defective ven
tilation, dirt and privations of all kinds, are exceedingly common
in the rural parts and small towns of England, as well as in France,
and indeed everywhere among the very poor ; and this seems
plainly to show that such causes are not of themselves able to give
rise to typhus fever.
Again, as regards typhoid or enteric fever, that it cannot be
generated merely by the fermentation of ordinary sewage may be
seen from the fact that multitudes of people habitually breathe
air, or drink water polluted by sewage without ever contracting
the disease. In such towns as London, and still more Paris, as Sir
Thomas Watson observes, more or less of sewer air almost always
finds its way into the houses even of the wealthiest classes ; and in
country places, where there are no sewers, the drinking water is very
frequently tainted, from the dangerous practice which prevails of
�28
THE EXTINCTION OF INFECTIOUS DISEASES.
having the pumps or shallow wells in too close proximity to the
privy and cesspit, and allowing the excremental matters to soak
into the soil. The Rivers Pollution Commissioners say in their
report that estimating the town population of Great Britain at
about fifteen millions of people, “ the remaining twelve millions
of country population derive their water almost exclusively from
shallow wells, and these are, so far as our experience extends,
almost always horribly polluted by sewage and by animal matters
of the most disgusting origin.” Yet in many country villages
where such water is used, typhoid fever is entirely absent for
years, till a case is imported which gives rise to a local epidemic
of the disease. An outbreak of the kind in the village of Nunney,
in which seventy-six persons were attacked out of a population of
832, and which was traced to the fact that the bowel-discharges of
a typhoid-fever patient had been allowed to mil gl j with the
drinking water, is thus commented upon by the emir ent authority
on Hygiene, the late Dr. Parkes. “ The case,” he says in his
“ Manual of Practical Hygiene,” seems quite clear—first that the
water caused the disease ; and secondly, that though polluted with
excrement for years, no enteric fever appeared until an imported
case introduced the virus. Positive evidence of this kind seems
conclusive, and I think that we may now safely believe that the
presence of typhoid evacuations in the water is necessary. Com
mon faecal matter may produce diarrhoea, which may perhaps be
febrile, but for the production of enteric fever the specific agent
must be present.” Facts such as these seem to show clearly that
neither typhus nor typhoid fever can be generated by the causes
assigned by Dr. Murchison. How can a disease be said to proceed
from a cause which, in numberless instances, over wide areas and
during long periods of time, though constantly and powerfully
operating never gives rise to a single case of it ?
Whenever a cause is given and known, we can try it in the
above manner, by observing its action at different times and places,
and under a variety of circumstances ; and notone of the numerous
influences supposed to generate the infectious fevers has been able
to withstand this test. Indeed, our belief that these diseases have
no other source than infection is mainly founded on the fact that
every other cause which we see operating around us fails in count
less instances to produce them. But when the cause is not given
or known, and it is merely alleged that some cause, other than in
fection, is capable of generating an infectious fever, we cannot
entirely disprove this assertion, since we do not know all the causes
that may possibly exist in nature. As Mr. Simon observes : “ To
say that a disease is contagious is not to say that it cannot arise
without contagion.” It seems to me to be this difficulty in proving
a negative which has so long prevented the settlement of the con
troversy. We cannot show that the spontaneous origin of the
contagious fevers is impossible, but only that it is not proved, and
that all the evidence adduced in its favour is inconclusive. We
�THE EXTINCTION OF INFECTIOUS DISEASES.
29
hold, moreover, that such a mode of origin is not only unproved,
but very improbable ; in the first place, because every known agent
whose effects have been carefully watched seems incapable of
producing them, so that if they really have any other source than
contagion it is an unknown one ; and secondly, because their pro
longed absence from extensive areas where a multitude of causes
under a great variety of conditions are at work, renders it unlikely
that any cause whatever, except contagion, is able to generate
them. With respect to small-pox, which has been absent for cen
turies from whole continents, till introduced by a person suffering
from it, the improbability of its ever originating de novo is so great
as to amount to a practical certainty ; and although the question
as regards typhoid fever is a much more difficult one, yet if we
consider the very significant facts that typhoid fever has no other
known and proved cause than infection, that many of the cases
formerly thought spontaneous have been shown to depend on in
fection conveyed in drinking-water, milk, etc., and also that the
disease is often entirely absent for long periods from country
districts till imported into them, we have strong grounds for be
lieving that typhoid fever has never in reality any other than an
infectious source.
Besides the foregoing arguments, which are the chief ones, Dr.
Murchison brings forward two others, on which I would like to say
a few words, on account of the extreme importance of the ques
tions connected with them. The first is an argument from analogy.
He points out that “ there are certain contagious diseases, such as
erysipelas, pyaemia, and puerperal fever,” which are well known to
be capable also of arising spontaneously or de novo, and infers from
analogy that typhus and typhoid fever can probably do so likewise.
In order to understand what is the force of this argument, it will
be necessary to advert very briefly to the other great leading divi
sion of infectious diseases, the inflammatory and septic group,
with which, as well as with those previously mentioned, it is most
important that the public should be acquainted.
There is a numerous class of diseases— some of them of very
common occurrence, and others terribly fatal—which have the
power of arising, not only from infection, but also independently
of this source, and which, therefore, we can never hope completely
to abolish or extinguish. Among them are purulent ophthalmia,
common catarrhal ophthalmia, gonorrhoea, erysipelas, dissection
wound poisoning, pycemia and septicaemia, puerperal fever, hospital
gangrene or phagedoma, and dysentery. These may be called the
'non-specific, or not purely infectious diseases, in contradistinction
to the specific, or purely infectious disorders, already considered.
I may remark here that the word “specific,” as applied to a disease,
is often used in a different sense from this to signify merely pecu
liar or special, as opposed to common or ordinary ; but of late
years it has been frequently employed in the very important sense
here intended, namely, to signify “like a species.” A specific
�30
THE EXTINCTION OF INFECTIOUS DISEASES.
disease, in the latter sense of the term, is a disease which resembles
a species of plants or animals, in having singularly regular and
unvarying characters, and also more especially in the fact that it
has only one kind of cause—in other words, that it always arises
by infection from another disease like itself, just as the members
of a living species always descend from parents like themselves.
A non-specific infectious disease, on the other hand, can arise from
other sources as well as from infection.
Now. there is this wide difference between the infectious dis
orders belonging to the non-specific class and typhus and typhoid
fever, that, in the former the power of or ginating without infec
tion has been proved, while in the latter, as we have seen, it is not
proved. It has been conclusively shown, partly by the observation
of the sick, and partly by experiments on animals, that all the ten
infectious disorders just enumerated (except the last of them,
dysentery) can be generated by introducing into the blood, or
applying to a mucous surface, the products of ordinary inflam
mation or putrefaction. Recent researches have ascertained the
fact that inflammatory products, such as pus, are all more or less of
a contagious nature, and tend to excite a similar inflammation in
other parts or persons. Thus one of the highest authorities on
infectious diseases, Dr. Burdon Sanderson, who investigated the
subject of contagion under the direction of the Privy Council and
their eminent medical officer, Mr. John Simon, says : “ In a certain
sense it has been long familiar that an inflamed part is a focus from
which irritating material is distributed to healthy parts by radia
ting lines of absorption; but it is only of late years that it has
been distinctly seen and recognised clinically that every exudation
liquid of an inflamed part carries more or less with it the pro
perties of an inflammation-producing virus.” In like manner, Mr.
Simon, in one of his Reports to the Privy Council, speaks of the
“ essential contagiousness ” of the inflammat ry process. He says :
“Inflammatory excitement tends to diffuse itself. Within limits,
hitherto not defined, inflammations, both common and specific, are
communicable from part to part and from parson to person.” I
may add the opinion of Mr. Jonathan Hutchinson, who says : “ Let
us accept clearly the doctrine, so essential to the explanation of
numerous p ithological phenomena, that all living pus is contagious,
and is capable of producing an inflammation similar to that in
which it originated.” Putrid or septic matters also, such as
ichorous fluids or putrescent pus, are highly p nsonous, and when
introduced into the blood, or absorbed into it from the surface of
a wound, they give rise to the frightfully fatal diseases, pyaemia
ind septicaemia. These affections, together with hospital gangrene,
ire commonly termed the septic diseases, and aie one of the chief
ilaDgers to which patients suffering from wounds are exposed,
whether the wounds have resulted from injuries or from surgical
operations, --bout a third of the deaths after operations in the
Londop 'mspitals being due to pyaemia. Another disease often
�THE EXTINCTION OF INFECTIOUS DISEASES.
31
arising from the noxious influence of putrefying substances upon
wounds is erys pelas, which is included by some surgeons among
the septic diseases. Puerperal fever also—that fearful malady
whose real nature was first pointed out by Dr. Robert Ferguson,
and which he describes as “ the most fatal of those peculiar to
women, as seven-eighths of the total mortality in child-birth are
owing to it ”—is essentially a septic disease, consisting of various
forms of pyaemia, sep'icaemia, and internal erysipelas, caused by
absorption into the blood of decomposing matters from the inner
surface of the uterus, which, after delivery, partakes of the charac
ters of a wound.
All the septic diseases are particularly apt to be generated by
the overcrowding of patients suffering from suppurating wounds,
which loads the air with putrescent animal products, and hence
they are sure to be of frequent occurrence in close and ill-venti
lated surgical hospitals. “ Overcrowding of patients after opera
tions,” says Mr. Erichsen, in his “ Science and Art of Surgery,”
“ is one of the most fertile causes of disease and death ; for the
overcrowding of wounded people, whether the wounds be accidental
or surgical, will inevitably produce one of the four septic diseases
—phagedsena, septicaemia, pyaemia, or erysipelas.” When once
produced by such means, they are afterwards propagated by infec
tion from one person to another ; the infection having this pecu
liarity, that it can act only on wounded people, since the poison
apparently cannot affect the system except through a wound.
Hence these diseases belong rather to surgery than to medicine,
and are often called the traumatic or surgical infections. Before
their generation by the overcrowding of the wounded, and their
propagation by infection, were clearly understood, the mortality
from septic disease in civil and military hospitals and in lying-in
institutions was sometimes perfectly appalling. An important
fact, pointed out by Dr. Burdon Sanderson and M. Davaine, and
which help- to explain the generation of these disorders, is that
their virulence is greatly increased by transmission from one animal
to another ; so that from a product at first but slightly contagious
there may be developed, after a few transmissions, a most deadly
poison. Even without any transmission, however, a contagious
poison of the utmost intensity can be rapidly generated, de novo,
by inflammatory and septic processes in the body ; as may be seen
from the fact that an unhealthy inflammation of the peritoneum,
excited by a purely non-infectious cause, such as a surgical opera
tion, may give rise to an effusion of serum and pus so virulent,
that the mere prick of a needle dipped in it is enough to occasion
death by septicaemia. Many medical men have lost their lives by
blood-poisoning from dissection wounds of this nature.
With regard to dysentery—one of the most destructive diseases
of hot climates—its mode of origin is very different from that of
the septic affections. The contagiousness of dysentery has only
been recognised of late years, and seems to be confined to the
�32
THE EXTINCTION OF INFECTIOUS DISEASES.
epidemic form of the disease prevalent in the tropics, while the
scattered cases which occur in this and other temp -rate countries
are not held to be contagious. As in the case of cholera and
t\ phoid fever, the infection is, in all probability, conveyed chiefly
by means of the discharges. The peculiar exciting cause of dysen
tery appears to be a miasma or malaria, generated in hot, swampy
districts, and closely allied to the malaria which gives rise to ague ;
the word miasma or malaria being commonly used to denote a
poisonous matter bred outride the body, while a contayium is one
which breeds and multiplies within the body itself. Since dysen
tery may arise from a miasm as well as from contagion, and since
the inflammatory and sepfic infections can be generated by the
products of ordinary inflammation and putrefaction, it is evident
that we can never hope to abolish these diseases, however greatly
they may be reduced m amount by human skill and energy.
The diseases which can be abolished, and on which above all
others, therefore, the attention of society should be fixed, are the
zymotic diseases, strictly so called. The word zymotic signifies
“ like a fermentation,” and is often employed in a looser sense so
as to include all infectious dise ises, and even some which are not
infectious; but Sir Thomas Watson, in his article on “ The
Abolition of Zymotic Disease,” restricts the term to a certain
group of infectious disorders, consisting of small-pox, scarlet fever,
measles, and others, which in their course and symptoms most
nearly resemble a fermentation. The resemblance between these
maladies and a fermentation, as pointed out by Liebig, is in many
respects very striking. Thus, for example, when a ferment, such
as yeast, is added to a fermentable liquid, there is first a period of
quiescence; then follows a period of disturbance, with rise of
temperature, during which two periods a great multiplication of
the ferment takes place ; next comes a stage of subsidence or
decline; and afterwards there remains an immunity or insuscep
tibility to the further action of that ferment. In like manner,
when the virus of a zymotic disease, such as small-pox or measles,
enters the body, there is first a period of quiescence or incubation ;
then a stage of disturbance, attended with rise of temperature or
fever, an eruption on the skin, and a great multiplication of the
virus or infecting matter ; then a stage of decline or defervescence ;
and, lastly, an immunity from the further action of that contagion.
The stages not only follow one another in regular order, but each
of them lasts a certain time, which varies but little in different
cases of the same disease. There is a large group of infectious
disorders, both in man and the domestic animals, presenting the
remarkable characters here described, and it is these disorders
which are specific, or, in other words, which resemble species in
having only one kind of cause, and in being therefore liable to
extinction. Many of them are admitted almost universally to arise
at the present day from contagion alone, and not one has been
proved to have anv other mode of origin. Op the other hand, the
�TIIE EXTINCTION OF INFECTIOUS DISEASES.
‘Septic and inflammatory group of disorders have not such regular
and unvarying symptoms, and none of them give immunity from
future attacks : and these are the non-specific infectious diseases,
that is to say, the class which can arise from other sources as well
as from infection. But typhus and typhoid fever, and the former
more especially, have well-marked zymotic characters of intubation
fever and eruption, regular stages and lesions, and subsequent
immunity, and Sir Thomas Watson includes them among the true
zymotic diseases. Their real analogy is to small-pox and scarlet
fever and not to pyaemia and erysipelas, with which Dr. Murchison
compares them, and this seems a strong argument against their ever
originating de novo. Dr. Buchanan, the present medical officer of
the Privy Council and Local Government Board, says, in his article
on Typhus Fever in “Reynolds’s System of Medicine,” in dis
cussing Dr. Murchison’s theory : “ The most serious obstacle to the
reception of this theory arises from the analogy of other specific
diseases, as to the present production of 'which by contagion, and
contagion alone, there can be no question.” The argument from
analogy, therefore, instead of supporting Dr. Murchison’s view,
seems rather to tell very strongly against it.
The last of Dr. Murchison’s arguments to which I shall refer is
of an a priori character, and is one which has been repeatedly
brought forward in discussing the spontaneous origin of the in
fectious fevers. It is urged that such a mode of origin is not only
possible, but must actually have taken place when the diseases first
came into existence, since the first cases must have arisen with
out infection ; and as this has happened once, why, it is asked,
might the same thing not happen again ? “ In the first sufferer
from a contagious disease,” says Dr. Murchison, “ its origin
must have been
novo, and there is no reason why the unknown
causes of the first case may not operate at the present day.” But
Dr. Murchison himself disregards this argument when he concludes,
from a careful survey of the facts, that small-pox and some other
disorders never now arise de novo ; and it is evidently by facts, and
not by speculative considerations, that the question has mainly to
decided. Still there is one thing, a knowledge of which would
be of immense value, and might aid us in forming an opinion on
this and every other point relating to infection. If we knew what
rhe poisons that give rise to infectious diseases real/y are—if we
knew their intimate nature, and how they produce the extra
ordinary phenomena of infection—we might be able to say
whether or not it is likely that they should ever be generated
Sp mtaneously. This brings us to the great question which of late
years has occupied, more than almost any other, the attention of
medical inquirers, namely, wliat, is contagiumt and how do the
different kinds of contagia produce their effects?—the word
contagium, in the plural contagia, being used to denote the
material substance or poison which gives rise to a contagious
disease. When we have carefully considered what the couc
�34
THE EXTINCTION OF INFECTIONS DISEASES.
tagia really are, we shall be in abetter position to decide as to their
modes of origin, and also as to the possibility of their utter extinction.
Till within the last twenty or thirty years the nature of con
tagion remained an inscrutable mystery and standing enigma in
medicine, and more has been done in the present generation than
in all past ages to clear up the difficulty. The explanation of the
facts of infection now given by the best authorities is contained
in the great theory known as “the Germ Theory of infectious
diseases,’’ and also called the doctrine of contagium vivum and
miasma vivvm (living contagium and living miasm), which Dr.
Liebermeister regards as “perhaps the most important questions
which have ever busied the medical world.” According to this
doctrine, the different contagia are in reality different kinds of
extremely minute living beings, which produce disease by growing
and multiplying in the body of the patient, and communicate
infection by passing from the body of one person or animal int o
that of another. These little organisms are generally considered
to be plants belonging to the bacteria, a tribe of the lower fungi,
and they have received various names, su'-h as microbes, micro
phytes, microzymes (Lttle living things, little plants, little fer
ments), on account of their vital properties, or else, from their
peculiar forms, they have been called bacteria, bacilli, spirilla,
micrococci, etc. (that js, rod-like bodies, very minute rods, little
spiral filaments, or little rounded organisms). Each kind of contagium attacks by p eference certain parts and tissues of the body,
and hence the pecubar symptoms and lesions that characterise the
different infectious diseases. If this view be correct, it is evident
that the contagia are not. properly speaking, poisons but parasites;
and the reason why certain disorders are called specific and never
arise but from infection, is that they are caused by distinct species
of living organisms which, like other species, are kept up only by
continuous propigation. Like other species, too, they might be
completely extirpated by human intelligence and energy. In Let,
the battle with contagious fevers and specific disorders is nothing
else than a war of extermination against a class of excessively
minute disease and death-producing parasites, which, though the
smallest of living beings, are infinitely mnre dangerous and deadly
to mankind than any venomous reptile or beast of prey.
The truth of the germ theory in its main features seems now to
be firmly established, and is admitted by large numbers of the most
eminent medical and scientific authorities in this and other countries.
On this point I may quote the opinion of Dr. Burdon Sanderson, who,
in 1870, in discussing the doctrine that the little particles found in
contagious liquids “ are organised beings, and that their powers of
producing disease are due to their organic development,” says :
“ We have accepted the doctrine as the only one which affords a
satisfactory explanation of the facts of infection.” Mr. John
Simon, in his Address as President of the Public Health Section
at the International Medical Congress held in London in 1881,
�THE EXTINCTION OF INFECTIOUS DISEASES
35
says: “ We have learnt, as regards those diseases of the animal
l)ody which are due to various kinds of external cause, that pro
bably all the most largely fatal of them (it is impossible yet to
say how many) represent bur, one single kind of cause, and respec
tively depend on invasion of the animal body by some rapidly
multiplying form of alien life.” At the same Congress, Professor
Klebs, of Prague, read a paper on the subject, in which he says :
The conclusion which appears tome to follow inevitably from
■this short survey of the results of modern investigation is this—
that specific communicable diseases are produced by specific
organisms.” In the discussion following the ] aper, Dr. Virchow,
the eminent German pathologist, observed that “ the study of
pathological anatomy had been greatly changed by the discovery of
parasitic organisms.” I may quote also the opinion of M. Bern
heim, who says, in his article on “ Contagion ” in the “ DictionBaire Encyclopedique des Sciences Medicales” (1874) : “Now we
ghall see that the results of existing science tend precisely to make
the contagia be regarded as animal or vegetable parasites, and
that consequently between contagious maladies and parasitic
maladies there is perhaps no essential difference.” In like manner,
Dr. Frankland, president of the Institute of Chemistry, says:
“ The researches of Chauveau, Burdon Sanderson, Klein, and
fethers, scarcely leave room for doubt that the specific poisons of
the so-called zymotic diseases consist of organised and living
®rganic matter.” In an address delivered in St. James’ Hall
during the London Congress of 1881, the celebrated chemist,
M. Pasteur, who has done so much to promote the knowledge of
this subject, alluded to his own “labours during the past twentyfive years upon the nature of ferments—their life and their
nutrition, their preparaiion in a pure state by the introduction of
organisms under natural and artificial conditions—labours which
have established the principles and methods of microbism.”
It was M. Pasteur’s brilliant researches on fer mentation ana
putrefaction that led the way to the discovery of the true causes
of infectious disorders. Fermentation is a process which occurs
When a fermentable compound, such as sugar, is pla< ed in coni act
with gluten, casein, albumen, or other nitrogenous substance, pro
vided air be admitted ; and it was held by Liebig that the ferments
in such a case are the dead nitrogenous substances, which begin to
decompose when acted on by the oxygen of the air, and thus in
duce changes in the sugar. But M. Pasteur showed that in every
fermentation, properly so-called, the alcoholic, the viscous, the
lactic, etc., little, living beings are present, which are the real fer
ments or agents in the process. Fermentation consists, in fact, in
the changes arising from the growth and multiplication of a microgoopic plant, whose germ is at first brought by the air, but which
afterwards lives without air, feeding on the sugar and the nitrogenised substances, and using their elements to build up its own
tissues. “When sugar is placed in the presence of gluten, or
C 2
�36
THE EXTINCTION OF INFECTIOUS DISEASE3.
casein, or an animal membrane,” says M. Pasteur, in a notice of
bis researches published in 1861, “it is not the nitrogenised matter
which is the ferment. The true ferment consists in a microscopic
vegetable, the germ of which is brought by the air at the com
mencement, and which multiplies itself, taking its carbon from
the sugar, its nitrogen and its phosphates from the gluten or tbe
casein.” In his “ Studies on Fermentation,” a translation of
which was published in 1*79, he says : “ The essential point of the
theory of fermentation, which we have been concerned in proving
in preceding paragraphs, may be briefly put in the statement that
ferments, properly so-called, constitute a class of beings possessing
the faculty of living out of contact with free oxygen; or, more
concisely still, we may say fermentation is a result of life without
air.” Putrefaction also, which is a kind of fermentation accom
panied by foul smells, was shown by M. Pasteur to be due to the
action of little living organisms, the septic bacteria, whose germs
are derived from the air. By a beautiful series of experiments,
which were confirmed by the researches of Professor Tyndall, he
showed that all ordinary air contains large numbers of these germs,
and that if they be totally excluded by boiling, hermetically closing
vessels, or other means, animal and vegetable substances can be
kept for years without putrefying. As it appeared from these en
quiries that little living beings are the real causes of fermentation
and putrefaction, the question naturally presented itself whether
the infectious fevers, which are so like a fermentation, may not have
a similar source. Accordingly this great question was vigorously
attacked by M. Pasteur and a number of most able observers in
different countries. The methods by which they sought to solve
it were chiefly the search for organisms by an examination under
the microscope of the contagious products and the blood in the
various infectious disorders of men and animals ; the endeavour to
separate from one another the different parts of which contagious
liquids are composed, in order to determine which of them pos
sesses the virulent properties ; the chemical analysis of these
liquids to see whether they contain any chemical poison; the
artificial cultivation of the little organisms or microbes, that is to
say, rearing them in some nutrient fluid, such as serum or meat
juice, in which they can grow vigorously, so as to rid them of
impurities, and to study their nature and development; dnd also
testing the powers of infectious liquids, and of the little organisms
in the pure state, by experiments on animals, which formed an in
dispensable part of the inquiry. By these means a large amoun t
of evidence was obtained, which seems to show in the clearest
manner the truth of the germ theory.
The reasons now usually given in proof of the germ theory, are
drawn pirtlyfrom facts of infection that have long been known,
and partly from the results obtained more recently by the exami
nation of contagious liquids. Among the former, the two facts
on which Dr. Burdon Sanderson lays particular stress as showing the
�THE EXTINCTION OF INFECTIOUS DISEASES.
37
contagia to be living beings, are their enormous multiplication within
the body of the patient, and also their long preservation and resist
ance to adverse surrounding influences outside the body. He holds
the germ theory to be “ the only one which affords a satisfactory
explanation of the facts of infection, and in particular of those
which tend to show that witbin the body of the infected individual
the particles of contagium rapidly reproduce themselves, while
out of the body they are capable of resisting for long periods the
influence of conditions which, if not restrained by organic action,
would produce chemical decomposition.” The multiplication of
the virus or infecting matter which takes place in a contagions
disease is extraordinary, and should be carefully noticed, as it is
one of the most important points relating to infection. “ A
quantity of small-pox matter not so big as a pin’s head,” says Dr.
Aitken, “ will produce many thousand pustules, each containing
fifty times as much of the specific pestilent matter as was originally
inserted ; and moreover the blood and all the secretions of the
body are equally infected with the specific poison of the pustules.
The miasmata from one child labouring under hooping-cough
are sufficient to infect a whole city.” This fact alone would seem
almost enough to show that a contagious virus must be organised
and living, for living beings are the only things we know of pos
sessing the faculty of reproduction or self-multiplication. No
chemical poison, whether of the inorganic or organic class, as
arsenic, or snake venom, has any power of reproducing itself, oris
evei’ multiplied in the body. Hence it takes a certain amount of
these poisons to produce death, and their effects are proportional
to the dose ; but the contagia can act in what is termed a minimal
dose, that is, a quantity quite impalpable and infinitesimal. Thus
Mr. Marson says of small-pox that “ a single breathing of the air
where it is, is enough to give the disease.” The reason of this
remarkable difference is that a chemical poison is not multiplied in
the body, whereas an infectious virus is rapidly multiplied, so that,
if once it gains a footing, the amount originally taken into the
system matters but little. Professor Naegeli, of Munich, in his
work on the “ Lower Fungi in their relation to Infectious Diseases”
(1877), holds this fact to be conclusive evidence .on the question.
“ The infectious matters,” he says, “ cannot be chemical com
pounds or collections of them, but can only be organised bodies,
because in this case alone is their increase conceivable from the
minimal quantity taken in, to the amount in which they become
dangerous to the human frame.”
Another important fact is the power of the contagia to retain
their virulence for long periods, sometimes for many years, outside
the body, and to resist changes of heat and cold, dryness and
moisture, or other influences which would speedily decompose and
destroy any dead organic matters. This accords well with what
we know of the bacteria and other minute organisms, which are
wonderfully tenacious of life, and moreover are able to exist in two
�38
TIIE EXTINCTION OF INFECTIOUS DISEASES.
states or forms—the one an active parent form when they are comp irativelv perishable, and the other an inactive form, as little buds
or spores, when they are very indestructible, and can continue in a
sort of dormant vitality for an indefinite time. It is on this
ground chiefly that Dr. Burdon Sanderson objects to a theory of
germs, differing from the one usually adopted, which has been
put forward by the distinguished physiologist and microscopist
Dr. Lionel Beale, in his work on “ Disease Germs ” (2nd ed,
1872). Dr. Beale holds as strongly as any one that the contaaia
are living and not dead substances. “ The only condition in which
matter is known to exhibit these powers of self-multiplication.”
he sa.vs, “ is the living state;” and be adds: “Every one will
admit that the particular forms of disease now under consideration
—the contagious fevers—r< suit from the introduction of living
particles of some form or other.” Assuming the infectious par
ticles to be living, however, there are evidently two suppositions
possible as to their nature; either they are independent organisms
or parasites coming from without, or else they are little living
cells or portions of protoplasm derived from the patient’s own
tissues. Dr. Beale adopts the latter alternative, and holds the
disease germs to be particles of degraded protoplasm, which are
capable of living independently, and can be engrafted on other in
dividuals, in whose bouies they can grow and multiply. This view,
however, is objected to by the great majority of observers here
and abroad, as purely hypothetical and wanting a real instance to
support it, and especially as being inconsistent with the fact that
many kinds of disease germs can live for such long periods out of
the body. “ Considering,” says Dr. Burdon Sanderson, “ that of
all perishable things protoplasm is among the most perishable—so
much so that no living particle of our bodies can be abstracted
from its place in the organism, even for five minutes, without
dying and being disintegrated—it appeared to me quite out of the
question to suppose, as Dr. Beale had suggested, that the particles
could be of this nature consistently with the astonishing power
which they evidently possess of retaining their activity for such
long periods, in spite of their being subjected to enormous varieties
of moisture, temperature, and all other conditions.” “If, then,
the doctrine of a contagium viviftn be true,” says Dr. William
Roberts, in his Address on Medicine to the British Medical Asso
ciation in 1877, “we are almost forced to the conclusion that
contagium consists (at least in the immense majority of cases) of
an independent organism or parasite.”
The results which have been obtained of late years by the
examination of contagious liquids with high powers of the micro
scope, relate in the first place to the physical characters of the con
tagia. Some infectious diseases, such as small-pox and measles,
are propagated through the air by inhalation ; while others, as
cow-pox and glanders, are communicated by inoculation with
liquid products, and hence it is often supposed that the infecting
�THE EXTINCTION OF INFECTIOUS DISEASES.
39
matters must have the form of a vapour or a fluid. But if this
were so, it would follow that they cannot be living, for living
beings are always solid, and never fluid or gaseous bodies. A
closer scrutiny has shown, however, that the real infecting sub
stance, or contagium, is neither a fluid nor a vapour, but consists
in all cases of extremely minute solid particles. “ As regards the
physical characters of contagious liquids,” says Dr. Burdon Sander
son, “ the fundamental fact is that contagium is particulate.’'
This important fact was pointed out in 1865 by Dr. Chauveau,
Professor in the Veterinary School at Lyons, after a prolonged
inquiry into the virus of cow-pox and other contagious diseases.
When vaccine, or cow-pox lymph, is examined under the micro
scope, it is found to consist of three parts,—namely, first, of
corpuscles which are similar to ordinary pus globules, and are
sometimes few in number, or even entirely absent in good vaccine ;
Secondly of numerous particles, far more minute and not exceed
ing 2^00 of an inch in diameter : and thirdly, of a clear liquid in
which these bodies float. The larger corpuscles were separated by
Subsidence, and were found on inoculating them to be inert. The
Separation of the smaller particles could not be effected either by
subsidence or filtration, but was at last accomplished by what is
termed the method of diffusion ; that is, by bringing carefully a
little water into direct contact with the contagious liquid, when
the soluble and diffusible parts of the liquid mix with the water,
an<1 the insoluble ones are left behind. In this way the minute
particles were separated from the rest, and were found on inocula
tion to communicate cow-pox, whereas the fluid after being deprived
of them was found absolutely inactive. M. Chauveau investigated
in a similar manner the virus of small-pox, sheep-pox, and farcy
(a form of glanders), and with the same results. It thus appears
that when an infectious disease is communicated by means of a
fluid, or through the air, it is because the air or the fluid contains
little solid particles, invisible to the naked eye, which are the real
infecting substances ; and this fact is a strong additional argument
in favour of the view that the contagia are living beings.
Besides showing the physical characters of infectious liquids,
tecent investigations with the microscope have ascertained that in
some of them little vegetable organisms of peculiar shapes are
present ; and it is these organisms, and the inquiries to which they
have given rise, that most fully demonstrate the germ-theory.
“ The doctrine that microphytes have to do with the process of
contagion,” says Dr. Burdon Sanderson, “is based on two sorts of
observations, viz., those relating to the physical characters of con
tagious liquids, and those relating to the existence of organisms of
characteristic form in them.” “ There are four contagious diseases,”
he says also, in 1874, “in respect of which the presence in the
contagious liquids of forms of vegetation, differing from those met
with after death in the normal tissues or liquids of the body, or
during life in the products of primary or secondary inflammation,
�40
THE EXTINCTION OF INFECTIOUS DISEASES.
has been established. These are small-pox, sheep-pox, splenic
fever, and relapsing fever.” The first disease in which charac
teristic organisms were detected was splenic fever or anthrax—a
very deadly disorder of cattle, sheep, and horses, common in all
parts of the world, and inoculable on all kinds of animals, includ
ing men, in whom it produces the rapidly fatal affection called
malignant pustule. Dr. Davaine and Dr. Pollender, in 1855, or
even earlier, discovered in the blood of animals suffering from
splenic fever, a microscopic plant, to which the name of Bacillus
authracis has been given, and which consists of little rods or staffshaped bodies, endowed with the faculty of developing spores.
In relapsing fever also, an infectious disease peculiar to man.
Dr. Obermeier, in 1872, detected in the blood a little organism or
microbe, having the form of minute spiral threads or filaments,
and since called the Spirillum (Jbermeicri. The organisms which
have been discovered in the matter taken from small-pox pustules,
are of the kind called Micrococci, that is, little rounded bodies,
and exactly resemble the minute particles already described as
occurring in vaccine lymph.
Although these little bodies have been found by numerous
observers to be continually present in the above diseases, this fact
cannot in itself be regarded as sufficient evidence that the diseases
are due to them. The organisms might be the consequence rather
than the cause of the morbid state of the blood, and might be
simply carriers and not producers of the infecting virus. In order
to decide this point, therefore, it is evidently necessary to separate
the organisms and obtain them in a pure state, and then to try
whether by inoculation they are able to produce the disease , and
for this purpose a more perfect process of separation is needed
than that employed by M. Chauveau, which merely divided the
insoluble from the soluble and fluid portions of a contagious
liquid. We want to know the vital as well as the physical
characters of the organisms, and whether they are the real causes
of the disorders in which they occur. This object has been
attained by the very important purifying process called the method
of successive cultures, which is now generally used in these in
quiries, and may be briefly described as follows : A little drop of
the infectious liquid containing the microbes is introduced on the
point of a glass rod into a clear nutrient fluid, such as meat-juice,
which is kept nearly at blood-heat; the latter fluid having been
previously boiled, and the glass rod heated to redness to deprive
them of all other, organisms, and the neck of the vessel being
plugged with cotton wool so as to exclude any germs from the
atmosphere. In a few hours the nutrient fluid becomes turbid
from the growth of the microbes, which rapidly multiply and fill
the vessel. A little of the fluid from this vessel is then intro
duced in the same manner into another portion of nutrient fluid
in a second vessel, and when this becomes turbid, a drop from it is
transferred to a third vessel, and so on for ten, twenty, or any re
�THE EXTINCTION OF INFECTIOUS DISEASES.
41
quired number of times. In this way the little organisms are
freed from all extraneous matter, and obtained as far as possible in
a pure state ; and if at the end of this process they exhibit under
the microscope the same appearance and power of development,
tod are found on inoculation to communicate the disease with the
same intensity as the infectious liquid from which they were
originally derived, it seems evidently to follow that they are the true
cause of the disease. M. Pasteur regards this method of inquiry
as indispensable, and as affording conclusive evidence on the sub
Ject. “ In the present state of science,” he says, “ the proof that
a microscopic organism is by its development a cause of disease
tod death, can only become peremptory on condition that succes
sive cultures of this organism have been obtained, indefinitely
repeated in liquids inert of themselves, and that these liquid.?
always show the same development, the same appearance of life,
associated with the same virulence, the same power of inoculation,
of disease, and of death.” The disease in which the organisms
Kave been most carefully studied and most fully proved to be the
real cause of the symptoms is splenic fever. On this point Dr.
^William Roberts observes, in the address already referred to, “ That
this organism (the bacillus) is the true virus of splenic fever has
long been probable ; and the labours of Bollinger, Davaine, Tiegel,
Klebs, and most of all, of Koch, have removed the last doubts on
the subject. Koch found without exception,” he continues, “that
if the tested material produced threads and spores in the incubator,
it Ao produced splenic fever when inoculated into the mouse ; and
on the contrary, if no such growth and development took place in the
fafittbator, the tested material produced no effect when inoculated
into the mouse. Proof could go no farther ; the infection abso
lutely followed the specific organism ; it came with it, it went
With it.” There are several other infectious diseases in which little
JKrganisms have been discovered of late years, as, for example,
erysipelas, diphtheria, gonorrhoea, and glanders ; while in some
jirtttiers none have yet been found, and we can only infer their presence from the similarity of the phenomena, though they are
probably too minute to be visible even with the highest powers of
the microscope.
fe- These minute parasitic organisms, which “ lie at the root of all
Infectious diseases,” to use Dr. Liebermeister’s words, may be
divided into two classes, between which there is a most important
difference. Some of them are what are called genuine or habitual
parasites, that is to say, they can live only in the animal body, and
in many cases only in the particular species of animal which they
infest; while others are occasional parasites, that is, they live and
htved habitually in the outer world, and only enter from time to
time, and under peculiar circumstances, into the bodies of animals.
This division of the parasites corresponds to the two main groups
of infectious diseases already adverted to, namely, the specific and
the non-specific infectious diseases ; the former being characterised
�42
THE EXTINCTION OF INFECTIOUS DISEASES.
by the presence of genuine, and the latter by that of occasional,
parasites. The reason why certain infectious disorders are called
specific is because, like species, they always descend from other
diseases like themselves ; a fact which clearly shows that the little
organisms found in them are always transmitted from one animal
to another, and cannot multiply and develop themselves, though
they may live for a season, outside the animal body. The non
specific disorders, on the other hand, can arise not only from infec
tion, but from other sources, and this proves that the organisms
associated with them are sometimes derived by transmission from
other animals, and sometimes come in from the external world. It
is evidently only the genuine parasites and the specific infectious
diseases that we can hope to exterminate ; whereas the occasional
parasites, being able to live outside, cannot be exterminated, and
r we can only guard ourselves against them, and against the diseases
in which they are found, by attentively studying the circumstances
which permit them to enter the body.
We have already seen how, according to the germ theory, infec
tion is produced, namely, by the microscopic organisms passing
from one animal into another, and we may now briefly advert to
the mode in which the non-specific infectious diseases are generated
in those cases where they arise spontaneously or de novo, that is,
from any other cause than infection. The most important and
fatal disorders of this class are the septic affections, such as septi
caemia, pyaemia, and puerperal fever, and the part which the little
organisms take in producing or complicating them has been investi
gated by numerous observers. In the blood and inflammatory pro
ducts of infectious septicaemia microphytes are constantly found,
which M. Pasteur has carefully studied by the method of succes
sive cultures, and has shown to be the true cause of the disease.
Dr. Chauvel, after giving an account of these researches in his
article on Septicaemia (1880). in the ‘ • Dictionnaire Encyclopedique
des Sciences Medicales.” says : “ It would follow, therefore, from
the experiments of Pasteur, that virulent septicaemia is due to the
introduction and multiplication in the economy of a microbe living
without air and a ferment, the septic vibrio.” This little organism,
according to M. Pasteur, M. Davaine, Dr. Burdon Sanderson, and
other authorities, is nothing else than one of the common bacteria,
or living ferments, which produce putrefaction, and which live
habitually in the air and water around us. Mr. John Simon speaks
of it as “the common ferment of putrid infusions,” and says that
“ apparently those ‘ pyaemic ’ and ‘ septicaemic ’ diseases have their
common essential cause in one morbid poison or contagium, which,
so far as can yet be discerned, is a particulate ferment of ordinary
putrefaction.”
I may here mention that the bacteria, the tribe of infinitesimally
minute plants to which all the contagia yet discovered belong, have
been made the subject of a special study by the distinguished
botanist Professor Cohn of Breslau, uid are described in his work
�THE EXTINCTION OF INFECTIOUS DISEASES.
43
“ On Bacteria, the Smallest Living Beings ” (1872). The principal
forms of the bacteria are those already adverted to, micrococcus,
bacterium and bacillus, spirillum and vibrio, and they are so ex
cessively minute that the common rod-like bodies are only
of
an inch long, or one-third the width of an ordinary red blood
globule, while the micrococci do not exceed
of an inch in dia
meter. The bacteria live in the outer world, and are universally
diffused throughout the air, and especially in water, as they require
moisture to bring out their active properties. Tbeir part in the
economy of nature is a most important and indispensable one,
namely, to cause putrefaction and to break down and remove all
dead animal and vegetable substances ; and this power of destroy
ing the dead seems nearly related to the disastrous tendency which
they so often manifest to become parasitic and prey upon the living
animal body.
Since, then, the little organisms found in septicaemia have come
in from without, the question to be considered is, What are the cir
cumstances that enable them at first to enter the body, and render
them so virulent ? or, to express this in other words, how is septi
caemia produced when it arises de novo, and not by infection from
one animal to another ? At ordinary times the bacteria are per
fectly harmless, as may be seen from the fact that they are con
tinually entering our bodies by the lungs and alimentary canal, and
may be detected in some of the abdominal organs, such as the liver
and spleen. Into every little cut and wound of the skin also they
must constantly find their way, and yet the great majority of
wounds heal rapidly and without any ill effects. There are some
parts of the body, however, in which bacteria are never found,
namely, in healthy blood and muscle, as they are apparently at once
destroyed whenever they enter the circulating fluid. What is it,
then, that in septicaemia permits them to live and multiply in the
blood, and converts a microphyte, harmless and insignificant at
other times, into the most deadly of all known poisons? The
reason of this, as ascertained by the long-continued labours of in
quirers, is that, in the process of putrefaction, the bacteria produce
a chemical substance called the septic poison (just as, in fermenta
tion, the little yeast plant produces alcohol), and this poison, when
absorbed into the system from the surface of a wound, gives rise to
fever and inflammation, so as gradually to overcome the vital re
sistance of the blood and enable the bacteria to enter and breed in
it. The septic poison was first discovered in 1856 by Dr. Panum,
of Copenhagen, and was shown by him to be the immediate cause
of septicaemia. Like other chemical poisons, it is not multiplied in
the body, and its effects, unlike those of the contagia, are propor
tional to the dose. Hence an important distinction is now drawn
between two forms of septicaemia ; in the one, which is not infec
tious and is probably of common occurrence in ite slighter degrees,
the symptoms are due to the absorption of the septic poison from
a wound, and tie patient recovers, if the dose has not been too
�44
THE EXTINCTION OF INFECTIOUS DISEASES.
large; while the other is an infectious and most deadly disorder,
produced by the entrance and multiplication of the bacteria them
selves in the system. The properties of the bacteria are altered, so
that they become parasites on the living body, and their virulence,
as pointed out by M. Davaine, is enormously increased by trans
mission through the animal economy. Pyaemia also, a disease
closely allied, if not, as some think, identical with virulent septi
caemia in its nature and origin, is, like it, almost invariably fatal.
Dr. Burdon Sanderson has shown that the intensely contagious
products of pus and serum found in these diseases always contain
swarms of bacteria, and may thus be distinguished from ordinary
healthy pus, which is but slightly contagious.
One of the immense practical benefits already derived from the
germ theory is the antiseptic treatment of wounds, which was intro
duced a few years ago by the eminent surgeon Sir Joseph Lister, as
a means of guarding against the septic diseases, and was expressly
stated by him to be founded on M. Pasteur’s doctrine concerning
putrefaction. As Pasteur had shown that putrefaction is caused
by bacteria, the antiseptic treatment aims at preventing the hurtful
influence of these little organisms on a wound. For this purpose,
the wound is covered with several folds of gauze steeped in a solu
tion of carbolic acid, whose fumes either kill the bacteria or at least
prevent them from decomposing the discharges, and thus giving
rise to the septic poison. This method, along with other pre
cautions, has now been introduced in the large hospitals here and
abroad, with such admirable results in preventing pyaemia, hospital
gangrene, and other septic affections, that Dr. Sanderson lately
observed, in alluding to the experience of German surgeons : “We
can no longer wonder that it is common to hear the discovery of
Lister spoken of in Germany as the greatest improvement in the
art of medicine which has taken place in modern times.”
There is still another disease of the utmost gravity, which has
within the last few years apparently been proved to be contagious,
I mean the dreadful malady tuberculosis, called pulmonary con
sumption or phthisis when it occurs, as it usually does, in the
lungs. This is by far the most important and widely destructive
of all diseases, for statistics, it is asserted, show that one-seventh
of the whole population, and as much as one-third of the adult
population who die in the prime of life are carried off by it.
Until recently, tuberculosis was regarded as a disease which arises
chiefly from debility or hereditary predisposition, and as not at all
contagious ; but in 1864, Dr. Villemin, of Paris, published the
extremely important and startling discovery that it can be com
municated to the lower animals by inoculating them with tubercular
products. The truth of his conclusions was in some respects
questioned at the time, but they have since been fully confirmed.
Dr. Koch, of Berlin, the high authority already referred to, observes
that recent researches “ have established the communicability of
tuberculosis beyond all doubt, and in future a place must be assigned
�TIIE EXTINCTION OF INFECTIONS DISEASES.
45
to it among the infectious diseases.” Mr. John Simon says : “ The
broad results of modern discovery in regard to ordinary tubercular
disease tend to represent it as a chronic locally-originated zymotic
process, which, starting under certain conditions in one first spot
of the (predisposed) animal body, advances by successive steps in
definite anatomical lines to infect the entire system ; a process,
which by means of its characteristic products is inoculable from
piri to pirt, and from subject to subject.” It was presumed that
a microscopic parasite must exist in tuberculosis as in other com
municable diseases, and after a long, fruitless search by various
inquirers, it was at last discovered by Dr. Koch, whose observations
on the subject are contained in a most important paper read before
the Physiological Society at Berlin in 1882. The little parasite as
described by him is of a rod-like shape, and has hence been called
the bacillus tuberculosis. Dr. Koch says that he has found this
parasite to be constantly present in the tubercular products of
men and animals, and that moreover, by obtaining it in a pure
state with the aid of successive cultures, and then testing it by
inoculation, he has proved it to be the true cause of the disease.
(Debility and hereditary tendency have doubtless, he remarks, a most
powerful effect in the production of tuberculosis, but they act only as
predisposing influences, while the real essential cause is the bacillus.
At a meeting of the Pathological Society of London in December
last, Dr. Dawson Williams, who had repeated some experiments
on the subject at the request of Dr. Wilson Fox and of Dr. Burdon
Sanderson, observed that “ the evidence in favour of the specific
nature of tubercle was now, he thought, very strong, and it was
strong also in favour of the view that the bacillus tuberculosis was
a necessary part of the tubercular process ; further, the recently
published experiments of Baumgarten and Arndt seemed to pi-ove
jthat the lesions of tuberculosis depended directly on the growth of
the bacillus, and were in fact produced by it.”
With regard to the question whether the tubercle bacilli belong
to the class of genuine or of occasional parasites, Dr. Koch holds
that they are “ not occasional, but genuine parasites, and can pro
ceed only from the animal organism,” a fact which, he says, would
greatly facilitate their destruction. He grounds his opinion upon
the circumstance that in his cultures the bacilli would only grow
lit a temperature between 30° and 40° centigrade (that is, between
86° and 104° Fahrenheit), and such a temperature cannot be ob
tained continuously in our climates except in the animal body. He
holds, moreover, that they may be introduced into the system by
inhalation as well as by inoculation, and thinks it probable that
they often enter in the former way, judging from the fact that
phthisis usually commences in the lungs. The principal source
from which the bacilli are derived is, in his opinion, the expectora
tions of phthisical patients, which are known to be capable of
transmitting the disease to the lower animals by inoculation, and
whose particles, when dried, may be wafted about by the air.
�46
THE EXTINCTION OF INFECTIOUS DISEASES.
Another source, according to him, is the milk and flesh of cows
and other animals affected with tuberculosis. Dr. Koch believes
that a knowledge of these facts will be of the greatest benefit in
the prevention of consumptive disease. “In future,” he says, “in
the war against this frightful scourge of the human race, we shall
have to do no longer with an undefined something, but with an
intelligible parasite, whose life’s conditions are for the most part
known, and can be yet more fully investigated.” Efforts to destroy
the parasite should, in his view, be combined with the no less im
portant measures needed for enabling the human constitution to
resist its attacks. Strong people, who live a healthy life and are
much in the open air, never, or very rarely, get consumption, but
only the weakly and delicate, who live and work indoors, or those
hereditarily predisposed ; and if a strenuous endeavour were made
to raise greatly tne physical powers and bodily development of
the community, and at the same time, as Dr. Koch recommends,
if the expectorations of the phthisical were disinfected, and the
milk and flesh of tubercular animals forbidden to be sold, this
fearful disease could, he believes, to an immense extent, be pre
vented and rooted out from among us. Many high authorities,
however, differ widely from Dr. Koch in regard to several of these
views, and especially on the question whether or not phthisis is
often due to contagion. Thus Dr. Andrew, in one of his Lumleian
lectures on “ The ^Etiology of Phthisis ” (published in the Lancet
of May 10th, 1884), holds that the disease is undoubtedly trans
missible by inoculation to the lower animals, and also that its true
cause is the bacillus, while the other reputed causes act only as
predisposing influences ; but he infers, from a study of clinical
facts and from common medical experience as to the origin of
consumption, that the bacillus is an occasional, not a genuine
parasite, and in the great majority of cases comes in from the
outer world instead of being derived by transmission from another
person or animal. Hence he believes that contagion, though pos
sible, very rarely occurs in practice, and has very little really to
do with the production of phthisis. He contends that “ although
phthisis may be undoubtedly produced in many ways experi
mentally in animals, and also probably in man, there is not suf
ficient evidence to prove that its prevalence is materially affected
by direct contagion.” After summing up his views on the subject
he says : “ From these I may be allowed to make one short prac
tical deduction—namely, that the prevention of phthisis, like that
of ague, is to be attained by sanitary works, especially by improved
ventilation and drainage, and not by isolation.” How different
would human life be, if so afflicting and widely spread a malady
could be effectually controlled and prevented by a clear knowledge
of its cause 1 *
* Tlie treatment which holds out most hope of a cure in this very fatal disease
would seem to be a residence for a time in certain high or alpine districts, where
there is an immunity from consumption, or, in other words, where tuberculosis
�THE EXTINCTION OK INFECTIOUS DISEASES.
47
The germ theory not only explains, as I have endeavoured above
to describe, the existing facts of infection, but also enables us to
understand how the infectious disorders may probably at first have
arisen in past ages. If infectious diseases are always accompanied
never occurs either among the people who live there or in the lower animals. That
there are such districts appears to be fully established, and is a most remarkable and
important, fact. Sir Thomas Watson, in his “ Lectures on the Principle ■ and Practice
of Medicine ” (5th ed., 1871), quotes a passage from the Westminster Review, m which
it is st ted that Dr. Schleissner, who was sent srnne years ago by the Danish Govern
ment to investigate the sanitary condition of Iceland, ascertained that in Iceland
•‘scrofula and consumption are unknown.” “This statement,” says Sir Thomas
Watson, “ the accuracy of which had been called in question, has very recently been
confirmed by unimpeachable te.-timonv, zealously collected and made public by Dr.
Leared. In a letter written by him upon the subject, Dr. Ilja'teln, a distinguished
physician resi ing at Reykjavik, dec ares that, during a p *riod of fifteen years, he has
had more than thirty thousand patients, and has made nume ous autopsies, yet not a
single case of tubercle of the lungs or of indigenous consumption has he met with.
He adds the corroborative testimony of Dr. Skaptason, the oldest and most expe
rienced physician in Iceland, who says: ‘During my thirty-two years’practice in
this country, I have nor, seen a single case of phthisis tuberculosa. I have seen a great
many cases of other diseases of the lungs, but phthisis tuberculosa never. In all the
autopsies I have made, I have never observed the least trace of tubercle in the
lnogs.’” A similar immunity from consumption, according to several observers, is
found in certain elevated regions anions high mountain ranges, such as the Swiss
Alps; and it is asserted ihat in districts enjoying this immunity, not only are the
inhabitants free from tuberculosis, but the disease is often arrested, and even radi
cally cured in patients who resort thither for treatment. Professor G. See, in his
latel published work on “ Bacillary Ph hisis ” (“ La Phtisie Bacilloire,” Paris, 1884),
ascribes the beneficial effects of the air of lofty moon'ains to the fact that it kills
or checks the increase of the bacillus, which he regards as the true cause of con
sumption. * Like many other plants, the bacillus cannot live in an Alpine climate,
M. See holds ‘ that phthisis is uniform in its > attire, that it is parasitic, and that the
trea'ment by climate should have for its object either to destroy the bacillus oi u,
prevent the parasite from developing itself,” and multiplying in the tissues. He says
that, as sh wn by the researches of M. Pasteur and others, “ at a height above 800
mfetres (about 2,600 feet) micmphytic life is compromised. But the most formal
proofs of the incompatibility of these altitudes with the life of the mi"rone have
been furnished by Miguel and Freudenstein; at 1,800 metres (about. 5,900 feet), no
more pa'asites. How or why the microbe-- disappear matters, little ; it is a fact, and
it is to this incorruptible quality of the atmosphere that high climates owe their
anti-bacillary or prophylactic power.” Whether it be from the cold or the large
quantity of ozone contained in the air, “the tubercular microbe is unable to live
in these conditions,” and hence M. See concludes that “ mountain climates
must now enter into the warfare of man against the microphytes which en
danger our race.” The most surprising statements, on this subject, however,
are those lately made by Dr. Gauster, chief physician to the State Railways
Administration in Vienna, in a series of articles commencing April 8th, 1884, in
the Wiener Medizinische Zeitung, on “the Influence of a High Climate on Tuber
culosis.” Dr. Gauster affirms that among the Alps thereare districts, having a pecu
liar soil and a height not below 730 metres (about 2,40a feet), which confer a com
plete immun'ty from con-umption, the disease never occurring there either in men
or animals ; while in other districts, thoush at a much greater height, there is no
such immunity. “Immunity from tuberculosis” he says, “is only to be found in
regions where, at a height of more than 730 metres, the soil is composed of the oldest
rocks, as granite, gneiss, and crystalline schist formations, and the quantity of ozone
in the air is constantly high.” He says that the existence of immunity districts, and
their wonderfully beneficial effects on imported cases of consumption, especially in
the early stages of th- disease, have for many years been known. An experience of
fifteen years has convinced Dr. Gauster himself that, in patients who reside for some
months in these districts, changes occur in the diseased lungs by which the morbid
products are gradually eliminated from the body. “ The results of these processes,’
he says, “are, in all the slighter cases, and in most ca-es of medium degree, a cure ;
but in the majority of advanced cases, a hasrening of the fatal issue.” He maintains,
therefore, that “tuberculosis in certain stages is curable in the high climate.” Dr.
Gauster’s assertions are so startling, and so opposed to ordinary medical experience
�48
THE EXTINCTION OF INFECTIOUS DISEASES.
by parasitic organisms, which are either their producers or their
carriers, it is evident that the question how the diseases arose
depends mainly on tbe question as to the origin of the little parasites.
Whence are these little organisms derived, and how did they be
come parasitic on the animal body ? Their origin must obviously
have taken place in one of two ways. Either they arose by what
is called “ spontaneous generation ” from lifeless matter, or else
they descended in the usual way from other living organisms.
Now the former mode of origin is entirely denied by M. Pasteur,
Professor Tyndall, Dr. Burdon Sanderson, and others, who con
tend, not that spontaneous generation never occurs in nature, bi.t
that it never occurs in this class of living beings. Thus M. Pasteur
says, in a lecture delivered before the Chemical Society of Paris
in 1861 : “ You will observe I do not pretend to show that spon
taneous generation never exists. In subjects of this kind one
cannot prove a negative. But I do pretend to demonstrate
rigorously that in all the experiments where the existence of
spontaneous generation has been believed to be recognised among
those beings of the lowest class, to which the controversy is now-a*
days confined, the observer has been the victim of illusions or
causes of error which he has not perceived or has not known how
to avoid.” In a report made in 1871 on the origin and distribu
tion of microzymes (bacteria), Dr. Burdon Sanderson observes :
“I shall be able to prove in the most decisive manner that, as
regards the animal tissues and liquids, and the liquids which will
be used as tests for the presence of microzyme germs, no spon
taneous evolution of any organic form ever takes place ; but it
will be quite unnecessary either to deny or assert its possibility
under other and different circumstances.” Dr. William Roberts
regards the doctrine of spontaneous generation or “ abiogenesis ” as
in itself a perfectly legitimate supposition, but holds that the bac
teria, humble though they be, are far too highly organised for such
a mode of origin, which, moreover, could not be expected to occur
among plants subsisting on the products of putrefaction. “ As
suming,” he says, “ that the occurrence of abiogenesis at some
time in the past history of the globe is a necessary postulate in
science, I see nothing unscientific—looking to the law of continuity
in the operations of nature—in the supposition that it may be
occurring at the present day somewhere or other on the earth’s
surface, but certainly not in decomposing liquids.”
So far as we have reason to believe, therefore, the bacteria are
never generated spontaneously or de novo, but always descend,
like the higher plants and animals, from other living beings. _ We
have seen, however, that what is called £l spontaneous generation,”
as to the curability of consump ion, that they would need ample corroborative
evidence for their support; and M. See states that the medical college of Vienna
has appointed a commission to inquire into the subject. In any case, however, it
seems natural to expect that the influences which entirely prevent consumption
among the natives of certain districts must have a powerful effect in checking the
progress of the disease when brought into these localities.
�TIIE EXTINCTION OF INFECTIOUS DISEASES.
49
“a de novo origin,” not unfrequently takes place in some infec
tious diseases, and this shows that these expressions are ambiguous,
and are used in a different sense when applied to a minute living
organism and when applied to an infectious disease. In the former
case they mean that the organism is evolved out of lifeless matter ;
but when an infectious disease is said to be generated spon
taneously, or de novo, the meaning is that it does not arise by in
fection from another disease like itself—that it is due to some other
cause than infection. As regards the little organisms found in
the disease, the phrase means, not that they arose from lifeless
matter, but that they came in from the outer world, and were not
derived by transmission from one animal to another. A spon
taneous origin of this kind is not uncommon at present among
some infectious disorders, and must at one time have occurred in
all, for, as Dr. Murchison observes, “ in the first sufferer from a
contagious disease its origin must have been de novo.” In in
quiring into the origin of the contagia and of contagious diseases,
it is their spontaneous or de novo origin, in this sense of the terms,
that has to be considered. The view now generally entertained
on this subject by high authorities is that all the different contagia
have probably descended, at periods more or less remote, from the
bacteria, and have been gradually brought to their present type,
in the lapse of ages, by means of variation, inheritance, natural
selection, and the other laws of evolution so admirably explained
by Mr. Darwin in his account of the origin of species. The
bacteria are well known to be eminently modifiable, and may
undergo surprising changes in form and properties from their
physical environment, or by passing from one species of animal
into another. “ If contagia are organisms.” says Dr. William
Roberts, “ they must necessarily have the fundamental ten
dencies and attributes of all organised beings. Among the most
important of these attributes is the capacity for ‘ variation ’ or
‘ sporting.’ ” In like manner Dr. Wilks observes, in his Address
as President of the Pathological Section at the International
Medical Congress in 1881, that, if specific diseases be due to a
living contagium, “it must be subject to the same laws as other
organic matter ; and if the doctrine of evolution be true, it
must have numerous relations with families of its own kind, and
perhaps with others which are now obsolete.” Some of the con
tagia, such as those of small-pox and scarlet fever, are probably
derived from variations in the bacteria which took place only in
remote ages, so that now-a-days the diseases are never found to
arise spontaneously or de novo. Others, as those of erys’pelas and
pyaemia, are apparently due to variations occurring more or less
frequently at the present day, and hence a de novo origin is common
in these diseases ; while in some other affections, such as relapsing
fever, diphtheria, and (if Dr. Murchison’s view be correct) even
typhoid fever, the variations may perhaps occur at rare intervals,
and under unknown or obscure conditions, so that, as many believe,
or
�50
THE EXTINCTION OF INFECTIOUS DISEAS15.
these diseases may now and then arise de novo. It would follow
from this that the first class of little parasites might be totally
extirpated, and the last confined within narrow limits; and we
have seen how greatly Lister’s method has contributed to prevent
the entrance into the body and fatal effects of the minute or
ganisms that give rise to septic diseases.
Having examined the questions whether infectious diseases can
arise spontaneously, and whether the germ theory is the true ex
planation of the facts of infection, we now come to the practical
inquiry as to the means best adapted for preventing and eradi
cating these diseases. The immense importance of this subject
will be seen if we consider the fearful amount of death and
suffering which infectious disorders are causing year after year in
>ur midst. Mr. Simon, whose invaluable Reports as Medical Officer
of the Privy Council and Local Government Board, and therefore
at the head of the sanitary service, have done so much for the pre
vention of disease in England, says : “ Looking at the ravages
which are every day suffered from familiar diseases of the zymotic
class, such as typhoid fever, and typhus, and small-pox, and
scarlatina, and measles, and hooping-cough ; and adding to these
the less constant, but occasionally terrible, destructiveness of
diphtheria and of cholera ; adding further the consequences of
venereal diseases ; adding again those serious traumatic infections
which make the chief common danger of surgical operations and
injuries • everyone can see that the field of zymotic pathology is of
enormous extent and incalculable importance.” The number of
deaths produced by infectious diseases appears from the Reports
of the Registrar-General, which, since 1838, give a tabular state
ment of the causes of all the deaths occurring throughout the
country. Thus if we take the five years from 1876 to 1880 (the
last year for which the annual report has as yet been published) we
find that during the whole period there were in England and Wales
9,726 deaths from small-pox ; 48,294 deaths from measlesj 85,208
from scarlet fever; 66,112 from hooping-cough ; 4,458 from
typhus ; 34,651 from typhoid or enteric fever ; and 15,243 from
diphtheria. This would give as a yearly average of the deaths
from each of these seven diseases, about 2,000 deaths annually
from small-pox ; from measles, 9,500 ; from scarlet fever 17,000 ;
from hooping-cough, 13,000 ; from typhus, 1,000 ; from typhoid
fever, 7,000 ; and from diphtheria, 3,000 annual deaths. In addi
tion to the foregoing there were from the other contagious dis
orders included in the Registrar-General’s reports, 10,268 deaths
from erysipelas ; from puerperal fever, 7,728 ; from syphilis,
10,615 ; from hydrophobia, 246 ; and from glanders, 24 deaths.
That is to say, about 2,000 persons died on an average each year
from erysipelas ; 1,500 from puerperal fever ; 2,000 from syphilis ;
50 from hydrophobia ; and 5 from glanders. Taking the eleven
years from 1870 to 1880, it will be seen that the aggregate number
of deaths from the seven infectious fevers mentioned above,
�TIIE EXTINCTION OF INFECTIOUS DISEASES.
51
amounted to 639,289, or about 58,000 annually, which is rather
more than one-ninth of the total number of deaths from all causes
during the same period. Hooping-cough, measles, and scarletiever, though liable to occur at all ages, are mainly diseases of
&i fancy and childhood—hooping-cough, according to the eminent
authority on vital statistics, the late Dr. William Farr, being most
fatal in the first, measles in the second, and. scarlet-fever in the
third and fourth years. Diphtheria also is most common in
children, for one-half of those who die of it are under five years,
while in scarlet-fever two-thirds of the deaths are below that age.
Typhus and typhoid fever, on the other hand, are chiefly destruc
tive to adults. In Ireland, where typhus is far more prevalent
than in this country, no fewer than 222,029 persons, in the period
from 1841 to 1851, died of typhus and typhoid fever.
The number of cases or attacks is not accurately known, for
as yet, unfortunately, no provision has been made for registering
all cases of infectious disease ; but we can form some idea of their
amount by considering the average mortality of each disease, that
is, the proportion of deaths that usually occur in a given number
of cases. Small-pox, that hideous and disfiguring malady, is the
most fatal of the contagious fevers, the deaths being estimated by
Mr. Marson at about one-third, and by Dr. Seaton at rarely less
than 20 per cent., and often 30 and 40 per cent, of the attacks.
When the disease occurs in a person who has been vaccinated, it is
Usually, though not always, of a modified or milder form, a,nd Dr.
Seaton observes that the mortality of small-pox after vaccination
“ is rarely known to exceed 7 per cent., and is more frequently 3,
4 and 5 per cent.” In typhus and typhoid fever, according to Dr.
jBuchanan and Dr. Murchison, about one patient in ten dies, if all
®ges are taken together, but in adults as many as one in five.
Diphtheria (a contagious sore-throat deriving its name from a
whitish sloughing membrane or skin that forms in the throat and
©ften spreads to the windpipe) is fatal to one in seven, or even,
according to Dr. Aitken, to one third of those attacked by it ;
ftvhile the mortality of scarlet fever is the most variable of
all, ranging from ®ne in twenty or thirty in mild epidemics to one
in five or six in severe ones, and on an average it is reckoned at
about one in twelve. If we take these figures, we may perhaps
infer that there occur in England and Wales on an average of years
about 12,000 or 15,000 cases annually of small-pox ; 10,000 of
typhus ; 70,000 of typhoid or enteric fever ; 15,000 of diphtheria ;
tnd 200,000 cases of scarlet fever. Dr. Murchison, judging by the
deaths from scarlet fever, estimates that considerably less than
half the children born contract that disease (in 1880 the total
number of births registered was 881,643). Hooping-cough and
measles, though the rate of mortality in them is comparatively low,
are so extremely contagious that few children escape them, and
Bence more than half-a-million cases of hooping-cough, and as many
of measles, must annually occur on an average in this country.
D 2
�52
THE EXTINCTION OF INFECTIOUS DISEASES.
In spite of the dreadful ravages committed by infectious
diseases, there are no maladies for whose prevention so little has
yet been done. Indeed, till very recently, they were regarded
almost as necessary and unavoidable evils, and except in the case
of vaccination for small-pox and in some other instances, few
energetic steps were taken to combat any of the infections current
among us, or to prevent their diffusion. “ As to contagions already
current in the country,” says Mr. Simon in his Report to the Privy
Council for 1865, “ practically any diseased person scatters his in
fection broadcast almost where he will—typhus or scarlatina,
typhoid or small-pox, or diphtheria.” In another impressive pas
sage in his Report to the Local Government Board for 1874, Mr.
Simon says: “ Among the causes which injuriously affect the
Public Health of England, considered as a total, certain operate
only on particular districts ; while others, though no doubt in
widely different degrees, appear to be of general, perhaps nearly
universal operation. Foremost in the latter class, and constituting
therefore in my opinion objects which claim earliest attention in
the sanitary government of England, two gigantic evils stand con
spicuous first, the omission (whether through neglect or through
want of skill) to make due removal of ref use-matters, solid and liquid,
from inhabited places ; and secondly, the license which is permitted
to cases of dangerous infectious disease to scatter abroad the seeds of
their infection.” Much has been done of late years, especially in large
towns, for the better removal of refuse matters by improvements
in the sewerage and in the water supply, and the next great
sanitary effort will probably be for the prevention and extinction
of infectious diseases. There are many sanitary reforms which
can be carried out by the authorities with little aid, except of a
pecuniary kind, from the public ; but the abolition of infectious
disease can only be accomplished by the cordial and intelligent co
operation of the whole community ; and hence the urgent need for
an open discussion of the subject, so that all may understand it
and agree as to the means that should be adopted for the pur
pose.
As the contagious fevers have no other source than contagion,
the requirements or indications for their prevention can be readily
understood, and the only difficulty is to know by what practical
and feasible measures these requirements can best be fulfilled. We
have already seen that a contagious fever can be communicated in
three ways ; either by the patient himself, both during his illness
and convalescence, or by the persons or objects which have become
contaminated by being in his neighbourhood. The patient com
municates infection by means of little particles, invisible to the
naked eye, which are exhaled in vast quantities from his body, and
which according to the modern view are excessively minute living
organisms, or microbes ; the tainted objects act simply as carriers of
these particles ; while the tainted or suspected persons may either
act as carriers, or may, for aught we know, be really themselves
�THE EXTINCTION OF INFECTIOUS DISEASES.
53
patients, and already suffering from the disease in its latent or
incubative stage. For the purpose of prevention, therefore, all
that is needed is that no one who has not previously had the disease
should come near any patient or suspected person till the period of
danger is past, and that all tainted objects should be thoroughly
disinfected ; in other words, isolation and disinfection are the
essential requisites for the prevention of the infectious fevers.
“ The isolation of healthy persons from those affected with the
disease, and from those who have intercourse with such patients,”
says Dr. Aitken, in speaking of scarlet fever, “ is essential, and is
the only rule that promises any good results.” Mr. Simon also,
speaking of scarlet fever, observes that “ at present we have not
any other known power of dealing preventively with the disease
than such as consists in intercepting all contagious communication
between the infected and the non-infected parts of the population.
Thoroughly to isolate the sick from intercourse with susceptible
persons, and thoroughly to trap and exterminate all contagium
which the bodies of the sick evolve, are the preventive feats which
have to be accomplished.” A complete system of prevention for
the infectious fevers would thus include, in the first place, the
isolation of the patients during their illness and convalescence ;
secondly, the isolation (often called quarantine') of suspected
persons till the period of incubation is over, and it can be seen
whether or not they are infected with the disease ; and thirdly,
the disinfection of clothing, bedding, furniture, and other con
taminated articles. A fourth indispensable requisite is the imme
diate notification to the sanitary authorities of every case that
occurs, so that means may be taken as speedily as possible to aid
the sufferers in their difficulties, and to prevent the extension of
the disease.
These requirements for limiting the spread of infection are in
cluded by Sir James Simpson—who was the first, in his “ Proposal
to Stamp out Small-pox and other Contagious Diseases ” (1868), to
urge the adoption of measures, not merely for the partial preven
tion, but for the complete and speedy extinction of the contagious
fevers by a great social effort—in the following rules, which he calls
the “ Regulations for Stamping Out.” His remarks have special
reference to small-pox, but similar measures, as he afterwards
states, are applicable, and will, he believes, sooner or later be
adopted for the prevention and extinction of all the infectious fevers.
The regulations which he proposes are:—“ 1. The earliest pos
sible notification of the disease after it has once broken out upon
any individual or individuals. 2. The seclusion at home or in
hospital of those affected during the whole progress of th$ disease,
as well as during the convalescence from it, or until all power of
infecting others is past. 3. The surrounding of the sick with
nurses and attendants who are themselves non-conductors, or in
capable of being affected, inasmuch as they are known to be pro
tected against the disease by having already passed through cow
�54
THE EXTINCTION OF INFECTIOUS DISEASES.
pox or small-pox. 4. The due purification, during and after the
disease, by water, chlorine, carbolic acid, sulphurous acid, etc., of
the rooms, beds, clothes, etc., used by the sick and their attendants,
and the disinfection of their own persons.”
The late president of the College of Physicians, Sir Thomas
Watson, in his article in the Nineteenth Century on “ The Abolition
of Zymotic Disease” (1877) earnestly urges the same views, and
thus enumerates the measures which he regards as necessary for
prevention : 'l To this end,” He says, “ the requisites are, first, the
unfailing and immediate notification to the proper authorities of
the occurrence of every case. Second, the instant isolation of the
sick person. Third, the thorough disinfection of his body, clothes,
furniture, and place of isolation. Fourth, vigilant and effectual
measures to prevent the importation of his disease from abroad,
and to strangle it should it by mischance return.”
It will be observed that the above proposals omit one of the four
measures which have been already adverted to as needed to consti
tute a complete system of prevention against the infectious fevers,
namely, isolation of the patients, isolation of suspected persons,
disinfection, and notification. The measure omitted is the isolation
of suspected persons, or quarantine, as it is often called, a word
used to signify the seclusion of persons apparently healthy, but
who have had intercourse with patients, till the period of incubation
of the disease is past, and it can be known whether or not they are
infected. This has always been felt to be the most vexatious and
harassing of the preventive regulations, and therefore it may
be dispensed with wherever there is reason to believe, either that
the other means would without it be found sufficient, or that society
would not willingly consent to its adoption. Still, such a measu ’•e
is often of the utmost value, and is, indeed, indispensable to success
when the disease to be combated is of a particularly infectious cf
very fatal nature, so that the strongest means are required to sup
press it. All the fresh cases, we must bear in mind, arise among
the persons who have been exposed to contagion, and in this way,
by isolating the latter for a few days, we obtain an immense puwff
of preventing the disease. If, on the other hand, the suspected
persons are left at large, those of them who are incubating the dis
ease will sicken in the midst of other healthy people, to whom they
may probably communicate infection before there is time to isolate
them. For these reasons the isolation of suspected individuals, or
quarantine, has been very frequently resorted to, though hitherto
almost solely as a means of defence against foreign infectious dis
eases, such as the plague, yellow fever, and cholera. It is by strict
quarantine regulations, as well as improvements in hygiene, that the
plague has been expelled from Europe, and that New York and some
other American seaports have been long preserved from the inroads of
yellow fever ; and our exemption of late years and until recently from
that fearful scourge, Asiatic cholera, is largely owing to the system of
quarantine which has been established against it in the Red Sea and
�THE EXTINCTION OF INFECTIOUS DISEASES.
55
on the frontiers of Russia, the routes by which cholera entered in
its former visits. The isolation of persons who have been exposed
to contagion is commonly effected in one of two ways ; either by
their seclusion in separate buildings, for a number of days not
exceeding the usual period of incubation of the disease ; or else by
surrounding the infected places with what is called a sanitary
cordon, or a line which no one is allowed to pass without permission
of the authorities, and by which the sick and those having inter
course with them are kept apart from the rest of the community.
In several towns in the north of England the local authorities have
very recently applied for and received from Parliament powers to
erect shelter-houses, in which the healthy members of infected
families can be received while their homes are being disinfected,
and also to impose certain restrictions on the residents in houses in
which infectious disease has broken out; compensation being given
for any loss that may be sustained by compliance with the sanitary
regulations.
But by far the most important and essential of the preventive
measures is the isolation of the patients themselves, and the main
difficulty in the whole subject is to know in what manner this can
best be effected. Sir James Simpson, as we have seen, proposes
that the patient should be secluded “ at home or in hospital ;” but
he, and all others who have carefully considered the facts, point out
the utter impossibility of effectually isolating a contagious fever in
the homes of the poor, on account of the overcrowding and the
want of a separate room or of any adequate means for preventing
frequent intercourse between the patient and his friends both during
his illness and his convalescence. Mr. Simon says, with reference
to the overcrowding of labourers’ cottages : “ Again and again, in
phrases so uniform that they seem stereotyped, reporters on the
spread of epidemic disease in rural districts have insisted on the
extreme importance of that overcrowding as an influence which
renders it a quite hopeless task to attempt the limiting of any in
fection which is introduced.” Dr. Aitken observes also, in treating
of scailet fever: “When, however, we look abroad at the actual
condition of the people among whom the disease works its ravages,
we see at once that, with regard to very many of them, and espe
cially with regard to the very poor in towns, isolation and disinfec
tion are no more than idle words.” To avoid the risk of transmit
ting the disease, those who have any intercourse with the patient
should as rarely as possible, and only after disinfection, come in
contact with healthy susceptible persons ; but how totally this is
disregarded in numberless instances may be gathered from the fol
lowing account, quoted in Dr. Aitken’s work from a communication
by Professor Bell to the Lancet, of a case of severe scarlet fever
which was seen in a small crowded room. Upon inquiry Dr. Bell
found the following facts : “ The father had charge of an extensive
society’s bread-shop ; the mother was a washerwoman, taking
clothes to her home to wash ; the eldest girl attended, throughout
�56
THE EXTINCTION OF INFECTIGUS DISEASES.
the day, the children of a lady’s family, and came home to sleep at
night; the other children attended, some an infant-school, some a
large mixed school, where hundreds of other children met. The
youngest played with young children in a house on the other side of
the passage.” How can we hope, in such circumstances, to prevent
the spread of a dangerous infectious disease ?
Even in the houses of the rich, where all the advantages of a
separate room and trained nurse, with disinfectants and other neces
sary appliances, can be had, the isolation of an infectious fever is
by no means easy, and very frequently fails in spite of the most
conscientious efforts. There is a wide difference in the infectious
ness of different diseases, and some of them are much harder to
isolate than others. Thus Dr. J ones Glee observes, in his article on
Scarlet Fever in “ Reynolds’ System of Medicine,” “ In degree of
contagiousness scarlet fever takes its place between measles and
hooping-cough above, and typhus fever below, diphtheria being
very far below.” Measles and hooping-cough are so extremely con
tagious, and so difficult to isolate, that it seems needless for the
present to think of their extinction, and we should rather at first
confine our efforts to the other infectious diseases. Of these, small
pox and typhus are much less common in the rich than the poor ;
indeed, typhus, though very dangerous, and often fatal, to the
medical men and nurses who attend it, is usually found only among
the poorest classes of society ; while enteric or typhoid fever, as
previously remarked, is propagated mainly by the bowel discharges
of the sick, and needs, as its essential preventive, the thorough dis
infection or destruction of these discharges immediately on their
issue from the body. The diseases which most frequently require
to be isolated in the houses of the rich, therefore, if we omit
measles and hooping-cough, are scarlet fever and the much rarer
affection, diphtheria ; and to show how little reliance can be placed
on the usual preventive measures in so highly infectious a disease as
scarlet fever, I may again quote from Dr. Aitken’s work the fol
lowing remarks by Dr. Davies, the medical officer of health for
Bristol. In writing of an epidemic of scarlet fever at Bristol in
1875, Dr. Davies asks the question : “ Are we doing any good with
our present preventive means ?” and observes : “ I feel certain that
we increase the anxiety of the domestic and social troubles of the
public by our preventive measures ; and I feel doubtful of the
answer to the former question.” “ I have never,” he continues,
“ used disinfectants so extensively as during the present epidemic ;
and yet our failure is complete. The doubts I have expressed do
not in any way extend to typhus and enteric fever, small-pox, and
Asiatic cholera.” From the remarkable tenacity of the virus of
scarlet fever, disinfection is more difficult in this disease than in
measles or typhus, and the power to infect continues longer, lasting
altogether during illness and convalescence for two months or more ;
and it is evident that the long presence of a fever in an ordinary
dwelling-house, full of susceptible persons, not only gives great
�THE EXTINCTION OF INFECTIOUS DISEASES
57
facilities for contagious intercourse, but must so thoroughly load
the bedding, walls, and furniture with virulent particles as to render
much more difficult the process of disinfection.
The above facts show clearly that the real cause of the enormous
prevalence and fatality of the infectious fevers is that they are
treated az home, where they cannot, in the great majority of cases,
be properly isolated; and hence the best authorities have of late
years come more and more decidedly to the conviction that these
diseases ought not to be treated at home, but in hospitals set apart
for the purpose, and so arranged that each different kind of disease
may be isolated in a separate building or a separate ward. The
hospital treatment of the infectious fevers seems to me one of the
most immense improvements ever introduced in medicine, and the
means which, in combination with others, will lead in time to the
complete and final extinction of all these disorders. In an infec
tious disease the objects of medical treatment are not only to cure
the malady, but also to prevent its extension to other persons ; and
the latter aim can only be secured, in the case of the contagious
fevers, by treating them in hospitals where their extension can be
effectually prevented. A large number of infectious hospitals have
lately been provided by the local authorities in the towns and vil
lages throughout the country, partly by erecting new buildings, and
partly by adapting private houses and cottages for the purpose, at
the earnest instigation of the Local Government Board and their
medical staff. “For a long time past,” says the late Dr. Seaton, in
his report for 1876, “the Board have been strenuously urging on
local authorities the provision of such hospitals.” Another indis
pensable means of prevention consists in hospitals or homes in the
country air where convalescents from the contagious fevers can be
isolated till their power of infecting is past; and a few institutions
of the kind have recently been provided, in great part through the
admirable efforts of Miss Mary Wardell and Mrs. Gladstone,
though hitherto chiefly by voluntary contributions, and not by
public funds.
The immense utility of fever hospitals and convalescent homes
as a means for stamping out zymotic disease, will be seen if we
consider for a moment their advantages, not only to the public,
but also to the infected families and to the patients themselves.
To the public the treatment in hospital affords a complete pro
tection by at once removing the patient, the centre and source of
contagion, from the midst of susceptible people, and placing him
in circumstances where his disease cannot extend. In a wellregulated hospital, where the nurses and other attendants are care
fully chosen as having had the disease, and do not come in contact
with the public outside except on rare occasions and after disin
fection, there is little likelihood that any fresh case should arise ;
and even if it did, it would be promptly isolated, so that the
mischief would spread no further. Thus Dr. Broadbent, the senior
physician of the London Fever Hospital, observed lately, at a
�58
THE EXTINCTION OF INFECTIOUS DISEASES.
drawing-room meeting at Mrs. Gladstone’s, that “ from the moment
when a scarlet-fever patient was in an ambulance or in a con
valescent home, all danger to the public ceased.” In like manner
Dr. Buchanan, the present medical officer of the Local Government
Board, says: “In regard to some infections, notably those of
scarlatina and diphtheria, there are no means at all to be compared
with isolation in hospital for preventing the spread of a limited
number of cases into a formidable epidemic.” “ There are,” he
says again, “ four infectious diseases—small-pox, scarlatina, diph
theria, and continued fever—which more particularly require to be
treated in hospital, when they attack persons who cannot be pro
perly isolated in their own houses and he adds that “ small-pox,
as well as other infections, is capable of being wonderfully limited
by isolation in hospital.” Particular care should be taken in any
outbreak of disease to isolate as quickly and effectually as possible
the first cases; for a fever is in some respects like a fire, which at
first can be readily extinguished ; but afterwards, when it has had
time to spread and gather strength, becomes difficult if not im
possible to control. In a Memorandum issued a few years ago by
the Local Government Board, it is pointed out that the separation
of the sick from the healthy “ is comparatively easy, if means to
attain it are taken early, while cases of the disease are very few;
but any interval of delay allows the cases to multiply, and perhaps
at last to become so numerous that endeavours to isolate them
cannot succeed.” If all the existing cases of an infectious fever,
and especially the first cases, were promptly removed to hospital,
and the convalescents afterwards transferred to suitable homes,
epidemics could be arrested at their origin, and the number of
patients needing isolation would soon be surprisingly reduced.
The only other sources of contagion which would then remaiii to
be dealt with are the persons and objects contaminated by the
patients before their removal to hospital ; and if the suspected
persons were secluded for a few days during the term of incubation,
and the tainted objects thoroughly disinfected, it is not too much
to assert that the disease might in a short space of time be radically
and completely extinguished.
To show how rapidly a contagious fever can be extirpated when
adequate means are employed for the purpose, Sir James Simpson
points to the instructive example afforded by the cattle plaque, a
terrible disease of horned cattle, which has its home in Siberia,
and was imported into England from the Continent in 1865. This
is the most fatal and most highly infectious of all the spreading
disorders of the domestic animals, the mortality being estimated by
Professor Fleming at about 90 or 95 per cent, of the attacks, and
during the two years which elapsed before it was subdued in this
country it destroyed nearly half-a-million of cattle. At first the
disease was allowed to gain ground through division of opinions ;
but when a stringent law for its prevention was passed by Par
liament and put in force, it immediately began to decline, and was
�THE EXTIN Clio., OF INFECTIOUS DISEASES.
59
soon entirely stamped out. The measures adopted were of such
a nature as to deal effectually with all the sources of contagion,
and consisted in the compulsory slaughter, with compensation, of
the sick and also of the suspected animals, the burial of the diseased
bodies, and the disinfection of tainted objects ; due notification of
every case to the authorities being likewise made compulsory. These
are the means which have repeatedly been employed on the Con
tinent against inroads of the cattle plague, and invariably with
success. “ Whatever be the place into which it penetrates,” says
M. Leon Colin, “ the cattle plague can be arrested, for we have
always the same resource, a resource absolute and radical, for sup
pressing the contagion, by causing to disappear the sick, the animals
which they have contaminated, and the objects which they have
Soiled.” Now, Sir James Simpson holds that small-pox and other
infectious fevers in man might be just as successfully eradicated as
Cattle plague, since we possess in isolation strictly carried out, a
means no less powerful for preventing them. “We could, in my
Opinion,” he says, “ as surely and as swiftly stamp out small-pox
as rinderpest (cattle plague) has been stamped out.” After pro
posing his preventive regulations, he says : “ The measures which
I have suggested would probably, in my opinion, stamp out small
pox in Great Britain within six months or a year, provided they
were carried out as faithfully and universally as the Legislature
can command.” It seems to me that these views are in principle
undeniably true, and that if society would only consent to the
effectual isolation, or, in other words, to the isolation in hospital
of all cases of infectious fever, whether in rich or poor, these
dreadful disorders, which have lasted from time immemorial and
destroyed millions of human lives, could in a very few years be
coni pie telv rooted out and banished from among us.
The objection which has been so often urged against fever hos
pitals, that they separate a patient from his friends and relatives,
Seems to be really an objection not to hospitals merely, but to
^solation itself in any form. Even when the patient is treated at
home he must, if we would prevent infection, be kept entirely
apart from his friends and relatives. In both cases isolation is
equally essential, and is the real difficulty that has to be met and
surmounted before we can hope for success. Doubtless it is a
most painful necessity to have to separate from a beloved relative
-—from a child, or parent, or husband, or wife when they are
stricken down by an infectious fever ; but if the separation is
indispensably needed for the extinction of these dangerous ma
ladies, and for the good of the whole human race, ought we not
Willingly to consent to it ? It appears to me, moreover, that fever
hospitals are in reality an inestimable boon to the family and to
the patient, no less than to society at large. They prevent, in
numberless instances, the spread of disease to other members of a
household, and they save the family from all the troubles and
difficulties attendant on isolation at home, which are particularly
�60
THE EXTINCTION OF INFECTIOUS DISEASES.
harassing at such a time of anxiety and distress. There is another
danger connected with the home treatment of contagious fevers
which should be mentioned, and of which the public is not suf
ficiently aware ; namely, that if a woman who is pregnant or
recently delivered contracts one of these diseases, and especially
scarlet fever, it is almost sure to prove fatal. “ Fever during the
pregnancy,” says Dr. Aitken, “most certainly ends in abortion and
death. If the woman be recently delivered, the disease will be of
the most malignant type and almost always fatal.” “ If scarlet
fever can be prevented,” he says also, “ the number of puerperal
fever cases would be diminished one-half ; and every possible step
ought to be taken to remove the pregnant female alike from the
influence of scarlet fever and from erysipelas.” Besides these
great advantages of hospitals, they enable the patient in very
many cases to have better food, nursing, and other accommodations
than he could find at home, while the richer classes may, if they
please, be treated in private hospitals or in separate wards or
rooms to which admission is obtained by payment. Conveyance
to hospitals, it may also be remarked, can be readily effected by
means of ambulance carriages, provided with a moveable bed,
which is taken into the sick-room and into the ward, so as to
avoid, as far as possible, any risk or inconvenience to the patient.
The benefits which a patient derives from a convalescent home are
obvious, for unless he has access to an institution of the kind, he
cannot for some time after his recovery go anywhere to seek a
change of air, and to recruit his strength without endangering the
lives of others. Indeed, the Public Health Act of 1875 expressly
forbids any person suffering from a dangerous contagious disease
to expose himself “ without proper precautions against spreading
the disorder, in any street, public place, or conveyance,” so that’ it
is difficult to see how a convalescent patient who is still capable
of infecting others, can travel, change his residence, or even leave
the house without infringing the law and rendering himself liable
to a penalty.
A question of the utmost importance is, whether the isolation of
persons suffering from a contagious fever should be made compul
sory and enforced by the State, and both Sir James Simpson and
Sir Thomas Watson plead earnestly in favour of a measure for this
purpose. “ If,” says the former, “ by a law which no one thinks
harsh or severe, lunatics are prevented from destroying the lives of
their fellow-men, why should it be thought harsh or severe that
people affected with small-pox should be prevented from dealing
out destruction and death to all the susceptible with whom they
happen to come into contact ?” The force of this appeal will not
be disputed, and it seems to me that a law making obligatory the
isolation of all cases of infectious fever, whether in rich or poor,
if it had the cordial approval and co-operation of society, would
be incomparably the most effectual means that could be taken for
the prevention of these diseases. Such a law would be no real in
�THE EXTINCTION OF INFECTIOUS DISEASES.
61
fringement of liberty, for the principle of liberty, as Mr. Mill
points out, requires only that acts which do not injure others
should be left free. On the contrary, acts which injure others
may rightly be controlled by the State, and surely there are no acts
more highly inj urious to others or more likely to be followed by
disastrous consequences, than to communicate the seeds of a
dangerous infectious disease. To extirpate these maladies, more
over, a most vigilant and united action on the part of the public
and the local authorities is absolutely necessary, and this cannot be
obtained without the aid of the law ; indeed, without stringent
laws to prevent them, the extinction of infectious fevers either in
man or the domestic animals seems an utterly hopeless task.
Hence a large number of enactments have recently been made
by Parliament for the prevention of infectious disease, and one of
them deals expressly with the subject of isolating the patient. A
clause in the Public Health Act of 1875 directs as follows:
“ Where any suitable hospital or place for the reception of the
Sick is provided within the district of a local authority, or within
a convenient distance of such district, any person who is suffering
from any dangerous infectious disorder, and is without proper
lodging or accommodation, or lodged in a room occupied by more
than one family, or is on board any ship or vessel, may, on a
certificate signed by a legally qualified medical practitioner, and
with the consent of the superintending body of such hospital or
place, be removed, by order of any justice, to such hospital or
place "at the c'ost of the local authority ; and any person so suffer
ing, who is lodged in any common lodging-house, may, with the
like consent, and on a like certificate, be so removed by order of
the local authority.” That is to say, the law permits the com
pulsory removal to hospital of any fever patient whom the medical
practitioner may certify to be without proper lodging and accom
modation. But the radical defect and injustice of this enactment
seem to be, that it is a law for the poor only, and not for the rich ;
it permits the removal to hospital, and compulsory isolation, of the
poor, but lays no similar obligation on the rich, although the com
plete isolation of a fever patient is quite as necessary among the
latter, and is in very many cases inadequately carried out. To be
just, the law should enforce isolation equally in all classes • and if
this cannot practically be done in any other way than by treatment
in hospital, it seems in fairness to follow that such treatment
should be impartially enjoined in all. Another defect in the enact
ment, which, as pointed out by Mr. Murdoch in his “ Remarks on
the Necessity for further Suppression of Infectious Disorders,”
has greatly diminished its efficacy, is that it imposes on the medical
practitioner the difficult and unpleasant task of interpreting the
phrase “without proper lodging and accommodation,” and thus
makes him the agent in compuisorily sending patients to hospital.
The only law which, I venture to think, would be both just and
effectual, is one making obligatory the isolation in hospital of all
�62
THE EXTINCTION OF INFECTIOUS DISEASES.
cases of certain specified diseases, whether in ri fh or poor. The
diseases which should be included in the measure, and should
always, unless for some special and urgent reason, be treated in
hospital, are, I think, small-pox, typhus, scarlet fever, diphtheria,
and perhaps also, under certain circumstances, typhoid or enteric
fever ; although the prevention of the last-named disorder requires
rather that the discharges should be thoroughly disinfected, and
that complete security should be given for this being done, than
that the patient himself should be isolated. All cases of the
foreign infectious diseases, such as yellow fever or the dreaded
pestilence, Asiatic cholera, should also, as it seems to me, for the
public safety, be treated in hospital. With regard to measles and
hooping-cough, they are affections of a less dangerous nature, and
moreover they are so extremely prevalent, so highly contagious,
and so difficult to isolate, that it seems better to defer for a time
any attempt to extinguish them by means of legal enactments,
and they might continue, as at present, to be usually treated at
home.
But, besides the isolation of the patients, the other leading
measures of prevention should also, in the opinion of the highest
medical authorities, be made compulsory : namely, the disinfection
of tainted articles of clothing or furniture, the notification of all
cases of infectious disease, and, in certain instances, the isolation of
persons who have been exposed to contagion—or quarantine, as it
is commonly called. It is often thought that quarantine is chiefly
applicable to infected ships, or to a line of frontier between
neighbouring countries ; but one of its most important and
valuable forms is the quarantine of infected houses; for the house
on land is in many respects analogous to the ship at sea. Infection
spreads most readily to persons who are in the same house, and
especially in the same room, with the patient, and seems very
seldom to be propagated directly from one house to another, since
the virulent particles are quickly dispersed and rendered harmless
by mixing with the outer air. Thus Dr. Buchanan says, in speak
ing of infectious hospitals: “ As regards the distance which, on
medical grounds, it is right to secure between adjacent inhabited
houses and an infectious hospital, I know of no evidence as to
what proximity, if any, can be a danger to persons not actually
under the same roof ; but there is abundant evidence to show that
very short distances suffice to prevent direct infection.” This fact
shows the great benefits which may be derived from a quarantine
of infected houses ; for when a case of fever occurs in a dwelling
house, if the patient is removed to hospital, and if the other
members of the household are isolated for a few days either at
home or elsewhere, during the term of incubation and while the
premises are being disinfected, the disorder may very often be pre
vented from spreading any further. These means would, I think,
be specially valuable if applied to the first cases of disease appear
ing in a locality, when every possible care should be taken to
�THE EXTINCTION QF INFECTIOUS DISEASES.
63
guard against the sources of contagion, and at once to stamp out the
malady at its commencement. As previously remarked, compul
sory powers have lately been granted by Parliament to the local
authorities in several towns in the north of England enabling them
to order the quarantine of infected houses, which if combined
with the removal of the patient to hospital, seems to me the most
complete and effectual system that could be adopted for rapidly
stamping out zymotic disease.
With regard to the disinfection of houses, furniture, or other
articles, this should always, according to Mr. Simon, be done under
the direction of the sanitary authority, who would ensure its
proper performance, and at the same time relieve the public from
a troublesome and expensive task. It should, he says, “ be made a
legal obligation, that every health authority of the country should
have all disinfectant processes necessary for the protection of the
public health done under direction of a skilled officer, and, as far
as necessary, at a public establishment, and at the public cost.”
The means commonly employed for disinfecting purposes, it may
perhaps here be remarked, are heat, free ventilation, and also
certain chemical substances, such as carbolic acid or chloride of
lime. Of these the surest disinfectant is great heat, whether by
fire or boiling water, or by the hot air of an oven, as it at once kills
the virulent germs. The most generally useful agent, however, is
free ventilation and a copious supply of fresh air, which dilutes
and disperses the poisonous exhalations, so that they have no
longer the power to infect. As observed in a memorandum issued
by the Privy Council: “ The great natural disinfectant is fresh
air abundantly and uninterruptedly supplied.” In disinfecting a
room which has been occupied by a fever patient, the usual plan is
to fill it, all apertures being closed, with chlorine gas, or with the
fumes of burning sulphur, and after it has been thoroughly
fumigated, to throw open doors and windows, and allow the freest
ventilation for several days; then to whitewash the walls and
ceiling, and, at the end of a week, the room may again be safely
inhabited. In Asiatic cholera and typhoid fever the virus is con
tained chiefly in the bowel discharges of the sick, and these should
always be thoroughly disinfected immediately on their issue from
the body. Another precaution, which was introduced by Dr. Budd,
and has lately been recommended by Dr. Cameron as in his opinion
the best of all preventives against cholera, is to flood the drains
and closets frequently with disinfectants during the presence of
the disease in the country, so as to prevent the little germs, c r
microbes, from living and multiplying in the sewage. By careful
disinfection and isolation, we may hope that cholera, like plague
and other scourges, will be effectually combated, and may, in the
end, be entirely overcome.
To enable the sanitary authorities to ensure due isolation and
disinfection in cases of infectious disease, it is evidently necessary
that every such case should be notified or reported to them, and
�64
THE EXTINCTION OF INFECTIOUS DISEASES.
that this should be done as speedily as possible ; for the sooner
preventive means are taken the less time is allowed for the spread
of contagion, and the more easily can the outbreak be arrested.
The prevention of these disorders, it may be observed, has been
immensely facilitated by the new sanitary organization introduced
by the Act of .1872, according to which the whole country has been
divided into districts, governed in matters relating to public health
by sanitary authorities ; each of these bodies having its medical
officer of health, while all of them are under the superintendence
of the Local.Government Board, aided by its medical officer. Mr.
Simon describes “the new sanitary organization of the country”
as consisting of “ the Local Government Board, viewed as a Central
Board. of Health, and the more than fifteen hundred district
authorities which, each with its medical officer of health, locally
administer the health laws.” In the notification of infectious dis
eases, every case should at once be reported to the medical officer
of health for the district. This system of notifying disease has
lately been adopted with excellent results in upwards of thirty
towns, some of them among the largest of the United Kingdom,
and has there been made compulsory by special Acts of Parliament
obtained on the application of the local authorities themselves ;
and Mr. Hastings has more than once introduced into the House of
Commons a Bill for extending the same principle of compulsory
notification to the whole country.
Although the highest authorities agree in thinking that the
notification of infectious diseases is indispensably needed for their
prevention by the State, and should be made compulsory, there is
much difference of opinion in regard to the question, Who is to
notify ? In the infectious fevers, the duty of giving intimation
must be performed either by the occupier of the house where the
disease has broken out or by the medical attendant; and a strong
feeling exists among large numbers of the medical profession that
the legal obligation to notify, and the penalties for neglecting it,
ought not to be laid on them, but on the householder. Thus, in
an important debate on the subject which took place at the annual
meeting of the British Medical Association in 1882, a resolution
was carried to the effect, “ That this meeting earnestly desires
compulsory notification of infectious disease, but it wishes to
express its opinion that the compulsion to notify should be placed
upon the householder as bis duty as a citizen, and not upon the
doctor.” In the course of the discussion, the President, Dr. Alfred
Carpenter, observed that “ There could be no doubt that it was
the duty of the patient, or his legal guardian, to notify the exist
ence of any infectious disease to the local authority.” This seems
to me a truth of the utmost importance, which should be carefully
considered by the public. The real person on whom the duty of
notifying infectious disease naturally rests is, I think, the patieDt
himself, and in some diseases, which do not impair the faculties,
he may be legally called upon to fulfil it. But in the contagious
�The extinction
of infectious diseases.
65
fevers the proper person on whom the obligation should be laid
seems to be the householder, as he is the patient’s natural guardian,
and, moreover, it is he, and not the doctor, who has an early know
ledge of the existence of the disease. The assistance of the medical
taan will doubtless be needed in most cases to diagnose the affection, and he will also usually be the one to fill up the certificate,
■though the householder may afterwards forward it to the sanitary
eathority. But supposing that the householder, after being in
formed of the infectious nature of the disease, refuses to notify it,
from a fear of injuring his business, or other reasons, I cannot but
think that it would then become'the duty of the medical man, and
that he should be legally required, to make the notification himself ;
for he could not justifiably refrain from interfering, and see a
breach of law committed, which might lead to the most deplorable
and even fatal consequences to many persons. The Bill of Mr.
Hastings proposes, I believe, to make the obligation to notify
bhwling on both the householder and the doctor conjointly ; and
this, as it seems to me, would be the true principle, if it were made
clear that the duty really and in the first instance rests on the
householder, and only when he refuses to discharge it, is incumbent
on the medical practitioner.
* There is one of the contagious fevers in which, besides isolation
and disinfection, a third preventive measure of a totally different
nature, and which appears to me of immense value, has been very
extensively used ; I mean vaccination in small-pox. In disinfection
the object is to destroy the germs of a disease after they have left
the. body, while isolation deals with them at their source in the
patient himself ; but vaccination may be described as consisting in
.this, that after the virulence of the germs has been weakened by
pertain processes, such as their passage through a different species
IOf animal, inoculations are made with the weakened or attenuated
Virus, in order to protect the system against the action of the same
virus in its stronger form. It was shown by Dr. Edward Jenner,
in 1798, that inoculations with cow-pox matter have the power of
protecting the constitution against the virus of small-pox—a fact
which the late Mr. Marson, who for forty years had charge of the
■Dondon Small-pox Hospital, regards as “the greatest discovery in
relation to disease ever made by man for the preservation of human
life.” It was also thought probable by Jenner that cow-pox is
nothing else than small-pox modified or mitigated by passing
through the cow ; and Mr. Ceely, and Mr. Badcock afterwards,
Succeeded in producing cow-pox by inoculating heifers wita
matter taken from a small-pox pustule; but as this is an experiment which very frequently fails, doubts still continued to exist,
till in 1881 the truth of their opinion was completely established
by Dr. Voigt, the superintendent of the Vaccine Institute at
Hamburg. By inoculating a calf with small-pox matter he pro
duced cow-pox, the lymph from which, after being further*
weakened by transmission through several calves, has been habiE
�66
THE EXTINCTION OF INFECTIOUS DISEASES.
tually used at Hamburg in vaccination, for the last two years, with
the most satisfactory results. “Vaccinia and variola (cow-pox and
small-pox) are derived originally from the same contagium,” says
Dr. Voigt, “and give to those affected by them an immunity one
against the other.” Again, the eminent discoverer, M. Pasteur, by
a.n in.vabiable series of researches, has lately shown that vaccina
tion in small-pox is by no means a solitary fact, and that the virus
of many other infectious diseases can be weakened or mitigated
in a similar manner, so as to furnish a protective material, or
vaccine, as he terms it, against the diseases. The two methods by
which he has succeeded in diminishing the power of an infectious
virus and converting it into a vaccine are, either by transmitting
it through an animal of a different species, or by allowing an
interval of several weeks to elapse between two successive culture®
of the little organisms or germs that produce the disease, during
which period they are acted on by the oxygen of the air and
gradually lose their virulence. By these means M. Pasteur has
already obtained the vaccines of several infectious disorders, the
most important of which are rabies (hydrophobia) in the dog, and
anthrax, or the splenic fever of cattle. Of the second method for
weakening the power of a virus he says especially,' We may hope
to discover in this way the vaccine of all virulent diseases,” and
he holds that “ we have here a proof that we are in possession of
a general method for preparing virus vaccine based upon the action
of oxygen and the air.”
The close affinity between cow-pox and small-pox, which are
really the same disease in different species, explains why the one
protects from the other, and according to the best authorities the
power of vaccination during childhood, especially when followed
by re-vaccination later in life, to prevent small-pox, or render it
milder if it does occur, is most remarkable. “ One thoroughly
good primary vaccination to start with,” says Dr. Seaton, in his
article on Vaccination in “ Reynolds’ System of Medicine,” “ and
one careful revaccination at puberty, so conducted as to give
evidence that the lymph was absorbed, are all that is necessary for
the complete protection of the population against small-pox.”
The facts which seem to prove most clearly the great efficacy of
vaccination are that, as shown by Jenner, inoculations with small
pox matter (which used formerly to be practised, but were made
illegal in 1840) produce no effect on a person who has had cow
pox ■ that the nurses who attend upon small-pox patients, and are
constantly exposed to the effluvia, very seldom contract the disease
if they have been previously revaccinated, not one of the nurses in
the London Small-pox Hospital having become infected during Mr.
Marson’s long experience ; and that the death-rate from small-pox
has been enormously diminished in every country where vaccina
tion is in general use. “ The present average death-rate from
small-pox,” says Dr. Seaton, “is scarcely, in any European country,
one-tenth part, and in those countries in which vaccination has
�THE EXTINCTION OF INFECTIOUS DISEASES.
67
been most carefully carried out it is much less than one-tenth part
•what it -was at the end of last century.” In England and Wales
the total number of deaths from small-pox in 1879 and 1880 were
536 and 648 deaths respectively, which, according to the RegistrarGeneral, are the lowest rates yet recorded. These figures show
how vast has been the reduction in a disease formerly more dreaded
in Europe than even the plague itself. They show, too, the
immense assistance which may be derived from a vaccine in the
final extinction of an infectious disease ; and they inspire the hope
that by careful isolation and disinfection, aided by vaccination,
we may succeed before long in completely stamping out and
abolishing small-pox, which Sir Thomas Watson describes as “ the
most hideous, loathsome, disfiguring, and, hydrophobia excepted,
probably the most fatal also of the various diseases to which the
human body is liable.”
There still remain two classes of infectious disease, on whose
extinction I would like, before concluding, to say a very few words,
namely, first, those derived from the lower animals, the most im
portant of which is hydrophobia ; and secondly, the venereal
affections, and especially syphilis. With regard to the terrible
malady hydrophobia, besides the vaccine lately discovered against
it by M. Pasteur, it has been earnestly urged by Sir Thomas
Watson, in the Nineteenth Century Review, that a means for its
complete extinction could be found in subjecting all dogs to a
quarantine of six or seven months (which might perhaps be done
by muzzling them), as recommended by Mr. Youatt and Sir
James Bardsley, for in this period every case of the disease which
was in process of incubation would show itself, and the animal
might be destroyed. “ By destroying every dog in which the
disease should break out during strict quarantine,” says Sir James
Bardsley, “ not only would the propagation of the malady be
prevented, but the absolute source of the poison would be entirely
Suppressed.”
As regards the venereal affections, their extinction is a subject of
enormous importance, for there are very few diseases which give
rise to such a fearful amount of human misery. The Acts for
their suppression, commonly known as the Contagious Diseases
Acts, which were so deeply unjust to women, have been virtually
annulled by the resolution of the House of Commons, in 1883,
mndemning compulsory examinations, and a better system of preTOntion is most urgently needed. The high authority, M. Mauriac,
holds that of the three venereal affections, gonorrhoea, syphilis,
and simple contagious sore, the first cannot be extinguished, but
that the two others admit of complete extinction, though the last
of them, being a slighter and merely local affection, could be far
more easily eradicated than the formidable malady, syphilis. It
Seems to me that the true object to be aimed at in the prevention
of syphilis by the State, is to deter individuals from spreading the
disease by the fear of being detected and punished. This object
�68
THE EXTINCTION OB’ INFECTIOUS DISEASES.
could, I venture to think, be best attained, in the first place, by
making the communication of syphilis a punishable offence in both
sexes, as. is strongly recommended by Mr. Berkeley Hill, and other
distinguished writers ; and in the second place, by making com
pulsory the notification of every case of syphilis and of simple
contagious sore to the sanitary authority, or in other words to the
medical officer of health for the district; and also, in addition to
these two enactments, by instituting a most careful and searching
inquiry into the origin of every case of syphilis, so as to discover
who has been guilty of spreading it. Syphilis differs from the
contagious fevers m this most important point, that the patient in
a multitude of cases knows perfectly well by whom he or she has
been infected, and therefore the origin of the disease can very
often be traced. All these inquiries, as well as the notifications of
disease to the authorities, should be kept strictly private, so that
no names would ever be divulged except those of individuals who,
knowing themselves to be diseased, assist in the spread of infection.
Whether an individual had acted in ignorance or from culpable
negligence would often appear from the circumstance that his
disease had been notified and he had been warned of its con
tagious nature. With regard to notification, which seems to me in
syphilis, as in all other dangerous infectious disorders, of immense
importance for its prevention, the legal obligation to notify
should, I think, be laid upon the patient himself, and not upon
the medical attendant ; although the latter could voluntarily give
intimation in cases where he desired to do so, and would doubtless
very often perform the duty at the patient’s request. By notifica
tion the amount and distribution of syphilis in the country would
become known, its increase or diminution could be tested, and
the disease would be rescued from the fatal secrecy which, more
than any other cause, promotes its ravages. It appears to me that
these measures would be just to both sexes, and, though some
times attended with very painful disclosures, would be no real
burden on any but those who wilfully or recklessly communicated
disease to other persons ; and they would also, I venture to think,
be found in the end more effectual than the previous Acts in
stamping out syphilis, which has so long been the scourge and
terror of mankind in all parts of the globe.
�ELEMENTS OF SOCIAL SCIENCE; or, Physical,
r
Sexual, and Natural Religion. An Exposition of the
True Cause and only Cure of the Three Primary Social Evils—
Poverty, Prostitution, and Celibacy. By a Doctor of. Medi
cine. London : E. Truelove, 256, High Holborn. Upwards
of 600 pages. Twenty.fifth Edition.
Sixty-first Thousand.
Price 2s. 6d. Stiff Boards; 3s. Cloth Boards—either post free.
Post Office Orders payable at High Holborn.
J
Translations of this Work have been published in the following
languages, and may be had of E. Truelove :—
In French.—Elements de Science Sociale. Paris: Germer BailliEre,
Boulevard St. Germain, 108. Third Edition, 1879.
In German. — Die Grundzuge der Gesellschaftswissenschaft. Berlin :
Elwin Staude.
Sixth Edition, 1880.
In Dutch.—De Elementen der Sociale Wetenschap. Rotterdam: Nijgh
& Van Ditmar. Second Edition, 1877In Italian.—Elementi di Scienza Sociale. Milan: Gaetano Brigola,
Fourth Edition, 1881.
In Portuguese. — Elementos de Sciencia Social. Lisbon: Silva
Junior. 1876.
In Russian.—Haia-ia Copia.ibHon Hayim. Geneva—Bale—Lyons: H.
Georg. 1877.
In Swedish.—Samhallsldrans Grunddrag. Stockholm: AssociationsBoktryckeriet. Second Edition, 1880.
In Hungarian.— A Tarsadalom-Tudomdny Elemei.
Buda-Posth:
S. Zilahy. 1879.
In Danish.—Grundtrcek af Samfundsvldenskaben. Copenhagen. Th.
E. Thomsen, 1879.
In Polish.—Zasady Nauki Spolecznej Geneva. Imprimerie Polonaise,
1880.
OPINIONS OF THE PRESS.
* This is the only book, so far as we know, in which at a cheap price and with
honest and pure intent and purpose, all the questions affecting the sexes, and the
influence of their relations on society, are plainly dealt with. It has now been
issued in French as well as in English, and we bring the French edition to the
notice of our friends of the International Working Men’s Association, and of our
subscribers in France and Belgium, as essentially a poor man’s book.”—Aarfionai
Reformer, edited by Mr. Charles Bradlaugh.
“ The Elements of Social Science is a most remarkable work, written by a man
evidently with great knowledge of pathology and political economy. It will be
greatly liked or disliked, according to the ‘school’ of the reader; but no one can
fail to consider it as one of the most remarkable works of the day, on the subjects
of which it treats. We are told that it has been largely read in London by medical
men.”—Medicat Press and Ciicular, February 23rd, 1870.
“ A very valuable, though rather heterogeneous book . . . This is, we believe,
the only book that has fully, honestly, and in a scientific spirit recognised all the
elements m the problem—How are mankind to triumph over poverty, with its
train of attendant evils ?—and fearlessly endeavoured to find a practical
Solution.”—T/te Pxaminer, January 4th, 1»73.
“In some respects all books of this class are evils: but it would be weakness
and criminal prudery—a prudery as criminal as vice itself—not to say that such a
�book as the one Id question is not only a far lesser evil than the one that ft
combats, but in one sense a book which it is a mercy to issue and courage t®
Dublish.”—Reasoner, edited by Mr. G. J. Holyoake.
“We have never risen from the perusal of any work with a greater satisfaction
than this."—Investigator.
“That book must be read, that subject must be understood, before the
population can be raised from its present degraded, diseased, unnatural, and
immoral state. Wo really know not how to speak sufficiently highly of this
extraordinary work; we can only say, conscientiously and emphatically, it is a
blessing to the human race."—Peoples Paper. By Ernest Jones.
“Though quite out of the province of our journal, we cannot refrain from
stating that this work is unquestionably the most remarkable one, in many
respects, we have ever met with. Thougn we differ toto ccelo from the author in
his views of religion and morality, and hold some of his remedies to tend rather
to a dissolution than a reconstruction of society, yet we are bound to admit the
benevolence and philanthropy of his motives. The scope of the work is nothing
less than the whole field of political economy.”—The British Journal of Homoeopathy,
January, 1860.
“ It is because, after an impartial consideration of this book, we feel satisfied
that the author has no meretricious professional object to subserve, that we are
induced to use its publication as a text for the discussion of a vital and pressing
subject; and because it bears evidences of research, thorough although misapplied,
professional education, some pretensions to philosophy, and a certain earnestness
of misguided conviction of the truth of peculiar prevalent economical theories,
Which seems to have led him off his feet, and to have induced him to venture
upon any extravagance in their support. It is in vain to attempt to hide these
subjects out of sight. This one book of 600 closely printed pages is in its third large
edition, It is of no use to ignore the topic as either delicate or disgusting. It is
of universal interest. It concerns intimately every human being.”—From an
adverse review, occupying six columns in The Weekly Dispatch, January and
February, 1860.
,
Extract from an Article by Professor Mantegazza, of Florence, in the Journal
Medico di Casa, of \6th January, 1874.
“This work has had eleven English editions, two French, a German and a
Dutch one; and is about to be published in Italian and in Portuguese; and we who
have read and meditated on it, rejoice with the author at this success, auguring
for it new and increasing good fortune.
“He is convinced that in this lower world too many people are born, and hence
very many of them are condemned either to a premature death, or, what is worse,
to a wretched life, oppressed by hunger and suffering. He comes forward there
fore to propose what we ourselves have modestly urged in our ‘Elements of
Hygiene ’ since 1864, when we said * Love, but do not have offspring.’ A disciple
of Malthus and of Stuart Mill, he is well versed in modern philosophy and in
political economy, and studies the abstruse problem in all its aspects, setting out
from the most elementary domestic hygiene to raise himself gradually to the
lofty regions of human dignity and civil progress. A foe to all hypocrisy and
prejudice, the author of the ‘ Elements of Social Science ’ calls things by their
real names, and shrinks only from the excessive sufferings and privations to
which the poor children of Adam are condemned. He is firmly convinced that
to measure human fecundity in accordance with the economical production of
families and of nations is the most certain means of destroying pauperism and
all the forms of want; and in this perhaps he is in error, for the evils of modern
society have many sources, and with the drying up of one (perhaps even the most
fruitful), another and another would present themselves, which only the eombined
and constant labours of future generations will perhaps be able to overcome.
However this may be, the courage with which the author faces one of the most
formidable problems of human society is most praiseworthy.
“ Human morality is gradually changing its centre of gravity to rest upon a more
■olid and durable basis. In this new morality the doctrines of Malthus and those
of the author of the ‘ Elements of Social Science ’ must also have a large share.
�In the place of alma-giving which humiliates, in the place of charity which
caresses an evil that it does not know how to cure, there will be substituted^
preventive philanthropy, which by studying want and suffering in their most
hidden and deep-seated springs, will be able radically to remove them. Juris*
prudence, medicine, and morality follow the same movement, are aiming at tho
same end—to prevent rather than to cure.”
**
motto of the work: * The diseases of society can, no more than corporeal
maladies, be prevented or cured, without being spoken about in plain language99
(John Stuart Mill), and its dedication to the poor and suffering, are sufficient to
show the tendency of the author. He uses, indeed, a directness of expression, an
outspokenness, which is seldom met with in our times, and will probably in most
circles of so-called refined society be styled very shocking if not cynical, though in
reality it is not so. The author only calls by their names things which we medical
men also have to discuss openly among ourselves and with patients, but which
are treated by polite society according to the Parisian proverb, ‘cela se fait, maia
cela ne se dit pas.’ The author, as appears from the title and from his profes
sional knowledge, is a medical practitioner. He merits, therefore, the attention of
his colleagues, the more so because, in the first place, they would scarcely guess
from the title that this is a book for medical men-—and secondly, because his
medical colleagues alone possess the education which permits them to estimate
without prejudice the aims and efforts of the author, to try the truth of the facts
which he lays down as premises, and, after due consideration, either to accept or
reject, or to limit and amend, his conclusions and proposals. . . . The author’s
remarks on the social questions in general are among the best and most deeplyfelt we have ever read.”—Schmidt's Jahrbiicher der gesammten Medinin. Band 152,
This is one of those books of which little is spoken, but which nevertheless
are wont to produce a quiet lasting effect, while finding their readers at length in
this way that under the influence of peculiar circumstances one person confiden
tially tells another that in such and such a work there is something to be found,
• • •
au^*hor is, as a natural inquirer, what one must perhaps still call a
materialist and a Darwinian; as a political economist—and he is by no means an
insignificant political economist—he belongs to the left wing of the free trade
school, to which, in spite of some differences of opinion, he lends on the whole a
great impulse, anticipating with confidence its ultimate and complete ■victory
throughout the whole cultured world.”— Vierteljahrsschrift fur Volkswirthschaft
wid Culturgeschichte, edited by J. Fancher. XII. Jahrg.
*
must
accustom himself to the openness with which the author treat!
his themes; but the work is unquestionably most instructive and interesting, and
to written with great knowledge of the subject.”—Hessische Morgenzeitung, Dec.
24th, 18 71.
No one, who has turned his thoughts to the solution of the most burning of
tai questions of the day, the social question, and who wishes to devote to it his
mental and practical energies, will be able to leave unread this book, whose
anonymous author, basing himself on the Malthusian essay ‘ On the Principle of
Population,’ deduces from it with keen logic a peculiar and most striking theory
On the cure of the three primary social evils—poverty, prostitution, and celibacy
; • •, Whatever may be said against this fearless laying bare of the most
Intimate relations of social life and agaiust his whole theory, purely and
undisguisedly materalistic as it is—even the opponent of the daring socialist will
be unable to deny him the merit of scientific closeness of reasoning, and what is
quite as important, of warm and zealous philanthropy; he will rather honour the
moral courage and mental energy which the author must have had to work his
way out of the bewildering maze of hitherto unsolved problems and conflicts, to a
conviction so logically consistent, so luminous, and yet so opposed to established
institutions and to the moral sentiments in which men have been brought up.”—•
KOnigtbtrger Hartungsche Zeitung. December 4th, 1871.
‘ The author treats, in an open and unreserved manner, the diseases of the human
frame, as well as those of society, because he is convinced, with Stuart Mill, that'
. they can only in this way be prevented and cured. In truth we have learned]
�from many years* experience that such Is the ease. We bring therefore to the
notice of our readers, and recommend them to procure, this excellent book."
Sonntags-Blatt, Organ fiir die Freidenker Deutschland*, edited by Dr. Auer. SDech't
January 26th, 1873.
8 P
“Many of the author’s views are diametrically opposed to oar own, but we
cannot refrain from describing the book as in very truth an epoch-making one
whose perusal must interest in the highest degree, both thx professional man and
the educated general reader. Nothing is gained by a prudish avoidance of the
subjects treated in the work; they nvxst be discussed, and mankind might con
gratulate themselves if this were always done in so candid and disinterested a
manner as by the author of ‘The Elements of Social Science.’”—Jfanoversch*
Anzeigen und Morgenuiiung. November 14th, 1871.
“A very remarkable book. ... A regard to the nature of the subject*
treated of forbids us to enter further into its contents—an exposition of the inner
conditions of social life which, for obvious reasons, lie outside the sphere of the
daily press. Suffice it to say that we have here to do with a work which differs
widely from the common-place productions of the book market, and which will
very probably go through no fewer editions in philosophic Germany than in
England.”—Reform, Hamburg, 28th October ,1875.
“ There must come an end to the ignorance of the laws of physiology. Every
ene ought to know; and it must be left to his own requirements and his own
judgment what use he will make of his knowledge. We must cease to regard as
God’s will, as destiny, as the inevitable, what is not so. We must cease to look
upon that as a duty, which can be defended on no single ground of humanity or
social interest Herein lies the great merit of Owen, when he already, in 1830,
published in America his ‘ Moral Physiology; ’ of the anonymous author and the
translator of the ‘ Elements of Social Science,’ and I may add of the publishers,
Truelove, in London, and Nijgh & Van Ditmar, in Rotterdam.”—From an article
by Mr. Van Houten (member of the Dutch Parliament) in the Dutch Monthly
Review, Vragtn des IKjds, October, 1876.
“ This large book is written by a man of science and of feeling ; it is pervaded
with the life, strength, and earnestness of a deep conviction. Politico-economical
ind medical theories are set forth so popularly that a child could understand
them. The author lays down as the foundation of his work the doctrines of
Malthus and Ricardo. . . . The injunction to abstain from marriage roused
(gainst them all humane and liberal people, while the momentous truth at the
root of their teachings lay buried as it were, and was long trodden under foot
and covered with bitter ridicule; but scientific truth never dies, it rises again
unexpectedly arrayed in all its armour, and often at the very time when
whole councils of physicians are predicting its inevitable decease. The author
of the ‘ Elements of Social Science ’ examines Malthus’s work, rigorously verifies
its propositions, and comes to the conclusion that Malthus was unquestionably in
the right; he does not, however, rest satisfied with Malthus’s remedy, but pro
poses his own universal means of relief. . . . We have here, doubtless, merely
glanced at the views expressed by the author; this is a large work, requiring
attentive perusal, and we confidently recommend it to the enlightened Russian
public, since only through them can the ideas therein contained find their way to
the world of labourers; the book is a great intellectual acquisition ; it is admirable
not only for its strictly scientific, logical, comprehensive and liberal views, but for
its deep humanity and warmth of heart. The author stands on practical ground,
he advocates things possible and capable of introduction in every country at a
given moment; his ideas, without doubt, do not exclude a social revolution, but
in their clearness and definiteness they lie nearer to actual life.”—OOinee jlUO
(Russian Monthly Journal), September, 1877.
3
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Dublin Core
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Title
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Victorian Blogging
Description
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A collection of digitised nineteenth-century pamphlets from Conway Hall Library & Archives. This includes the Conway Tracts, Moncure Conway's personal pamphlet library; the Morris Tracts, donated to the library by Miss Morris in 1904; the National Secular Society's pamphlet library and others. The Conway Tracts were bound with additional ephemera, such as lecture programmes and handwritten notes.<br /><br />Please note that these digitised pamphlets have been edited to maximise the accuracy of the OCR, ensuring they are text searchable. If you would like to view un-edited, full-colour versions of any of our pamphlets, please email librarian@conwayhall.org.uk.<br /><br /><span><img src="http://www.heritagefund.org.uk/sites/default/files/media/attachments/TNLHLF_Colour_Logo_English_RGB_0_0.jpg" width="238" height="91" alt="TNLHLF_Colour_Logo_English_RGB_0_0.jpg" /></span>
Creator
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Conway Hall Library & Archives
Date
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2018
Publisher
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Conway Hall Ethical Society
Text
A resource consisting primarily of words for reading. Examples include books, letters, dissertations, poems, newspapers, articles, archives of mailing lists. Note that facsimiles or images of texts are still of the genre Text.
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Pamphlet
Dublin Core
The Dublin Core metadata element set is common to all Omeka records, including items, files, and collections. For more information see, http://dublincore.org/documents/dces/.
Title
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State measures for the abolition of poverty, war, and pestilence
Creator
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Drysdale, George
Description
An account of the resource
Place of publication: London
Collation: 68, [4] p. ; 18 cm.
Notes: By 'A doctor of medicine'. Author's name handwritten in pencil on title page. Publisher's advertisement for Drysdale's Elements of social science, and reviews, on unnumbered pages at the end. Three articles, the last two reprinted from the National Reformer. Part of the NSS pamphlet collection.
Contents: State remedies for poverty -- Can war be suppressed? -- The extinction of infectious diseases.
Publisher
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E. Truelove
Date
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1886
Identifier
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N195
Subject
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Social problems
Rights
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<a href="http://creativecommons.org/publicdomain/mark/1.0/"><img src="http://i.creativecommons.org/p/mark/1.0/88x31.png" alt="Public Domain Mark" /></a><span> </span><br /><span>This work (State measures for the abolition of poverty, war, and pestilence), identified by </span><a href="https://conwayhallcollections.omeka.net/items/show/www.conwayhall.org.uk"><span>Humanist Library and Archives</span></a><span>, is free of known copyright restrictions.</span>
Format
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application/pdf
Type
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Text
Language
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English
Communicable Diseases
NSS
Poverty
War