seen in Georgia, so far as I know. This superabundance theory may be considered hypothetical by some, but why so, when this peculiar morbid condition did not appear in Georgia to any remarkable extent until 1868, although intermittent bilious and remittent forms of malarial fevers had prevailed from time immemorial in the very locality where this hemorrhagic form made its appearance.

It is never met in localities free from malarial poison. As a rule, anemic subjects, whose blood corpuscles have been disintegrated by malarial poison, were the victims. This hemorrhagic phase is generally in proportion to the intensity of the malarial attack and the condition of patient at the time of attack. The causes of its disappearance, to my mind, are first, that we have less malaria; secondly, the antidote quinine is more generally employed, or perhaps each has influenced the absence of this tendency.

If overdoses of malaria are the sole and promoting causes of this virulent type, should we again have more than our usual share of this invisible miasmatic element, why not reasonably expect recurrences of the same morbid conditions? The causes of malaria are said to be specific vegetable micro-organisms. Klebs claims to have discovered the germ from marshes and lowlands and has named it bacillus malaria. Laveran's hematozoa is said to be always in the blood of those suffering from malaria, and the different species cause the distinct types of malarial fevers.

These investigators deserve great praise for their discoveries and should be commended by all unselfish investigators, as well as suffering humanity everywhere. But whether or not much has been added to our therapeutic knowledge in this particular malady, so far as the treatment is concerned, is yet a question, as we still rely mainly on the same old and reliable specific, quinine, and its alkaloids, as the sure antidote. I trust this digression is pardonable, as I only desire to emphasize the tendency to morbid changes in certain diseases, especially the two mentioned in this paper.

CAUSE AND PREVENTION OF CONSUMPTION

IS IT A CURABLE DISEASE?

BY J. S. TODD, M.D., ATLANTA, GA.,

Professor Therapeutics Atlanta Medical College; Ex-President of the Association, Etc.

Consumption is a contagious and infectious disease, preventable and curable.

It is generally defined as an infectious disease only.

The two words contagion and infection are often used synonymously, and the confusion which has arisen therefrom is not settled. Therefore it best serves my purpose to say it is both, at the risk of being scientifically inexact.

That it is contagious and infectious is proven by the fact that it can be inoculated; that the air of an apartment or locality can be so highly impregnated with the specific cause that its inhalation will give rise to the disease; that in a dried state-as on clothing-it can be transported and not lose its virulence, as is so often exemplified by the frequency of washerwomen contracting the disease from those infected.

That the disease is caused by a specific organism, the tubercle bacillus of Koch, a germ sui generis, is now almost universally admitted.

His demonstrations have stood all the tests and fulfill every assertion; the specific organism is always present in every case.

In the language of Dr. Ainsworth, of Brooklyn, N. Y., in volume LXX., number 3, Medical News, "It has satisfied every condition of proof that can be demanded, in that it

conforms to the requirements of the formulated proposition to demonstrate that a given disease is caused by a specific organism.

1st. It is present in all cases of the disease, and in such distribution as will explain the lesions.

2d. It can be isolated in pure culture.

3d. The disease is reproduced by inoculation with the Isolated organism.

More convincing proof could not be procured nor reasonably demanded.

The disease is not hereditary; that is, a child is seldom born with it, so rarely that the exception proves the rule; one in 22,000,000 chances.

The children of parents, both consumptive, need not necessarily have the affection; indeed such progeny, if isolated or passing their lives in a locality where there were no cases of the disease, would never contract or develop it. They are more predisposed to the malady than the children of the healthy, if exposed; they inherit a soil that furnishes ready and rich pabulum and favorable conditions for its growth and development, but the germs, the cause, is the product of contaminated environment, not a development of inherited tubercle. But isolation or absolutely pure air, is not necessary to at least greatly reduce the prevalence of phthisis, now that we know the cause.

Another fact brought out by knowing the cause, is that none of us are immune. It can be contracted, and it is a sad fact, often the case by those with no hereditary predisposition, for individuals with no history of tuberculosis for generations succumb to the malady, and whole communities which but a short while ago were celebrated as health resorts for consumptives are now peopled by a rapidly disappearing population, victims of this contagious disease.

As illustrations of the latter assertions, Monaco, in

France, and the greater prevalence of the affection in Colorado, Florida, Southern California, or wherever consump tives congregate, are unanswerable proofs of its contagious and infectious character. It was practically unknown among the negroes when they were slaves; now it is so common with them that it has failed to excite comment. It is generally stated by the best informed writers on this disease, that one-seventh of all the deaths are attributable, directly or indirectly, to the ravages of this minute germ. No country or people are totally exempt; all living animals, even the cold-blooded, are inoculable with it.

We dread cholera, plague, smallpox, diphtheria, yellow fever, but none of these are more contagious than consumption; all put together do not cause half the mortality; each of the first named are only occasionally with us as epidemic, and are under strict police surveillance, guided by health authorities to prevent their spread; the latter has become almost a household disease in many localities; no community is exempt, and still we raise no warning voice. The people think the disease is hereditary entirely; therefore not preventable. But I am thankful that the great city of New York has awakened to the importance of the subject and after a campaign of information, lasting several years, has at last declared consumption a communicable disease, and made it incumbent on physicians to report all cases to the health authorities. Their circular of information is so replete with information that I incorporate it entire in this article. It is published in English, German, Italian and Hebrew, and scattered broadcast-verily "bread upon the waters." I ask your careful attention to its reading:

Information for Consumptives and Those Living with Them. Health Department, Criminal Court Building, Centre, White, Elm and Franklin Streets, New York.

Consumption is a disease which can be taken from

A cold may

others, and is not simply caused by colds. make it easier to take the disease. It is usually caused by germs, which enter the body with the air breathed. The matter which consumptives cough or spit up contains these germs in great numbers-frequently millions are discharged in a single day. This matter, spit upon the floor, wall, or elsewhere, is apt to dry, become pulverized and float in the air as dust. The dust contains the germs, and thus they enter the body with the air breathed. The breath of a consumptive does not contain the germs and will not produce the disease. A well person catches the disease from a consumptive only by in some way taking in the matter coughed up by the consumptive.

Consumption can often be cured if its nature is recognized early and proper means are taken for its treatment. In a majority of cases it is not a fatal disease.

It is not dangerous for other persons to live with a consumptive if the matter coughed up by the consumptive is at once destroyed. This matter should not be spit upon the floor, carpet, stove, wall, or street, or anywhere except into a cup kept for that purpose. The cup should contain water, so that the matter will not dry, and should be emptied into the closet at least twice a day, and carefully washed with hot water. Great care should be taken by a consumptive that his hands, face and clothing do not become soiled with the matter coughed up. If they do become soiled, they should at once be washed with hot water and soap. When consumptives are away from home the matter coughed up may be received on cloths, which should be at once burned on returning home. If handkerchiefs are used (worthless cloths which can be burned are far better), they should be boiled in water by themselves before being washed.

It is better for a consumptive to sleep alone, and his bed