HOW THE WORLD RECEIVES A NEW IDEA. (Aew York American.' The Quest of The Germ: With Observations Thereanent By Eugene H. Wood, A. M., M. D. It's me against the world and I am everlastingly right.- The Author PUBLISHED BY THE AUTHOR, MILWAUKEE, WIS. 1906. COPYRIGHTED 1906 BY EUGENE H. WOOD The right of foreign publication reserved PRINTED BY TOWELL BROS., MILWAUKEE, WIS. DEDICATION THIS VOLUME IS DEDICATED TO THE MEMBERS OF THE ACADEMY OF SCIENCES, PARIS, FRANCE, AND THEY ARE NOTIFIED HEREBY THAT THE EQUITIES OF THE AUTHOR'S CLAIM TO THE BREANT CHOLERA PRIZE ARE PARAMOUNT. PREFACE. This is no slouch of a book. It is worth its price to any man or woman for the information it contains, which can be found in no other book. There is a good deal of reading scat- tered along through it that will be interesting to everybody, especially to those whom it may concern. The style is plain, simple, concise and direct-no beating about the bush here. There is one page in the book which is worth twenty times its price to any physician, and the whole is of greater value to the practitioner than larger and more pretentious volumes; in fact, as stated in the following pages somewhere, no member of the profession-eminent or humble-is fully equipped to practice the healing art who is not conversant with the principles of medicine and scientific knowledge herein set forth. AH physi- cians who read the book will admit the truth of that statement, because its contents supply a defect in their education. The book has then great merit as an educational work, and as such wonders will be wrought by it. It is an impossibility to demonstrate that the theories propounded by me are erroneous, whereas all other theories of the diseases discussed herein have been proved to be without basis in observed facts. It is a great work then-modestly as it makes the claim-that at one effect- ual sweep wipes out all that has ever been written on the subject of these diseases. That tickles me hugely; that is something I enjoy immensely. Here is my little feeble bantling Gangas- PREFACE. II thenia that I have been tending and dandling and taken out for an airing occasionally during the past twenty odd years that will suddenly bloom out into full growth and be able bodied enough to knock the stuffin' out of all the other ideas ever ad- vanced. Oh! yes, my bantling can say to all the authors and writers who have produced such a flood of stuff: Carry your wares to the junk shop! Your ideas have been superseded and rendered obsolete by me! All hail to Gangasthenia! Bow down your heads ye Eminences and ye Hyas Tyhees and ye others of that ilk and acknowledge the supremacy of an idea. Most assuredly this is an educational work which will t^ach the people of this country some most valuable truths about the nature and treatment of cholera and yellow fever; it will educate congress on these subjects and the law makers will be willing to pass a law enacting that those diseases are not due to germs or, which is the same thing, they will pass an act abolishing quarantine against them. Then I can point with pride to the fact that the science of medicine is actually making some pro- gress, not by the discovery of new germs, but by the recognition of the fact that those and other diseases are not due to germs. Gangasthenia will be victorious and I will triumph then. Foi its educational effect and for the great good it will accomplish this modest little book may be justly termed a great scientific work. The reader will observe that the idea conveyed by the title is strictly followed on two distinct lines which cross and recross each other at various points. The bacterists, it is shown, are still at the quest of the germ in the bodies of human beings, while I am pursuing the same object in the minds of the bacterists. The results of our quests are different. I will have succeeded in driving the germ from their minds while they will never succeed in finding the object of their quest because it does not exist else- where than in their minds. There may be one or two solecisms in the book but judicious III PREFACE. persons will overlook them because of my evident modesty, sincerity and honesty. It may be objected that my style is not dignified. Dignity of this day is due to moral sclerosis of the spinal cord or to hypocrisy. I am affected with neither the dis- ease nor the vice-accordingly my style is not dignified-so I ac- cept the imputation. But never mind the manner of the presen- tation but give due consideration to the matter presented. Style is nothing and science is everything. Here is science, "There is no science unless under certain given conditions we can say precisely what will happen: we can predict only when we have seen the causal relations." The reader will note in the follow- ing pages that the author makes some predictions. He is en- abled to do this because he understands the causal relations of disease. Eugene H. Wood, M. D. National Home, Wis. June, 1905. SECOND PREFACE. It was my intention to publish this book last year, but the indifference and poor judgment of publishers and lack of funds prevented that consummation. The book contains some cotemporaneous allusions which have now become post-tem- poraneous. They may stand because the whirligig of time does not change the point of view. The artist has depicted in the frontispiece the difficulty one meets in endeavoring to introduce a new idea to the world. I have had experience in such endeavors. In 1901 I published a small volume entitled:-"Religion and Authority." In my book I defined Authority to be, "The attributive quality which enables its possessors to command the obeyance of those sub- ject to them and to enforce their mandates." To the philoso- phic mind authority is nothing more, nothing less than the idea conveyed by those few words, and yet the world persists in its acceptation of its erroneous concept of the nature of authority and will so persist for several generations to come. I have had other experience in my efforts to enlighten the human mind. In 1880 I coined the word " Gangliasthenia " and wrote an article on the subject which was published in the "Michigan Medical News" of Detroit. Now, after a lapse of twenty-five years, I consult the dictionaries in vain to find my word. I find indeed every derivative of ganglion but the fools who compile dictionaries have omitted the most important one, to wit, the word coined by me. They have omitted the word which in its profundity and comprehensive significance is in itself a valuable contribution to science. Since the word is my coinage and as its present orthography does not suit me I will elide the syllable "li" from it and I hereby ordain that hereafter the word shall be written "Gangasthenia"-and let all word-mongers take notice. Here is a list of the words derived from the root ganglion: Gangliac, Ganglial, Gangliate, Gangliated, Gangliform, Gan- II SECOND PREFACE glioforni, Ganglionary, Ganglionic, Gangliar, Ganglionated, Ganglioblast, Ganglioneura, Ganglioneural, Ganglionitis, Gan- gliopathy, Gangliopathic, Ganglions, Ganglionless, Ganglioid, Ganglionized. By cancellation we can reduce these twenty words to five and by this method relieve the overburdened vocabulary of fifteen useless words. Some of these words con- vey no rational idea, and some are repetitions. To these five add gangasthenia-the most important member of the group- and these six will be sufficient for all purposes. The medical dictionaries have recognized gangasthenia. In Gould's Medical Lexicon (1899) it is defined, "Ganglionic asthenia; neurasthenia due to defect of ganglionic function." In the American Medical Dictionary gangasthenia is de- fined to be, "Diminished ganglionic nerve power, neuras- thenia." The funniest thing about this definition is that it is preceded by the letter L in parenthesis to indicate that the word is derived from the Latin: whereas it is composed of two Greek words, as everybody knows who has any pretensions to scholarship. These two definitions are defective by reason of their in- sufficiency and indefiniteness and this defect needs to be remedied in the next editions of those dictionaries. Let it not be stated that gangasthenia is neurasthenia, for that does not define it. It should be stated that it is the basis of the gan- glionic diseases: that it may be local or general, chronic or acute and a list of the ganglionic diseases may be added. Also state that there are two forms of the condition veno-motor and arterio-motor according to the set of motors that are affected by the environment. Therefore I demand a place for Gangasthenia in the dic- tionaries, and I demand that it be given a correct definition, otherwise the lexicographers shall hear from me again. National Home, Wis. January 1906. Eugene H. Wood, M. D. THE QUEST OF THE GERM. GERMS. The quest of the germ continues. It has been going on for many years. Germs are numerous, they are found everywhere. They are divided into two classes: the nocuous or pathogenic or disease producing and the innocuous or non-pathogenic or non-producers of disease. There are several genera and num- erous species, but the classification is not complete. Few persons have any conception of the size of germs. Germs are minute but atoms are much more minute. A Frenchman in- stituted a comparison to convey an adequate idea of the size of an atom. He said that in size an atom was to an orange as an orange is to the earth. A germ is larger than an atom and some idea of its size may be obtained from this comparison; an atom is to a germ as a germ is to a house or to a brewery or to St. Paul's cathedral or to Mont Blanc or some other large object. There are large collections of germs in some of the labora- tories devoted to bacterism, the largest is perhaps in the laboratory of the Centripetal Medical university. Let us inquire about the matter. "Hello! Central! give me the Centripetal Medical universi- ty." "Hello! Yes. I want Dr. Thingumbob, professor of bac- terism. ' ' "Hello! Is that Professor Thingumbob?-Yes, well I am 10 THE QUEST OF THE GERM. an old physician and I never learned much about germs when I attended medical college and I want my son to know all about them. I am thinking of sending him to attend your university. Are you well equipped for imparting a knowledge of germs?'' "Yes, we have every appliance needed for the study of germs and we have more mounted specimens than exist any- where else, so your son, if he comes here, will have opportunities for study and advantages for acquainting himself with the nature of germs which he can not obtain elsewhere." "How many mounted specimens have you?" "We have three million nine hundred and seventy-five thousand eight hundred and seventy-four. We expect soon to reach our fourth million. We have been in pursuit of germs for many years and we are still faithfully working at our favorite quest, for it is by the discoveries we make and only by them that the progress of medical science can be noted." "I suppose the discovery of a new germ-one hitherto un- known-is a source of great rejoicing among such devoted scientists. ' ' "Yes, indeed. The discovery of a new germ immortalizes a man. My own unworthy name has been bestowed by my con- freres on one bacterium and on one bacillus." "Then I am to understand that you have a microbe which you yourself discovered and which you have distinguished by the appellation of bacterium Thingumbobii and another which you have labeled bacillus Thingumbobii? So your name was be- stowed on the germ for the honor of having discovered it and it was honored with your name to distinguish it from other germs. Professor, I congratulate you. You and the germ are equally honored and distinguished." "Sir! What do you mean?" "I mean that I do not believe in the germ theory to the same extent that you do and I have no son. I've " Bang! 11 THE QUEST OF THE GERM. BACTERISTS. It is amusing to observe a lot of bacterists when they get together. Each brings his microscope and mounted speci- mens and they discuss the difficulties of the quest and proudly exhibit to each other the specimens each has captured or ob- tained by purchase from or by exchange with other bacterists. "Here," says one, "is a specimen of the comma bacillus which I obtained from that eminent man of science Prof. Koch himself." And he exhibits a slide on which is mounted a lot of the stems of the ciliated epithelium of the bowels. The cilia of these have been washed off by the serous discharge from the bowels, and when the watery evacuations become profuse the mucous membrane is denuded of what remains of the epithelium which the tin god of the bacterists gathered from the rice water evacuations of choleraic patients and labeling them comma ba- cilli assigned to them the function of causing the disease. And this is what the fools fondly call science. There is no reasoning in this method from cause to effect, but the effect is seized and blindly labeled cause. "Here," says another, "is the germ of yellow fever dis- covered by Dr. Sanarelli of Brazil and sent to me by that hon- ored scientist-specimen prepared and mounted under his own supervision. ' ' "I beg your pardon," said a second bacterist, "but San- arelli did not discover the true germ of yellow fever. My friend Dr. Soandso of Brazos had that honor and I show you a speci- men of his preparation." "But," interposed a third bacterist, "neither Sanarelli, nor Soandso, but that celebrated expert on yellow fever, Weiss- nichts, who has done so much to extend our knowledge of mi- crobes in and around New Orleans. I show a specimen pre- pared by him." Then while they looked and examined they wrangled and 12 THE QUEST OF THE GERM. could come to no definite conclusion as to which was the true germ. At this juncture a wise bacterist spoke up and said: "Now I will show you the true germ of yellow fever-the real thing as discovered by the sole, solitary, and only: by that unique and pre-eminent savant-the one living expert on yellow fever Dr. Eugene H. Wood." And he put his slide on the microscope. They all took a long look at the slide and when they were through they exclaimed as one man: "And that is the real thing! ' ' And the exhibitor said, '1 It is, and we will prove it. ' ' There was nothing on the slide. MORE ABOUT GERMS. A knowledge of the physical nature of germs is being gradually acquired by the untiring and steadfast work of the bacterists-of course they are paid for their labor and are expected to show some returns for the money received. But the vast amount of money paid to professional bacterists for their services and on account of their researches yields less adequate results than that which is derived from the expendi- ture of money in any other field of human effort. In Chicago recently three prominent bacterists have devoted much time and money to experiments as to the longevity of the supposed typhoid bacillus in the sewage of that city. The prime cause of their operations was to prove that this partic- ular bacillus perished in its transit through the waters of the drainage canal long before it reached the Mississippi river: that it had no chance whatever of surviving the trip to St. Louis and of begetting intestinal troubles in the good citizens of that place when they swallowed it in the water from the river which they drank; and it was a foregone conclusion that with the time, and the money at their disposal and with the appliances which they could devise they would be able to establish their THE QUEST OF THE GERM. 13 premiss. They did it and proved beyond the peradventure of a doubt that the supposed typhoid bacillus could live only two days in the water of the Chicago river contaminated by Chicago sew- age. This result is announced triumphantly, -with much rhetori- cal flourish and blare of words trumpeting the fame of the dis- coverer-a professor in the Midway university. The discovery will bring much renown to that institution and will further swell the soul of its worthy president with pride. He will wave the little rush-light he carries with great glee and will fancy that the rays of science thence proceeding will illuminate the dark places of the world-instead they do not even pene- trate to the benighted corners of Chicago. CHICAGO DAMPHOOL REPORTER. The writer of the article announcing this discovery states that it is one 11 whose results will entail important and lasting benefits to medical science"; that it will be added "to the book of science" (what book is that?) "the most authentic annals of all things mundane": that "no such important bacter- iological experiments have been made" (what? never?) "as those whose results have led to the discovery." If this is amusing it becomes extremely funny when we find the reporter, in the exuberance of his fancy, attributing moral and other qualities to this supposed typhoid bacillus by characterizing it as "treacherous," "sinister," "deadly and dastardly," "malignant and hateful," "dangerous," "squirm- ing, wiggling, bob-tailed," "scoundrelly." Where? oh! where was the editor's blue pencil ? The article referred to appeared in "The Chicago Chron- icle" of Sunday, Feb. 14th, 1903. It is not surprising that the reporter or space-writer was allowed to deliver himself of so much nonsense, for the Chicago Sunday papers are engaged in a most strenuous rivalry as to which shall furnish and inflict upon the patient and long-suffering people of the city of grouches and grafters the largest amount of sludge for a nickel. 14 THE QUEST OF THE GERM. FACTS ABOUT THE TYPHOID BACILLUS. Now as a matter of fact it has been noted as the result of clinical observation and necroscopic examination that cases of typhoid fever occur in which there are no characteristic mani- festations of the disease; that cases of typhoid fever occur which on post mortem examination do not show the typical lesion of the disease. Further, it is emphasized by a prominent bacterist that typhoid bacilli may develop in the intestines of an indi- vidual and pass from the same without causing typhoid fever and that an individual may become the bearer and distributer of the infective agent without being himself infected. The bacterists account for these anomalous proceedings by the enun- ciation of a sophistical principle that infection does not infect unless the vitality of the individual has been reduced to the point of least resistance. And, pray Messieurs Bacterists, does this principle apply to the infection of smallpox, scarlatina, measles, diptheria or any of the truly infectious diseases? It appears then that typhoid fever may occur and no ba- cillus be present in the blood or discharges of the person as a cause of the disease! that the bacilli may be present and pass away without infecting the individual: that the fever may occur and the individual may die and necroscopy reveals no typical lesion of the disease. Hence it is possible, nay it is highly prob- able that typhoid fever is not caused by the so called typhoid bacillus, but by some autogenic virus the nature and action of which has not been ascertained. There are occasional local epidemics of what is termed typhoid fever in this country. And these are usually traced to contaminated water supply. In view of the well known in- ability of the bacterists to diagnosticate between typhus and typhoid fevers, and of the preceding facts it is very probable that the water supply may be contaminated by some poison of a vegetable or animal origin sufficiently virulent in its nature to cause a fever analagous to typhoid and mistakenly recognized THE QUEST OF THE GERM. 15 as that disease. Even though the typhoid bacillus may be found in the water it is illogical for a scientific person to attribute such epidemics to that cause-but not for the bacterists, for, they are nothing if not illogical. If these conclusions are correct-and the author considers that they are unassailable then the hulla-balloo about the typhoid bacillus in Chicago and St. Louis is based on a figment and the people of St. Louis may as well relinquish all concern about the contamination of the water of the Mississippi river by the waters of the Chicago drainage canal. They will doubt- less adopt this view, moved thereto by the scientific opinions herein presented by the author, who though not recognized as such is the only living expert on certain medical questions which require for their solution mental acumen, perspicacity and profundity of thought. If the officials in Chicago had consulted the author, as an expert, on the question which has bothered them so much and has caused so much expense to them he would have settled the matter some time ago. The citizens of St. Louis will not worry about the dangers liable to spring from the imbibition of Missis- sippi water when they read the opinions herein set forth. They have the author's permission to publish the. opinion for the benefit of the numerous visitors to the Exposition. The author also gratuitously gives notice that if any visitor apprehends that Mississippi water is dangerous to health he will find an anti- dote to all germs which it may contain in a remedy well known to all and sundry the citizens of St. Louis, to wit, St. Louis whisky. COMMISSIONER OF HEALTH REYNOLDS. The Health Commissioner of Chicago is a most efficient officer, and he has his own troubles with the germs in his juris- diction. The pneumococcus and the typhoid bacillus worry him most. In the summer of 1902 there was an epidemic of fever on the west side in the district known as the Ghetto. 16 THE QUEST OF THE GERM. Disease always lurks where people are ill-fed, ill-clad and ill- housed. This was the case with the majority in that district. But there was the deadly germ in the water. So the Health Officer inserted in all the newspapers a monitory notice ad- dressed to all the people in Chicago: ' ' Boil the water! ' ' Then he hoisted the black flag over all the pumping stations along the lake front. He kept them flying all summer. Death lurked in the water, and he was doing his duty in warning the people. He experiences much satisfaction with himself when he does his duty and combats the deadly germ. One day he sent three inspectors to the west side. One carried a two-quart sprinkler containing kerosene; one carried a notebook; the third had nothing to carry. They were instructed to examine the fruit for sale on the stands and in the stores; germs settle on de- caying fruit and if they found any such they were directed to sprinkle the kerosene over it and render it unfit for consump- tion. The inspectors found some cases of spoiled fruit and some bunches of decaying bananas. These they condemned and the kerosene was duly applied to them. The man with the note- book recorded their action and next day a full account of their proceedings was published in all the newspapers with com- mendatory remarks on the efficiency of the Health Officer, and his corps of inspectors whose energy and activity and bright intelligence are unsurpassible. It is through this well trained body of officers that he carries on his warfare against germs, while he sits in his office and dictates a weekly essay to his typewriter on the prevalence of germs and the methods used to exterminate them which is published in the daily papers regu- larly on Monday morning. In these dissertations he descants on the state of the weather. Does a fall of soft, wet snow take place he congratulates the people on the fact that the large flakes as they descend carry with them to the earth all the germs in the air and he announces that the atmosphere has been cleared of them. A cold wave strikes the city and he comes THE QUEST OF THE GERM. 17 out with an extra bulletin advising all citizens to: 11 Ware the deadly pneumococcus?" No such thing. He advises them to avoid draughts and exposure to cold. Yet he knows as all bac- terists know that the pneumococcus is the cause of pneumonia and that it is an infectious disease. Why then does he not warn the people to avoid this ' ' treacherous, " 11 sinister, " 11 dead- ly and dastardly," "malignant and hateful," "scoundrelly," "squirming, wiggling, bob-tailed" germ-the pneumococcus? Does he not know that this is a wise and wary bird, and that when the large wet soft flakes of snow begin to fall it gets under cover and ensconces itself in dry and safe nooks and corners, whence it watches the passers by upon the streets and when it discovers an individual whose vitality has been reduced to the point of least resistance a colony of these germs beset him and are drawn by inhalation into his lungs-and presto! that condi- tion of things is set up which is recognized as pneumonia? The pneumococcus understands his business and he can circumvent all the health officers in creation and is liveliest and gets in his deadliest work in midwinter when the weather is coldest, when the wind is bleakest and bitterest. No exotic creature this, like the yellow fever germ which the first frost untimely nips. The pneumococcus is the hardiest and most vigorous of germs and fairly riots in the coldest climates. It revels in Alaska and in far off St. Petersburg. It delights to ravage large cities like New York and Boston and Chicago. Well may Commissioner Reynolds apply that metaphorical title: "The New Captain of the Men of Death" to pneumonia. It is appropriate. Mean- while the pneumococcus enjoys its proud pre-eminence as be- ing more destructive to human life than its cousin germane the bacillus tuberculosis, and laughs with scorn at the futile efforts made by health officers with their bulletins and warnings to stay its devastating ravages among the children of men by which not only infants and aged but those in the prime of life are carried to the grave. 18 THE QUEST OF THE GERM. VIEWS OF PHYSICIANS. Meanwhile what are the health officers doing to check the de- struction of human life by this devilish germ ? Oh! they issue bulletins about the mortality from pneumonia and make com- parisons between the number of deaths from this disease last week and last month and the corresponding periods last year and the year before, and the previous year and the preceding year and so on; and they add greatly to statistical information thereby but not an iota to medical knowledge. There is a great sameness about these bulletins and a great lack of originality, but they have a certain value-chiefly to the health officer, for thereby he earns his salary. And they actually have the gall-these health officers, pre- sumably intelligent men to declare that "pneumonia is an in- fectious diseaseI " So blinded are these bacterists by the absurd dogmas evolved by themselves in regard to germs that it is im- possible for them to take or entertain rational views of any disease. The fundamental principle has been adopted that all diseases are caused by germs, and they are striving to prove this absurd notion to be correct by inconsistencies and sophisti- cations the like of which can be found nowhere else in any pro- ductions of the human mind except in the speeches of Wm. J. Bryan. A fool doctor up in Madison, Wis., has recently advanced the idea, "made the astounding declaration" that appendicitis is of microbic origin and that it is contagious. About the same time another fool doctor, before the Academy of Medicine in Paris stated "that it was the abuse of meat diet which was the cause of appendicitis." Per contra, a surgeon in Seattle re- ports that he operated in two cases of appendicitis and found in each appendix removed a single bird shot, supposedly swal- lowed by the patients when eating game. Here are two theories based on the products of irrational imaginations and the ground- work of a third which has for its basis the logical deductions THE QUEST OF THE GEEM. 19 to be drawn from a correct observation of physical facts. The bacterists will accept the first theory-will swallow it whole and never wink an eye. Those may follow them who will. Now we will suppose a patient to be sick with pneumonia, lying on a bed in his room at his home. According to the germ theory his every exhalation carries forth from his lungs, where they breed with great rapidity, several millions, more or less, of full fledged pneumococci, into the atmosphere of that room, where they float around until the air is super-saturated with them. Now admit into that room, one by one, a dozen or five hundred persons-non-immune to pneumonia and how many of the dozen or of the five hundred who had been admitted to that room and had breathed that germ-laden air would be infected with pneumonia? Not one. Now' take the case of a man with smallpox under like con- ditions and admit a dozen or five hundred non-immune persons to his room under like circumstances and how many of the dozen or five hundred would be infected with smallpox? Every one. Common sense, reason, human experience and science all unite in declaring that if such experiments could or might be made the results would be as stated and no man may gainsay the conclusion to be drawn from the suppositious experiments:- that pneumonia is not a contagious disease and those who would classify it as such are fools. The germ theory is responsible for the excessive mortality of pneumonia. It is very gravely stated in the medical text- books of the day that "the pneumococcus is the cause of pneu- monia. ' ' In fact that is the opening sentence of the chapter on "Pneumonia" in a certain textbook which has come under the author's notice. The principles of etiology are utterly subverted by such pronouncements as this. The teachers in the schools are men who have been indoctrinated with the dogmas of the bacterists and of course they teach the same idea to their pupils. The result is that the physicians of this generation absolutely 20 THE QUEST OF THE GERM. do not know how to treat pneumonia and the consequence is that most pneumonic patients die. FALSE TEACHING. One of the chief features of the modern teaching is that there is a natural crisis to the disease. If the physician attend- ing a pneumonic patient is asked what prospect he has of re- covery he replies: "It is impossible to tell at this stage of the disease. The crisis occurs from the seventh to the ninth day and when that occurs then-" What then? "Why if the pa- tient takes a turn for the better he will recover and if not-" When an attending physician begins to talk about waiting for the crisis in any case of pneumonia the friends of the patient may as well make up their minds that the crisis will be death. There is no natural crisis to the disease and the physician who under- stands how to treat pneumonia will create an artificial crisis by his treatment, so that on the fifth day his patient will be on the road to recovery instead of pursuing his journey on the path which leads to the dark and narrow valley of the shadow of death, whence there is no return. In the author's hands pneumonia has been more amenable to treatment than any other disease, for in the more than forty years of his practice he never lost a patient by death from that cause, and he has treated many cases; some of double pneu- monia and one case which was complicated with parturition. In that case the mother made a prompt and rapid recovery and the child suffered no set-back. In another case the patient had had two previous attacks of pneumonia, and the author predicted that when his patient recovered from this his third attack he would remark that his recovery was quicker and found him in better condition than when he got over his two previous attacks. The patient did make remarks to that effect which were very gratifying to his attending physician. A fourth attack of pneu- monia carried of this patient at a place which was unfortunately THE QUEST OF THE GERM. 21 too distant from the author's residence to permit his being sum- moned. PNEUMONIA-A CASE. A chapter from the author's experience will illustrate some points, and he will narrate it in the first person. Sam Bisbee, a farmer living a mile and a half from town was taken sick in March a few years ago and, as he knew that I had about given up practice, he sent for Dr. Forsyth, a young man, a recent graduate who had just opened an office in the village. The doctor came and examined the sick man. "What's the matter with me?" asked Sam. "You have pneumonia-in fact double pneumonia, for por- tions of both lungs are affected," replied the doctor. ' ' What is the cause of pneumonia ? ' ' was Sam's next query. "The recognized cause of pneumonia is a microbe the name of which is the pneumococcus," answered the doctor. "That'll do," exclaimed Sam. "No damned doctor that believes that a damned pneumococcus is the cause of pneumonia can doctor me. Here Mary," he said to his wife, "pay the doc- tor for his visit and let him go." Mary did as she was bid and the doctor returned to town. Sam next sent for Dr. Sampson, a young man of a year or two's practice. When he came he examined the sick man and the foregoing colloquy was repeated with the result that when he also stated that the pneumococcus was the cause of pneu- monia Sam directed that he should be paid for his visit and he too departed. Sam told me about these things afterward Then Sam said to his wife: "Send and fetch the old doctor"- meaning me. I came and when I had examined the sick man I told him that he had double pneumonia. "What is the cause of pneumonia, anyway, doc?" Sam asked. In the familiarity engendered of a country practice among country people they have become accustomed to elide half 22 THE QUEST OF THE GERM. of the physician's title and usually address him with an en- dearing frankness as ''doc" I am used to the abbreviated title and so I answered: "Yesterday you were out in your clearing, as you told me. You chopped with your coat off and worked up a fine perspira- tion. You saw Frank Jones passing along and hailed him. He stopped and you went out to the road to talk with him about business. You stood there in the March wind without your coat on until you were chilled. You simply caught a severe cold and it has settled on your lungs." "Right you are," exclaimed Sam, "and no damned pneu- mococcus has nothing to do with it?" " 'Not if the court knows, herself and she think she do,' " said I. "That's all right. Take hold and begin your treatment," said Sam. Which I did with despatch for Sam's case brooked no delay. "Furthermore," I said to Sam, "my boy, it was a lucky thing for you that you sent for me. I will bring you through with flying colors. ' ' And I was as good as my word. I tackled him like a house afire. Sam's house-the earthly tabernacle in which he dwelt-was literally on fire, inflamed (flamma, a flame) and it was necessary to put it out. I did not turn on the garden hose, but sent in an alarm and brought the fire engines into play. I did not adopt the "expectant" plan and wait for a crisis, but I created a crisis by the specific method of treatment which I have employed in all my cases from the first one to the last. The crisis came, as wrought by the method on the fifth day-the in-flamma-tion was subdued, smothered, put out and Sam was on the road to recovery and he reached that sta- tion on the road in due time. I have seen it stated in the papers that P. B. M. Widener, a multi-millionaire of Philadelphia paid to his physician, as an THE QUEST OF THE GERM. 23 honorarium for bringing him safely through an attack of double pneumonia the sum of $800,000. Sam's case netted me just $15.00. Circumstances alter cases. THE POINTS. The points which the author desires to emphasize are: that the pneumococcus is not the cause of pneumonia: that it is not an infectious disease: that there is no natural crisis in the disease: that the excessive mortality of pneumonia is due to the fact that physicians generally are ignorant on these points and do not know how to treat the disease properly. The expectant plan of treatment was introduced many years ago, and is still in vogue. In pneumonia the doctors expect a crisis and until it comes they twiddle their thumbs and look wise and talk learnedly and do something which accomplishes nothing. Meanwhile the air cells of the lungs are filling up and its tissue is becoming solidified-hepatized-and irreparable damage has been done. The doctors continue to tiddliewink with the disease and treat the heart or the liver or the bowels or the stomach and keep the patient's vitality up by forcing him to partake of strong food and leave the lung alone. But the lung is the only organ con- cerned in the trouble and the disease must be combated at its very onset, for it is in the first, second and third days that the chief harm to the lung is done; what follows are the results of the inflammation allowed to proceed unchecked during the first few days of its progress. author's views. Shall the author outline his method of procedure? It is the duty of members of the medical profession to publish for the benefit of mankind and for the advantage of the medical fratern- ity such notable discoveries in medical science as they may make. It is made obligatory on them by the terms of the Escu- lapian oath and by the rules of the code of ethics to which all 24 THE QUEST OF THE GERM. physicians are supposed to have subscribed aud by which all are supposed to be bound. The honor and the fame which spring from such discoveries are regarded as a sufficient reward to those who light upon them and make them known. Honor and fame are very unsubstantial things and do not supply physical needs. So it has come to pass in these days of commercialism and individualism that the physician who makes a discovery of any importance keeps it to himself and seeks to absorb all the profit which might thence arise. Which means that individ- ualism is the note of the medical profession of today. Regard- less of loving cups and banquets that is the prevalent note among physicians of this day and generation, and it pervades them in a more concrete and inveterate form than it does any other class of the social organization. The author is financially a poor man, he has endured many of the toils and received but few of the rewards of professional life. Now he is stranded at the National Home in Milwaukee, a par- taker of the hospitable provision made for him and other old soldiers by the bounty of our generous Uncle Sam. He takes much interest in reading the newspapers and the items which particularly attract his attention are the obituary records. He reads these to note especially the cause of death and the age of the deceased and he finds many notices in which pneumonia is given as the cause. He reads of many cases in which young persons just entering manhood or womanhood are smitten and die. He reads of prominent men in the prime of life who are seized by pneumonia and carried off from fields of eminent use- fulness. He reads of strong men in the vigor of manhood who succumb to the disease and of healthy women who yield up their lives to this fell destroyer. He reads about the very aged who are stricken. With impaired vitality there is small hope for the old. But for all between the ages of three and seventy he sees no reason why the great majority should not recover. He reads about the ravages of pneumonia in the large cities and THE QUEST OF THE GERM. 25 laments his inability to do anything to stay the tide of death. Sometimes he laments almost as personal loss some death; as once he read of a beautiful young woman in Chicago, who a little while before her wedding day was attacked by pneumonia and died in a few days and for burial was enwrapped in the gown which she would have worn at her wedding. Then he re- greted that he might not have been summoned to attend her and might not have had the great happiness of conducting her along the road that leads to the station of recovery. But all regrets are vain. He might yet do something for the benefit of human- ity. He believes that if his method of treating pneumonia were generally understood by physicians and commonly employed by them in the treatment of their pneumonic patients the mortality from this cause in this country would be reduced one-half-per- haps more. This consideration alone ought to induce him to publish his method and he has had in mind for some years the preparation of a volume to be entitled: "Pneumonia, A Mono- graph." The book is all planned. There would be a historical sketch of the different methods practiced in the treatment of the disease from the beginning of the last century down to the proposed serumtherapy of recent date-which the author re- gards as a particularly absurd proposition. This would be a most interesting chapter-the old methods being arranged in chronological order. The author's method would follow in de- tail with recorded cases that had been treated according to it. But this is a dream. He does not possess means sufficient to accomplish this purpose, however laudable, and people must continue to die of pneumonia in spite of the fact that he possesses knowledge, which if rendered available to physicians by the proposed publication would be the means of saving many valuable lives from the clutches of the dread destroyer-Pneu- monia. DIFFICULTIES. The difficulties in the way of the publication of such a book 26 THE QUEST OF THE GERM. and of the spread of the views and methods it might contain, by its extensive sale might be surmounted. But the difficulties in the way of the adoption of those views and of those methods by medical men generally the author deems to be insurmountable. It is a difficult matter to eradicate old views from the minds of mankind, and it would be more difficult to induce physicians to relinquish methods of practice with which they were familiar and adopt new plans of treatment. The author knows whereof he speaks for he has had experience in trying to enlighten the minds of medical men and he has found them "dreadful sot" in their ways. Some twenty years ago he made two important dis- coveries in medicine, accounts of which he set forth with partic- ularity in several articles which were printed in a medical journal published in Detroit. The author deemed those two discoveries to be the most important of the age and holds that opinion today. But what was the result? His discoveries fell flat and are now buried in oblivion. No physician recognised the value of these discoveries and today they are unknown to the younger generation of medical men. And yet those two discoveries embody the most valuable addition made to medical knowledge in a quarter of a century. They ought to have placed the author on the tipmost topmost heights of the pinnacle of fame and given him honor, money galore and troops of friends. Instead he finds himself a member of the Soldier's Home and his only resource is the small pension allowed him by Uncle Sam. Shall he die here "to fortune and to fame unknown, unwept, unhonored, and unsung?" Not if he can help himself. He intends to resuscitate his discoveries and present them in new form to the world of science. He intends to strive, old as he is, for that recognition of his discoveries which he knows they merit. He is impelled by every sentiment of his nature to con- tinue the pursuit of that splendid reward which he knows he deserves as the legitimate award to be made to the scientific merits of his discoveries and which prize he is absolutely certain THE QUEST OF THE GERM. 27 he is entitled to receive as the solver of those medical problems for the solution of which the prize was offered. The first step in that direction is this book in which he attempts to controvert some of the ideas of the bacterists. THE BREANT PRIZE. In 1846 the cholera prevailed in Paris, France, and caused the death of many thousand persons. A M. Breant, a man of considerable wealth, lost his entire family in the epidemic. He was appalled by his loss and in order to stimulate research into the nature of cholera with a view to provide means to prevent such terrible calamities in the future, he provided in his will that the sum of eight hundred thousand francs should be held in trust by the Academy of Sciences in Paris and he directed that the sum should constitute a prize to be awarded to the person who would discover the cause or nature of Asiatic cholera or a remedy which would cure it in the immense majority of cases. M. Breant died in 1849, and the sum thus set apart passed into the charge of the Academy of Sciences and has been held by that institution ever since, or say fifty-five years. Many persons have claimed the prize but it has not been awarded to any of the numerous claimants. Prof. Koch did not obtain it for his alleged discovery of the comma bacillus as the alleged cause of cholera and this fact places Koch's alleged discovery on the practical footing where it belongs as of no scientific or other value whatever. Notwithstanding which Koch's fame has been trumpeted in every quarter of the globe. The author filed his claim to the Breant cholera prize in 1878 and he is as con- fident as a human being can be of any mental conclusion arrived at by observation ratiocination and experiment that he has ful- filled the requirements necessary to establish his title to the prize in that he has indicated the true nature of Asiatic cholera and has pointed out a remedy which will cure it in the immense majority of cases. But the correctness of his theory, though 28 THE QUEST OF THE GERM. rationally sound, lacks confirmation and the specific nature of the proposed remedy lacks demonstration on a large scale, say in a country in which cholera might be prevalent among a people or in a city in an epidemic form. Only under such circum- stances would it be possible to prove that the alleged specific was efficacious "in the immense majority of cases." The author has not at any time in his life possessed the necessary funds to enable him to purchase a sufficient quantity of the specific and to pay his expenses in visiting such country and there make the re- quired demonstration which would establish his title to the Breant cholera prize. He has solicited the aid of wealthy persons, and of influential journals. He has written to American ambassadors, ministers and consuls in those countries in which cholera prevailed epidem- ically. He has appealed to government for help to enable him to establish the truth of his theory and to prove a clear title to the prize. But he has obtained no assistance from any source whatever. He has carried on the struggle unaided. He has stood alone and stands thus today, unsupported in his efforts by even a word of recognition from a single physician. He wrote a communication on the subject to Governor Taft in the Philip- pine Islands which was referred to Major E. E. Carter, commis- sioner of health, and that official attempted a joke at the author's expense. Among the different communications referred to Com- missioner Carter was one from a St. Paul physician, accompanied by some printed matter, in which was set forth the theory that cholera was caused by something whieh acted as arsenic acts on the human system and the originator of the theory had con- ceived the idea that in accordance with the doctrine of sim- ilia similibus arsenic was the specific for cholera. The method of its administration was to be by a process termed Arsen- ization, which was described to be the application of minute por- tions of the drug upon the slightly incised surface of the arm after the manner of applying vaccine virus. This process it was THE QUEST OF THE GERM. 29 asserted would render its subjects immune to cholera. The originator of this process offered his services to Governor Taft for the purpose of rendering the American soldiers in the islands immune to cholera and they were declined. But Major Carter conceived that here was too good an opportunity to perpetrate a practical joke, at the author's expense, to let slip. On the principle of similia similibus, which he rendered ' ' like things to like," he sent the St. Paul physician's letter and printed matter to the author, "respectfully referring" the same to him. The point of the joke as Major Carter intended it to be and as the author understood it to be, was that Major Carter "referred" the lucubrations of one crank to a person whom he considered to be another or "like to like." A joke over which there is no doubt the Major and his confreres enjoyed many a hearty guffaw, and his Excellency perhaps even condescended to relax his dig- nity and smile at the refined wit of his subordinates. Since then the Major has referred no other matter to the author, because by the next mail he received from him a letter containing such a severe verbal castigation that he will not soon forget. The author first wrote to Governor Taft in the summer of 1901, and suggested that he should cable for two tons of the specific for cholera. The next season more than sixty thousand persons died of the disease in the islands. The sum of $50,000 was appropriated by the Philippine government to be expended in efforts to extirpate the cholera, and for all the good the money did it might just as well have been cast into the deepest part of Manila bay. One-tenth of that sum would have sufficed to carry out the author's suggestions and this amount expended, as he advised, would have been the means of saving the lives of all or of nearly all who perished from the disease. The chief justice of the supreme court in the islands was one of the vic- tims. When the author read a dispatch announcing this death his righteous indignation was aroused and he wrote to Governor Taft vituperating the miserable stupidity of medical men, who 30 THE QUEST OF THE GERM. when an actual specific for cholera had been pointed out to them neglected to use it and thus allowed their choleraic patients to die. The Governor paid no attention whatever to any of the author's communications and referred them to the commissioner of health with the result noted above; which shows that Major Carter considered anything emanating from the author as the work of a crank. The ideas of a crank to obtain recognition, as the measure of their success, must show results-a crank in this connection meaning a person who has ideas which are different from those of other people. In that sense the author pleads guilty of being a crank. He recognized the erroneousness of many views con- tained in medical works. In fact he found many such books, written by men of eminence, whose names bore as suffixes numer- ous letters showing that various literary and other honors had been bestowed upon them, to be full of errors. He has an anti- pathy to medical error, and likes to combat it. The proper way to meet it and overcome it, is to present in opposition to it a de- monstrable truth. In the course of his studies and observations he became convinced that the germ theory of many diseases was erroneous and he discovered that the underlying condition of those diseases was a change in the ganglionic nerves, and he coined the term, Gangasthenia to denote this condition-and from this as a basis evolved the ganglionic theory of disease. He wrote an article on gangasthenia and voiced his views in no uncertain terms. The article was said by the editor of the journal, in which it appeared, to have been written in vigorous English; to have sustained the position logically; and that its positive utterances vested the general subject with additional in- terest. But it has passed into temporary oblivion. The germ theory holds sway over the minds of nearly all mankind. But it is erroneous to apply it to those diseases which are of gan- glionic origin, and it is demonstrable that there are such diseases. So the combat is resumed where it left off twenty odd years ago. THE QUEST OF THE GERM. 31 The battle is between Gangasthenia and Bacterism. The old knight shies his visor into the arena and calls on his disciples to rally to his standard in the name of Truth versus Error. We will carry our fight into the ranks of the Bacterists and engage them on their own grounds and rout them, horse, foot and dra- goons-if we can. The word is "do or die." SECOND DISCOVERY. The other discovery made by the author is that bromide of ammonium possesses therapeutic virtues which were prev- iously unknown and that it is a specific remedy for the afore- said condition, designated by him as gangasthenia, from which he evolved the ganglionic theory of certain diseases. He pointed out in an article on the subject that bromide of ammonium possessed medical properties which made it applicable in a much wider range in the treatment of disease than that in which it had hitherto been used: he showed in fact that it was a prompt, reliable efficacious medicinal agent: that when admin- istered for the only condition to which it was applicable the results were always certain, surprising and gratifying to the practitioner. These conclusions were drawn from frequent ob- servations of its effects when used by the author both tenta- tively and from practical knowledge of its action during a num- ber of years, prior to the time when he gave the results of his experience to the public. And he gave those experiences freely, willingly, gladly, under his obligation to duty as a physician, rejoicing that he could contribute his mite to the vast hoard of human knowledge, gratified that he could do something that would help to relieve human suffering and save human lives from perishing by disease. The discovery in regard to bromide of ammonium by the author was that its use was indicated by the following symp- toms: Frontal headache, suffusion and blurring of the eyes (asthenopia), soreness of the upper eyelids, lachrymation, ptosis or convulsive closure of the eyes due to paresis of levatores pal- 32 THE QUEST OF THE GERM. pebrarum, a sense of swollenness or bulging in the eyes (ex- opthalmos), a wavering dilatation of the pupil, injected and icteroid conjunctiva?, excessive sweating, sleeplessness, disagree- able dreams (phantasmagoria), anorexia, nausea, vomiting and retching, stiffness of fingers, numbness, swollenness and sweat- ing of hands, blue or other abnormal color under finger-nails, capillary congestion of hands, pain in nape of neck, running up and into the occiput, pain in shoulders, elbows and knees, pain at sacro-spinal junction, (lame back), a sense of weariness (muscular debility) or pain, or pain with spasm, (cramps) in the calves of the legs, pain between shoulders or under scapulae, any degree of coolness of hands or feet appreciable by the normal sense of calorie, oedema of feet and ankles, congestive intestinal, uterine, renal, gastric and pulmonic hemorrhages, despondency and irascibility, lassitude, languor, listlessness or weariness, hy- perthemy and hypothermy, hopelessness (acute form-apathy), drowsiness in the day time, atonic voice, tinnitus aurium due to congestion of the labyrinth, pulse slow or threadlike, a sense of chillness and a sense of constriction around the chest. At first glance this seems a formidable array of symptoms for one medicine alone and single-handed, as it were to grapple with and overcome. But when these evidences of disease are rightly interpreted they are found to be nothing more nothing less than symptoms of passive congestion and signs of gan- gasthenia. There is no principle of medicine which ought to have greater weight with the honorable physician than that time-hon- ored maxim: Obsta principiis,-resist the beginnings-of disease. And it is at the very onset of a congestive disease, in the pro- dromic stage, during the mild symptoms, before the severe stage is developed that bromide of ammonium is to be administered in order to avert or arrest its course. It is in this stage that its surprising, almost magical efficacy is manifested. This is a medicine with whose use everyone ought to be familiar aud it THE QUEST OF THE GERM. 33 ought to be kept as a household remedy ready for use in all cases when incipient symptoms of disease appear. HOW THE DISCOVERY WAS TREATED. There is published in this country a work entitled: "The United States Medical Dispensatory." It is a thesaurus of in- formation in regard to the natural history, chemical nature, medical properties and uses of all substances that are used as medicines. A copy of this work may be found in every drug store in the land where it is kept for reference. It is more frequently consulted by physicians for information than any other book published on medical science. From time to time new editions of the work are issued as the numerous additions to knowledge and discoveries of new remedies made by scien- tific physicians and published by them in the journals of the day render such editions necessary. From these sources the editors have compiled the Dispensatory for it is largely a com- pilation of the results of the work and observations of the num- erous writers who contribute to the medical and other journals published in this and foreign countries. The volume has in- creased in size with each successive edition until now it has quadrupled the size of the original issue and contains many more times the matter than was contained in the first edition: so that it has become in consequence of its many accretions a bulky almost unweildy volume. Much has been added that is of no practical value whatever: much has been added that might better have been omitted: much has been left out that would have given greater value to the work and which therefore ought to have been admitted. In this last category the author places his discovery of the medical properties and uses of bromide of ammonium. This discovery was published in 1880 and though two or three new editions of the Dispensatory have been issued since then none of them contains a word of reference to his discovery. He therefore arraigns the editors of the Dispensa- tory as recreant to their trust as the purveyors of information 34 THE QUEST OF THE GERM. of value to medical men: as untrue to the confidence reposed in them that they will furn'ish to the profession all important discoveries in medical science: and as false to their obligations to science and he leaves them to the general judgment of his medical brethren. The point which the author desires to make by the recital of the foregoing facts is that two important discoveries made by him and published for the benefit of suffering humanity everywhere have failed to receive that just recognition to which their value and importance entitle them: that in consequence the Breant Cholera Prize which justly belongs to him has been withheld from him for twenty-six years and he sees no prospect of its ever being awarded to him. Therefore he feels perfectly justified on account of the neglect, contempt and scorn heaped on him by those who had it in their power to aid him to a realiza- tion of his hopes and expectations about that prize to refrain from making known his specific method for the treatment of pneumonia. That is one reason. Another is that if he had published it years ago it would now be forgotten and if he were to publish it now it would not supercede the methods at present in vogue, worthless, as those methods have proved to be. It is difficult to rid the minds of men of ideas with which they have become imbued during pupilage. They cling to those ideas through life. The idea of a crisis in pneumonia goes hand-in- hand with the idea of the pneumococcus as its alleged cause. Abolish these ideas, return to the old etiology and the old pathol- oly which were in vogue before the pneumococcus was pitched upon as the alleged cause of pneumonia, and there might be some slight chance that the author's method would be generally adopted for the treatment of the disease. But the teaching of the last thirty years would have to be got rid of first before that method would have that slight chance of being adopted and you can not wipe ideas out of the mind as easily as you can figures off a slate with a wet sponge. THE QUEST OF THE GERM. 35 JOHN D. MIGHT. There is one condition upon which the author would dis- close his method. Let some wealthy man institute a prize to be awarded to the person who would prescribe the method which by actual test gave the best results in the treatment of pneu- monia. For instance there is Tom Lipton who has spent a million or more to recapture the America's cup. Well, it isn't worth the money. Perhaps he got value received in the handle to his name. But he would be a wiser man if he would set apart some of his money as a prize according to the preceding suggestion. Or there is John D. Rockefeller, who has so much money that he does not know what to do with it. He lost a grandchild by scarlatina. That touched his sympathies and forthwith he established a hospital for scarlet fever patients and in connection he built a laboratory for the bacteriological study of the disease. It is a wise investment. John D. Rocke- feller has never been known to invest money unwisely, but it is doubtful if he will institute the prize suggested by the author. He is aware of the dreadful havoc made by pneumonia in New York. He knows that it annually carries off more people in that city by nearly two thousand than does consumption and that while the board of health makes efforts to curb it the officials are unable to check its ravages for the only effort possible to them is the issuance of "a general warning to the public setting forth the necessity for precaution"-and th;s amounts to nothing as a preventive measure. Mr. Rockefeller reads the papers and he is apprised of the fact that some of his friends and many of his neighbors are victims of pneumonia. He reads about the excessive mortality of the disease and knows of the inability of physicians to cope with it. There are no statistics of the recoveries from pneumonia. The per cent of recoveries from a disease which causes so many deaths would be an interesting and instructive feature of health reports if it could be introduced. Mr. Rockefeller takes no interest either 36 THE QUEST OF THE GERM. in the deaths or the recoveries. But if his own family might be invaded and one of its members-his favorite grandchild or his favorite son-might be stricken by pneumonia, and the ministrations of the most eminent physicians of New York failed to save that member from death that would, indeed be a different matter. Ah! then his sympathies might be touched. And to show that he felt for the many who lost friends by death from pneumonia he would perhaps found a hospital for pneumonic patients and install therein the most eminent experts in the treatment of pneumonia that he could find in New York. He is a man who plans and executes thoroughly and he would not be satisfied to build a cheap hospital, but he would expend on the one which he would erect as a monument to the memory of a member of his family that might die of pneumonia several millions and would make it, regardless of expense, the largest, the most comfortable and convenient, and the best equipped hospital in the city of New York. If this book chances to fall under his eye let no gloomy forebodings cast a shadow on his mind for neither he nor any of his family is likely to be a victim of pneumonia, because they are seldom, if ever, exposed to the severities of the weather. Yet the disease is liable to attack any person at any season of the year. Sixty-five persons in New York contracted pneumonia, and died of the disease, while attending Gen. Grant's funeral which took place in the month of April. These speculative forecasts are not made for the purpose of alarming Mr. Rockefeller. The aim of the author is to forearm him and offer him an opportunity to fore- arm his fellow-men against the attacks of the dread destroyer of human life-pneumonia. BUT DON'T TELL HIM. If Mr. Rockefeller will offer a prize of $100,000 to be awarded to the person who will devise that method of treating pneumonia which shall prove by actual test in the treatment of pneumonic patients, to produce the best 37 THE QUEST OF THE GERM. results by yielding the greatest number of recoveries from the disease the author will compete for the prize and in such case he has no doubt that he would win it. Thus Mr. Rockefeller w'ould become one of the greatest benefactors known to the world for through his instrumentality the author's method would be established as the best method. Mr. Rockefeller would be the means by which a knowledge of that method would be diffused throughout this country and be extended to those countries wherever pneumonia prevails. He would thus be saved the expense of erecting the suppositions hospital for every physician who might be called to treat a pneumonic patient would establish a branch hospital in every house to which he might be summoned and would be prepared by a knowledge of the method to pursue the hospital practice in the treatment of his patient. Thus by Mr. Rockefeller's public-spirited auction the mortality from pneumonia would be reduced at least one- half and perhaps more wherever the method was made known. And future generations will rise up and call him "blessed." If this happens to meet his eye the author begs that he will give the matter his serious consideration and the author promises in all sincerity that he will do his part toward a consummation so fraught with value to the health and lives of his fellows. And with this he drops that portion of his subject that relates to pneumonia. MORE ABOUT GERMS. Germs are everywhere in the atmosphere. They are most numerous near the earth's surface and pervade the air in num- bers which gradually become lessened as higher altitudes are reached, and it is supposed that at the outer limit of the at- mosphere's envelope no germs exist. Take a sheet of glass which is perfectly clean and expose it in a place where there is no motion to the air. In a comparatively short time germs will settle on it. This sheet placed under the microscope is found to be covered with germs of the innocuous variety which all 38 THE QUEST OF THE GERM. persons inhale with the air they breathe and which are carried off with every exhalation. This kind produces no harmful re- sults to the lungs or to the system. These germs pass in and out of the lungs with every breath and cause no damage to the health. It is different with the nocuous or pathogenic germs. A very few of these may be inhaled and if the person who in- hales them is non-immune to the disease which these pathogenic germs cause that person will become infected by those germs and that particular disease will be developed in his system, having been introduced through the medium of the air. The few germs which have found their way by the air passages into the system of any person multiply with great rapidity and in a short time the person becomes a center of infection to others by discharging into the air at every exhalation immense numbers of the same kind of germs which infected him. That these germs pass out into the air from the lungs of patients who are affected with contagious diseases was proved in a London hospital where there were a number of children affected with measles. The surgeon in attendance coated the inside of some glass tubes with glycerin and had the children breathe through them. In the glycerin thus breathed over, when placed under a microscope, the surgeon found ovoid bodies, bright and shin- ing, which were recognized as the contagium vivum of the dis- ease and the experiment showed that during the continuance of the disease the germs were being constantly exhaled and that it was by the medium of the air alone that the germs were distributed and the contagium brought into contact with the bodies of the non-immune. The same is true of the germs of smallpox, scarlatina, diphtheria and perhaps of some other dis- eases. The germs of these diseases might be captured and isolated by similar experiments. Germs of most diseases become diluted in the air when wafted by the wind, become so disseminated and separated, that they are no longer singly competent to impart disease. Yet THE QUEST OF THE GERM, 39 some supposed germs are alleged to be borne by the wind for thousands of miles through the upper air and to descend upon some land far distant from their origin, and are believed there to have caused the disease of which they were the pathological progeny. Thus some years ago a woman died in Indian Terri- tory of what was diagnosticated as Asiatic cholera. But how, was queried, could the germs of cholera reach that country and produce a single case of the disease? Did this question non- plus the physicians who attended the patient? By no means. That was easy. There had been a hail-storm on the day prior to that on which the woman was taken ill. She had picked up several hail-stones, placed them in her mouth, allowed them to melt and had swallowed the resulting fluid. The germs of cholera were in those hail-stones. Borne on the wings of the wind they had been wafted from India and when passing over the Indian Territory they had been caught in a hail-storm and had been frozen into those particular hail-stones which the woman had put into hei' mouth and hence the disease. This explanation may be termed far-fetched, but it is the only way the bacterists could account for that sporadic case of cholera: and if it were cholera it was the most truly sporadic case of the disease that ever occurred anywhere. The rapidity with which germs multiply discloses the marvel- ous operation of nature in the methods provided to prevent con- tamination of the atmosphere. It can be illustrated by a simple experiment. Place a pot containing the liquor in which a shank of beef has been boiled uncovered in the open air. When the contents have become cool the vessel is seen to contain a semi-solid jellylike mass. This consists of water and gelatin. A germ settles here and there upon the surface and soon there appear spots like mould. These are colonies of germs which are the progeny of the original settler. These continue to feed on the gelatin and to increase in numbers by arithmetical pro- gression until the gelatin is liquified and the pot contains a mass 40 THE QUEST OF THE GERM. of germs which give off the odor of putrescent matter. If a drop of this liquid be placed under the microscope it is seen to be filled with germs that can not be counted, and all the innumer- able mass in the pot have proceeded from the few original set- tlers, being reproduced by a process of germination, or perhaps more correctly speaking by proliferation, in an incredibly short time. Thus it has been learned that the function performed by some innocuous germs in the economy of nature is to do the work of scavengers by promoting and hastening the process of putrefaction. Leibig's old law was that "molecules (the old name for atoms) in motion impart their motion to other mole- cules" and this was supposed to explain the processes of fer- mentation and putrefaction. It has been ascertained by the re- sults of microscopic observation that both these processes-the one productive and the other destructive are due to the actions of germs provided by nature-each to operate in its own sphere of activity. So Leibig's law has become obsolete-its erroneous- ness having been proved in the progress of science by new dis- coveries. It is a rational conclusion of science that the nocuous germs multiply with an almost equal rapidity when a few of them find lodgement in the plasma of the human body. The physical nature of germs has been studied most in- defatigably by the bacterists so that now they know many things about them that are correct and many more things about them that are incorrect. The germ which is supposed to be the cause of yellow fever is set down as a very delicate creature and the popular notion is that the first frost kills of all those which dila- torily remain in a locality, when the grand migration of their fellows, warned by the lateness of the season, is made to more congenial climes. On the other hand some germs withstand the rigors of the coldest climate and so vigorous are they that they may be frozen in ice and when the ice melts in the spring they come out and disport themselves in their usual agile and lively manner with all their customary airs and graces. The bacter- THE QUEST OF THE GERM. 41 ists are naturally astounded when they discover that some germs act in this fashion. But even in these particulars the rule does not hold good. The U. S. vessel Brooklyn had yellow fever on board one season while lying in tropical waters. She was put out of commission and anchored all winter in Boston harbor. In the spring she was placed in service, manned and ordered south. No sooner had she entered the tropical region than two men were taken sick with what was diagnosticated as yellow fever. Whence the infection? Were the surgeons puzzled for an explanation? Not they. There were a few germs concealed in or about that part of the quarters occupied by those two men which had escaped destruction in the almost arctic winter of Boston harbor and the men had been infected by them. Man is a gullible creature and often cheats and deceives himself about the nature of disease. The gauzy explanation of the surgeons of the source of the infection of the two men on board the Brook- lyn might satisfy themselves and their confreres but will not be acceptable to the devotee of science as she is, the cultivator of rational observations and the adopter of demonstrable truths. It was because the supposed germs of yellow fever were con- sidered to be susceptible of destruction by cold that a few years ago the wiseacres on the National Board of Health applied to congress for an appropriation of a million or so for the purpose of having a "frost-ship" constructed. This "frost-ship" was to be supplied with a powerful apparatus for producing air re- duced to a low temperature, which was to be introduced into all parts of ships arriving at the ports of this country (which were suspected of being infected with yellow fever) and which it was expected would destroy all yellow fever germs. In con- sequence of this fool proposition the National Board of Health was abolished by congress. It has been replaced by the Amer- ican Health Association, a body of volunteer and unofficial wise- acres who are deeply interested in questions which concern the public health and who at their last preceding meeting were re- 42 THE QUEST OF THE GERM. ported to have voted unanimously in favor of the proposition that yellow fever is propagated by means of a harmless mos- quito-that the germ of the disease is introduced into the human system by the sting from the proboscis of that insect. Thus sciolists flourish and science gets another black eye. Germs are introduced into the stomach in drinking water derived from a source that has been polluted and in which they have developed in large numbers. The alleged cause of cholera is supposed to infect its victims through this medium, being first carried to the water and disseminated therein by the winds. The supposed cause of the various conditions which are recog- nized under the general term of "malaria" was believed until within a year or two to have its source in paludal regions, but now the bacterists announce as a tenet of their belief that the cause of "malarious" conditions is conveyed into the blood of its victims by the sting of the mosquito. If this were so "mal- arious" diseases ought to be more prevalent in those districts in which mosquitoes are more abundant than elsewhere as for instance along the Yukon river in Alaska, where the pests drive the bears fairly crazy during the month of August, or along the Amazon river in South America where mosquitoes attack the na- tives in droves. But observation discloses the fact that "mal- aria" is very unusual in Alaska and that few natives suffer from it in the valley of the Amazon. Prior to the period, when the bacterists laid the blame of "malaria" on the mosquito they had discovered a germ which they designated bacillus malariae but for some reason they were compelled to abandon this germ as its cause and on looking around for a nonsensical idea took up with the notion that the mosquito was the cause of so called "malarious" infection. It has never occurred to the intellectual myopes who spend their time in boring into the ends of mi- croscopes with their eyes that the poison of so called "malaria" may be of autogenic origin or self-produced in the bodies of those who may be affected with some one of the various forms 43 THE QUEST OF THE GERM. of disease included under that popular and unscientific term. The human body is a factory of poisons which are constantly being produced and it is full of microbes which fulfill essential functions in the human economy. There may be some change in the environment of the individual which may work changes in the function of certain microbes in the system and those may increase disproportionately in numbers or become changed rela- tively in character so as to become a menace to health and thus be constituted the germ which causes "malaria." The author has circumnavigated the globe and has been exposed to cholera germs in Calcutta, to yellow fever germs in South America and to "malaria" in various regions of the earth but has never been the victim of any serious illness during a long life nor in the course of his wanderings over the earth's surface. But twice he has had an attack of intermittent fever. Once when a boy of twelve he fell into a mill-race in the month of December- the water being coated with a thin covering of ice and the second time when as an act of politeness he pulled off his shoes and socks and waded across a small stream of water in Peru. There was a picnic and the crowd divided into two parties on the return. When the first party reached the small stream about ten feet wide and eight inches deep and after crossing it they removed to the thither side the temporary foot bridge on which they had crossed--the limb of a willow tree about six inches in diameter. When the second party, including the author, reached the stream, it became incumbent on him to do as narrated and replace the foot bridge, which he did and stood in midstream and handed the senoritas across. The water, derived from the melting of the snow on the nearby Cordilleras mountains was of an icy coldness and next day the author had a chill and fever. He utterly repudiates any idea of "malaria" in his case and attri- butes his attack to the only thing to which a rational person could attribute it-his exposure to the frigid temperature of the water. At all events he believes that but for his involuntary 44 THE QUEST OF THE GERM. tumble into the water when a boy and his voluntary pediluvium in the waters of the Peruvian stream he never would have been affected with so called "malaria" in his life. And he believes further that a person may pass his life in the midst of the Dismal Swamp or in any district regarded as "malarious" and if he observes the rules of health as regards food and clothing and ex- posure to sudden changes of temperature he will never be af- fected by the so called "malaria" in any form. MILK AS A PREVENTIVE OF DISEASE. The opinion that germs or the poison which causes changes by or in consequence of which they are developed finds con- firmation in a discovery made by Professor Behring of Berlin. He has discovered that "milk contains an enzyme which has an inhibitory action on pathogenic bacteria." The author be- lieves this discovery to be true only as it relates to the bacter- ium of diphtheria and it corresponds with an opinion advanced by him some years ago that the use of milk as a diet prevented diphtheria in those who used it. He observed that in the families of farmers who saved the milk of their cows from which to make butter and who fed the sour milk and the butter milk to their pigs, the children were often attacked by diphtheria. On the contrary, the children who were given milk, pure, whole, wholesome milk as a part of their regular daily food he noticed were exempt from attacks of that disease. Cases of the disease occur de novo without infection from any source whatever and it is a rational conclusion that the specific poison which causes it must be of autogenic origin. One of the many poisonous sub- stances developed within the human body, by the perversion of the hepatic function, supposedly, is the double salt known as the oxalate of lime and potassa which is held in solution in the serum of the blood, and which is eliminated by the kidneys. Octohedral crystals of this salt are produced as a residuum, from the urine when the watery portions of that excretion have been allowed to evaporate. The presence of this substance in THE QUEST OF THE GERM. 45 the system is in large measure responsible for the condition recognized as "biliousness" and as that condition is commonly treated by a purgative medicine and thereby the poisonous sub- stance is carried off through the bowels. But it is conceivable that this product of abnormal function might be developed in excess and might be eliminated through the lungs. Ordinarily oxaluria is detected by the fact that the patient complains of a very offensive taste and this is one manifestation of the presence of the oxalate in the system. Suppose it to be eliminated by the lungs. At every exhalation the breath passing through and over the pharynx is laden with the molecules of the oxalate, which acting as an acid and irritating poison begets an inflam- mation which becomes diphtheritic in character. In the products of this inflammation-the false membrane-the bacterists have found a bacterium, which they allege to be the cause of the disease. At least this bacterium, thus engendered, is a carrier of disease to those susceptible of being infected thereby as has been proven by numerous instances of such infection and it is therefore the cause of the disease in others. But it has not been established that the source of the disease in the original case was other than autogenic. The treatment most in vogue is by injections of antitoxin-a fluid obtained from the blood of horses who have been treated on the lines by which the antitoxin for hydrophobia has been produced. It is in fact the serum of the blood of horses. While this fluid does not act as a specific for diphtheria it produces better results and saves a larger per cent of the lives of diphtheritic patients than any other method of treatment. At the same time the author ventures to anticipate and expresses a hope that some method other than serum therapy will yet be devised, some new remedy discovered which will yield better results than that method: something which will act as a specific for the disease. Meanwhile, as prevention is better than cure, he suggests that all parents be advised to provide for their children, good, whole, wholesome milk as a part of their daily 46 THE QUEST OF THE GERM. food, for according to Prof. Behring milk contains an enzyme (an enzyme is a ferment-a chemic and hydrolitic ferment-not an organized ferment such as yeast) a substance whose action is inimical to the bacterium which causes diphtheria. But whether it is this substance, which is a component part of the milk and whether it acts as asserted by Prof. Behring or whether it is the lactic acid of the milk which acts to prevent the development of the oxalates which in excess poison the system who shall de- cide. On either hypothesis it is most advisable for parents to provide for their children as part of their daily food good pure milk, for, according to the observations of the author those chil- dren are exempted from attacks of diphtheria who are thus pro- vided. The fact that milk is a wholesome food for children is well known but when it becomes generally understood that it has been established, as the result of scientific experiment and observation that the use of milk as food for children prevents diphtheria, it will be used more abundantly and it may be that diphtheria will become, by reason of this preventive use of milk less frequent and fatal than it is at present, and perhaps event- ually its occurrence will be very rare. It has been stated as a fact of current history that diphtheria is unknown in Ireland, where milk constitutes a large part of the diet of children. The nervous system of the body is divided into two parts or grand systems which act independently of each other but which by means of branch nerves communicate at many points so that each is capable of being acted upon by the other. These two divisions are known as the cerebro-spinal system con- sisting of the brain and spinal marrow and the nerves thence proceeding: and the ganglionic system or nerves of organic life. They are also known as the voluntary and involuntary nervous systems because the one is under the control of what is termed the will, and over the other the will exercises no control whatever. This latter supplies the nerve force or motive power to all the in- THE NERVOUS SYSTEM. THE QUEST OF THE GERM. 47 ternal organs of the body, and for the purposes of this book it may be considered as an entirety or each ganglia may be con- sidered by itself. These ganglia lie imbedded in the fatty tissues posterior to the organs which they supply with the nerve force generated by them by means of branches distributed to all parts of the organ supplied. For instance the largest ganglia of the body are in the solar plexus which is located posterior to the stomach and the function of which is to supply force to that organ. Other ganglia lie posterior to the kidneys, the bowels, the liver, the lungs, the heart and so on and furnish motive power to those organs. The action of these organs is constant, whether the individual is waking or sleeping, and proceeds without intermission from the dawn of life until the moment of death, or until the ganglia, affected by disease, un- dergo degenerative change and are no longer capable of supply- ing nerve force. In such ease the organ itself undergoes de- generative changes and being no longer able to perform its function becomes, for that reason itself the cause of death. For instance the cause of the degeneration of the kidney in what is called Brights disease was for a long time unknown. At length it was determined by numerous necroscopic examinations that the primary lesion in that disease was destructive changes in the renal ganglia by which they were in a sense obliterated, and because it is impossible to restore those ganglia to their pristine condition, the changes in the kidney consequent upon this cessation of their nerve force and the changes in the blood resultant therefrom which combined changes are recognized un- der the general term of Bright's disease make it absolutely certain that the disease will always eventuate in death. But for this striking discovery the bacterists would today be searching for the (bacillus which they might list as the cause of Morbus Brightii and it has been forever placed beyond their power to allege that it belongs to the class of germ diseases. The first condi- tion of the renal nerves at the incipiency of the disease is that 48 THE QUEST OF THE GERM. of gangasthenia. The ganglia are called upon to supply more nerve force than they can furnish. Ordinarily while the urine is of normal quality its excretion goes on without any extra de- mand upon the ganglia, but once let the urine become loaded with that product of malnutrition-the urates-and it becomes an exceedingly difficult task for the ganglia to supply the neces- sary nerve force for its elimination. It is easy work to keep up the needed force when the urine is clear and as limpid as water, but when it is scant and high colored and heavily charged with urates the ganglia are overworked in the call for force to enable the kidneys to eliminate the acid urine. This state of affairs may continue for weeks and the individual unaware of the deadly changes being wrought within his body may through neglect and indifference or more likely through ignorance take no steps to have his physical troubles relieved. At length the overworked ganglia "throw up the sponge" cease to supply nerve force to the kidneys and literally perish through degenera- tion-the first sign of which they manifested in gangasthenia: prompt notice of which they gave out in the symptoms of that condition and which read aright enables the practitioner to avert the fatal results sure to follow the first warning. It is in such cases as this that the judicious physician finds opportunity to act in accordance with that time-honored maxim: obsta prin- cipiis, and successfully. The ganglia are small flat bodies, which are placed as stated posterior to the organs which they supply and are of dif- ferent sizes and shapes. The largest single ganglion in the body is in the solar plexus posterior to the stomach and it is named from its shape the semi-lunar ganglion. There is still a plexus of these nerves lying on the anterior aspect of the spinal column which still bears the name of the great sympathe- tic applied to it by anatomists many years ago though there is nothing of sympathy in the nature of the functions which it performs. There is also a set of long nerves in the chest lying THE QUEST OF THE GERM. 49 on each side of the spinal column which were misnamed the splachnic because they were supposed in some way to control the bowels. Their proper function has not been determined and there remain many other unexplained mysteries in the human body notwithstanding the numerous experiments of the physiologists and the many demonstrations of the anatomists. One of the chief functions of the ganglia is the performance of that phenomenon termed the circulation. For convenience sake these ganglia have been designated vaso-motors though no one has ever been able to point out the special ganglia which perform this particular function. There are two classes or divisions of the vaso-motors or vessel-movers, to wit, the arterio-motors or artery-movers, and veno-motors or vein-movers, and these two sets of nerves act independently of each other and each can be acted on separately by disturbing agencies. This fact can be demonstrated by phenomena which are of frequent occurrence and of almost daily observation. The blush brought to the cheek by self-consciousness or the shame of conscious guilt is a temporary congestion in the arterioles produced by a slight dis- turbance of the arterio-motors. The pallor of fear caused by fright or terror denotes a temporary passive congestion of the venules produced by an overwhelming depression of the veno- motors. Suppose now that the blush becomes permanent and that the face is suffused with a dusky red, shall we not say that this condition is due to incipient gangasthenia and thereby show that we are capable of drawing a rational conclusion? Or shall we accept the dictum of the bacterists and admit that their ir- rational conclusion that the condition is due to the agency of a nocuous germ is the only possible deduction of science? Or if the pallor becomes permanent shall we hold that the condition is due to veno-motor gangasthenia: shall we basely relinquish the scientific principles we have evolved and join the standard of those foes of true science the bacterists? Or shall we main- tain the truth against those who are incapable of making correct 50 THE QUEST OF THE GERM. observation and scientific deductions? Let us stick to our colors, gangasthenia forever! Down with the bacterists-the entire gang of them! Let them and their labors be covered with oblivion! Each ganglion or cluster of ganglia may be the subject of asthenia or loss of power. It has been explained that the in- cipient condition, which if permitted to proceed and increase from day to day until Bright's disease supervenes, is asthenia of the renal ganglia. In another disease known as exophthalmic goitre certain cervical ganglia become asthenic. In this disease the thyroid gland becomes enlarged and the eyes protrude-are actually forced forward by the contraction of the concave muscle stretched across the orbit posterior to the globe of the eye. In the concavity of this muscle the eyeballs rest and it has been demonstrated by experiment that irritation of the cervical gan- glia causes the muscle to contract and protrusion of the eye is thereby produced-and this undue prominence of that organ be- comes an objective symptom of the disease and has been adopted as a part of its designation-(exopthalmos. Gr.-literally, eye- out.) But the feeling of protrusion is often present as a sub- jective symptom of disease. It is markedly present in most forms of the so called "malarious" diseases. In yellow fever exopthalmos is felt subjectively by all patients. One who passed through a siege of the disease in 1878 and suffered a relapse and yet recovered describes this feeling by saying that "his tortured eyes semed bound to jump from their sockets." The sense of protrusion is often present but patients seldom speak of it unless particularly questioned about it. That form of it vulgarly known as wall-eyes is a striking feature in topers and causes no pain because the protrusion is brought about very gradually This is simple exopthalmos, uncomplicated with disturbance of any other organ. The enlargement of the thyroid gland is not due to any proliferation of its cells-to any hypertrophy of its proper tissue, but entirely to the increased quantity of blood re- tained in it in consequence of the veno-motor gangasthenia af- THE QUEST OF THE GERM. 51 fecting its veins, the result of which is venous passive congestion of the gland-the blood distending it as water does a sponge. And here the author desires to record one of the numerous errors of medical writers noted by him when searching for infor- mation in their works. Dr. Wm. A. Hammond was an eminent physician, the author of some medical works and of a number of novels which had some vogue in their day. In his treatise on diseases of the nervous system he says when writing of the dis- ease under consideration: "I am inclined to think that, in the present state of our knowledge, we are scarcely warranted in locating exopthalmic goitre in the ganglionic nervous system, and that we are justified in regarding it as an affection of the brain and spinal marrow." This is a most absurd opinion. Dr. Ham- mond was not gifted with a scientific imagination. His imagin- ation was of a low order-the kind that produces poor fiction. This is the author's pronouncement: Exopthalmic goitre is es- sentially a ganglionic disease and its every symptom is a sign of gangasthenia. But the most remarkable circumstance connected with this disease is that the bacterists have not claimed it to be of microbic origin though they have very good grounds for such a claim. It was recorded in a medical journal some years ago that two women who lived at the base of the Alps in Switzerland were affected with exopthalmic goitre. They passed the sum- mer in a valley at a considerable elevation. During their stay in the valley all symptoms of the disease disappeared: their en- larged thyroid glands were reduced to their normal size, their eyes assumed their natural expression, and their general health became much improved. Soon after their return to their homes the exopthalmic goitre began to manifest itself again and the women were soon affected by it to the same degree as previous to their ascent to the Alpine valley. Now it is a fact well es- tablished by the observations of the bacterists that certain germs are incapable of attaining any great altitude. The germs of "malaria" can not ascend to the second story of a house though by unintermittent effort they may climb up a mountain five 52 THE QUEST OF THE GERM. hundred feet high. The germs of yellow fever, a disease of the sea coast, seldom reach an altitude of more than one thousand feet. Now, what more natural than for a bacterist on reading the preceding record of the cases of the two women in Switzer- land to assume that exopthalmic goitre is due to a germ, which while it was active in the low land could not produce its specific effect at an altitude. The assumption would be fully sustained by the facts according to the logic of the bacterists and their reasoning about this suppositious germ would be of a parcel with their methods in regard to other supposed causes of dis- ease. The author would like to start some fool bacterist on the quest of the germ of exopthalmic goitre. There is not the slightest doubt but that he would find something which he could and would allege contrary to common sense, contrary to the principles of science, contrary to every rational consideration to be the germ of that disease. The bacterists have done that very thing before in relation to the germs of other diseases, they are doing it every day and a little thing like the discovery of a germ hitherto unknown of a disease very well known would not feaze them. Well! "Ephraim is joined to his idols." The question is shall we "let him alone?" Not much. CONDITION RESULTING FROM GANGASTHENIA. The condition which results from gangasthenia, or from a diminution of the supply of nerve force to an organ is passive congestion of the organ. The nerves (ganglia) move the ves- sels and the vessels move the blood and if the nerves cease to move the vessels, the vessels cease to move the blood and passive congestion ensues which in degree of severity corresponds ex- actly with the degree of the diminution of ganglionic nerve force. If the gangasthenia is slight the passive congestion that ensues is mild and if the gangasthenia is severe and pervades the entirety of one or other set of nerves which control the cir- culation of the blood the passive congestion ensuing will be of corresponding severity and will manifest itself by symptoms of THE QUEST OF THE GERM. 53 the most aggravated and violent character. The form of con- gestion present will correspond in kind with the form of gan- gasthenia antecedent to it. Thus if the gangasthenia is of the nerves which control the arterial circulation, the resulting con- gestion will be arterious. If the gangasthenia is of the nerves which control the venous circulation the resultant congestion will be venous. Certain changes occur as consequences of pas- sive congestion. In veno-motor congestion changes occur, in the more severe forms of that condition in the character of the blood and in its relation to the containing vessels. Thus when the nerve force from the veno-motors ceases entirely stasis of the blood occurs in the veins. They become distended to their fullest capacity and then takes place the change in the character of the blood and in its relation to the vessels. The serous part of the blood drains into the stomach and is ejected per orem. And the veins of the other abdominal organs are relieved of a part of their contents by the drainage into the intestinal canal of the serum which then passes away per anum. "But," inter- jects a bacterist at this juncture, "what you describe is chol- era." "What rational objection is there to the description?" "None, only you attribute the disease to what you term acute general veno-motor gangasthenia and according to the doctrines of bacterism it is caused by the comma bacillus." "It is un- fortunate for the comma bacillus that our doctrines clash. It will be a fortunate day for science when that bacillus is put out of business." Yours truly, with kind regards to ProL Koch! ARTERIO-MOTOR. PASSIVE CONGESTION. The effects of arterio-motor passive congestion are chiefly changes of the relation of the blood to the vessels by hemorrhages. These occur mainly through the mucous surfaces of the differ- ent organs. As such effects we get gastric, intestinal, renal, uter- ine and pulmonary hemorrhages. It is not believed that they occur in consequence of rupture of or a solution of the continuity of the containing vessels, but these vessels become distended 54 THE QUEST OF THE GERM. with blood and the blood oozes out, and may accumulate and be discharged in large coagula, as from the intestines and the blad- der, or it may be ground up into small coagula by the action of and be ejected from the stomach as the black vomit of yellow fever and milk sickness or it may drain off in fluid form as from a congested uterus or it may be coughed up in the same form by haemoptysis from a congested lung. The best oppor- tunity to observe this process of oozing of blood is in cases of scurvy in which blood can be seen to ooze from the swollen gums and the best opportunity to observe the distension of the arterioles is in the "ferrety eye" of yellow fever patients, in which the entire sclerotic coat shows up covered completely with the arterioles distended to their fullest extent with bright scarlet blood. It is believed that cerebral hemorrhage occurs as the result of passive congestion and that it takes place by oozing and not from a solution of continuity in the walls of a vessel and that the oozing continues until a coagulum forms for which there is no means of exit and the result therefrom is usually death. Now the best time to treat cerebral hemorrhage is on the principle of obsta principiis before it occurs. It is the re- sult of arterious passive congestion which is due to arterio- motor gangasthenia. When physicians are taught in their pupil- age the nature of this condition and learn to recognize it at a glance: and when it is recognized and treated in a rational man- ner cerebral hemorrhage will seldom occur. It ought, indeed, never to occur when the ganglionic theory of disease is thor- oughly understood. It is a most extraordinary fact that no bac- terist has had the hardihood, the audacity to allege that cerebral hemorrhage is due to a germ; it would be a consistent utterance if some fool of a bacterist would make some such fool-hardy statement. We have seen how the state of the circulation in arterious congestion is shown by the congested conjunctivae constituting the "ferrety eye" of yellow fever. In the venous congestion the conjunctivae are clear and the sclerotic is of a porcelain ap- THE QUEST OF THE GERM. 55 pearance. There are other means of observing the circulation in both veins and arteries when those vessels are congested. By looking at the finger nails one can perceive through their trans- lucent substance the condition of the vessels when congested. If the congestion is in the veins the blood under the finger nails will show blue, and in the case of choleraic patients, about to die, the blood having become thick, viscid and tarry it will ap- pear black. What may be called the "congestive arc" will ap- pear at the distal end of the nail, where attached to the fleshy tissues, when pressure is made on it at its middle with the thumb nail and the appearance of this "arc" will, after some practice, enable the observer to judge of the general state of the circulation. Pressure with the thumb will produce a white spot if made on the back of the hands of a person affected with arterio-motor congestion. The rapidity or slowness with which the blood returns to the exsanguined spot also affords the means of judging of the degree of congestion. When no congestion is present the blood returns like a flash to the spot to which the pressure was applied, showing that the circulation is normal. ZYMOSIS. Zymosis was supposed to be the progenitor of all germs. When germs entered the system zymosis entered also and set up a factory by the operations of which germs were produced. Hence in the classification of diseases certain ones which were supposed to be due to microbes were classed as zymotic. When, however, it was ascertained that germs did not multiply by the process of fermentation but by another altogether different pro- cess the term zymotic was dropped by medical writers and it has become obsolete among the learned and scientific. It is still retained in that old fogy medical office which is under the supervision of the Surgeon General of the Army in Washington: the surgeons of the army are still obliged to make their reports upon blanks furnished to them which contain a long list classed as "Zymotic Diseases." The attention of that officer is hereby 56 THE QUEST OF THE GERM. called to this evidence of old fogyism which pervades one branch of his business and the expectation is that he will issue new blanks in which the various diseases will be classified in accord- ance with modern scientific ideas. Dear Sir:- Please do not fail to classify in your new blank as such all disease which can properly be placed under the heading of "Ganglionic Diseases." A list of these as determined by a scientific gentleman of emi- nence-one of the great medical notabilities of the day may be found in the present volume. It is sent to you "without re- mark" verbum sap. Very respectfully. The Author. COMPLIMENTS TO THE SURGEON GENERAL. In consequence of the preceding paragraph it may be ex- pected that the Surgeon General will get up a new blank form for issue to the surgeons of the army upon which to make their reports instead of the antiquated form now issued by that offi- cer. Every little helps, to be sure, and this new blank upon which the "Ganglionic Diseases" will be given official recogni- tion will aid in disseminating the information that gangasthenia has become an established fact of science. But the author does not care a damn whether the Surgeon General will issue a new blank or not, for it will soon dawn upon the minds of the bac- terists that the germ theory is not the "whole thing" and that there other theories, witness, the ganglionic theory. THE CAUSE OF GANGLIONIC DISEASES. The cause of ganglionic diseases consists of a number of factors of causation all of which are included in the phrase "environment of the individual" and this embraces every cir- cumstance of the life of the individual. Environments differ and therefore manifestations of disease differ. The environment which will cause one disease will produce that disease only. There is no specific cause for a ganglionic disease. Thus sea- sickness is one of these diseases. The environment which causes it will not cause cholera nor yellow fever nor yet scurvy, which mostly used to affect persons on shipboard. The chief symptom THE QUEST OF THE GERM. 57 of sea-sickness is vomiting due to congestion of the stomach, and the sufferer from this affection being pallid we know that the gastric congestion is venous and that it is due to veno-motor gangasthenia. No one has ever claimed that sea-sickness is caused by a germ ■which has its habitat on ships and commits its ravages there by invading the stomachs of passengers, and no one has ever alleged that sea-sick persons are affected with gastritis. In fact here is a simple disease which soon disappears when its subject changes environment, when he steps ashore. The violent vomiting of sea-sickness in aggravated form is present in cholera and the condition of the choleraic patient's stomach is precisely the same as that of the sea-sick patient's stomach- venous congestion due to veno-motor gangasthenia, which is caused in like manner as it is caused in the sea-sick person, by the factors of causation which united constitute the environment. But now comes that "amoosin' little cuss" the bacterist and with great mental acumen is able to perceive in the symptoms of cholera the indubitable evidence of the operations of a germ and he sets about finding it. He has found something which he alleges to be that germ and he is satisfied: he seeks no further. Vomiting is also a prominent symptom of yellow fever and in this instance the pathologist declares that a yellow fever pa- tient vomits because his stomach is the seat of inflammation. Mind you there is no rational cause for gastritis as a compli- cation of yellow fever, and not a single product of the in- flammatory process is ejected from the stomach of a yellow fever patient, nothing but the fluids ingested and blood ground up by the peristaltic action of the organ into small coagula so that it resembles coffee-grounds, and is called black vomit. Further as soon as the fever subsides the patient no longer vomits, the gastritis has disappeared and the stomach readily retains food and drink. Idiopathic gastritis is a very rare dis- ease and it may almost be said with truth that it never occurs. Cases of what are diagnosticated as gastritis very often occur in the practice of the city practitioner because the term has a 58 THE QUEST OF THE GERM. scientific and satisfying sound to a patient and he would rather be treated for that than for something the name of which sounded plebeian. So gastritis is an aristocratic disease and is most often encountered among the wealthy who can afford to pay well and are willing to pay well to their attending physi- cians for applying high-sounding terms to their ailments. It is a fact that gastritis caused by some irritating substance like arsenic is a true inflammation and it does not subside spontane- ously, but it is a very serious and severe disease which seldom ends in recovery. Necroscopy of the subjects of death from ar- senical poisoning shows the stomach to be much disorganized even beyond repair. But in yellow fever the stomach of patients is in not the least degree disorganized by what is universally regarded by medical writers as the symptomatic gastritis of the disease, but on the subsidence of the fever all signs of gastritis disappear and the stomach is fit to receive food and drink and promptly makes the demands of the system for such supplies known by the usual and normal sensations therein. Sunstroke is a disease, which in one form of it, is char- acterized by such an excessive degree of abnormal heat of the body that the only method of reducing the exalted temperature is by the external application of ice. There are two forms of sunstroke recognized. One in which the surface of the body is cool and the countenance is pallid, and in this form resort is usually had to stimulation as the most correct and most effective method of treatment. In the other form the body is hot and the countenance is flushed: the abnormal heat of body is termed a fever and hence this form has been designated thermic or heat fever. Now this excessive heat of body in this form of sunstroke has been improperly termed fever. Fever as defined by Galen is heat in excess of nature (color praeter naturam) and this definition is considered to be the only correct one ac- cording to all ideas extant at the present time. But if one SUNSTROKE. THE QUEST OF THE GERM. 59 understands the mechanism of true fever he will perceive that fever is not the proper term to apply to that condition of ab- normal heat of body present in the form of sunstroke designated as thermic fever. In other words thermic fever is not a fever. The same is true of so called yellow fever and of so called typhus fever. The author makes a distinction based on the dif- ference in the source of the heat in these diseases and the source of the heat in true fever. Califorication of the body is effected by the action of normal ganglia on normal blood circulating normally in a normal capillary area, and increase of the pro- duction of heat by this process in excess of the normal degree (praeter naturam) constitutes true fever. Bear in mind that this heat is produced by the normal action of those normal ganglia termed the vaso-motors. It is characteristic of true fever that the exalted temperature of the condition is distributed alike to all parts of the body and that all portions of the surface feel equally hot to the hand of the practitioner whose own bodily caloric is normal. But there never was a case of thermic fever, there never was a ease of typhus fever and there never was a case of yellow fever in which the hands and feet of the patient did not feel cool to the normal hand of the observer while at the same time the body was burning up with excessive heat. Now the abnormal heat of true fever is derived as the nor- mal heat of health is, from the same source to wit: the normal action of the ganglia. In true fever the blood circulates with in- creased swiftness in both veins and arteries and there is no con- gestion. In consequence of the accelerated motion of the blood there is increase of the bodily heat which is recognized as fever and it is the signal hung out by nature as a warning that there is present in the body an enemy termed disease. But in thermic fever, yellow fever and typhus fever the ganglia have been overwhelmed by factors of causation which have depressed them so that they are no longer capable of performing their function of moving the vessels which move the blood. Now there is in the operations of the human body what is known as 60 THE QUEST OF THE GERM. the law of compensation. When one of two of the various dual organs of the body becomes disabled from any cause and is no longer able to perform its proper function its burden is thrown upon its fellow. So when the ganglia which move the vessels which move the blood have been overwhelmed and are no longer capable of performing the function of vaso-motors the burden of their work is thrown upon the cerebro-spinal system of nerves and in consequence of this shifting of the burden of circulation and calorification upon a set of nerves unaccustomed to the task the work gets poorly done and the heat is unevenly distributed-some parts being cooler than normal while other parts are burning up with abnormal heat. Because the heat in these diseases is from a different source than the heat of true fever! because passive congestion is present in these diseases and not in true fever, and Decause therefore the abnormal heat of these diseases in not a true fever the author makes a distinc- tion to denote these differences and has designated the abnormal heat of these diseases ' ' Hyperthermy. ' ' Etymologically the words have the same meaning but the new term marks a dis- tinction which will enable the observant physician to distinguish between congestive and inflammatory diseases: hyperthermy is symptomatic of one class of disease and true fever (or fever simply) of the other. And this distinction thus evolved and thus marked though enunciated more than twenty years ago by the author has received no recognition from medical writers. It is based on profound philosophical study of the nature of dis- ease and is the outcome of scientific medical principles, but the term coined to indicate the difference between the source of bodily heat in the congestive and inflammatory diseases has not been adopted by the lexicographers and is therefore unknown to medical men. But for the purpose of elucidating the point in hand the term fever will be employed when the congestive dis- eases are referred to, and thermic and yellow and typhus will continue to be regarded as fevers in order not to confuse the minds of readers who are accustomed to so regard them. Thermic THE QUEST OF THE GERM. 61 fever has never been attributed to a germ though a congestive chill is. But here is a disease in which the bodily heat reaches its highest range and it has never been claimed by the bacterists as a germ disease and has never been classed by them as such. According to the germ theory germs are the primary and es- sential cause of fevers but in thermic fever we find a higher degree of bodily heat than occurs in any other disease and it is absolutely certain that no germ is present and that the dis- ease is caused by the environment of the individual and it is absolutely certain that the sunstruck person is not bitten by the Anaconda moscpiito. HEMORRHAGES. Hemorrhages occur as idiopathic affections and thus occur- ring they are never attributed to the action of germs. Thus we may have as single affections haemetemisis which is a con- comitant of yellow fever: intestinal hemorrhage which occurs in typhus and dengue, renal hemorrhage which gives its name to haematuric fever, and uterine hemorrhage which is a symp- tom of typhus and of yellow fever. Of course these hemor- rhages when they occur intercurrently in the course of these diseases according to the doctrines of the bacterists must be the results of germ action, but when they occur independently, idiopathically they are attributed to rational causes. The same may be said with truth in regard to each symptom of these diseases: taken singly, separately and disconnected from the group which constitute each particular disease none are sup- posed to be caused by germs, but taken in combination in the form which is recognized as a special disease by a particular designation all are supposed to be caused by the action of germs. In sea-sickness there is vomiting due to congestion of the stomach. Why in the name of all that is rational can not the vomiting of cholera and of yellow fever be attributed to the same cause? It is literally due solely to that cause. But why in the name of common sense do men supposed to be educated 62 THE QUEST OF THE GERM. allow themselves to be led by the nose by those fool bacterists and accept their anomalous and paradoxical doctrines without even a protest ? The fever of sunstroke is admitted by all to be due to the environment, why then should yellow fever or typhus be at- tributed to anything else? Are the absurdities and assininities of the bacterists to ihile the minds of men continually? Shall their fool doctrines continue to govern the actions of men to their great detriment and to the loss of many lives every year? These are serious questions and worthy of the consider- ation of scientists and statesmen. Why if a disease is neither contagious nor infectious should there be quarantine against it? It has been proved beyond any doubt that yellow fever is neither. Heaven and earth and the sea and all things therein have been searched in vain for the germ of the disease and it has not been found: it can not and never will be found for the best of reasons that no germ of yellow fever exists. Have the bacterists given up the search for it? Was a fool ever known to depart from his folly? These fools have at length been reduced to the pitiable extremity of blaming a poor harm- less innocent mosquito for propagating the disease. And yet it is a matter of historical record that Havana was free from yellow fever for more than a hundred years from 1654 to 1761. Is it supposable that no person was bitten by the special brand of mosquito by which it is alleged the disease is propagated. Not on your life. But historical evidence shows that Havana had not been free from yellow fever since 1761 when the germs of the disease were re-introduced by two vessels which arrived from Vera Cruz. While Cuba was in possession of this country the medical officers of the army made experiments in regard to the in- fectiousness and contagiousness of the disease. Two men who volunteered for the purpose who had never been subjects of yellow fever and were therefore supposed to be non-immune to it, wore the undergarments of and slept in the beds occupied EXPERIMENTS. THE QUEST OF THE GERM. 63 by two of their comrades who had died of yellow fever. Now the disease has always been supposed to be capable of being communicated by fomites-clothing worn by patients who suf- fered from it. Here was a crucial test. The garments worn by persons who had died of the disease were taken from their dead bodies and were donned by men in prime health who were supposed to be non-immune and were worn by them with- out bathing their bodies for several days: at the same time these men occupied the beds previously used by the men who had died, without change of sheets, for several nights. These men passed the ordeal unscathed and thus proved that there was no contagion in infected garments and no infection in con- tagious garments and that the disease is neither infectious nor contagious. Since then Havana has undergone sanitary regen- eration under the supervision of the Americans who occupied the island subsequent to the Spanish war and as a result of that thorough-going work Havana has been reported to be free from yellow fever. When the work was begun there were im- passable mud holes in the streets and green, slimy pools in the back yards; the sew'ers were few in number; two-thirds of the population lived on unpaved streets and half of them lived on streets which were constantly in an extremely unsanitary con- dition rendered so by deposits of much decomposing animal and vegetable matter: the houses are small and densely occupied: the privy sink, open kitchen and stable adjoined each other and were in close proximity to the sleeping apartments. The people were poor and so were ill-fed. In one district the sickly and anemic residents looked as dirty and cheerless as the streets and houses. Fine food they for yellowr fever to feast upon. The conditions of life here described constitute a part of the environment of the individual and add to these conditions solar heat ranging from 75° to 80° for days in succession and there you are. It needs no prophetic vision to predict the re- sult. Yellow fever would be assuredly engendered. As a result of the work carried on under American occupation Havana is 64 THE QUEST OF THE GERM. now a clean city: its streets have been paved; sewers have been built and it is reported to be entirely free from yellow fever. But there is no saying how long it will remain so immune. The disease has made its unwelcome presence known in some of the cleanliest cities, given conditions of environment favorable to its development Havana will some day again be the seat of an epidemic of yellow fever. But the sanitary officials have adopted a modified quarantine against vessels arriving at the port and having yellow fever patients on board. The patients are taken to the fever hospital on stretchers, the other passengers are kept under observation for a few days and finally allowed to go ashore and the ship is disinfected. They will never learn that the precaution of detaining passengers aboard a supposedly in- fected ship and the expense of disinfecting a ship in which there can by no possibility be infection are altogether unneces- sary. The "Philadelphia Medical Record" in a recent article commends the methods of the sanitary officials at Havana and advises Americans to copy those methods. They rather let the editor of that journal if he wishes to be ranked with "the most advanced Americans" advise that the severe restrictions of the quarantine laws in this country be relaxed and quarantine on account of yellow fever be abolished. Does he not know that a shipload of yellow fever patients might be landed at the wharves of Philadelphia and not a single one of the population would be infected by the disease. If he did not know it before this he is hereby apprised of the fact. "One swallow does not make a summer" but one case will prove the verity of a state- ment. Col. Geo. E. Waring was in charge of the work of clean- ing the city of Havana. He became ill and deemed it advisable to return to New York. En route he developed an attack of yellow fever and when he landed at New York he was taken to his own home where he soon after died. Now no person con- tracted yellow fever from the supposed infection emanating from his body. You say: "Every precaution was taken to pre- vent infection: his clothing and the bed clothes he used were THE QUEST OF THE GERM. 65 burned; his room and all his personal effects were disinfected." These precautions were entirely unnecessary, for there is no in- fection or contagion in any of the emanations from a person suffering from yellow fever. Some years ago a physician in New Orleans, who was more intelligent than his fellows took this same ground and in order to prove his sincerity and in affirma- tion of his views offered to swallow the freshly vomited matter ejected from the stomach of a patient in the throes of death from yellow fever. He did so and was entirely unharmed by the nauseous dose. So it may be safely stated that a thousand yellow fever patients might be landed in Boston, New York or Philadelphia and be distributed in various sections of those cities and no person would be infected by this wholesale intro- duction of diseased persons among healthy inhabitants of those cities. So strong, some years ago was the belief in the capability of clothing worn by yellow fever patients to spread the infection of the disease that a southern physician proposed to distribute such clothing at various points in all the large northern cities. The people of the north were horror struck at the diabolical pro- position and its author was regarded as an unhuman miscreant. Knowledge has increased somewhat since that time. Now the man would simply be laughed at, and as to his proposition we would say: Send on your clothing and we will wash it and dis- tribute it to the poor. Yet it is a matter of record that yellow fever prevailed in Boston, New York and Philadelphia during some of the years in the last decade of the eighteenth century 1790-1800. The only way to account rationally for the pre- valence of the disease in those cities during those years is by stating that the environment of the inhabitants of the cities at the time yellow fever prevailed was such as to cause or develop it. This statement would be borne out if we could have historically correct and reliable descriptions of that environ- ment. By the way it may be stated that venesection was mueh the vogue of those days and the doctors used to bleed their yellow fever patients. The practice has been so nearly aband- 66 THE QUEST OF THE GERM. oned that old fashioned spring lancet is a curiosity in these days. FEAR IS A FACTOR. Fear is a prominent factor of causation in the production of ganglionic diseases. By the shock it causes by its suddenness 'and by the terror it excites it may be the sole cause of death. An instance of death from this cause recently occurred in Rome. A young American lady was attacked by a robber and she was so overcome by terror that she could not rally from the shock. Fear is a factor in the production of yellow fever and acts as a direct depressant of those nerves whose involvement is the essential feature of the disease. The wide spread effect of fear was notable at the beginning of the last epidemic of yellow fever that occurred at Memphis. A shoemaker who lived in an out- lying section of the city took some clothing out of his trunk to air it. The clothing had not been disturbed since it had been packed away in the previous summer. He was taken ill in a few days and his disease was soon declared to be yellow fever and it was affirmed by the physicians that he had been infected by the germs of the disease which had remained in his clothing during the whole of the previous winter. Information of the matter passed rapidly from one to another and alarm spread like wild fire among the inhabitants of the city. Those who were able to do so fled in panic from the city. There were not enough coaches to convey all who wished to depart. Those which left the city were crowded and many persons clung to the railings in order to get away from the pestilence. All were driven by fear of the dread disease to escape from the city. More than half of the population abandoned their homes and sought points of safety in the north and remained absent until the first frost came and made the city a safe place to return to by the destruction of the supposed germs of the disease. Fear not only drove many away but those who remained were also its subjects and it is certain that a much less number of those who remained would have been attacked by the disease but for THE QUEST OF THE GERM. 67 the great dread of infection which constantly wrought in their minds and depressed their spirits. It is also certain that the shoemaker would have been the first victim even if he had not opened his trunk and taken out his clothing to air it. He would have started the epidemic in any event. Fear and other factors of causation would do the rest under any circumstance of its origin. Environment of the individual is a phrase in which is in- tended to be included all factors of causation which singly or by united action on the individual may cause or produce dis- ease-and these factors of causation are to be found in the air he breathes, in the food he eats and in the conditions of his social existence and germs are excluded. The air is a variable fluid and is constantly undergoing changes in its constituent elements and in the forces which pervade it. Ammonia is one of those elements, and its amount is the subject of change. At one time the amount may be greatly in excess of that which per- vades the air at other times and there may be periods when there is what may be termed a minimum of the gas present in the atmosphere. It has been observed that in a community where there was a factory which made fertilizers out of fish the people were free from "malaria" and this immunity was at- tributed to the diffusion in the air of an abundance of ammonia from the factory. It has also been noted that vessels in the cattle trade were free from yellow fever and this was attributed to the presence of ammonia derived from the urinary discharges of the cattle. During one epidemic in New Orleans it was ob- served that albuminoid ammonia was present in the air in large quantity w'hile of free ammonia there was but a trace. It is free ammonia which is essential to life, for human existence de- pends on the pre-existence of three substances, carbonic acid, water and ammonia. If any one of these three were withdrawn from the world all vital phenomena whether of animal or vege- table would cease. It is a fair inference that a substance such ENVIRONMENT. 68 THE QUEST OF THE GERM. as ammonia which is essential to life is in proper proportion necessary to the sustentation of health and when but a trace of it can be found in the air while one of its deleterious compounds is found at the same time and place to be in excess it is a ra- tional deduction that the absence of the healthful compound and the presence of the injurious compound may have some- thing to do with the prevalence of an epidemic which is cotem- poraneous with this unusual condition of the atmosphere. Is this condition alone responsible for the prevalence of the epi- demic and can it be accounted for by other atmospheric con- ditions which prevail at the same time? In a story entitled: "Chita: A Memory of Lost Island," written by Lafcadio Hearne, and published in Vol. 76 of Harper's Magazine, the author de- scribes the state of the weather which prevailed during an epi- demic of yellow fever at New Orleans, in midsummer of 1867. The description is in a fictional writing and while it may be termed in a measure poetical, by leaving out the poetic feature, it will be found graphic and may be accepted as exact. CONDITIONS OF ATMOSPHERE. "Heat motionless and ponderous. The steel blue of the sky bleached from the furnace circle of the horizon; - the luke- warm river ran yellow and noiseless as a torrent of fluid wax. Even sounds seemed blunted by the heaviness of the air; - the rumbling of wheels, the reverberation of footsteps fell half- toned upon the ear, like sounds that visit a dozing brain." "Daily, almost at the same hour, the continuous sense of atmospheric oppression became thickened; - a packed herd of low bellying clouds lumbered up from the gulf; crowded blackly against the sun; flickered, thundered, and burst in torrential rain-tepid, perpendicular-and vanished utterly away. Then, more furiously than before the sun flamed down; - roofs and pavements steamed; the streets seemed to smoke; the air grew suffocating with vapor; and the luminous city filled with a faint, sickly odor, - a stale smell, as of dead leaves suddenly disin- 69 THE QUEST OF THE GERM. terred from wet mould, - as of grasses decomposing after a flood. Something saffron speckled the slimy water of the gut- ters ; - sulphur some called it; others feared even to give it a name! Was it only the wind blown pollen of some innocuous plant ? I do not know; but to many it seemed as if the Invisible Destructor was scattering visible seed! . ... Such were the days; and each day the terror stricken city offered up its hecatomb to Death; and the faces of all the dead were as yellow as flame. Lime was poured into the gutters; and huge purifying fires were kindled after sunset." "The nights began with a black heat;-there were hours when the acrid air seemed to ferment for stagnation, and to burn the bronchial tubing; - then, toward morning, it would grow chill with venomous vapors, with morbific dews, - till the sun came up to lift the torpid moisture, and to fill the buildings with oven-heat. And the interminable procession of mourners and hearses and carriages again began to circulate between the centers of life and death; - and long trains and steam-ships rushed from the port, with heavy burden of fugitives." "Wealth might flee: yet even in flight there was peril. Men, who might have been saved by the craft of experienced nurses at home, hurriedly departed in apparent health, un- consciously carrying in their blood the toxic principle of a malady unknown to physicians of the West and North; - and they died upon their way, by the road-side, by the river-banks, in woods, in deserted stations, on the cots of quarantine hos- pitals. ' ' The writer evidently believes in the germ theory of yellow fever; believes that it is caused by a specific poison. He does not seem to be able to appreciate the fact that the very atmos- pheric conditions he describes-the intense solar heat and the excessive moisture were sufficient to engender the disease. To be sure, his is not a scientific article, but he voices the general convictions of the people of the city that the epidemic was of microbic origin and therefore they had no room in their minds 70 THE QUEST OF THE GERM. to entertain an idea that was entirely opposed to those convic- tions. Yet those atmospheric conditions constituted their en- vironment and embraced the chief factors of causation which in every case gave rise to an attack of the disease. If the physi- cians who practiced in New Orleans had understood the true nature of yellow fever and if they had known how to treat it correctly there would not have been a single death from that disease during the epidemic of 1867, nor subsequently in any epidemic. If they had known they would have been forearmed and would have treated all cases on the principle of obsta prin- cipiis, and by so doing they would have aborted or prevented the development of the disease in every case. How? The air was deficient in that life sustaining compound, free ammonia, which is so essential to the sustentation of health. Now if the physicians, when they observed the first signs of failing health in any person had administered to that person some bromide of ammonium-the only substance which will supply to the system what it needs in consequence of the deficiency of free ammonia in the air or of the exhaustion of the same substance in the body, their patients would have been able to withstand all the depress- ing effects of the climate in which they lived; would have been strengthened by the efficacious properties of the remedy to en- dure the trying effects of the noxious weather: and would have passed through the ordeal of excessive heat and moisture un- scathed by disease. Alas! for the ignorance and superstition of men. These have caused thousands of deaths,-of persons whose lives might be saved for years of future usefulness. The work of these twin relics of barbarism are visible every day alongside of the works of science and enlightenment. Meanwhile the heads of our universities and illustrious men of science wave their little rush-lights and think that the rays of knowledge thence proceeding penetrate to the darkest corners in which ignorance and superstition are entrenched. But they don't. Like the torch in the hand of the statue of "Liberty Enlighten- THE QUEST OF THE GERM. 71 ing the World" on Bedloes island their rush-lights illumine but a very small section of the earth. In view of the opinions expressed in the preceding para- graph the author gives expression to the following bold utter- ance:-No physician however eminent he may be or however humble in the ranks he may be is fitted to practice his pro- fession unless he understands the nature of gangasthenia and can readily recognize it by its mildest symptoms and unless he has a thorough knowledge of the therapeutic properties of the bromide of ammonium. And no person is competent to con- trovert this statement. THE CASE OF MR. GROTJAN Will illustrate some of the points heretofore presented. Peter Adolph Grotjan, a native of Hamburg, trained in a counting house, came to this country in 1796. In 1804 he entered into partnership with Capt. Woodbridge Grafton, of Salem, Mass., to trade in the West Indies. He wrote an account of his ad- ventures, the MS. of which remained, at his death, in the hands of his eldest daughter and was published in Vol. 15 of Scribner's Monthly from which the following extracts are taken: - "During my stay at Santiago de Cuba the yellow fever was very fatal to Americans, and other new comers, but having been seasoned in the United States during the years 1897, '98 and '99 and not being in any way alarmed I escaped its baneful in- fluence. A young gentleman of Philadelphia, with whom I had a slight acquaintance, arrived at Santiago as supercargo. As soon as he understood that the fever was prevalent, he got much alarmed and asked me what course I advised him to pursue. I told him, if possible, to divest his mind of all fear, to be mod- erately but constantly occupied with exercises not very laborious, to taste no ardent spirits or heating wines, to drink claret, lemonade and other cooling drinks called tisanes, to eat moder- ately, take warm baths two or three times a week, go to bed early, and take a walk and a dish of coffee at sunrise; and if he 72 THE QUEST OF THE GERM. could not divest himself of fear to visit the highlands in the in- terior for a week or two. I have reason to believe that my ad- vice, as is generally the case was not followed, because it did not suit him; for, in a few days after this interview, I learned that he had taken the malignant fever and was very ill. I vis- ited him instantly, but found his condition without hope. In one short day afterward he died in my arms, after a very severe, delirious struggle, during which it took all my strength to hold him. We were alone in the room, the servant, his only attend- ant, having gone for the doctor. When the struggle at last sub- sided, he sank exhausted upon the bed and asked for a glass of water. He died in the act of drinking it and fell back a corpse. ' ' In Mr. Grotjan's efforts to save the life of a Captain Bal- lenger, who commanded a slaver which had been captured by a British man-of-war and sent to Kingston as a prize he in- curred an attack of yellow fever. Capt. Ballenger was ac- cused under oath by two slaver's seamen with having been on board the British frigate Hermione, when, ten years previously, her crew had mutined and murdered all her officers. The ac- cusation was false and was made out of a spirit of revenge. Mr. Grotjan learned that the captain was about to be arrested and started to warn him. He says: "I learned that he had gone to a board-yard, about a mile and a half from the city, on private business. To this place I proceeded at a rapid pace, and at midday in June when the rays of the sun are nearly perpendicular. There I found him and communicated to him all that I had seen and heard We stood in a distant and private part of the yard, exposed to the heat of the day, but my mind was so much engaged that nearly three hours passed imperceptibly away in consultation." [They agreed upon ar- rangements for the captain's safety and Mr. Grotjan started on his return.] He continues:-"I had not been long on the road when I began to feel the consequences of my fatigue, exposure, and THE QUEST OF THE GERM. 73 agitation of mind. I felt a slight pain in the back of my head, a dry heat without perspiration, and a lassitude and pain in my limbs. When I reached home and told my host how I felt he recommended a glass of hot punch and retiring immediately to bed. . . . From the rapidly increasing symptoms I felt con- vinced that I had that day contracted yellow fever in the natural way, from heat, exposure and over-exertion .... I had no sooner retired and assumed a horizontal position than I began to vomit at short intervals .... Although I felt much dis- tressed that evening I remained perfectly sensible. About a week elapsed, during which I had been frequently delirious, when during one night I had the most horrible feelings and sensations that I ever experienced, and my nurse subsequently said that, from hour to hour, she did not expect me to live for many minutes. It is remarkable that my senses and recollec- tions were perfectly alive, but troubled with acute and fan- tastic appearances. Whether my eyes were open or shut I saw the room full of the most frightful visages glaring at me as the central object. (Note: This phenomenon is termed a phan- tasmagoria, is characteristic of yellow fever, and is one of the subjective symptoms of gangasthenia.) Toward morning I fell asleep and when I awoke found myself in the first perspira- tion of my illness. I was so weak that I could scarcely speak. Hitherto nothing had remained on my stomach nor had I had any evacuation except by artificial means. I asked for a glass of Rhenish wine, and it was brought to me. About half of it did not alone taste grateful but remained with me undisturbed. The crisis of my disorder had taken place the preceding night and the result was favorable. From that day I began very shortly to recover, but it was more than two weeks afterward before I felt strong enough to walk." For several reasons this is a most remarkable record. The statement by the writer that he took the disease "in the natural way, from heat, exposure and over-exertion" is the most posi- 74 THE QUEST OF THE GERM. tive proof that can be derived from any source that yellow fever is not infectious and it must be admitted that he has pointed out the factors of causation which produced the very severe attack of yellow fever from which he suffered. Fear was not one of those factors for we find him visiting the young Philadel- phia gentleman in Santiago as soon as he learned of the illness of that person and remaining with him until the end. Accord- ing to all the recognised laws and established beliefs regarding the infectious nature of the disease Mr. Grotjan should have contracted it when he exposed himself to such alleged infection by nursing the young man who was ill with yellow fever. He did not so contract it though he might have been covered with black vomit ejected by the patient during his delirious struggles. Mr. Grotjan contracted the disease "in the natural way" and that is the only way in which any person can or ever did con- tract it, because it is produced by or engendered of the environ- ment, and there is no germ to act as its cause, for none has been found and none will ever be found. Possibly Mr. Grotjan was bitten by a mosquito. There is no doubt that he had been bitten often and by many different mosquitos but-the subtleties of modern science are either too abstruse or are too ridiculous to be pursued further on this line. The theory, however, may as well be adverted to in this connection as elsewhere. MOSQUITO THEORY. In Decem- ber 1903, the International Sanitary Convention met in Wash- ington, D. C., and L. 0. Howard writing in the Century Maga- zine for October 1903, in reference to the meeting of the con- vention says, that he "was greatly impressed by the fact that this body, representing the most advanced medical thought of the Americas and undoubtedly the soundest judgment in sani- tary matters, unanimously accepted as absolutely demonstrated fact that certain mosquitos carry yellow fever-constitute the only means by which it is spread. This statement is incorrect in THE QUEST OF THE GERM. 75 two particulars. The convention did not ' ' unanimously ' ' accept. There are always in such a collection of asses a few wise men who invariably dissent from all asinine conclusions, and there- fore the acceptance of the alleged fact could not have been un- animous. Second the alleged fact was not, is not a fact, but sludge which is the product of brain-ooze. Now this alleged fact was said to have been established by experiments made at Quemado, Cuba. Eleven persons were bitten by contaminated mosquitoes. With nine of them there was no results. ( !) : with two yellow fever appeared. In one of these two cases there had been possible opportunity for infection from other sources and in one the circumstances were such as to exclude any other source of infection and the commission, therefore, [mark this conclusion] announced that the mosquito serves as the inter- mediate host of the parasite (germ?) of yellow fever, "Oh! lame and impotent conclusion. " Oh! Rags and tatters of science. This is the very lamest conclusion ever presented for the con- sideration of rational men. And now some fool is out with "Directions for the Destruction of Yellow Fever Mosquitoes" which he sent to Congress with the expectation that his pamphlet would be printed, but the resolution ordering it printed was referred to a committee and it will find sepulture there. The statement of Mr. Howard regarding the mosquito theory con- cludes with these very significant words:-"The causative micro- organism of yellow fever has not been found". And it might have been added with truth: It never will be discovered for there is no such thing. Compare, if you please, the case in which a patient contracts the disease "in the natural way" and the case in which the patient is alleged to have had the morbific agent introduced into his system by the bite or sting of a mosquito and what is the conclusion that rational persons will draw as to the causation of the disease in the two cases ? Obvi- ously enough Mr. Grotjan's attack was caused and only could have been caused by the conditions which he has detailed. And 76 THE QUEST OF THE GERM. obviously enough the person who drew the conclusion that the attack of the disease in the other case was due to the bite of a mosquito and the person who accepts that conclusion are, not to put too fine a point on it, a pair of blathering idiots. The theory that mosquitos carry yellow fever will die a natural death and the author proposes for its epitaph: ' ' Conceived by fools and died a-borniu. " But Mr. Howard, not content to give currency to the bald- erdash which he heard uttered by that aggregation of wiseacres in Washington, "drops into" prophecy and delivers himself of the following unfortunate forecast which most unhappily escaped the blue pencil of the editor of the Century Magazine. He says: "It may be safely predicted that never again in the history of the United States will an epidemic of yellow fever occur." "What never?" "Well, hardly ever!" But why? oh! why? "Because" Mr. Howard explains, "a mosquito must be blamed for one of the greatest of human ills." The ex- planation is not quite clear and is very weak but if it satisfied the editor of the Century Magazine it would be hypercritical to find fault with it. But as to its fulfillment the inhabitants of San Antonio and of Laredo, Texas,* may tell about that. The author, however, contents himself with characterizing the pre- diction as banal and that is a very harsh epithet to apply to anything. [The author soliloquizes: "Banal, canal, anal, Banal! I don't seem to remember what that word means. It is not a common word. Those word-slingers-novelists and space- writers-sometimes pick up a thing kind of promiscuous like and let it drop with the remark that it is banal and that settles the matter, for, to declare a thing banal is supposed to be final. Editors occasionally use the word but they do not know its mean- ing any more than anybody else and when they do use it they show that they are IT. But banal is not final for there is some- thing that is banaler than [Mr. Howard's prediction and that is the mosquito yellow fever theory which is the banalest thing ever ♦And of New Orleans in the year 1905. THE QUEST OF THE GERM. 77 evolved from the minds of men. Truly David Starr Jordan is a wise man, for he once wrote: "There is no nonsense so un- scientific that men called educated will not accept as science." He is recognized as an educated man and yet he accepts as science the doctrines of the germ theory as applied to cholera and yellow fever for he thinks that it would not be wise to re- move the quarantine against them. ["Quid rides, doctissime doctor?"] MR. GROTJAN's CASE AGAIN. But to return to the case of Mr. Grotjan. If a physician who understood the nature of gangasthenia and who was ac- quainted with the medical properties of bromide of ammonium had been called to see Mr. Grotjan, when he got back to Kings- ton from his trip to that lumber-yard to meet Capt. Ballenger, he would have recognized at a glance that Mr. Grotjan was affected with gangasthenia in a mild form and he would im- mediately have administered to his patient a dose of bromide of ammonium with directions to repeat the same at intervals of an hour until the patient dropped off to sleep or say four to six doses. The result would have been that Mr. Grotjan would not have vomited as soon as he assumed the recumbent attitude and at no time thereafter during the same night: that he would have slept soundly, would have awakened refreshed by his slumber and would have had a good appetite for his breakfast. In a word he would have been so nearly recovered from the fatigue lassitude and pain which were the effects of the ex- haustion produced by exposure to excessive solar heat, over- exertion and mental strain that he would have needed but a few doses of the medicine the next day to restore him complete- ly. In fact the attack of disease with which he was threatened would have been prevented; the fever would have been aborted: the sufferings which he endured in consequence of the very severe siege of yellow fever through which he passed and which brought him so near to the gates of death that he could hear 78 THE QUEST OF THE GERM. the hinges creak, would have been averted-and all this by the timely use of a simple, harmless, efficacious remedy. Now, the author is not a prophet, nor yet the son of a prophet, nor is he gifted with much foresight but he ventures to adopt Mr. Howard's prediction that "never again in the history of the United States will an epidemic of yellow fever occur'' after the knowledge of the ganglionic theory of the nature of that disease and of the therapeutic virtues of bromide of ammonium have been diffused throughout the length and breadth of the land and the originators and propagators of the mosquito theory may ' ' put that in their pipes and smoke it, ' ' for it is the truth and no dammed lie like that theory. There never has been a medical writer who expatiated on the subject of yellow fever but who has described the condition of the stomach in that disease to be one of inflammation and it is entirely consistent with their generally erroneous views as to its cause that they should be mistaken about the condition of the stomach. In the ganglionic theory there is no place for in- flammation of any of the internal organs of the body and one of the errors most frequently encountered in medical works is that gastritis exists as a concomitant of yellow fever-a statement which means that an anomalous and paradoxical condition could exist when all the evidences of disordered action point to conges- tion as the only condition present. This is proved by Mr. Grot- jan's case. He records that when the crisis had passed-that is when the function of the ganglia had been restored by the vis medicatrix naturae and they had resumed operations again, so the blood was propelled in normal current through the arteries once more, and all congestion had disappeared the stomach made its demand known without delay and the patient asked for "a glass of Rhenish wine"-a glass of wine meant in those days a tumblerful. When it was brought he drank half of it and "it did not alone taste grateful but remained with me undisturbed. ' ' Now, any physician who understands anything about gastritis THE QUEST OF THE GERM. 79 knows that there is no sudden spontaneous subsidence of the inflammation and he also knows that if Mr. Grotjan's stomach had been inflamed the wine would have been ejected very soon. Instead it remained with him undisturbed and the reasonable supposition is that, his stomach being in a receptive mood, the second half of the wine followed the first in a very little while. The lessons of the Grotjan case-which he who runs may read-are that the disease was contracted in the natural way and was not caused by germs but by the factors of causation which constituted the environment: that the stomach was not inflamed but congested: that the attack might have been pre- vented or aborted if proper treatment had been employed in the prodromic stage of the disease and that recovery occurred through restoration of the ganglia to their normal condition- and it may be added as a correlative that death ensues in con- sequence of their softening and disintegration. The rational deduction from these facts is that the only method of treatment worthy of being termed scientific is that which proceeds, on the principle of obsta principiis, to use the only remedy which is indicated by the symptoms at the onset of the disease. By this means and by this means alone yellow fever in the United States will be so restricted that an epidemic of the disease will never occur again. But what is the use of publishing such truths; no attention will be paid to them. Physicians all subscribe to the code of ethics which requires that when they make any important dis- covery in medicine they shall publish it for the benefit of hu- manity and of their medical brethren. Many do this because they are honorable men and consider that it is obligatory on them to disclose their discoveries and not use them for their own advantage. Impelled by this sentiment the author set forth in a number of articles which appeared in the Michigan Medical News, a journal published at Detroit, the ganglionic theory of ANOTHER SPECIFIC. 80 THE QUEST OF THE GERM. certain diseases evolved by him and the result was that his theory has passed into temporary oblivion. Since then yellow fever has occurred in epidemic form in several southern cities and medical men have treated the disease on the ancient lines and have so continued to treat it up to the present time and the author's revelation is regarded to this day as a dead letter. His theory has been adumbrated by the incessant work of the bacterists: the valuable therapeutic agent pointed out by him to be used as a specific preventive of yellow fever has been cast aside and the disease still commits its customary ravages in those communities in which it makes its appearance. What's the use then of publishing one's discoveries. There is absolutely no use in attempting to enlighten the minds of men which are sodden with ignorance and superstition-at least for one who is among the humblest in the ranks of the profession-as the author is. If he were one of the "Hyas Tyhees" (big Injuns) of medi- cine he might have had a hearing and obtained some recognition but his lucubrations were unnoticed: his contributions to science were not accepted and because the child of his brain was accord- ed no welcome, and became, as it were, an outcast he determined that if it ever fell to his lot to make any discoveries in the future to keep them locked in his own mind, and he has abided thereby. This resolution sprang from deep disgust at the reception accord- ed to his advanced views and arose from discouragement at the non-recognition of his efforts to substitute true science for ignor- ance. Perhaps the hyas tyhees of medicine do not like his style because they prefer the didactic style: Well, he considers di- dacticism as stupid and banal. But "there are others" and though they are few in number they have expressed admiration of his style which has been declared to be "vigorous and log- ical." "Which, the same" can not be said of various lucubra- tions emanating from the bacterists. However, the author has made one other important medical discovery since then which he has not made public and not alone because of the determination THE QUEST OF THE GERM. 81 previously expressed but because he was aware that it would serve no beneficial purpose. He knew that if he would make known the fact that he had discovered a specific for a disease that is written down "incurable" in the books that he would find no person to give credence to the statement: and that he would have the epithet "crank" applied to him. Now, if he were one of the Hyas Tyhees of medicine and made such a state- ment, in regard to a particular disease, some attention would be paid to the announcement but the Hyas Tyhees consider this one incurable. One of them, Prof. Bartholow, who has written a treatise on the practice of medicine states that there is no specific for the disease in question. Another, Dr. Wm. Osler, who is also the author of a work on medical practice, states therein that he has never witnessed a recovery from the disease and he has seen and treated a large number of patients who were affected by it and they all succumbed to it. These gentlemen are away up in the profession and their statements are given credence over and above anything the author might say to the contrary. A patient affected with this disease goes to a physi- cian and he, on examination, makes a correct diagnosis and says your case is hopeless. He takes down Bartholow and Osler and reads his sentence to him and the man "goes away sorrowful" for his mind is impressed with the idea that there is no help for him. Suppose the author met this man and on learning of the condition of things would declare that he had knowledge of a specific for the disease. The man would exclaim: "Who in are you anyway? Why here's Bartholow and Osler and a lot more away up men who say there is no cure for me." The author replies: "Though ten thousand Bartholows and ten thousand Oslers and half a million other nincompoop doctors all say the same thing I can cure you for I have discovered a specific for the disease." Now that is an emphatic statement but do you suppose that the man would give any heed to it? Not on your life. He would shake his head and trudge along 82 THE QUEST OF THE GERM. muttering to himself something about "the dammed crank."' The author has a friend in a nearby city and to that friend he gave the information that he possessed knowledge of a specific for the disease in question and requested him to look up some patients affected with it and recommend them to come here and obtain the treatment which would cure them. This was summer of 1903. My friend found two persons affected with the dis- ease and urged them to come here and assured them that they could be cured. They simply did not accept his statement as true: they knew better, for, do not Bartholow and Osler and other Hyas Tyhees of medicine declare that the disease is in- curable. One of these men died recently and the other is wait- ing for the inevitable end: he will not stir a step on a 20-mile journey to procure an infallible remedy for his disease. The author has learned of a case of the disease in Milwaukee and he desired a lady of his acquaintance to make known to the friends of the sick man the fact he could be cured by means of a specific which the author would prepare for him. When the statement was made to the patient's wife that lady referring to the author asked: "Well, if he can do such great things what is he doing in the Soldier's Home?" With all due respect to the good lady the reply may be made: ' ' That is none of your business I ' ' Her query is aside from the matter presented for her considera- tion and exhibits a natural peculiarity of the human mind. If a person is believed to be inspired his statements will receive im- mediate and unquestioning credence from his hearers. Or if a person is regarded as having commandence concerning certain matters his utterances relating thereto will be accepted as cred- ible by those to whom they are addressed. But if a person is not considered to be inspired and commandence relative to cer- tain matters has not been ascribed to him, his hearers will be apt to inquire somewhat impertinently: "Who are you?" And this inquiry Is prompted by a peculiarity of human nature which while it ordinarily exhibits a most astonishing credulity about THE QUEST OF THE GERM. 83 things incapable of being understood will question the reliability of statements emanating from a source which it thinks it is able to pronounce judgment upon and so it throws doubt upon the statements and manifests mental acumen by a question concern- ing the personality of their author. Human nature does not ask, Are the statements true? but inquires, Are they likely to be true considering their source? And so the person not be- lieved to be inspired and the person without commandence can not obtain credence for their statements although they may be true and credence is given to contrary statements which are untrue because their authors are supposed to be inspired or to possess commandence in regard to those matters concerning which the statements have been made. However, to satisfy the curi- osity of the good lady referred to, and perhaps of some others who may make the same query mentally, the author will explain that he is an old man in his sixty-ninth year: that his life has been embittered by misfortunes: that he has become soured by disappointments and from having been one of the best-natured of men he is now often splenetic and morose: that he is finan- cially a poor man having no resources but his small pension de- rived from government: that he has never accumulated any money and having no home of his own he very gladly accepted the provision made for old soldiers by the bounty of our gener- ous Uncle Sam and came to this home, where is furnished abund- antly, without money and without price, all things necessary to existence; where if he is sick he can be admitted to a hospital in which he will receive the best of medical care and be attended by trained nurses; where if he dies he will be given a soldier's funeral and be buried in a cemetery in which his grave will be kept green for ages to come;-in a word he is in an institution where under wise supervision all things are done decently and in order and he rejoices that he was a soldier. Madame or Sir; Is the explanation satisfactory? But what possible connection these matters have with the statement about the disease in ques- 84 THE QUEST OF THE GERM. tion and its specific is inconceivable. You are affected with the disease and the specific for the disease is offered to you. Those are matters which concern you in the highest degree and you ask, not-is the statement true? but what sort of a person is the man who makes the offer? Well, there you have a reply; do the above details enable you to judge if he who makes the state- ments is reliable or not. By no means. The only way you can judge of the matter is to put it to the test. The author admits that he is ignorant of many things about the nature of diseases and the properties of medicines but he claims to know a few things and these are two of the few things which he knows for certainties: he understands exactly the nature of this disease and with all other doctors that is a matter of conjecture, and he knows that the specific of which he has knowledge acts phy- siologically on that portion of the human system whence is de- rived the abnormal product which in excess loads the urine and gives it the characteristic that confers a name upon the dis- ease. By the way the name of the disease is diabetes. The ex- act source of the glucose is pointed out, actually demonstrated, by the physiological action of the specific and some day a new name for the disease will be invented which will indicate its true pathogeny in a much more precise way than its present designa- tion, which means literally "pass-through". The author cured himself of an attack of diabetes in 1880 and there has been no recurrence of the disease in his case. He has treated since then two other male patients, affected in like manner, successfully with the same remedy. No restriction whatever is placed on the diet. The patients are directed to partake of sugar to satiety, until they no longer have desire for anything sweet. The author when he had diabetes, used to go to a confectionery store on Broadway (he was then in New York) when hungry for sweets and eat from the counter freshly-made candy until his hunger was satisfied, the clerk meanwhile keeping count of what he con- sumed. He usually did this twice a day about 10 a. m. and 4 THE QUEST OF THE GERM. 85 p. m. his desire for sweets being fiercest at those hours. This desire is an instinct of the physical nature and its promptings are above reason. It is scarcely worth while to note, except to show the absurdity of the practice that physicians in accordance with the instructions contained in the books, always interdict the use of sugar and of all starchy foods to their diabetic patients. The author declares such restriction of the diet to be not only absurd but cruel and unscientific-in fact it is a mon- strosity of practice begotten of illogical deduction by erroneous observation and as such is productive of very great harm be- cause the diabetics are affected with an intense longing which they are forbidden to gratify, and ungratified desire is always a disturbing factor. The one remedy selected, by the author, from the vast range of the materia medica, with which to treat himself was chosen as much by a physiological instinct of the same unerring kind as the physical instinct that prompts the diabetic to eat sugar, and he believes that if he had not com- plied with the dictates of that instinct and had chosen some other remedy or some combination of remedies the disease, in his case would have terminated as usual. And if he had not ad- ministered the same remedy to his two diabetic patients their cases would have terminated as such cases usually do. But this one remedy cured three diabetic patients and no other known remedy has ever been known to cure a single case of the disease, the author therefore claims that it is a specific for dia- betes. Now, though more than three hundred persons die of diabetes annually in New York city and more than one hundred and thirty die from this cause in Chicago and many more pass away from this disease in other large cities and throughout this country and in other countries, for reasons previously expressed the author declines to disclose the name of the specific and he further repeats his chief reasons: 1. That no physician would use the specific in the treatment of their diabetic patients but all would adhere to their present antiquated and unscientific 86 THE QUEST OF THE GERM. methods; 2. That the author would not be gBen that just recognition by the Hyas Tyhees of medicine which he regards would be due to the merit of the discovery. But if any person who is affected with diabetes, whose eye may chance to light on these wmrds desires to obtain some of the specific let such person address the author on the subject and for a money con- sideration he can procure enough of it to treat himself until he is completely recovered-until there is no longer a trace of sugar in his urine. During the use of the specific the diabetic is allowed to eat any kind of food he wants to eat-restriction on diet only as to quantity, he must not eat too much. The few last preceding lines are in reality an advertisement and it is so skilfully concealed that it will probably escape the observation of those to whom it is addressed. But we shall see. At this point in the course of the preparation of this book the author deems it proper to introduce an article written by him in 1880, being one of those published in Vol. IV of The Michigan Medical News. The subject is "Yellow Fever.'' The article was inscribed to the National Board of Health but as that organization is defunct the author ventures to inscribe it to the American Public Health Association and to the Inter- national Sanitary Convention. The author thus conspicuously calls the attention of the members of those two prominent organizations to the matter of this article in order that they, by perusing it, may be led to relinquish the "Quest of the Germ" of yellow fever. He has no doubt that, if they will read this article and the preceding pages of this book, they will be con- vinced by the cases cited and the ratiocination based thereon that his views are correct and therefore there could have been no more appropriate motto than that which was originally placed above this article, to wit: four Greek words which meant- "Not Practice but Theory" would solve the mysteries of dis- ease, of this particular disease. By the way, isn't it funny THE QUEST OF THE GERM. 87 that some fool bacterist has not discovered that diabetes is caused by a germ ? Perhaps it is and it may be that the reason the author's specific cures that disease is because it kills the germ-but the specific is not a germicide. YELLOW FEVER. Yellow fever is another of the "curious" and "singular" diseases which remains an unsolved problem of medicine. It is a remarkable fact that many of the ganglionic diseases have been termed curious or singular by medical writers and they seem most anomalous epithets to apply to any disease; but let that pass. It is a disgrace to the so-called science of medicine that with every opportunity to investigate and elucidate its nature, its true cause is still enshrined in mystery. Their Emi- nences attribute it to a poison in the blood, but they are "bark- ing up the wrong tree." (This pat metaphor is taken from the action of Col. Davy Crockett's dog.) They are on a still-hunt for a poison in the blood. This poison they fancy is real. Let us humor the fancy. There is a poison in the blood. It con- sists of myriads of minute demons which exist in the blood. Zymosis is the mother of these demons. She pervades every situation in which the demons can breed and thrive, but especi- ally does she relish the blood of human beings. Let one of the demons find entrance, through the stomach or the air passages, to the blood, and Zymosis enters too, and begins to breed more demons. She brings them forth with the rapidity of thought, until in a short time the blood is populated with myriads of them. Each demon straddles a corpuscle and goes racing up and down through the vessels raising Cain with the circulation. The demons in their fury gallop their steeds-the corpuscles- 89 along so rapidly that the blood gets heated up. They are fiery devils and enjoy the heat. They get warmed to the work and drive the faster, and when the blood gets red-hot they proceed to fortify themselves and block up the avenues so they can not be driven out. A lot of them gather in the kidneys and drive the swollen corpuscles into the arterioles and pile them up and jam them down, and at length that outlet is blocked up. The doctors look very grave at this and shake their heads and say: 44Suppression, due to the virulence of the poison." If they could only see the gleeful little demons dancing and capering around they would have a different idea. Another lot attack the stomach, but the vessels here are too delicate, and yield to the pressure and burst. The blood exuded from the ruptured vessels is vomited and again the doctors look grave and shake their heads and say: "Black vomit." Some think the poison can be found in that, but one wise doctor, who denies the ex- istence of a specific poison, offers to drink some of the black vomit and to prove his sincerity does so without harm to him- self. (Actual occurrence, some years ago, in New Orleans.) But the vomit is harmless for the demons have escaped from it, because the blood is no longer in motion and they can not gallop their steeds up and down in it. Another lot of demons attack the nerves and play hide-and-seek among the nerve-cells, which makes the nerves ache and fairly howl with pain. The demons laugh at this until their sides ache and little tears run down their cheeks. Meanwhile the doctors are not idle. They send other demons into the blood with warrant to throttle, strangle and drive out the first demons. The work gets poorly done, and at length nature, finding her hand-maid, science, a poor stick, ral- lies her forces and does the business by dispossessing and elimi- ninating the demons herself. These demons do not like cold and presently a frost comes and they depart to a tropical climate, except those who linger 90 too long and get untimely nipped. They return to their home from which they have only come on an excursion. Meanwhile the job of catching some of these demons has become a national affair, and the National Board of Nincom- poops is authorized to catch any amount of them. It is satis- factorily shown that these demons have a substantial existence, for, nothing else could cause such a fever in the blood. That is an unanswerable argument. But the hunting of these demons being an expensive business, money is needed for the purpose. The money is forthcoming and an Eminence is dispatched to the exotic country where the demons dwell. He searches every- where, sifts the atmosphere and analyzes the earth, the water and the blood, but does not bag a demon. After many months spent in the useless search he returns and says so. The presi- dent of the Board of Nincompoops says it is a great pity, for if he had only caught even a single little one and fastened it on a piece of glass so that we could exhibit it we might get an appropriation to build our frost-ship, for the demons are afraid of frost. But now we will have to depend on paper pellets and quarantine. (Quarantine is a great hulking fellow that stands at the mouths of water-ways-the demons travel by water -and shoos them away.) This fable teaches that the asses of the profession are usual- ly selected to be members of boards of health. These fellows appear to the eyes of ordinary mortals to be dignified, erudite and profound. When they are probed, however, it is found that their dignity is the thin varnish of their arrogance; their erudition consists of the borrowed covering of their asininity and their shallowness is exhibited in the results of their obser- vations, which show that they only look at the surface of things. They are "barking up the wrong tree." The existence of a poison in yellow fever is assumed when it would be more ra- tional to assume its non-existence. This poison is a chimera, a creature of the imagination begotten of ignorance and super- 91 stition. The light of science is indeed but a rush-light if it can not dispel the darkness that surrounds the nature of this disease. Putting aside all idea of a poison let us see what illu- mination of the subject will proceed from a penny dip. [This ironical simile is supposed to mean the writer's reference to his own intellect by which he would have it understood that he has a very humble opinion of his mental powers-ironically speak- ing.] Yellow fever is not a fever. (This sounds dogmatic enough, but not more so than the enunciations of medical writers in general.) The very name is a misnomer and misleading, and shows that medical science has made no progress in this particular since the days of Galen. He defines fever to be calor praeter naturam, and the incorrect definition holds good today. Yellow fever is a hyperthermy. Hyperthermy is one thing: fever is another. In hyperthermy the ganglia, the sources of normal heat, are depressed. All calorification of the body is due to the action of the nervous system. But the ganglia being rendered inoperative by reason of the depression, the law of compensation steps in and the burden of calorification is thrown upon the cerebro-spinal division of the nervous system. This law means simply that when one organ is disabled the burden of its function must, perforce, be assumed by its fellow. Here the burden of heat production is cast upon the cerebro-spinal nervous system and the governor of the heating apparatus being out of order, the caloric generated is excessive and irregularly distributed. Of course to produce this effect the nerves have to exert an undue amount of force. In other words hyperther- my is due to hypersthenia of the cerebro-spinal nerves and per contra fever is due to hypersthenia of the ganglia. The theory will hold water. For hyperthermy can be prevented or banished not by an anti-febrific but by an anti-hyperthermic remedy, that is by an agent which restores the sthenieity of the 92 ganglia and produces co-sthenicity between the two divisions of the nervous system, whereas this agent has no control or in- fluence over the febrile condition. And this proves the theory to be true. Yellow fever is a disease, the chief characteristic of which is general idiopathic passive congestion, and this condition of the blood in its relation to the containing vessels is due to general gangasthenia. A single prodromic symptom of the disease in- terpreted by the light of an emotional expression gives the loca- tion of the congestion, and points out the kind of gangasthenia to which the congestion is due. Blushing caused by the feeling of self-consciousness or the emotion of shame, produces a temp- orary diffused redness of the countenance. The rosy suffusion of the face is accounted for by the explanation that the circu- lation of the blood in the arterioles has been temporarily im- peded. The pathology of a blush is evanescent arterious con- gestion. In the beginning of yellow fever a bright scarlet hue spreads over the cheeks-a permanent blush, which, as the dis- ease progresses, changes to a dusky purplish red color. This flushing of the face is due to arterious congestion. All idio- pathic passive congestion is due to gangasthenia, and the con- gestion of yellow fever being arterious must be attributed to arterio-motor gangasthenia. In the incipiency of the disease the condition is mild and when the disease is fully developed it becomes acute so that in the stage of complete development yellow fever may be properly designated as acute, general, arterio-motor gangasthenia cum icterus. The conjoined icterus being due to the general condition is added to the name to de- note the particular disease and to distinguish if from diseases of the same character but which show differences of feature. Thus "milk-sickness" could be called acute, general, arterio- motor gangasthenia sine icterus for the two diseases are identical except in this particular of the jaundice. Sunstroke may be instanced as the type of the ganglionic 93 THE QUEST OF THE GERM. diseases. Cholera will then stand at the head of the hypother- mics and yellow fever at the head of the hyperthermies. With change of environment these two diseases are almost inter- changeable, Thus, if the individual in whom yellow fever is developed at Havana were in Calcutta the disease would assume the shape of cholera. It goes without saying then that the en- vironment is the cause of this disease as well as of cholera. Yellow fever and cholera are in some respects the converse of each other. In the one the serum of the blood passes from the veins and is ejected per anum while the corpuscular portion remains in the vessels. In the other the corpuscular part of the blood is ejected per orem, while the serum is left to circu- late and gives the "gaseous" pulse of the disease. The consecutive abnormal heat which sometimes supervenes during recovery from choleras is hyperthermy to which if icterus were added it would be almost identical with yellow fever. This denotes in some measure their interchangeability. If it were possible in yellow fever to shift the depression from the arterio- motors, to the veno-motors, the disease would without doubt be converted into cholera and vice versa. This is not an "adumbra- tion of the truth," but is truth itself shining out clear and bright through the clouds of error. It is unnecessary to trace out the symptoms of yellow fever and suggest a ,plan of treatment adapted to the indications, because, if the single remedy, herein recommended, be employed at the proper stage of the disease it will never develop into a virulent form. A number of years ago some physician-name forgotten- observed that the excretions in yellow fever were highly am- moniacal, and hence he deduced that ammonia in any form was inadmissible in the treatment of the disease. The observation is an undoubted fact but the deduction is erroneous. The body is in some sort a laboratory and its varied products are in great measure the result of chemical action, especially so when vital 94 THE QUEST OF THE GERM. processes are perverted. Excess of ammonia in yellow fever as well as in typhus is supposed to be derived from the conversion of urea into that product; but there always remains an excess of urea. It may be possible that ammonia as a normal product in normal quantity is the physiological stimulus of the ganglia, and its excess in the blood and excretions is due to the fact that they have become incapable of being acted on by it. Or, perhaps there has been an increased demand for ammonia and the supply being derived from a wrong source and of improper quality is rejected as unfit for the purpose for which it is de- signed. At all events whatever may be the cause of its excess it must be taken as an evidence of its deficiency in amount of proper quality, and construed as an indication for the admin- istration of ammonia as a remedy. This is, however, not the only indication for the use of am- monia in this disease. Every symptom demands it in the one form in which ammonia can be administered to obtain its fullest and most potent effect and devoid of harmful action, and that is in the form of bromide of ammonium. This beautiful, white, stable salt, bland and unirritating in its operation is derived from the combination in certain proportion of two fluid substances; both of which are volatile, acrid and pungent. It seems as though it were specially designed to meet the "unknown ele- ment" of the congestive diseases. It is an extraordinary fact in the history of medicine that this remedy has been so long consigned to obscurity: its potent and valuable properties un- discovered and unknown. When it shall be assigned its proper rank it will be found to tower above its fellows and will be recognized as one of the Sampsons of the materia medica. This suggests a surmise that perhaps there are many other obscure remedies, whose medicinal virtues and therapeutic properties are not correctly understood, and gives ground for the hope that the medical millenium will yet dawn, when there will be found to be a specific for every disease. THE QUEST OF THE GERM. 95 The "damask check" is the invariable precursory sign of yellow fever and of typhus. It can be recognized at a glance. A short time ago a woman came to town from a nearby lumber camp and applied to a physician for medical help: she ob- tained a prescription and procured some medicine. I accident- ally met her on the street and exchanged a few words with her in the way of greeting. Without asking her any questions, by a glance at her face and from the querulous, atonic sound of her voice, I seized the clew to her condition. I knew that the medicine prescribed for her would not meet her case and that unless she received the right kind of treatment she would become seriously ill. I expressed my convictions to her em- ployer who had brought her to town, and told him just how she felt and that there was but one remedy for her disorder. She returned to the camp and her employer informed her of my statements. She used the remedies which had been prescribed for her by the other physician, that day without any benefit. In the evening her employer returned to town and desired me to prescribe for her. I gave the bromide of ammonium. The result was that the woman recovered entirely and the severe attack of disease with which she was threatened was warded off. [In extenuation of the seemingly unethical course pursued in relation to this case, I desire to say, that while I strive to regulate my conduct by the spirit, I most heartily damn the letter of the Gode.] This is one case out of hundreds of the same nature and might and will yet be the history of thousands and tens of thousands of cases of what would otherwise be yellow fever, when the therapeutic uses of this remedy become generally known and the true nature of this disease is thoroughly under- stood. It will be perceived from this case that the right appli- cation of this remedy depends upon a proper appreciation of the condition to which it is applicable. This is the result of a correct comprehension of the signs presented by it, which is 96 THE QUEST OF THE GERM. to be acquired only by observation and experience. Thus the administration of the remedy becomes an act of judgment, and not, as is usually the case in prescribing medicine, the per- functory exercise of a mental habit. But if the condition can not be appreciated the methodical use of the remedy can be learned. The sign derived from the peculiar color of the face de- notes that the change of condition of the ganglia has already commenced: that depressing agencies have been in operation for some time; that solar heat, atmospheric conditions, fear, care, anxiety and sleeplessness have wrought their effect. This sign furnishes the first indication for treatment. Obsta principiis is the art of medicine in a nutshell. Here are the beginnings. Prescribe at once, procure rest for the sleepless patient who has been getting up, every morning for a month or more, more weary than when retiring. In rest there is recuperation. This is the true method of prevention. No need to wait until the ganglia are hopelessly depressed, the burning heat of hyperthermy is developed, the miseries of intense congestion have supervened, or the tortures and hell of full-formed disease are at hand either to make a diagnosis or to begin treatment. But give the remedy and give it first, last and all the time. Such allies as it needs will suggest themselves. The part that solar heat plays as a depressing agent or as a factor in causing gangasthenia is a problem in itself. In the regions where the congestive diseases mostly prevail the nights are nearly as warm as the days, and the inhabitants sleep, if they sleep at all, with but scanty covering. At best but a few hours of slumber are obtained. The nights are oppressively warm, the at- mosphere sultry, and the earth and the houses heated by the sun's rays render the close air still more stifling. Such nights occur at intervals in temperate regions-three and four in suc- cession-and are followed by cooler ones. The lassitude caused by the sleeplessness due to the former is dispelled by the grate- THE QUEST OF THE GERM. 97 ful and restful coolness of the latter. But increase of temper- ature is not the sole effect produced by the excessive heat of the sun's rays. The electrical and other conditions of the atmos- phere are changed, and these changes have also to be considered in their relation to the body as factors in causing depression. Without discussing these, however, the relation of solar heat alone to the body may be stated thus: The atmosphere heated by the sun's rays maintains the body at nearly its normal temperature. There is then no necessity for generating caloric within the body while nature is supplying sufficient exter- nal heat. But the individual, unmindful of the tropical heat enveloping him, consumes almost as much carbonaceous food as would suffice for the calorification of his body in a temperate climate. Under these circumstances a struggle ensues between the power of the body to expend the caloric derived from the ingested carbon and the power of nature to maintain the tem- perature of the body and prevent the expenditure of the body's heat engendered within it. The struggle continues for a week or a month and at length the flagging power of the body suc- cumbs, the ganglia become exhausted and disease supervenes. Recovery means restoration of the ganglia, and death results from their softening and disintegration. I have never seen a case of yellow fever. To me there is no such disease. I read the descriptions in the books of a dis- ease so named. I see the symptoms as they are depicted by dif- ferent writers. I witness the post-mortem examinations and note the various pathological changes that have occurred in the bodies of those who have died of this disease. I place the sev- eral specimens under the microscope and carefully study the alterations of minute structure. I have searched through many books in large libraries in pursuit of information on the subject, but everything has a different meaning for me than that which is writ down in the books. I read between the lines and the printed words tell a different story to me from that which they 98 THE QUEST OF THE GER¥ tell to others. And that is the story which I have endeavored to tell here. The traditions of the profession are demolished by this laying bare of the mystery surrounding yellow fever by one who has never seen a case of the disease. Perhaps the truth expressed in the motto at the head of this article that ' ' not prac- tice but theory" will elucidate disease may yet prevail, and its application may furnish the solution of the nature of many dis- eases now so little understood. Will their Eminences lend an attentive ear to the voice of one crying, in the wilderness of theories: "Here at last is the truth?" Will they submit to be guided by the light of my penny . dip out of the bog of error in which they are floundering? We shall see. A PROFOUND DISCOVERY. The preceding article was written in 1880, and the records show that no such profound discovery in medicine has been made during the years intervening. There have been some brilliant discoveries in other sciences and some in medicine and all have received due recognition and to some have been awarded the Nobel prizes, but there has never been so profound a discovery the announcement of which fell so flat and which has been re- ceived with such silent contempt as this discovery made by the author. The virtues of the bromide of ammonium were known to one physician prior to this discovery but he took advantage of his knowledge and made it the basis of a nostrum which he vends under the name of "Favorite Prescription." This has been analyzed and it has been found that each bottle of the nostrum contains two drachms of bromide of ammonium and each dose would contain between two and three grains of the bromide so that in order to get the benefit of one ounce of the remedy it would be necessary to purchase four bottles of the nostrum, which affords the proprietor of the "Favorite Prescrip- tion" a very large profit. Another physician in a Wisconsin city has prepared a nostrum which he vends under the name THE QUEST OF THE GERM. 99 of "Restorative." In the author's judgment each bottle of this "Restorative" contains one ounce* of the bromide and as it is put up in 8-oz vials and as the dose is two teaspoonfuls before each meal and at bedtime in a little water the person who bought a bottle and followed the directions would take at each dose the same amount of bromide that he would if it were prescribed to him according to the author's usual formula: 1 oz bromide; water q. s. ad 4 ozs, dose 1 teaspoonful. The author believes that the physician in the Wisconsin city derived his knowledge of the bromide and its uses from the articles published twenty- four years ago. The physician advertises his nostrum to be beneficial for all affections of what he terms ' ' the inside nerves ' ' -meaning, of course, the ganglia, and it is because he vends it as a panacea for the condition named gangasthenia and for all diseases thence arising that the author is certain that the "Re- storative" contains-each bottle of it-an ounce of the bromide of ammonium. * These two men have made much money out of the sale of their nostrums the active agent in each of which is the bromide while the author has received neither emolument nor honor, though much of both are his due, for making public, for the benefit of humanity his discovery of the admirable thera- peutic virtues of that remedy. Now it is possible for any per- son who may be affected with the symptoms of gangasthenia which are given on a preceding page of this book to go to any drug store and purchase an ounce of bromide of ammonium, put it in a 4-oz vial, fill it with water and take a teaspoonful as occasion requires. By so doing such person will obtain for 20 or 25 cents as much of the bromide as is contained in one bottle of the "Restorative"-cost $1.00 or as much as is contained in four bottles of "Favorite Prescription"-cost $4.00. This for- mula is one that should be kept as a household remedy, ready prepared to be administered as occasion shall demand. It is a simple harmless remedy and is so certain in its effects that the ♦Guesswork: may ba less. 100 THE QUEST OF THE GERM. Wisconsin man advertises his offer that any person may obtain five bottles of the ' ' Restorative ' ' on trial for a month, to be paid for when the person is cured. He knows whereof he advertises and the author also knows that there is no other medicine whose efficacy as a remedy could be mentioned in such confident terms except the bromide of ammonium, and hence the Wisconsin man's confidence in the virtues of his nostrum as a "Restor- ative" of the "inside nerves" or ganglia. Each bottle of the "Restorative" and of "Favorite Prescription" contains other in- gredients to give color and pleasant taste to its contents and to serve as a vehicle for the active agent. But it is believed that the sugar or water or alcohol or glycerine or whatever substance may be added to the contents of each bottle has no particular medicinal effect, and that the proprietors of those nostrums de- pend solely for the therapeutical effects of their preparations on the action of the agent which imparts to them its curative virtue, to wit: the bromide of ammonium. It will be much cheaper, therefore, for the person who is affected with gan- gasth nh(for symptoms of which see page 31) to purchase an ounce of the bromide, dissolve it in a 4-oz vial and take of this solution a teaspoonful at a dose when needed than to pay $1.00 for a bottle of either of the aforenamed nostrums. It is ad- visable to keep it on hand at all times. If, for instance one finds after retiring, that one can not sleep, it will only be necessary to get up, and take a dose of the bromide in order to procure sleep and needed rest. The bromide acts magically in frontal headache and for other pains in other regions of the body. Let whoever may read this get a supply at once and keep it on hand and save much suffering by taking it at the onset of the affection and thus ward it off. BOIL THE WATER. The newspapers are to blame for the vogue of the germ theory. The health officers are always ready to furnish "stuff" to the papers in order to exploitate their own activity in waging THE QUEST OF THE GERM. 101 unceasing warfare against the ever present germ. When what was termed typhoid fever prevailed on the West Side in Chi- cago two years ago the injunction "Boil the Water" appeared daily for some months. One old couple followed the directions as carefully and as strictly as though they were performing a religious rite. Even when some wag of a printer for a joke took out the word ' ' water ' ' and inserted the word " ice " instead this couple complied with the order. The old man read the pa- pers regularly and when he noticed the changed reading he said to his wife: "Why, Mariar, it says to boil the ice." "Well," she replied, "that's because there's germs in the ice." And they boiled the ice. And the notice to that effect ran along for a week before it was observed and they boiled the ice every day. The printer did not lose his place, for the joke was considered good enough to prevent his discharge. Even the health officer laughed when it was told to him. At length the old couple were both taken sick one day and the doctor was summoned to see them. The old lady said she did not understand how they could be taken sick for they boiled the water every day. The doctor examined the vessel in which the water had been boiled and found in the bottom a sediment consisting of what may be termed the debris of the water that had been boiled. It had accu- mulated until it had rendered the water poisonous. The doctor explained the necessity of cleansing the vessel daily before fill- ing it with fresh water. JOHNNIE CIRCUMVENTS GERMS. But how did it happen that their boy Johnnie was not taken sick at the same time?-for he was obliged to drink the boiled water at home and was required by a regulation of the health officer to take a bottle of the same to school to drink while there. Now everybody knows that boiled water is flat to the taste and nobody likes to drink it as a regular beverage. As a matter of fact very few drank it that summer in Chicago. The vast majority of the inhabitants drank lake water as usual and 102 THE QUEST OF THE GERM. suffered no harm from it for the very good reason that it was harmless. But trust a boy to find some trick by which to es- cape the disagreeable. On his way to school Johnnie poured the boiled water out of his bottle and filled it again from a public fountain. If he became very thirsty he would take a drink out of the lagoon as he passed through the park and as everybody knows who knows anything about the germs in the lagoon a drink of the water therein is a preventive of other germs, because the germs bred in the still water of the lagoon are big fierce vigorous fellows and they devour all your puny little typhoid and other germs, which exist as alleged in lake water, wherever they encounter them-in Johnnie's stomach or elsewhere. So his occasional draught of lagoon water was anti- dotal to the boiled water and was a highly commendable pre- cautionary measure. It is a pleasure to record the fact that the old couple recovered and that on the advice of their very sen- sible physician they drank unboiled lake water all through their illness and ceased thereafter to boil the water-and the ice- much to the delectation of Johnnie. The various bulletins and manifestoes issued by the health officer that summer created a veritable reign of terror among the residents in the suburbs of Chicago. It got so that when a lady called to visit a friend, the visitor was met at the door by the hostess who would open the door about an inch and on recognizing her caller would exclaim: "Gracious! You have been trapesing all over town and have collected all kinds of germs in your skirts. Won't you please step onto the lawn and shake the germs out? I am so dreadfully afraid of germs since I read that last bulletin in the paper from the health officer. I boil all the water, I am so afraid of germs getting into the house somehow that I use every precaution against them." So the visitor obligingly steps onto the lawn and shakes her skirts thoroughly in order that she may not carry any contaminating germs into her friend's house. THE QUEST OF THE GERM. 103 The vogue given the germ theory has started scientific in- vestigations in search of some substance which while harmless in itself would be death to germs-to every sort and kind and variety and species and genus of the germ family. Such a sub- stance has, after long research and many experiments, been found and has been placed on the market under the title of "Liquozone. " The proprietors of this substance are flooding the country with small bottles of it gratuitously distributed. There is no plan yet devised that will draw public attention to a patent medicine so quickly as the giving away of trial bottles of it. This plan has been so successfully carried out by the proprietors of Liquozone that the proprietor of "Favorite Pre- scription ' ' finding his sales suddenly diminished has as suddenly discovered that his nostrum is also death to germs, not of all kinds but of sundry kinds which he has depicted in a scare- head at the top of his advertisement. Well the "Favorite Pre- scription" has been advertised, during the years in which it has been before the public, as a panacea for almost all the ills that flesh is heir to, and if it has recently developed germicidal powers it will be a good thing-for the proprietor and those newspapers in which he advertises. The very interesting story of "Chita" by Lafcadio Hearne, previously referred to and quoted from in these pages contains other matters of interest which may be incidentally introduced at this point. The writer describes a terrible catastrophe which overwhelmed Last Island on the coast of Louisiana. A terrific hurricane swept up over the gulf; huge waves dashed over the island and destroyed every habitation. Every person on the island perished except a child three years old and her father. The child was found floating on a table and was rescued by a fisherman whose wife adopted her and named her after a child lost by death. The father went to New Orleans and began to practice medicine. "Dr. La Brierre, for eleven years devoted STORY OF DR. LA BRIERRE. 104 THE QUEST OF THE GERM. himself heart and soul to the practice of that profession he had first studied rather as a polite accomplishment than as a future calling." "He had grown quite thin-a little gray. The epi- demic had burthened him with responsibilities too multifarious and ponderous for his slender strength to bear. The continual nervous strain of abnormally protracted duty, the perpetual in- terruption of sleep had almost prostrated his will." He was called at this juncture to visit a patient at Viosca's Point, a two days' journey by water on the bayous and along the coast. His daughter reared by her foster-mother and now a girl of fourteen was at the fishing village to which he was going. Poetic justice requires that he shall know and become known to her but disease intervenes to prevent their recognition of each other and inexorable Death provides a cruel and unhuman de- nouement. On the first day of the trip the doctor at break- fast ate a little macaroni and cheese, and lay down to sleep again. When he awoke in the cooling evening he felt almost refreshed. He ate less sparingly at the second meal. Next morning he had a cup of hot coffee and then he felt really hungry:-he ate more macaroni and cheese than he had ever eaten before. At supper time it seemed to him that he could not get enough to eat. Soon after supper the sloop arrived at the Point, but the doctor came too late-the man had died and was buried. So there was nothing for him to do except to rest. He retired and "he woke before day with a feeling of intense prostration, a violent headache and an aversion for the mere idea of food." He falls into wild, semi-delirious reminiscences of former occurrences. " Eh! what a pain! Evidently he had worked too much. A decided case of nervous prostration. He must lie down and try to sleep. These pains in the head and back were becoming unbearable. Still, it was strange! he could not perspire. How his heart beat! How' his temples pulsed! Why, this was fever! Such pains in the back and head. Still his skin dry-dry as parchment-burning. A bursting weight 105 THE QUEST OF THE GERM. of pain at the base of the skull made him reel like a drunken man. His eyes glowed and there was blood in his mouth. His pulse was spasmodic and terribly rapid." He took 30 grains of quinine and laid down again. "His head pained more and more;-it seemed as if the cervical vertebras were filled with molten iron. And still his skin remained dry as if tanned. Anguish grew intense-nausea-dizziness and a brutal wrench- ing within his stomach. Everything began to look pink. It darkened more. Something kept sparkling before his sight like firew'orks. [Similar subjective symptoms occur in thermic fever. Of a patient attacked by sunstroke it has been written: "His eyes blurr and varying colors cross his vision. Vertigo seizes him and he falls."] Then a burst of blood filled his mouth. The light became scarlet as claret. This-this was not malaria." "It was one of those rapid, violent attacks which often despatch their victim in a single day." The doctor's nurse-the daughter's foster-mother "ordered the girl under no circumstances to approach the cabin where the sick man was lying." It is evident to a physician that, while the foregoing de- scription of the subjective symptoms of yellow fever has been elaborated with some degree of correctness and has been some- what embellished by poetic fancy, Mr. Hearne never suffered from an attack of the disease. He has given an account of the circumstances which were the immediate cause of the doctor's attack. On the previous evening the doctor ate ravenously at supper. He was said to have felt hungry. Now this feeling was not hunger but an abnormal craving excited by the ab- normal condition of the stomach which was then in the in- cipient stage of congestion. The doctor simply overloaded his stomach and ought to have known better than do so. Mr. Hearne without indicating this to have been the immediate cause of the attack has given the circumstances so fully that it may be inferred that he left it to his readers-at least to such of 106 THE QUEST OF THE GERM. them as had an interest in the pathology of his story-to make the deduction that the immediate cause of the doctor's attack was his giving indulgence to the abnormal craving on the previ- ous evening; he had eaten to complete satiety and in the morn- ing naturally enough he had "an aversion for the mere idea of food." Among the factors of causation in the doctor's en- vironment this gorging of his stomach with food stands forth as the chief one and though this is an imaginary case it is given with such reality that this particular feature may be accepted as supporting the author's views on that point. But what a different ending the story might have had! Suppose the doctor had understood the therapeutic use of brom- ide of ammonium and had taken 30 grains of that remedy (which is not much of a dose) instead of the same weight of quinine and had continued to take the remedy in proper doses until he was fully recovered. Suppose that yellow fever was known to be non-contagious-as it will be so known when the people of this country become educated up to the point of no longer giving credence to the ignorant idea that it is contagious by the publication of this book and by its shedding its enlighten- ing influence over their minds-in such case "Chita" would have been allowed to attend the patient. He aroused by the sight of this girl who bore such a striking resemblance to his wife would have made inquiries about her: the story of her rescue from the sea would have come out and the doctor con- vinced by the evidence would have claimed her as his own child. The foster-parents would have relinquished all claim upon her and the doctor would have returned to New Orleans accom- panied by his daughter. Now as science in a short time will have made this more joyful yet pathetic denouement probable, will not Mr. Hearne, if this happens to meet his eye, please to re-write his story and give it a more pleasing finale and one that is in accordance with the probabilities of the disclosures of science? For in the story the father dies of his disease, entirely THE QUEST OF THE GERM. 107 unaware that his own child is living, and is near him ready to minister to his comfort. Oh cruel fiction more remorseless than science! [Alas! poor Hearne is dead. If this shall meet the eye of some kindly story writer will he or she write a new conclusion to the story on the lines indicated?] It has been explained that the veno-inotor ganglia are dis- tinct from the arterio-motor ganglia and that when each is separately affected-for if both sets of ganglia were affected at the same time, instant death would ensue-the phenomena thence arising are different and the various combinations of phenomena denote clearly which set of ganglia is involved. Thus when the arterio-motors are depressed we have the flushed coun- tenance and when the veno-motors are depressed we have the pallid face-the most obvious sign giving the key to the nature of the involvement. There is a disease, however, recognized by one name in which either set of ganglia may be involved and that is sunstroke and it is a disease of which there may be said to be two forms. In one of these forms the veno-motor ganglia are depressed and the patient is pale with moist and cool surface and the treatment is by warmth and stimulation. In the other form the patient is flushed of face, skin dry and hot with hyperthermy, and the usual treatment is by cold and depressants. In this form the arterio-motors-ganglia are de- pressed. It is by the chief features of these two forms of one disease-this bi-fronted disease-that we may learn to distin- guish the one form of ganglionic involvement from the other. On this basis can be listed in two classes. THE GANGLIONIC DISEASES. Due to arterio-motor gan- gasthenia. Yellow fever. Typhus fever. Due to veno-motor gan- gasthenia. Cholera, Cholera Infantum. Cholera Morbus, Diarhea. 108 THE QUEST OF THE GERM. Dengue. Hematuric fever. Scurvy. Hematemesis. Hemoptysis. Hemorrhages, cerebral, intes- tinal. J uterine and renal. Milk sickness (rare.) Jaundice, functional. Pink-eye, in the human. Influenza. Sunstroke thermic form. 1 ' Malaria, ' ' so-called. Sunstroke, gelid form. Exopthalmic goitre. Sea sickness. Heartburn (cardialgia) the bromide. neutralizis the butyric acid in stomach. Morbus Brightii, incipient stage. Anaemia. Chlorosis. Dipsomania. Sleeplessness. Beri-beri, tentatively. The author has copied an article written by himself some years ago on yellow fever which may be regarded as the type of the diseases due to arterio-motor gangasthenia, which is the acme of arterio-motor ganglionic involvement and in the course of the development of which all the signs of arterio-motor gan- gasthenia are manifested. So one might by synthesis of those symptoms form a disease which would present in unmistake- able form the disease recognized as yellow fever. The author has treated all the symptoms present in yellow fever as distinct diseases in different individuals-the jaundice, the arterious congestion exhibiting the characteristic pink or ferrety eye, the vomiting, the hyperthermy and the various aches and pains and all these symptoms have at various times yielded in his hands to the potent virtues of the bromide of ammonium. If those single diseases had appeared in conjunction in one individual there would have been as typical a case of yellow fever as ever occurred in any tropical country during an epidemic, and though the author has stated that he has never seen a case of the dis- ease, yet he has seen the disjecta membra of a case and has THE QUEST OF THE GERM. 109 treated it by piecemeal. But it is impossible that such a case could ever appear in this northern climate because the environ- ment is not such and probably never will be such as to develop a case of the kind. But there will always be cases of disease which will present in one combination or other all the prominent symptoms of yellow fever which will all disappear before the therapeutic action of bromide of ammonium. And as each symptom singly yields to it so all in conjunction will yield to it, with the one proviso of caeteris paribus. INTRODUCTION TO ARTICLE ON CHOLERA. Cholera is the type of the veno-motor gangasthenic diseases as yellow fever is the type of the arterio-motor gangasthenic dis- eases and as the article on yellow fever has been copied the ar- ticle on cholera will also be introduced as a sort of companion piece to the other. Suppose some one were to announce to the author that in India, or in China, or in Egypt, or in Turkey or in Russia it had been discovered that bromide of ammonium is a specific for cholera, he would reply: ' ' Huh ! that's no news to me, I made that discovery more than twenty-five years ago, and furthermore I discovered the condition to which it is due and named it gangasthenia. ' ' In this connection it is proper to explain that the term ganglia is used generally, without attention to the arbitrary divisions of the anatomists and physiologists, as embracing the whole ganglionic tract, and it is considered in its ultimate distribution and the force which it exerts to be co- extensive with the capillary area. The blood as a tissue of the body is pervaded by the nerve force derived from it as water is by electricity when a current of that fluid is turned into it from a battery. Hence we have gangasthenia a term which means loss of ganglionic nerve force. The loss may be partial or complete and may be local or general but however limited the condition may be or if it embraces the entire tract there is but the one term to indicate it. The article on cholera follows. 110 THE QUEST OF THE GERM. When originally published it was inscribed to the Academy of Sciences, Paris, France. That may stand without change. The article was headed by the motto: Palmam non sine pulvere which was intended to be prophetic, and to mean, "I have obtained the award not without labor." The reference of course is to the Breant Cholera Prize which has been in charge of the Paris Academy of Sciences since 1849, and it has been held so long in the undisturbed possession of the Academy that the members of that institution must have come to regard the fund as an irreversible and bona fide asset. Yet they have had no equity in it since the author filed his claim to it in 1878, since which time he has made every effort possible to him to establish his claim. It must not be understood that he asserted his claim without any foundation for the same because for a number of years prior to 1878 he was constantly making tentative use of bromide of ammonium in his practice and the results as shown by the recorded cases-to be hereafter given-and the ratiocina- tion by which he evolved the ganglionic theory of certain diseases justified him fully in asserting his claim to that prize. He be- lieved then and, his views have not since changed, he believes now that the Breant prize belongs to him. It is generally con- sidered that Galileo is one of the most pathetic figures in human history because he was placed on a real rack and forced by tor- ture to recant openly what he knew to be true while at the same time his mental attitude toward the truth remained un- changed. This book will place the author before the people of this country as the most pathetic figure in their history because for more than twenty-five years he has been on the rack-the rack of hope and despair-hope of obtaining the possible-the rewards due to the merit and importance of his discoveries and despair of finding, anywhere, in response to his numerous soli- citations, that assistance without which he can not establish his title to the prize which he knows belongs to him. He is still on the rack. THE QUEST OF THE GERM. 111 There seems to be an entire indifference on the part of physicians and of people generally to the question as to whether there is a specific for cholera or not. Nobody seems to care. Everybody seems interested about the small ills of life and seems content to leave the greater evils undisturbed to work all possible harm to society. The author compares this condition of affairs to the situation in Chicago at this present writing. Some finnicky fellow introduced a resolution into the city council requiring the police to enforce the ordinance against spitting on the sidewalks and in public conveyances, elevators and other places. It was passed and in consequence an anti- spitting crusade has been inaugurated in that city and offenders are haled by the dozen and the score, every day, before the justices and fined. Now this is a really trivial matter and does not concern municipal officials at all unless a forced construc- tion is given to certain provisions of the document which con- fers authority on them. The whole thing is due to the officious- ness of the health officer and the outcry made by some over- fastidious persons-ladies chiefly-who do not want to drabble their long skirts in the saliva ejected on the sidewalks. There is another way to avoid contamination from this cause. Let the edict go forth that no woman is a lady who wears long skirts and no man is a gentleman who spits on the sidewalk and forthwith the spitting nuisance is a thing of the past. But it is a trivial matter anyway. Chicago is the dirtiest city in the world, bar none; its streets are full of mire and festering filth and yet the inhabitants are compelled, under penalty, to add their saliva to the corrupt mass between the curbs which is crying aloud by its offensiveness for removal. The anti-spit- ting crusade goes on and meantime the streets are a foul eyesore, a reign of crime prevails in the city, and vice as a festering ulcer pervades the levees: at the same time the officials devote their energies to graft. But what better can be expected of a city whose chief officer is an anarchist,* and whose council con- ♦This refers to Carter H. Harrison. THE QUEST OF THE GERM. tains such anarchists as Hinky-Dink, Bathhouse John, Johnny Powers, and others of that stripe. Well, therefore, is it named "The City of Grouches and Grafters." The foundation, the prime cause, the watchword, the one principle of Tammany is "Graft," but the grafters of Chicago can give Tammany "cards and spades" and then beat them at the game. Also, some of the most notorious grouches in this country live there. So, well- named is "The City of Grouches and Grafters." But this is a digression, a sort of appropriate interpolation by way of an example or illustration and the thread of the story is resumed. The article referred to follows: CHOLERA. Cholera is an unsolved problem of medicine. The books throw absolutely no light upon its nature and give no clue to its proper treatment. No disease has been more written about. Its phenomena have been accurately described and its every feature graphically portrayed. Every man who has ever seen a case has tried his hand at conjecturing its nature, and the theories evolved have been as diverse from each other as the minds of those who have propounded them have been different one from another. It is useless, then, to refer to any of the false hypotheses that have been based upon erroneous concep- tions of its cause. If the problem is to be solved it must be solved de novo. A correct interpretation of its phenomena, as they are recorded, will furnish the solution, and here the books supply some aid. What are the phenomena of cholera? Three principal fea- tures are recognized as constituting the disease in its virulent form: vomiting, purging and cramps. Conjoined to these are a number of minor subjective and objective symptoms. The disease does not come on suddenly, but is preceded by evi- dences of a prodromic stage, such as anorexia, languor, weari- ness, insomnia, perspiration, a sense of chilliness and fugitive pains. These phenomena, or rather the condition to which they are due becomes intensified under the continued operation of the causes which have produced it and the development of 114 THE QUEST OF THE GERM. the full-formed disease results. The symptoms accordingly change; anorexia is followed by nausea, and this changes to vomiting: the feeling of weariness in the calves of the legs becomes a pain, and the pain becomes spasmodic in its char- acter and changes to cramp. The vision is disordered; a hum- ming is heard in the ears with every heart-beat; the face be- comes pallid, the pulse feeble and small; sweating is copious; the evacuations are ejected with violence and the contents of the stomach are forcibly thrown out. The heart beats or churns as though it would burst-a sound difficult to describe, but once heard never to be forgotten; it "thumps" as though it were imprisoned and was striving to burst through the walls of the chest. This tumultuous action of the heart can be ac- counted for, as it will appear by the almost complete paralysis of the right side of that organ. In consequence of the con- tinued purging and vomiting the character of the blood rapidly changes by loss of its serum. The bowels act as a sluice-way for the watery portions of the blood to drain out of the body, while the corpuscular portion only is retained within the ves- sels and becomes thick, of a dark color and of a tarry con- sistency. Now other phenomena appear; the pulse sinks rapidly; the extremities become cold; the patient is restless and complains of intense thirst; the surface is bathed with sweat; the urine is scanty and the skin begins to assume a bluish or leaden hue. The evacuations become more copious; the thirst in- satiable; the pulse thready, the breath cold; the tongue cold, pale and moist; the skin cold and shrunken; the hands and feet shriveled as if long soaked in water and of a livid color, es- pecially at the nails which seem almost black; the eyes deeply sunken; the conjunctivas dry and the sclerotic of a dirty porce- lain whiteness; nose and lips blue and cold; the urine and tears suppressed; the respiration short, hurried and oppressed. The intellect is generally clear and sound, but an extraordinary THE QUEST OF THE GERM. 115 apathy is commonly evinced. The voice is changed and be- comes husky and feeble. An effort seems needed to propel it outwardly, and it sounds hollow, muffled and indistinct to the patient. Post-mortem examination of the bodies of those who have died with cholera shows that the venules are congested, the veins distended and the right side of the heart and pul- monary arteries are filled with tarry blood that has been de- prived of its serum. Ptosis as a sign of gangasthenia finds its intensest expression in cholera, for choleraic patients die with their eyes closed. An inquiry into these phenomena to ascertain in what form, manner and degree, in the light of a rational physiology, the divergences from the healthy and natural performance of function must inevitably disclose the character of the disturb- ance that has led to the perturbed conditions exhibited in the aggregation of symptoms designated by the name cholera. Circulation is the function that first suffers derangement, and to appreciate the nature of the disorder of this function it will be proper to ascertain how its normal performance is effected. A few sentences from Flint's Physiology ought to explain this matter: "The capillaries are generally so small as to admit but a single row of corpuscles which move like beings endowed with volition. When the circulation is natural the movement is always quite slow when compared with the movement in the arterioles. Here at last the impulse of the heart is lost." "The circulation in the capillaries of a part is subject to such great variations and the differences in different localities are so considerable that it is quite impossible to give any definite rate which will represent the capillary circulation." "There is a force in operation-the action of the heart- which is capable of producing the capillary circulation; and there is nothing in the phenomena of the circulation in these vessels which is inconsistent with the operation." 116 THE QUEST OF THE GERM. "The action of the arterioles is competent to produce all the variations which are observed in the capillary circulation." The calcium light of a great intellect has been thrown on the subject and makes it as clear as mud. All physiologists agree in the statement that the current of venous blood is maintained by the action of the right side of the heart, whose operation is compared to that of a pump. They admit that muscular contractions, the action of the dia- phragm and the vis a tergo of the left side of the heart also assist in the propulsion of the blood through the veins. With singular unanimity, however, they overlook the chief motive power by which the blood is propelled through the vascular apparatus, to wit: nerve force. That is, they take no cognizance of innervation and ascribe the performance of the circulation to some power inherent in the vascular organs themselves. In consequence of this it has come about that our latter day physiologists regard all function as being mechanically ef- fected, and that we have an instrumental or physical and not vital one. The mainspring of all action in the human body is disregarded and left out of sight or consideration by them. In order, therefore, to appreciate the normal performance of the function of circulation it will be necessary to restore the omitted power. Accordingly I state as a physiological truth that the circulation throughout the whole of the vascular or- gans, in the heart, in the arteries and veins and in the capil- laries is effected by the power exerted by the ganglia: that every atom of the ultimate tissue of these organs is affected by nerve force, and, that the blood itself, as a tissue of the body, is permeated by and influenced in its every corpuscle by the force derived from these nerves. This is a proposition that will scarcely be disputed. Hence if circulation is deranged it must follow that innervation has been disturbed. The symp- toms which have been enumerated as present in cholera denote 117 THE QUEST OF THE GEKM. that the circulation has been deranged and that congestion has ensued. Hence we conclude that cholera is the result of dis- turbed innervation. This brings us to the application of the axiom: Whenever idiopathic passive congestion be present it denotes depression of the ganglia, and the intensity of the con- gestion will be the measure of the degree of gangasthenia. In cholera the face is pale and not flushed, the conjunc- tivas are clear and not injected, the surface is cool and not hot, the nails are blue or black and not purple. These differences distinguish the form of passive congestion present in the dis- ease and just one of the symptoms makes the distinction clear. It has been determined that the sudden pallor of fear, or the blanched countenance of a fainting person is induced by the stoppage of blood in the venous side of the circulatory organs. This slight signal is thrown out by nature to catch the eye of the observer, and furnishes the key to the location of the congestion in all diseases of which permanent pallor is a fea- ture, and the fact that the passive congestion of cholera is venous is established thereby. The veins, for the purpose of explaining the phenomena of this disease, must be considered as a whole, from their com- mencement in the periphery to their termination at the end of the pulmonary arteries, including the right side of the heart. And the arteries from the beginning of the pulmonary veins, including the left side of the heart, to their termination in the peripheral capillaries, must be regarded as an entirety-as the whole of the arterial blood carrying apparatus. This view bears out the recognized duality of the various parts of the body. These two divisions of the vascular apparatus are distinct in function and separate in action and must necessarily be controlled by different sets of nerves which may be termed in the aggregate the vaso-motors; but when it becomes requisite to distinguish the sets of nerves separately they can be desig- 118 THE QUEST OF THE GERM. nated as veno-motors and arterio-motors. These sets of nerves can each in their own spheres be diversely affected either tem- porarily or continuously, or they may suffer singly from de- pression which will be severe and prolonged. If the whole veno-motor tract of nerves were gradually affected by depression until finally there were complete cessa- tion of the nerve force derived from them, while the arterio- motor tract was not affected in the least degree, the condition presenting the phenomena of cholera would be superinduced. Then, the blood, as soon as it passed through the capillary area would be cut off from the influence of nerve force and would congest in the venules and veins, ^s a result of this stasis the serum would separate from the corpuscular portion of the blood within the vessels, vomiting would take place because of the congestion of the stomach. The serum of the blood in the portal veins would at first ooze out by exosmose through the distended follicles of the mucous surface of the small intestines. The accumulation would be discharged through the natural out- let. The acts of vomiting and evacuating the bowels would exert a pressure on the distended veins that would squeeze out more of the watery portion of the blood, to be in its turn ejected, and the exertion of this pressure would suffice to force the thickened blood along in the veins. These operations would be repeated until at length the blood would be wholly deprived of its serum, and there would only be enough of its volume left to fill the right side of the heart and the veins to dis- tension. The arteries and left side of the heart, not receiving any blood from the veins and right side of the heart would be empty, as also would the capillaries. The accompanying ob- jective and subjective phenomena would correspond in manner and degree with the derangements of the circulation, and as the changes in the blood and condition of the circulatory ap- paratus in the supposed case correspond precisely with those found in cholera, so the phenomena of this case would be ex- THE QUEST OF THE GERM. 119 actly similar to the appearances exhibited by a ease of this dis- ease. This superinduced state resembling cholera is due to a supposed veno-motor gangasthenia. In cholera we find an idiopathic passive congestion. According to our axiom it must be due to gangasthenia. If the congestion be venous it is due to venor-motor gangasthenia. But we have shown that the passive congestion of cholera is venous, ergo-. Cholera is due to veno-motor gangasthenia, Q. E. D. Just as in the supposed case the congestion being venous it was due to the same condition. How simple! The nerves move the vessels, the vessels move the blood. If the nerves cease to move the vessels, (gangasthenia) the vessels cease to move the blood, (passive congestion.) Nature is simple in all her operations. It is only in pro- portion to our ignorance that she appears to be mysterious. The mystery that has hung over the origin of this disease, and the failure of every effort that has hitherto been made to ex- plain it is owing to the fact that our inquiries have been pushed in the wrong direction. The assumption of a specific poison at the outset has been adopted by nearly all writers on the subject; consequently their efforts have been expended in trying to dis- cover the nature and properties of an impalpable something whose existence is purely hypothetical. The views here expressed account for all the phenomena of the disease. The vomiting is due to congestion of the stomach; the serous evacuations proceed from the congested bowels: the cramps are reflected from the same source to the calves of the legs and are the sure sign that congestion of the small bowel exists. It may also be explained that the great nerve trunks which supply the extremities are of a mixed nature, and the cramps occurring here or elsewhere may be to a lack of co- sthenicity between the two sets of nerves. 120 THE QUEST OF THE GERM. Animal heat is produced by the action of nerve force. Normal heat is the result of normal nerve force acting on normal blood normally distributed in a normal capillary area. In cholera none of the conditions essential to the generation of normal heat are present; hence hypotheriny. This explanation will answer for the diseases which are due to the same form of gangasthenia as cholera, but in a less degree of severity, to wit: diarrhea, cholera morbus and cholera infantum. To give a proximate idea of the degrees of severity of these diseases they might be compared thus: Positive, diarrhea; comparative, cholera morbus and cholera infantum: superlative, cholera. The cause of cholera is the environment of the individual. Its epidemicity is accounted for by the fact that whole com- munities are subject to the same environment. The mildly gangasthenic persons have their condition intensified by the continued operation of depressing influences until the disease assumes the shape of cholera. The treatment of cholera has been as varied as the theories of the disease have been numerous. The gamut of the materia medica has been run from A to Zed-from acid to zinc-to find a specific, and the formulas that have been devised as remedies are almost as numerous as the combinations of which medicines are susceptible. But all remedies have been proved to be useless, and the choleraic patients still slip through the doctors' fingers, and drop through the center out of the circle of their environment. The reason is plain, they have not un- derstood the pathology of the disease. Strange to say, by some fatuity, the specific has escaped their notice. Not even accident has revealed it. Reasoning, observation, and research expended upon the disease, its manifestations and various re- sults would never disclose the remedy because they have not unfolded its pathology. The action of the specific divulges the secret of the disease. The physiological effect of a medicine THE QUEST OF THE GERM. 121 solves the mystery enshrouding its pathology. This therapeutic agent, so potent in virtues, so admirable in its properties, so prompt in its remedial action-never before suggested or hinted at-that is indicated by every symptom of the disease, that fulfills the design of a curative agent: in fine, that fills the bill in every particular is the bromide of ammonium. The therapeutic action of this medicine was discovered by its tentative use in disease, and the pathological condition which it met was deduced from observing its effects in correcting the condition. This is reversing the usual order of procedure, but "logic is logic." Some bland idiot rises to explain that it acts by liquefying the blood, because ammonia is the only substance which will prevent coagulation of the blood. The idiots of the profession are incorrigible and will continue to liquefy the blood. They do not understand and the idea will have to be inserted into their heads by means of a trephine. The remedy acts as a sthenic; it energizes the ganglia and restores innervation, and all the evidences of deranged func- tion disappear under its influence. It is as specific in the mild as it is in the severe degree of gangasthenia, and thus not only exhibits its potency but proves that the shape of disease assumed is due to differing degrees of severity of the same con- dition. The following cases show this: Case 1. Diarrhea. Emma S., at 13, hands cool, face pallid, complains of weariness, nausea, slight frontal headache and pain in bowels; has frequent watery evacuations. Pre- scribed bromide of ammonium in ten grain doses every hour or two until relieved, - to be continued thereafter every six hours until restored. Recovery. Case 2. Cholera morbus. Mrs. J. F., at 30, hands and feet cold, face very pale, complains of pain in calves of legs and aching in bones; had vomited often and violently, evacuations serous and forcibly ejected; pulse much reduced; features 122 THE QUEST OF THE GERM. shrunken; had suffered from general feelings of illness and de- pression for some days previous to the attack. Prescribed bro- mide of ammonium in fifteen grain doses every hour until re- lieved and to continue same four times daily, until restored. Recovery. Case 3. Cholera infantum. M. W., male, at six months, hands and feet cool, face markedly pallid; evacuations frequent, flooding the diaper; vomited with violence, ejecting fluid con- tents of stomach in a forcible stream to some distance; much depression and great restlessness and seeming distress. Pre- scribed bromide of ammonium in three grain doses every hour until relieved, to be continued four times a day afterward. The little fellow, after a few doses, soon sank into restful slum- ber, and under the continued use of the medicine marched right along back into rosy health. Case 4. Cholera, sporadic. C. B., a farmer, at 36. Found this patient almost in collapse; face and hands of a cyanotic hue, voiceless, nearly pulseless - pulse a thread; body cold, cramps in limbs, fingers partially flexed and stiff, countenance choleraic; had been retching and purging violently for several hours; attack began on the previous day, but he had been feel- ing badly for a week or more. Gave him immediately twenty grains of bromide of ammonium and repeated the dose every five minutes until he had taken one hundred grains. The remedy acted magically; the voice returned; the pulse became tangible, the surface warm and the condition of the patient in every way ameliorated. The dose was continued every hour for six hours, and afterward four times a day. Under its in- fluence he made a complete recovery. The gentlemen who have contributed to the formation of professional opinion on points connected with the science of medicine consider that it is illogical to argue from the single to the universal-to say, that because a remedy has proved ef- ficacious in one case of a disease, it will be so in all cases of THE QUEST OF THE GERM. 123 the same or like disorders. The remark is correct but the bro- mide of ammonium is an exception to the rule. This remedy is absolutely certain in its action. The administration of a dose of this medicine imparts to the prescriber the sweet con- sciousness that, in all cases, it can be relied on to perform the duty assigned to it without failure. There is no uncertainty of effect with it. There is no waiting to see how it will act. You administer a dose and announce with prophetic calmness: It will have such and such an effect-and the prediction is al- ways fulfilled. Here, after many years, is the solution of the problem presented by cholera. Here are the explanation and the rem- edy, to the discoverer of which, the Breant Cholera Prize be- longs. The dire malady has at length found its match. This is the valiant David of medicine which is to overcome this Goliath of disease; this the ounce of prevention which is worth tons of all other kinds of cure. Palmam qui meruit ferat. NOTES ON CHOLERA. The following article by the author appeared in "The Medical Age" of Aug. 25, 1884,-the Age is the successor of "The Michigan Medical News":- The rise, progress and history of cholera epidemics seem to be of slight interest to any but those among whom the dis- ease rages or has raged, that is if one may judge from the little attention bestowed upon the subject. Yet there is a rem- nant to whom everything connected with the disease is of pecu- liar interest. I refer to the claimants for the Breant Cholera Prize, in the custody of the Paris Academy of Science. Of these I know of but three: J. Collis Browne, of London, claimed it for chlorodyne; Dr. John Chapman, editor of the West- minster Review, hopes to win on the strength of having first pointed out ice as a curative agent; and myself, who claims 124 THE QUEST OF THE GERM. the Prize on the basis of gangasthenia and the virtues of bro- mide of ammonium. Last summer I began an article for this journal on, ''The Cholera: Damietta and its Lessons," and having written the title, ended with that,-concluding to await the report of the investigations made by French and German Cholera Com- missions. Pasteur, the head of the French commission, after a thorough and laborious search for the cause of cholera, gives as his conclusion that no single cause is adequate to produce the disease; that there is no microbe or germ that acts as such cause, and that the raison d'etre of cholera is past finding out. Not so Herr Geheim-Rath Koch. He went to India, after discovering a bacillus in Egypt, and found the same microbe there, and this he asseverates is the essential cause of the dis- ease. In consequence of this alleged discovery he became the "hero of the hour" in Berlin, and was recognized by those who believed in him and his doctrines, as an expert in all that relates to cholera-except the treatment. Then came the outbreak at Toulon, and enters upon the scene the Koch aforesaid. "Bring me a dead marine," he cries, "and I will soon settle this question." No one in all France-not even that past-master in the science of bacteriology -Pasteur himself-is competent for the task, and the imported German mountebank-miscalled an expert-declares the French bacillus not to be French at all, but Asiatic. And then follow these utterances: "Koch says that phenic acid is the best disinfectant." The man is an ass. "Koch says that there is no specific for cholera." There he lies like a knave. "Koch says that the home of cholera is India." Ah! ha! he is a lunkhead. It is as though one were to say that St. Louis is the home of insolation. THE QUEST OF THE GERM. 125 Meanwhile, in Marseilles and Toulon "They are killing men and women" For lack of human skill. That is, they are letting them die; which amounts to the same thing. And this too in spite of the efforts which I have made to promulgate my views and thereby disseminate cor- rect ideas of the nature of the disease and its remedy. These ideas have been given chiefly through the pages of the medical journal which was the predecessor of this, and they obtained wide circulation. Of course they have not been accepted be- cause, as an eminent physician once remarked to me, "You are twrenty-five years ahead of your time." Even now grave men are seriously disputing the evidence of their senses, and arguing that gangasthenia does not exist as a primary con- dition. The venerable idiots have their rights, and one of them is to dispute innovations and to send on its rounds during every epidemic of cholera a "sure cure" for the disease. But they have been very chary of their remarks during the two seasons, passed and passing. It is beginning to dawn upon their minds that the old doctrines are passing away with themselves, and that their opinions are getting old timed and must be consigned to limbo along with the bacilli. Microbes in the wrater! Oh! yes. Billions of them and al- ways have been. The historic Brahmin refused to drink it be- cause by so doing he destroyed life, and himself perished. Microbes in the bowels, too, in myriads, but no cholera. The microbes prove nothing unless they have the Asiatic features. Perhaps Koch can perceive the impress made by the Almighty upon human spermatozoa, and can distinguish that of the Afri- can from that of any other race. Perhaps! The swallows have disappeared. If the birds of the air find the atmosphere unwholesome and migrate to a cooler re- gion, we have yet to learn that they have flown away panic stricken by fear of the microbes. The heat is intense, the air 126 THE QUEST OF THE GERM. damp and stifling. The birds have gone because they could not endure the suffocating furnace-like atmosphere. This and nothing more. Note also the weather. Since June 30th it has been in- tensely hot. The dispatches in this regard are but repetitions from day to day. How they coincide with those from Memphis in the days of yellow fever, or from the cities during the prev- alence of thermic fever. The nature and degree of this heat are the determining factors of the environment. And yet if these lunkheads of science are not headed off, they will en- deavor to convince the world that there is a bacillus insolationis, which, if it were believed in, the first case of sunstroke in any place would create as great a panic as the first case of cholera or yellow fever does. These are however but the puerile observations of scientific lunkheads-the microbes, the birds and the weather. While, as usual, the cause lies there right under their noses, but no one can see it. On July 14th I wrote the Secretary of State: "Sir:-The Academy of Sciences, in Paris have known of a specific for cholera since 1878 . . . The basis of my claim is this: Cholera is acute, general, veno-motor gangasthenia. The specific for gangasthenia is bromide of ammonium, Corollary: The bro- mide of ammonium is a specific for cholera. Please to cable this fact to the American consuls at Marseilles and Toulon and urge them to advise the use of the remedy, etc." Note the use of the term corollary; it gives the force of exactness to the phraseology of an otherwise inexact science. I surmise that the underling who got hold of that letter remarked: "Here is another crank who writes to the State De- partment," and having read it to a circle of admiring auditors who all laughed, he filed it in the proper pigeon-hole or con- signed it, more likely, to the waste basket. Now there need to be no fear of cholera, for, when the vir- THE QUEST OF THE GERM. 127 tues of the bromide of ammonium become known, there will be no more cholera. For information about these virtues I must refer my readers to my previous articles. Of course the proper work to refer them to is the U. S. Dispensatory, but the editors of the latest edition have, with appalling, ineffable, unsurpas- sible stupidity omitted to mention any of the medical properties of this remedy. There is but one condition underlying the disease and but one remedy-a specific-for it, and I do not intend to go to Egypt, or France, or India to prove these allegations. I have done my duty in pointing out the condition and by inventing a term by which to convey an intelligible idea of the disease, as well as by indicating the only remedy. It is the privilege of members of the profession to employ it or to depend each upon his own method. One might appeal to somebodys phil- anthropy, if there were such a sentiment in any medical man in this world-but there is none that ever I have encountered -except in name. If ever that blatant, bloviant, trumpet-mouthed dame, yclept Fame, ever does come in this direction, she need not call on me unless she first deposes Koch from the high niche to which she has elevated him, and brings along and lays at my feet the Breant prize-which belongs to me and to me alone. The journal in which the preceding article appeared was conducted by an editor and four associates and it would appear from the No. containing this article that there was great toler- ance of dissenting opinions. For this No. contains besides the above outspoken article presenting the author's rational opin- ions, first, an article translated from the French on "Static Electricity as a Preventive of Cholera"; second, an article on "The Prophylaxis of Cholera," in which this extraordinary language is used: "In the case of cholera, as in that of all 128 THE QUEST OF THE GERM. other zymotic diseases, there is a germ which will not grow unless deposited in fruitful soil (!)"; third, a paragraphic item containing this: "Even Koch is not infallible, and the profession will not be surprised to hear that his microbe (comma bacillus) is an effect and not a cause." Thus within the pages of the same journal. The author advocates rational views of the nature and treatment of cholera while one editor presents some foreign ideas about the use of static electricity and an- other editor supports the superstition of the germ theory of the origin of choleia and a third casts doubt in Koch's alleged discovery. Here are three erroneous opinions and one correct statement-that of the author. The editors, whose minds are besotted by superstition, cling to the germ theory. It is em- bedded in their minds by concrete fastening of prejudice and ignorance and it would give them too severe a wound to relin- quish it. But doesn't such irrationality jar you? ILLUSTRATIVE CASES. For the benefit of his readers the author deems proper to introduce at this point some of his recorded cases which illus- trate the practical use and therapeutic action of bromide of am- monium : Congestive Uterine Hemorrhage.-Mrs. W., at 29, married, no children, for three months has had slight, constant and con- tinuous uterine hemorrhage, and had been treated by three physicians. They had doubtless put her through the usual routine of styptics and astringents. I was called to her case and found her still flowing, gangasthenic signs well marked, pulse thready. Prescribed bromide of ammonium according to the usual formula and dose. The very first dose checked the hemorrhage and there was no more. Under its continued influence the patient who had become much reduced, was able in ten days to walk to the front gate, and in two weeks from my first visit she went on a journey. Moral obvious. THE QUEST OF THE GERM. 129 Congestive Intestinal Hemorrhage.-Mr. B., at 54, pre- sented signs of general gangasthenia. Cold hands and feet, pain at sacro-spinal junction and at nape of neck; frontal headache, no appetite, pulse slow, some pain across bowels. Had been ailing several days, feeling "out of sorts." Bowels moved frequently, eight or ten times a day, and each passage was accompanied with hemorrhage-blood fluid. Prescribed bromide of ammonium. Recovered and was up the next day. Congestive Pulmonic Hemorrhage.-Mr. M. C. B., lawyer, at 26, was in failing health and excessively worried about his condition. Visited distant cities and consulted some very emi- nent medical men who prescribed for him but without the slight- est benefit and he returned unimproved in health. In conversa- tion with nim one day I told him I could help him. Well, he would keep on with Dr. 's treatment for a while yet. One day in spite of that treatment he had a discharge of blood from his lungs that gave him serious alarm and he came to me. He had sleepless nights, poor appetite and was reduced in flesh: movements languid as if tired, hands cool and swelled when hanging down, and their surface had a peculiar mottled ap- pearance ; palms exuded a greasy sweat. The hemoptysis occurred without premonition at irregular intervals and the discharge was from a teacupful to a pint in amount. These attacks left the patient prostrated and despondent. The only lung symptom was slight hepatic dulness over lower lobe of right lung. He had slight oxaluria to correct which he took some nitromuriatic acid. [If oxalates are present they must first be neutralized because they are incompatible with the bromide.] Followed this with the bromide of ammonium in full doses four times daily, and gave separately some fluid ex- tract of cinchona, I did not prescribe this: patient was taking it on the prescription of one of the eminent city practitioners whom he had consulted and as he desired to continue its use I did not interdict it but allowed him to take it as a placebo. 130 THE QUEST OF THE GERM. No hemorrhage occurred after the first dose of bromide. Patient began immediately to recuperate, and in two months, under the continued use of the remedy, had gained sixty pounds in weight-or at the rate of one pound per day. Dur- ing this time he underwent the fatigues of an arduous political campaign, and at its close his vigor was renewed and he en- joyed better health than ever before. Congestive Intermittent.-Mr. A. D. W., at 39. The pecu- liar feature of this case was the continued and violent paroxys- mal retching. Patient's bones ached, and he said that in the South, where he had served during the civil war, they would call his disease dengue. Quinine had no effect in controlling the periodicity of the attacks. In the midst of the third paroxysm of his disease, which had bothered me considerably, I observed that his hands were cool, and with this as an indica- tion I gave the bromide. I prepared a dose and telling him to take it I left the room. In a short half hour I returned and found the dose of medicine untasted on the table. I insisted that he must swallow it at once, and he objected that he could not and even if he did it would be immediately ejected. I placed it to his lips and commanded him to drink it. He did so, and no sooner had it reached his stomach than the vomiting ceased instantly. This was a revelation to me for I had not yet learned that the bromide could be classed as an anti-emetic. Its use for a short time prepared the way for the quinine and the two were used in conjunction in the further treatment of the case. Acute Passive Congestion of Stomach.-Nellie, G., an actress, was taken sick on the stage. When I arrived found her suffering intense distress in the stomach, with incipient nausea and severe pain reflected on the splanchnic nerves to a point between the scapuhe-pulse slow. Gave her fifteen grains of bromide of ammonium every five minutes. At the end of twenty minutes she was ready to resume her part. She THE QUEST OF THE GERM. 131 told me that the attacks were of frequent occurrence: that usually she had been treated by hypodermic injections of mor- phia, mustard plaster, etc., (the routine business) and was al- ways sick for two or three days with vomiting and headache. Moral obvious. Marasmus of Bowels.-Mrs. E. W. G., at 30, was taken sick in the spring with "chills." Her doctor who was not a graduated physician treated her with large doses of calomel and quinia, but the "chills" were not amenable to such treat- ment. She slowly and gradually grew worse, and her disease was eventually diagnosticated as marasmus, supposed-conjec- tured-to be due to tubercle of the mesenteric glands. Here was a person dying before my eyes and I was powerless to help, because her family had no confidence in me, and yet I knew that her death could be prevented by the potent virtues of bromide of ammonium. I sent her surreptitiously-as the code regards such acts-three doses of the remedy. The effect is described in her own language reported to me by the person to whom it was addressed: "It made me so hungry that I had to get up in the night and eat. ' ' She died, however, in the fall, a victim to the stupidity and prejudices of her friends and the ignorance of her physicians. One of these was called from a distant city and actually all he knew was to prescribe fluid extract of Eupatorium perfoliatum-a remedy that was entire- ly inappropriate to the case and worse than though it were inert. Several morals obvious here. Cholera Morbus.-Was awakened about midnight some time in the month of August 1881 by Mr. P., a farmer, who lived three miles out in the country, and who told me that his wife was very sick and was vomiting and purging at the same time. He wanted some medicine for her relief, or if I thought 132 THE QUEST OF THE GERM. best, he wished me to visit her, I had no relish for the night ride and so wrote this prescription: R Ammonii bromidi oz I Aquae q. s. ad oz iv M. Sig.-Dose 1 teaspoonful in a little water every 10 or 15 minutes, until relieved of the urgent symptoms, and after- ward 4 times daily until recovery. I returned to my slumbers with the satisfaction of know- ing that I had sent an agent that would accomplish its errand of healing and mercy with more certainty than any other at my command. The result justified my confidence. I met the patient some time afterward, and she expressed her gratifica- tion at being so promptly relieved by the remedy I had pre- scribed for her. She said she felt that she would have died without help, but the first dose checked the vomiting, and after four or five doses she went to bed and slept till morning. She certainly suffered from a severe attack of cholera morbus, for which the bromide of ammonium is your promptest and surest of all remedies. Cholera Morbus.-Case 2 was the daughter of Mrs. P., the preceding case. Her husband came to me and described his wife's case as one of cholera morbus, for which I prescribed the foregoing formula, and as, I afterward learned it had the same desirable effect as in the case of the patient's mother. Cholera Morbus.-Case 3 did not occur in my practice or the result might have been different perhaps. A farmer, who, from working in the harvest-field, was overcome with thirst and drank large draughts of cold water, became extremely prostrated. His disease assumed the form of cholera morbus. My young medical friend was sent for, and he took out his pesky little squirt-gun, loaded it up several times with a solu- tion of morphia and atropia, and fired it off at a certain entity called a disease by inserting the point of the gun underneath the patient's skin. Result: the patient died. THE QUEST OF THE GERM. 133 "Why did you not give him some of the bromide of am- monium?" I asked my young friend. "Because I did not think of it." he replied. This case illustrates the action of bromide of ammonium in the same way as the boy said salt spoiled potatoes when you did not put it on. • THE LEARNED DR. WOOD RE-INTRODUCES GANGASTHENIA AND MR. BROM-AM TO THE WORLD THE DOCTOR:-"Let none of you damned fooU dare even to 'peep.'" DISCOURSE OF AMMONIUM. The Author.-"Ladies and Gentlemen:-Allow me to re-introduce to you Mr. Bromide of Ammonium, my former protege. I desire to make you acquainted with his character- istics and will therefore allow him to speak for himself." (Sotto voce to Brom-am) "Don't mince your words. They are a lot of pedantic, didactic dammed fools. Give it to 'em straight. Give 'em Hail Columbia. Sock it to 'em good and strong." Mr. Brom-am (stepping forward).-"Messieurs Your Em- inences, Messires Hyas Tyhees and others of that ilk: Attend. You think you know all that is to be known about ME but you don't know even a little bit. What you do think you know isn't so, like many other things you think you know. In fact you know more things that "ain't so" than any other class of human beings. The reason is that medical science is not an exact science. But it need not all be conjectures and errors and absurdities and lies. And these are chiefly the kind of statements that you make about ME as I shall prove to the entire satisfaction of every rational person to whom these presents shall come." "There was published in New York in 1885 a work entitled "Reference Handbook of the Medical Sciences," in 8 large volumes. Think of a 1 Handbook ' in 8 vols! The volumes were written composed and compiled by ninety Eminences in medicine, who give after their articles the bibliography whence 136 THE QUEST OF THE GERM. they derived the information embodied in their contributions to the 'Handbook.' Hence we have a compilation that con- tains a repetition of all the superstitions that are still fostered by medical men; all the monstrous absurdities and contemptible hypotheses invented by physicians of all nationalities; all the errors ever bred by illogical deduction from false observation, but not a single profound thought-not a single original idea. But I am more concerned about what is stated regarding MYSELF than about all the other matter contained in the 'Handbook.' Let it be remembered that the learned Dr. Wood discovered my most admirable and potent virtues in 1876 and after five years' tentative and practical use of ME, having acquired thereby a complete knowledge of MY properties he gave that information to the world. And now comes one Edward Curtis, a professor of something or other in one of the numerous medical colleges of New York and writes an article on "The Bromides" collectively and he says a number of things about ME that are not so and he does not state any- thing in reference to me that is correct, though he might have obtained all the information in regard to ME (personally as I may say) from the articles of the learned Dr. Wood published in 1881. Why a mere professor in a medical college overlooked and neglected the discovery of the learned Dr. Wood and belched forth a lot of undigested stuff which literal- ly has no basis in fact is more than one can account for, except it be on the ground that the poor fellow did not know enough. Hear him! He states that the most active member of the firm or combination entered into by ME is not ME, but the other partner-bromine. Did anybody ever hear anything so absurd? Oh! yes. There are lots of statements in the books which on the face of them are just as absurd as this. The speaker who addresses you is ME-Ammonium-the hypothet- ical radicle which is the base in the combination which goes under our joint name. The very nomenclature indicates that THE QUEST OF THE GERM. 137 our personal relation is the something Ammonium and this fellow Curtis publishes his ignorance when he states that the something in conjunction with ME, is the most active member of our combination. Does he not know that in the form of vapor I pervade the atmosphere and am a component part of every living thing: that no flower would give forth an odor if I were not present: that if I were withdrawn completely from the air all plants and all animals would perish from the earth-wdiile bromine is a by-product. Yet this mere professor says-and thereby does despite to the profundity and original- ity of the learned Dr. Wood-that this almost inert by-product is the active member of our combination. For this I, Am- monium-the really active partner in the firm stand here and point the finger of scorn at that fellow Curtis who is a mere professor in a medical college-and for aught I know it may be a one-horse college at that-and, with my most contempt- nous air, exclaim: Rot." "Hear him further! 'But on the other hand, the de- rangements of nerve function caused by exhaustion, general or local, are distinctly not to be treated by bromine medica- tion. For in such latter case, because of the generally de- pressing character of the bromine influence, the exhaustion will be deepened and the nervous symptoms therefore intensi- fied.' Oh! what infernal rot! Now let ME introduce to you again a certain condition designated GANG-AS-THE-NI-A by the learned Dr. Wood, who discovered it and first introduced this profound term to science in 1881. What a fine high- sounding mouthful of a word it is; but the strangest thing is that the lexicographers-with one exception-have not recognized this beautiful polysyllabic word though their souls de- light in just such terms. I have no quarrel with them. They have many words to pick and choose from, but they have overlooked the most important word coined in the last twenty-five years and I give them fair warning here and now 138 THE QUEST OF THE GERM. that this child of the learned Dr. Wood's brain, which embodies the most profound and original idea contributed to medical knowledge during the past twenty-five years must be recognized by lexicology and must be admitted by them to the pages of the lexicons which they edit. And further MY advice to them is to define it correctly as depression or exhaustion of the ganglia and not as neurasthenia simply. And now having re- introduced to you the condition designated gangasthenia by the learned Dr. Wood, I have the great felicity to inform you that the learned Dr. Wood discovered in ME those medicinal virtues, those therapeutic properties which constitute ME a specific for the special condition discovered and named by him -the one discovery being the complement of the other. Now what shall be said of a mere professor in a one-horse medical college, who pops up in the pages of that ponderous 'Hand- book' of 8 vols and says in opposition to the enunciations of the learned Dr. Wood that 'derangements of nerve function caused by exhaustion are distinctly not to be treated by brom- ine medication?' What can be said but that the statements of the learned Dr. Wood are profound truths and the statement of the other amount to no more than the braying of an ass." "But hear him still further-this mere professor in a med- ical college, speaking of ME (personally as it were) he says: 'From the point of view of the clinician, ammonic bromide may be regarded as substantially a duplicate of potassic bromide in medicinal virtue, while, at the same time, more acrid in taste and in local action.' 'Acrid in local action', says he. Does any one apply ME locally? Why does he single ME out from the materia medica and object to MY taste when there are so many other medicines whose taste is bitter or nauseous, or lasting and therefore much more ob- jectionable than ME on these accounts. It wounds ME very deeply to have my taste objected to and I appeal to the many thousands who have tasted ME to say if MY taste is not only THE QUEST OF THE GERM. 139 just slightly pungent and very evanescent. But let that pass." "This mere professor in a medical college has not only insulted ME by his remarks about MY taste but to that he now adds an injury to MY reputation by saying that I am 'substantially a duplicate of the potassic bromide in medicinal virtue.' He does not seem to be aware of the fact that the learned Dr. Wood nailed that lie twenty-odd years ago and I am inexpressibly shocked to find it still going the rounds. Well, it must be killed beyond resuscitation this time. I have shown you that our activity depends upon ME the base. The same is true of all MY sisters of the bromine line. Would any one dare to make so fantastically foolish an assertion that potassium and ammonium are substantial duplicates of each other? I guess not. No one is such a damned-fool. If any one said that I'd paste him in the eye. No! Messieurs and Messires and others of that ilk let ME assure you that I stand a head and shoulders above MY sister the potassic bromide and I am not talking through MY cork either. I have a wider range of application and meet more indications than any other bromide. If properly used I can be of more benefit to humanity than any other or all other bromides put together. A 'duplicate of potassic bromide'! Not much! Why I am a giant in my potentialities and the other bromides are pigmies. So -we may consider the remarks of that fellow Curtis about ME laid on the shelf." "But there are others who have undertaken to furnish information about ME and who have made as hopeless and woeful a failure of the matter as Curtis has done. Here is the United States Dispensatory edited and published in Philadel- phia, edition of 1900. The editors are purveyors of valuable and reliable information to the busy practitioner, who con- sults this work oftener than any other. It is his vade mecum, his handbook, his encyclopaedia in one. He looks to it to be informed upon the medical uses and dosage of remedies the 140 THE QUEST OF THE GERM. whole of which no man is competent to carry in memory. Well, let us see what this book has to say about ME.? Here it is: 'Th:s bromide resembles potassium bromide in its phy- siological powers, (action?) but has a less depressing effect upon the arterial and muscular systems. It is certainly superior to potassium bromide in most cases of epilepsy and. even of minor neuroses. The dose is from one to two drachms in dilute solution.' Well, wouldn't that paralyze you? Such a damned conservative estimate of ME seems to have been written by some eminent ass about ninety years old. Say Lippincott & Co. unless you get some more wide-awake editors your dispensatory will soon become obsolete. Just those few words and nothing more about ME-about MY medicinal virtues-and it is evidently all original too. Poor fellow! He knew very little about ME, and so he delved into his inner consciousness and brought forth very indefinite and misleading stuff,-even the dosage not definite! 'Muscular and arterial systems', says he. Show ME the fool that ever hinted that MY physiological action is on the muscular and arterial systems. You fool! Don't you know that since the learned Dr. Wood discovered the nature of MY physiological action that every one who knows anything about ME knows that I act on the ganglionic nervous tract and act as a sthenic; that is I stimulate and im- part strength to all parts of that portion of the nervous system when suffering from exhaustion. Such damned stu- pidity is enough to make decorous and well-behaved bromide break out into p'ofanity. A whole page of the book is devoted to some account of MY chemical nature and preparation. But physicians care nothing about MY chemistry. They want to know about my 'Medical Properties and Uses' and they want to Know all that is to be known. Former editions of the dispensatory used to contain a reference to an article by Dr. Gibb of England, published in 'The Lancet' about ME. There was also at one time a statement that I was incompatible THE QUEST OF THE GERM. 141 with acids in a previous edition. But all these things have been omitted. And yet scattered through the journals there is much valuable information in regard to MY potent virtues and any enterprising editor could have compiled enough about ME to occupy at least two pages of the dispensatory and w'hich alone would have been worth to any physician half the price of the book. See to it Messrs. Lippincott & Co. that in the next edition of the dispensatory this ommission is made good or I will get after you. What you want to do is to get hold of some live, hustling, up-to-date editors and give them carte blanche with your old dispensatory. Give them a pair of shears and tell them to go through it and prune, and prune, and prune until they have reduced your bulky over- grown unwieldy old book to a decent size-and price accord- ing. The editor of the dispensatory refers to ME as superior to the potassium bromide in most cases of epilepsy and even of minor neuroses. Do you not know that I am a specific for not only the minor neuroses of ganglionic origin but also for the major neuroses of that character? The learned Dr. Wood has also demonstrated that I exert the same beneficent effect in the maximum neuroses--such as typhus, yellow fever and cholera, and 'Don't you forget it!' when you come to write ME up again in the next edition of your damned old dispensa- tory. ' ' "Now I will pay MY devoir to another Philadelphia publication, to wit: 'The American Dispensatory', ed 1896. The article about ME opens with that stock lie that 'in almost every respect I have the same action as bromide of potassium.' That statement will probably not appear in future editions after the editor of that work reads this book and I advise him to do so, for his better information. So this statement in regard to ME may be considered effectually squelched. The article continues by stating that: 'I do not appear to re- strain the movements of the heart. ' Great heavens! No one THE QUEST OF THE GERM. 142 has ever accused ME of restraining the movements of the heart. Couldn't the fellow find something else to state about ME? With equal truth he might have stated that I do not seem to restrain the movements of the bowels, or of the blood, or of the big toe. But these things are irrevelant. He might have said with some degree of originality that I do measurably re- strain the movements of certain other organs by diminishing erotic desire or by acting as an anaphrodisiac. And I can give no philosophical explanation of just how I produce this effect. It may be that MY partner is the active agent in this matter. Then comes that stock phrase about the acridity of MY taste and it is stated to be 'more irritating' than bromide of potassium. 'Irritating,' to what? 'Irritating/ how ? ME ' irritating '! Oh ! this is outrageous: this is un- endurable. What calumnies these fools give currency to about ME! ME 'irritating'? Why I am the most beneficent member of the entire materia medica if rightly used. I calm and assauge. I remove crows-feet-those marks of advancing age which cluster at the outer angle of the eyes. If the ladies (God bless them) only knew how I promote a youth- ful appearance and ward off those signs of age and mental worry they would throw massage and unguents and every- thing connected therewith to the dogs and keep ME con- stantly within reach. I will explain. The skin is composed of three layers: the epidermis or outer layer: the rete mucosum or middle layer and the cutis vera or inner layer. This latter is of an aponeurotic nature and contracts from certain causes operating through the nerves which I affect favorably and produces wrinkles in the epidermis or outer layer of the skin. When I am administered to any person whose face bears these tell-tale marks of age I cause the cutis vera or inner layer of the skin to relax and the crows-feet gradually, under my influence, disappear as though smoothed out by a flat-iron-and once removed they do not return: the 143 smooth and youthful appearance remains through after life. So if any lady who may happen to read this is annoyed by those premature marks of age, the results of care, mental worry, anxiety, overwork, or impaired digestion or other trouble and desires to have them removed by a purely scientific method by an agent that will reach the seat of the difficulty let her have recourse to MY aid. Purchase of ME at the drug-store one ounce and place ME in a four ounce vial and fill it with water: Of this first bottle of the solution of ME take one teaspoonful in a little water before each meal and at bedtime. When the first vial is exhausted procure a second ounce of ME and of the solution take a dose before breakfast and supper and at bedtime. Of the solution of the third ounce of ME take a dose before breakfast and at bedtime and of the solution of the fourth ounce of ME take a dose at bedtime. Afterward keep a vial of the solution of one ounce of ME on your toilet table and if on retiring you find that you are sleepless get up and take a dose and you will soon drop off into restful slumber. Some precautions are necessary. It is a well-known fact that acids of all kinds-vegetable and mineral-are inimical to MY integrity-are incompatible with ME: that whenever I meet an acid a rupture ensues between ME and my partner whereby I become neutralized and non-effective. So care must be taken, while using ME according to above formulas, not to consume acids or acid fruits or else some embarrassing or injurious results might ensue from the encounter between ME and some acid inad- vertently partaken of. So also if the appetite is increased as in most cases it is when persons take ME internally, great care must be exercised while eating not to indulge too freely in the pleasures of the table-and not a mouthful be- tween meals. These directions and the preceding formulas are worth millions to the ladies of this country alone in the way of promoting their beauty and preserving their youthful THE QUEST OF THE GERM. 144 THE QUEST OF THE GERM. appearance. Why I recall that on one occasion the learned Dr. Wood prescribed ME for a farmer's wife who was thin, careworn, overworked and had poor appetite. She came after a few weeks to visit the learned doctor, and when he entered the room where she was he did not recognize her. In- stead of the thin etiolated old-looking person he remembered to have seen he was surprised to find a round-faced, rosy- cheeked, plump, young-looking lady. This transformation had been wrought by MY potent virtues and the learned doctor gave all the credit of it to ME. In return I doff my cap-the tinfoil that covers my cork-to the doctor as a gentleman of great acumen who knows a good thing when he finds it." "But it is not in such cases alone that I am efficacious, but I might have been the means of saving many valuable lives if MY virtues had been promulgated abroad throughout the world. The learned Dr. Wood has in another place re- ferred to the case of Mercedes, queen of Spain. When about fourteen years of age she attended school at the convent of Notre Dame in Paris, and at the same time a young American lady was an inmate of the convent and a pupil. This young lady in letters to her friends-since published in Scribner's Monthly-describes the princess: 'She is large and well- formed for her age and sits up very straight, though she droops her head a little. Her complexion is very fine and clear with a healthy tinge, and her features are pleasing, especially the eyes, which are of a soft gray or hazel, deep set, with dark lashes and very bright and full of expression. Then she has a very white throat and pretty-shaped ears, and altogether promises to develop into quite a handsome woman. She has made herself liked by her sweet, modest ways and the spirit with which she enters into all our doings.' The prin- cess was married at eighteen to Alfonso, king of Spain. This sweet and lovely young woman seems to have soon lost her attractiveness for the profligate king who went gallivanting THE QUEST OF THE GERM. 145 after other women. The queen thus deserted became extreme- ly jealous, brooded over her wrongs until she fell ill. One writing from Madrid about this time says: 'We had all noticed and lamented the change which took place in the queen a month or two ago: we saw that the bright color of her cheek had faded, that her soft dark eyes grew larger and a little languid; we all thought that the sea-baths prescribed by her physician with the change of air and scene would prove efficient, and that her indisposition would at most be but of a few days' duration. Still the last time she drove out with the king-just three weeks ago-she looked much worse than usual. She wore a large white grenadine shawl closely drawn about her shoulders as though she felt chilly, although the day was warm; a lace handkerchief was tied about her throat and a pretty little chip hat was drawn down over her eyes as if to shade them from the light, while she held a white parasol over her head though it was near sundown. There was an utter weariness and listlessness in her general aspect in complete contrast with the cheerful countenance of the king. The poor child was even then stricken with death though she little suspected it.' Her condition as thus depicted denotes chat she was affected with mild gangasthenia which developed into typhus fever, although her physicians called it gastric fever with intestinal hemorrhage. The Dons did not understand the case. It makes no difference where the dis- ease occurs; in palace or in hovel-physicians do not under- stand typhus. But suppose that MY medical properties had been known to one of the queen's physicians and he had ad- ministered ME in proper doses at the onset of her disease it is highly probable from what I know of MY potentialities that the queen would have recovered-and there would be seated on the throne of Spain an altogether different person from the one now there. So I might have acted as a factor in changing the course of historical events, and some one 146 THE QUEST OF THE GERM. would some day write me up as the chief factor in sociological probabilities, or possibilities." "There was the case of another young woman that in- terested me very much. She was known by a title of en- dearment as 'The Daughter of the Confederacy.' I read all that was published about her case in the newspapers, and her disease was stated to be due to that very indefinite and unknown something commonly termed malaria. It was quite clear from the dispatches that her physicians did not under- stand her case at all; and I declare it to be an absolute cer- tainty that if they had understood the nature of gangasthenia and had been versed in the use of ME as a remedy that they would have employed ME in her case and the result would have been that she would have recovered. Some day, I ask those physicians, when they come to understand the nature of gangasthenia-if they ever do-and when they become familiar with MY potentialities-if they ever do-to declare in a public manner whether this statement, provisionally per- ceived, but made known after the fact is correct or not. But the possibilities of the case! Let us suppose that by reason of my therapeutic virtues 'The Daughter of the Confederacy' had recovered: that in course of time she got married and bore a son, who might grow to manhood and who one day might be elected President of the United States-the grand- son of Jeff Davis President of these United States-just think of it. Stranger things than that have happened. You see there are possibilities in ME. But let the veil of oblivion be drawn :ov0r such imaginary forecasts. Those things might have happened but they never will happen! 'The Daughter of the Confederacy' is dead and she died a victim of the ignorance of her physicians and I hope that when-if ever- they come to a realization of their inability to cope with dis- ease without MY aid they will say so and that with MY aid she would have recovered. I hope they will be manly enough THE QUEST OF THE GERM. 147 to admit their ignorance-clear enough-without such admis- sion-but that they will give full recognition to the fact that if they had employed ME, a valuable life would have been saved-this in justice to the learned Dr. Wood and MYSELF." "But there are others; yes there are many others whose lives might have been saved by resorting to MY aid in time. I will instance one other. Why should typhoid fever reach into the United States Senate, seize Senator Hanna and hale him off to death and he a man of amazing vitality? Poor Hanna! He adds another name to the long list of those who have fallen victims to the ignorance of their doctors. Those who attended Hanna did not know what he was suffering from. Hanna had typhus, and Rixey and those other fellows do not know enough to diagnosticate between typhoid and typhus. Yet the thing is easy-'just as easy as the girl knew her dad' as I shall presently prove by calling your attention to a schema of the symptoms of each drawn up by the learned Dr. Wood some years ago to enable physicians to make a differential diagnosis between the two diseases. He formu- lated this schema because he found that the medical mind is incapable of distinguishing between typhus and typhoid fevers. Hanna's physicians gave the latter designation to his dis- ease because it is a popular term and also because people being instructed by the daily papers are supposed to understand the nature of a disease to which that name is applied. And yet the doctors said the case presented some anomalous symp- toms. True for you. Symptoms were very anomalous for typhoid but entirely regular for typhus if they had known enough to recognize the true nature of the case. It was stated that Senator Hanna had an attack of influenza in December 1903. Well, he never fairly recovered from that, though he might have become as robust as ever if his physician had known how to treat his condition properly. The condition was gangasthenia in mild form and that condition continued 148 THE QUEST OF THE GERM. and became intensified until it assumed the form of typhus. The most important principle of medicine was obviously neg- lected- obsta principiis. If that rule, more essential to be en- forced in the treatment of the ganglionic diseases than of any other class, had been followed in Hanna's case he would be alive today. Typhoid? Pooh! It was typhus and Hanna's death was due to the rankest kind of ignorance. Palace or hovel: senate-chamber or hut, it makes no difference where these cases occur, doctors never will be able to understand them until they are taught the nature of gangasthenia and become acquainted with MY therapeutic properties. Here is the schema. TYPHUS. Is a hyperthermy. Is a congestive disease. Is a gangasthenic disease and is due to the environment of the individual. Symptoms. Frontal headache. Insomnia, bad dreams. Weariness not weakness. Asthenopia. Pain at the nape of neck, run- ning to base of brain and thence to frontal region. Pain at sacro-spinal junction. Extremities cool. Hands congested, and at length sweating, giving the "wash- erwoman's hand." Hemorrhage from bowels due to congestion, usually cop- ious and rarely absent. TYPHOID. Is a fever. Is an inflammatory disease. Is (probably) a cerebral dis- ease and due to cerebras- thenia. Symptoms. Headache not frontal and slight. Sleep not disturbed by dreams. Debility and not a tired feeling. Vision not blurred. None of this pain in typhoid. Pain in lumbar region. Extremities hot. Hands dry and of natural color; no ' ' washerwoman's hand ' ' in typhoid. Intestinal hemorrhage rare, and if it occurs is due to ulcera- tion. THE QUEST OF THE GERM. 149 TYPHUS. Pain in long bones due to con- gestion of medulla. Conjunctivae congested. Anorexia, or nausea, or vomit- ing. Countenance a darkish red or of a dusky hue. Finger nails purple or dark red. Patient apathetic. Patient restless. Eruption-mulberry rash. Occurs during late summer and autumn usually, but may prevail at any season. Post-mortem reveals general congestion. TYPHOID. No pain in medulla of femora or tibiae. Conjunctivae clear. Anorexia, nausea seldom, vomit- ing never. Cheeks slightly hectic, never dusky. Nails of natural color. Patient capable of emotion. Patient stays in bed. Eruption-petechias. Most frequent during winter months. Post-mortem discloses character- istic pathological lesions and no congestion. "Let Dr. Rixey and those other fellows who attended Senator Hanna look on this picture and then on that and let them say which one corresponds with the Senator's case. And when they become thoroughly cognizant of MY most potent and admirable qualities let them say, whether or not, if the Senator had been treated with doses of ME, when he was ill of influenza, during the December previous to his death, he would be alive today? These cases are typical of hundreds, of thousands that are occurring every year. The ignorance of physicians at the present day is a most stupendous problem. Who is to blame that so many persons are yearly victims of this ignorance? Obviously the teachers in the schools, and the writers of books. These hand down and perpetuate the traditional superstitions that are fostered by ignorance. Pro- gress of medicine, forsooth! There is none, only that which 150 THE QUEST OF THE GERM. comes of the discovery of a new microbe. The bacterists are busy at the quest of the germ, but I propose to place beyond their interference some of those diseases which they claim to be- long to their peculiar province. Around the list of ganglionic diseases given on a preceding page I draw a line of demar- cation. Those diseases are amenable to MY action and I put up this notice: 'Ware all bacterists! I lay this injunction on the bacterists that they must give over seeking the germs of those diseases for they are not of microbic origin. This, MY fiat, is addressed also to the Messieurs Eminences, Messires Hyas Typhees and others of that ilk. They must cease to pursue the quest of the germs of those diseases. If they shall still believe that some of those diseases thus withdrawn by ME from their research are of microbic origin they must relinquish such belief under pain of being classed as damned- fools for giving credence to statements which have been demonstrated to be false by the learned Dr. Wood and MYSELF." "In conclusion and on behalf of the efforts of the learned Dr. Wood to enlighten you and in reprobation of the slights and neglect bestowed upon those efforts and as an expression of MY own utter condemnation of your course and detesta- tion and contempt for yourselves personally I will voice a wish. It is related of Byron that he wished that the pretty mouths of all the pretty women in the world wTere united in one pretty mouth and that he might have the pleasure of kissing that composite mouth. It is told of Alexander the Great that he wished that the necks of all mankind might be united in one huge neck and that he might have the pleasure of cleaving it with his sword. Now I am not so lascivious as Byron, nor so blood thirsty as Alexander, but I wish that the posteriors of all the editors of journals and authors of books who have omitted all mention of ME and MY properties as discovered by the learned Dr. Wood-and of professors who have failed THE QUEST OF THE GERM. 151 to set forth in their lectures the profundity of thought in- volved in the term gangasthenia and who still teach that the ganglionic diseases are due to germs;-and of all bacterists who still claim that the ganglionic diseases remain subject to their investigation were all united in one huge posterior and that I might have the pleasure of kicking that composite posterior from Maine to Texas-and finally into the bottom- less depths of hades where it belongs. Such procedure is justifiable on the grounds of the shameless wrong done to the learned Dr. Wood by the contemptible assortment enumerated. In the time of Galileo everybody gave credence to the Ptolemaic theory of the solar system: now every school-child knows and understands the Copernican theory. When Galileo announced his discovery it was too profound for the compre- hension of mankind: for was it not contrary to the evidence of the senses. But it was true and the evidence of the senses was erroneous. So it is today. The ganglionic theory is too profound for the comprehension of those minds which are im- bued with the doctrines of the germ theory, but is very simple when once comprehended. So I present to you the learned DR. WOOD as a prophet without honor in his own country, whose profound discoveries have been so long neglected, that he stands today the most pathetic figure in the history of the country. And so, farewell! Mr. Bromide of Ammonium bows and retires from the stage-for the present. GUDGEONS. or words to that effect from Shakspeare is sport on a grand scale compared to the funny spectacle of the bacterists baiting their hooks with a mosquito and catching all the gudgeons in the land. How readily they swallow this fairy tale about a "Baiting with a sprat to catch a gudgeon," 152 THE QUEST OF THE GERM. mosquito-bait, hook, bob, line and sinker-is shown by an article in vol. 59 of the "Popular Science Monthly" by that pre-eminent bacterist Dr. George 1\I. Sternberg. This article is very improperly admitted to the pages of that journal which seldom issues Sludge. It ought the rather to have been em- balmed in the "North American Review" or found a resting place between the covers of the "Century." But let us take it where we find it and proceed to mince it. Sternberg has occupied positions of trust and emolument under government for many years at Washington. He has been Surgeon General of the Army and President of the American Board of Health- ctf lamented memory (lamented by those who composed it; they Would like to be back in sinecure office again). He it was who suggested the frost ship by means of which he proposed to de- stroy all yellow fever germs that attempted to land in this country as stowaways on board ships arriving from infected foreign ports. That silly proposition knocked the American Board of Health into smithereens and it might have survived to the present day-but only the fittest survive. So as the Board was utterly unfit it became defunct. Sternberg has been the most persistent and consistent questrist of the yellow fever germ in this country and after all his search and research and investigation he knows less about it than any man in the world. That germ is like a maggot in his brain-he can not rid himself of it. He has pursued the quest of this germ for years and so successful has he been in not finding it that now he is regarded as the greatest living expert in all that relates to the germ and the disease which it is supposed to cause and has only a single contestant for that honor. Mention of whose name his innate modesty forbids in this connection. Stern- berg's dictum on these subjects-the germ and the disease-have hitherto been undisputed; his fiat is law to the bacterists. So when he declares that "the bacillus of Sanarelli has nothing to do with the etiology of yellow fever" that is a solar plexus THE QUEST OF THE GERM. 153 blow and knocks Sanarelli out of the ring. Dr. Sanarelli is a Frenchman who went to Montevideo in search of shekels and fame, and he first sought fame by the alleged discovery of the yellow fever germ. Well, he found it, or said he did and he wrote a long article about it which with numerous and elaborate illustrations occupied eighty pages of "Annals of the Pasteur Institute" lor August 1897. About the same time Dr. Han- burg at Rio de Janeiro also discovered the germ of yellow fever and he also wrote an article about his bacillus which was pub- lished in the same number of the same journal that contained Sanarelli's article - and these articles are mentioned in the journal from which this information is taken as "two very im- portant communications." Well, Dr. Sternberg says that these two articles are of no value or importance whatever. And whenever Dr. Sternberg says anything on this subject you may bet your boots that it is so. But the funny part of the whole business is that Sanarelli's and Hanberg's bacilli are not as like each other as two peas, but are as unlike each other as a porcupine and a polar bear. And so ex nihilo nihil fit: no- thing comes out of nothing. Sanarelli's eighty pages of text and illustration and Hanberg's unknown number of pages of composition amount to just nothing at all because Dr. Stern- berg has said so and he knows what he talks about-apparently. Under Dr. Sternberg's direction numerous experiments were made by his trained assistants during the years 1887, '88 and '89 and the doctor made a lengthy report-(published somewhere and it matters not one whit where), in which the result of these long continued and expensive experiments is stated in these words: "The specific cause of yellow fever has not been demonstrated." Why, you damned fool, there is no specific cause of yellow fever. The author published his ar- ticle on yellow fever and settled once and for all time the question of the cause of that disease and here you were search- ing for three years for something which never has had an THE QUEST OF THE GERM. 154 existence. What an infernal ass! You have wasted as much public money in the quest of a suppositious germ and other tomfoolery of similar sort as would found a university. Ah! ha! but you got your L.L.D. For what pray? Why of course for your research into the cause of yellow fever, and for the numerous articles contributed by you to the journals. Your title was cheaply earned because your researches and contribu- tions to what is alleged to be science amount to precisely the same thing as Sanarelli's and Hanberg's-just nothing at ail. Crede experto. We will let Sternberg make some more fun for us. In this article of his he refers to "the recent researches of Reed, Carroll and Agramonte in Cuba." The parties named were medical officers of the U. S. Army in 1901. The experiments made by these officers were directed to ascertain one fact. They first assumed the fact and then set about to prove it. They assumed that the mosquito serves as the intermediate host ("intermediate host" is fine!) of the microbe of yellow fever and they proved the fact to their own satisfaction and im- mediately announced it. The mosquito was swallowed whole by all the gudgeons in the country. Sternberg accepted it with his eyes shut for he says of these experimenters: "Having demonstrated the fact that yellow fever is propagated by the mosquitoes Dr. Reed and his associates next endeavored to ascer- tain whether it may also be propagated, as has been commonly supposed, by clothing and bedding which had been in use by those sick with this disease." What an egregious lot of asses! First they proved an assumed fact, and now they attempt to prove a foregone conclusion, for if the disease is spread by mosquitoes it could not be spread by fomites. Well, they did put the matter to a number of most crucial tests and most truly and most undoubtedly demonstrated it to be a fact that yellow fever is not spread by infection or contagion conveyed by clothing or bedding. In effect they most effectually dis- 155 THE QUEST OF THE GERM. posed of the last leg on which a plea for quarantine could stand. Will some Honorable Gentleman therefore please to pop up somewhere in a newspaper or in a pulpit or in some journal, or in the forum and explain Why? Oh! Why? Why maintain quarantine against yellow fever? Just let someone, somewhere give a single solitary little bit of a reason having any validity whatever in support of maintaining such quarantine anywhere in any state of this Union or at any port of the United States. And Echo answers there is no reason! Sensible Echo! Then let quarantine be abolished-against yellow fever-abolished by the Senate and House of Representatives of the United States in Congress assembled-abolished by the legislatures of all the states wherever yellow fever has been or is likely to be preva- lent. All the money expended for labor, for germicides, for septicides in the exercise of quarantine power in the disin- fecting of ships and localities; all the money lost to commerce by the interruption of travel and traffic on land and sea would amount to a stupendous sum and all of it might have been saved by the brief scientific truth of this phrase: There is no germ that causes yellow fever. Then take into account the many thousands of lives that have been sacrificed by the nes- cience of medical men. The aggregate of these losses is simply appalling and all due to the contemptible fad-the miserable delusion of the germ theory. How long? 0, Lord! how long? shall this monstrously silly, absurd, nonsensical and ridiculous idea that violates the laws of Competency, of Parsimony, of Integrity, of Generality and of Honesty pervade the minds of men? How long? The Lord only knows. It was but yesterday that some fool bacterist-one of Sternberg's gudgeons-had in- troduced in Congress a resolution calling for the printing of his pamphlet giving "Directions for the Destruction of the Yellow Fever Mosquito." The resolution was referred to a committee where it will be provided with needed sepulture. But the idea of the germ as the cause of yellow fever must 156 THE QUEST OF THE GERM. be killed and killed effectually and it can only be done by the abolition of quarantine against the disease. But this is a digression. Let us return to the Sternberg and have some more fun with him. He rises to explain. Well correct theories need no explanation but he finds that there is one position of the "mosquito" theory that needs to be strengthened and accordingly he attempts to fortify it by beg- ging the Question. It has always been held by the bacterists that the yellow fever germ was a very delicate exotic creature and could not stand cold weather and so was killed by the first frost of the season. But now that the mosquito has been made the "intermediate host" of the germ the old notion of frost killing the germ must be abandoned. "One by one the roses fall." So Sternberg to forestall objections on this score vol- unteers the information that, Ha! ha! ha! "Yellow fever epi- demics are terminated by cold weather because [profound thought, attention all!] because then the mosquitoes die or become torpid. ' ' Ho! ho ! ho! Oh dear! Isn't that too funny ? Dear George: you will be the death of us with your comical remarks and you exclaim: 0, that mine enemy would write a book! Well, here it is. Pitch into it. Only we are your friend and are trying to rid your brain of that maggot which has infested it, lo, these many years. But there is more fun ahead for us. In his article Stern- berg quotes circular No. 5 issued from the Govenor-Generals office in Havana under date of April 27, 1901. This circular was signed by Gen. Leonard Wood, but it must have been written by or at the instigation of that trio of young doctors who are said by Sternberg to have "demonstrated the fact that yellow fever is propagated by mosquitoes" and of course they wanted new regulations to be issued in accordance with this surprising "demonstration" of nescience. They drew up the new rules and of course Gen. Wood signed them-laughing the while in his sleeve at the absurdity of the efforts of these young THE QUEST OF THE GERM. 157 men in trying to hoodwink the scientific world by a theory so simple and so apparently nonsensical. The first paragraph of the circular asserts the mosquito theory to have been demon- strated without any peradventure. (All the same it is false.) The other rules are based on this assumption of its correctness and the funniest one is that which provides that: "Nurses and attendants shall remain isolated, so as to avoid any possible danger of their conveying mosquitoes from patients to non-im- munes" - doctors being allowed to visit patients at will. Now isn't that the funniest precautionary regulation against the spread of any disease ever devised by the mind of man? Ho! ho! ho! Ha! ha! ha! "Danger of conveying mosquitoes!'' Surely David Starr Jordan is a wise man for he said: "There is no medical craze as absurd as not to have a following among phy- sicians who are supposed to be educated." But why isolate the nurses and not the doctors? Is there no "danger of con- veying mosquitoes ' ' by the doctors ? A mosquito that knows his business can hide in a doctor's pocket just as easily as he could in a nurse's. That regulation is n. g. Another para- graph is based "on the assumption that mosquitoes never travel far." Did anybody ever see a mosquito "travel?" According to the cuts in the comic papers mosquitoes do travel, with grip- sacks under their wings and the cuts and these regulations are on a par for comicality. The concluding paragraph directs that in each case a "chart of pulse and temperature be kept as the best guide to proper treatment." More nescience, "Proper treatment"! These fellows know nothing about prop- erly treating a case of yellow fever. The way to treat the dis- ease is to begin the treatment at its onset on the obsta prin- cipiis principle. These fellows have pursued a continual round of baseless assumption and futile deduction; words take the place of things and notions are fostered of which the absurdity amazes us. They have abandoned every position ever occupied and defended by the bacterist and as a last resort they blame 158 THE QUEST OF THE GERM. an innocent insect as the "intermediate host'' of a no-germ. Now they are cornered. If they abandon the mosquito, they can not assume any other insect to be the host. Well, they must abandon the mosquito theory for it is not tenable. So they must accept the ganglionic theory at last as the only theory that is competent, general and honest enough to explain the nature of yellow fever. We make our compliments to Dr. George M. Sternberg, A.M., M.D., L.L.D., etc., etc., etc., for the amusement he has afforded us and dismiss him. Adios, George. Now turn we to another article and try to get some enter- tainment out of it. A fellow by the name of Doty-to be specific Alvah H. Doty, M.D., Health Officer of the Port of New York-has contributed a bunch of Sludge to Vol. 167 of the "North American Review," under the caption of "The Scientific Prevention of Yellow Fever." The content of this Sludge has no relation to its title and the article ought to be labeled "An Argument in Favor of the Re-organization of the American Board of Health." By the way who is editor of the N. A. Review now? There is a good deal more Sludge admitted to its pages in these days than formerly. We used to get some very readable stuff in years gone by, interspersed occa- sionally with Sludge, but nowadays-Pah! The office filled by Doty is a political adjunct to New York, and the appoint- ment to it depends upon "pull." The emoluments of the po- sition were some years ago about $50,000, quite a snug salary for a man of Doty's caliber. Doty, when he wrote the article, believed, in Sanarelli's microbe, but it may be stated as a matter of fact that he now believes in the mosquito theory of yellow fever, for he seems to be one of those gudgeons who would rise to mosquito bait. Doty states that quarantine as at present managed is not successful in keeping the disease out of this country and what is needed for that purpose is a Na- tional Board of Health. With such an institution in good THE QUEST OF THE GERM. 159 running order there is no doubt the disease could be success- fully combated. But as things are at present Doty is in despair. He will find his soul down in the heels of his boots if quarantine shall be some day abolished. That at least is our present hope. Incidentally Doty says some other things that are of no account whatever. But he quotes one or two things that have some significance. Thus he gives us a copy of a resolution adopted by the Third National Sanitary Con- vention held in New York in 1895 which reads: "Resolved that personal quarantine may be abolished provided fomites of every kind be rigidly restricted." Well, now what is the sense of placing "rigid restriction" on fomites after those young doctors in Cuba have demonstrated the fact that yellow fever can not be disseminated by fomites? After that the germ theory has not a leg to stand on and only fool bacterists will believe in the mosquito theory and every sensible man in the profession to whom these presents may come will accept the demonstrated truth of the ganglionic theory and will support and contend for the doctrine that yellow fever is not of microbic origin. Likewise will every other sensible person. So we leave the fool bacterists to wallow in the folly and the shame of their ignorance in announcing the mosquito theory; in supporting and advocating something that subverts the evidence of the senses and controverts every principle of scientific deduction. Let 'em wallow! Doty also quotes some sensible remarks from Reynolds "System of Medicine," which we copy: "A survey of the whole history of the disease [yellow fever] leaves it still to be considered that, at the most, contagion is to be admitted as a merely possible supposition, extremely hard even for its ad- vocates to trace with certainty in any definite instance, while the geographical relation of the disease and its promotion by local unsanitary conditions are palpable and overwhelmingly important." Bravo! Doctor. Loud applause heard in the dis- tance, from the learned Dr. Wood. Here is one man who has 160 THE QUEST OF THE GERM. profound views of the nature of the disease, and correct as far as they go. But yellow fever has prevailed in cities where the utmost cleanliness was preserved and the best sanitary condi- tions were "palpable." How do you account for that doctor? If you were alive today, it is safe to assert, that you would not accept the mosquito theory but would embrace the ganglionic theory as affording the only rational explanation of the disease. This theory attributes it to the environment of the individual- to all the circumstances which affect the individual. All de- pressing agencies cooperate to produce it. These exist in the varying conditions of the atmosphere in general, and in the particular part of it which each person breathes, as regards its purity, warmth, coldness, dryness, moisture, electricity, and motion-and especially the amount of ammonia it contains. They are to be found in the social relations which man sustains to his fellows; in the circumstances of his life as regards his food, clothing, labor and sleeping arrangements; in short in everything that affects his corporeal existence from within or without. The chief factors of causation are excessive solar heat and the lack of ammonia in the atmosphere, but all the factors contribute their share to the propagation of the disease. The conclusion of the whole matter is that there is no specific cause and that it is impossible for such cause to exist. Doty's efforts as fugleman for the National Board of Health have come to naught. If he ever again contributes brain-ooze to some journal he is hereby requested to send a copy hitherward in order that we may bestow on it our special animadversion and have some more fun with his efforts. So we dismiss him. Adieu! Doty. The first imformation we had of the existence of this prize was obtained from an article printed in "The Scientific Amer- ican" of date of Nov. 24, 1877. This information thus derived THE BREANT CHOLERA PRIZE. 161 THE QUEST OF THE GERM. is authentic: and makes the existence of this prize a bona fide thing. We copy from that article: "By a will dated August 28, 1849, a French gentleman named Breant left to the Paris Academy of Sciences the sum of $80,000 (400,000 francs), to be awarded as a prize to any person who would discover either a cure for Asiatic cholera, or the cause of the disease. He further directed that the interest of this fund, until the principal was finally awarded, should be donated as premiums to investigators who might contribute important information tending to advance knowledge relative to the malady. The rules of the French Academy, under which the prize will be awarded are as fol- lows. The competitor is required: (1). To point out a system of medicine [treatment?] that cures cholera in the immense majority of cases; or (2). To indicate in an incontestable manner, the causes of Asiatic cholera, so that by suppressing those causes, the epi- demic will cease; or (3). To discover some certain prophylactic as evident for cholera, as, for instance, vaccine is for small-pox." "The existence of this Prize has been the cause of an im- mense amount of medical research, and hundreds of papers have been submitted to the Academy. The great Prize has never been awarded, and probably it never will be, for before the cause or the cure of Asiatic cholera can be discovered, the malady itself, owing to our constant progress in knowledge of preventive sanitary precaution, will probably, like the plague, have disappeared altogether." These editorial vaticinations have come to naught so far, and it is highly probable that eventually all will be unfulfilled. For it is highly probable that after many years of waiting and expectation the great Prize will finally be awarded to us. We filed our claim to the Prize first under date of April 12, 1878. Copies of this claim were filed in the office of the Secretary of State at Washington, and in the archives of the 162 THE QUEST OF THE GERM. then Legation now Embassy of the United States in Paris. The former copy has recently been withdrawn by us from the custody of the Secretary of State. We discovered the specific for cholera without having any definite knowledge of the na- ture of the disease and in order to comply with the terms of competition for the Prize it was necessary to set forth some sort of a theory to account for the action of the specific in curing it. So we evolved the following which we copy from our original claim: ' ' The cause of the disease is passive con- gestion originating positive irritation. The blood accumulates in vessels which retain their healthy excitability and stimulates these vessels into excessive action. The congestion occurs in the portal system of veins and is dependent upon a depressed condition of the capillary circulation of the liver. The venous radicles in the intestinal mucous membrane share in the con- gestion and are unable to receive the blood from the arterial radicles and capillaries, which therefore become distended and irritated. This irritation relieves itself by profuse secretion- severe and exhausting serous discharges result which with the attendant phenomena constitute Asiatic cholera." When that was written in 1878 it was considered by us to be a philosophical and scientific exposition of the nature of cholera. But now after the lapse of twenty-six years (to a day) all that stuff seems to be the most arrant nonsense-like many another theory evolved by many another man. But all the same we were right about the remedy as time will show. We copy further from our original claim: "The remedy for this disease is Bromide of Ammonium. This medicine acts especially in al- laying irritation of the ganglionic nervous system and in re- lieving disorders of the mucous membrane. Its specific action is upon the vaso-motor nerves. Hence when it reaches the liver it acts like an 'Open sesame!' upon the closed capillaries of that organ, the current of blood dammed back in the portal veins flows through the liver. The engorgement of the capil- THE QUEST OF THE GERM. 163 laries of the intestinal mucous membrane is relieved; warmth is restored to the extremities; the cramps of the muscles pro- duced by the irritation of the ganglionic nerves cease and all the phenomena of the choleraic attack disappear under the benign effects of the remedy." The modus operandi of bromide of ammonium, that is to say its therapeutic action is fairly depicted, but after much thought and study of the subject we concluded that our claim needed to be amended in regard to its theory. Accordingly on April 12, 1885, seven years to a day, after filing our original claim and nineteen years ago at this present writing we sent to the Perpetual Secretary of the Academy of Sciences our "amended and additional claim" to the Breant Prize in which we declared that: "Cholera is acute general veno-motor gan- gasthenia. The term gangasthenia explains itself. All forms of it are due to the environment of the individual. The par- ticular nosological shape assumed by any ganglionic disease is due to the nature of the environment. The environment de- termines the kind of ganglionic depression and the results flow- ing from it follow each other in natural order: 1. passive con- gestion; 2. the phenomena of disease, Cholera being a gan- glionic disease is thus developed." The specific again named was Bromide of Ammonium. It will be perceived that if there is no error in the state- ments on which our claim is based that we are entitled to the Breant Prize. There is no room for error. We have proved in an incontestable manner that the cause of Asiatic cholera is and only can be found in the underlying condition which we have designated "acute general veno-motor gangasthenia" (See ar- ticle, "Cholera," in this book) and we have pointed out a spe- cific for the condition upon which the collective phenomena recognized by all mankind as cholera depend. In brief we have indicated the cause of cholera and have pointed out the specific Tor the disease and as a logical conclusion to these statements of 164 THE QUEST OF THE GERM. fact and knowledge we are entitled to the award-have been entitled to it since the day our claim was filed with the Perpet- ual Secretary of the Academy of Sciences in Paris. In equity the Breant Prize has belonged to us for twenty-six years but notwithstanding our equities the Academy of Sciences has-as far as our information extends-continued to bestow the interest of our money during these twenty-six years upon some member or members of the profession in France whose contributions to medical science have been adjudged, by the Academy, to be worthy of one of the annual prizes derived from that interest. Unless the Academy contemned a notification sent by us, some years ago, to the effect that we would hold the Academy respon- sible for all the interest on the Breant fund and informing the Academy that no further awards from the interest on our money could be made: that such awards must cease because such matter was no longer at their discretion, had been removed from the purview of their judgment, for the reason that our equity was supreme and absolute-unless, we say, that such notification has been disregarded awards derived from the interest have been made annually to competitors by the Academy; that is unjustly, wrongfully and inequitably the interest of our money has been misapplied by the Academy of Sciences, whereas it should have been allowed to accumulate until the final award of the Breant Cholera Prize to us-to whom it belongs. There can be no doubt about such final adjudication. We will, if you please, leave the decision to the most eminent bac- teriologist the world has yet produced and to the biggest fool bacterist to be found anywhere. We pit Pasteur against Koch. Hear Pasteur? He has said:-"No single cause is adequate to produce cholera: there is no microbe or germ that acts as such cause and the raison d'etre of cholera is past finding out." That settles the question as far as Koch and all other fool bac- terists are concerned for it annihilates (reduces ad nihil-to nothing) the comma bacillus and we will finish the job by re- THE QUEST OF THE GERM. 165 ducing Koch to the same dimensions before we get through with him. But Pasteur asserts that the problem presented by cholera was too deep for him to fathom-not so however with the uni- versal Yankee nation, whose mottoes ever are "Excelsior" and "Nil Desperundum. " We will disgruntle the effete scientists of the old world by showing them one who in a single particu- lar is greater than Pasteur, one who denies and disproves his dictum, one who asserts that the raison d'etre of cholera is not past finding out, one who, at the very time at which Pasteur made his pessimistic statement had already found out the "rea- son for the being" of cholera and one who because of this dis- covery will yet capture the Breant Prize. Behold us! And hide your diminished heads Ye Eminences, Ye Hyas Tyhees and others of that ilk when ye learn the fact that the mildest, meekest, most modest and most humble of the members of the medical profession in this country has carried off that glittering prize from hundreds of competitors who have been hungrily striving after it for, lo, these many years. What a great honor that will be for us, and also for this country that an American physician has captured this great prize. We do not care for the honor: we want the prize itself and if we can get that we will share the honor with the medical fraternity of the United States, assigning to each a proportionate share of it. We will relinquish all the honor of this great discovery to those who are by courtesy our professional brethren. They may share it between them, share and share alike. Excluding quacks and fool bac- terists there are some 70,000 regular physicians in this country and upon each one of them out of our abounding generosity we bestow one-seventy thousandth part of the honor of the dis- covery. The Eminences, the Hyas Tyhees and others of that ilk; the mere professors in the colleges and most editors of jour- nals though they have acted very shabbily toward us are gra- ciously granted a share of the abundance of the honor. We would not retain an iota of the honor. But we want the money 166 THE QUEST OF THE GERM. and in return for this wholesale bestowal of the honor on our confreres we expect them to aid us by all the means at their disposal to secure the award of the Breant Prize. We advise them to do this in order to escape future deserved chastisement. And in order to commemorate this memorable division of honor among our dearly beloved brethren we propose to have a leathern medal struck of which shall certify that the holder thereof has been made the recipient of One Share of the Honor of this great discovery; but there is a condition precedent to its bestowal. Every physician who desires to be made the recipient of this said medal must be a subscriber to this book.-Price, paper cover 75 cents; bound in cloth $1.50. Send in your subscrip- tions early and avoid the rush. Now, if our theory is correct, the third condition established by the Academy of Sciences is an impossibility because it can not be complied with. In the nature of things "some certain prophylactic as evident for cholera, as, for instance, vaccine is for small-pox" can not be discovered. There was however, a fraudulent effort made by a fellow named Ferran, some years ago, in Spain, during an epidemic of cholera in that country to prove the efficacy of a vaccine in the treatment of the dis- ease. He pretended that he had discovered such a vaccine and he did a thriving business in applying his alleged vaccine, at $10.00 per, to the arms of all who resorted to him. It was his practice to administer a pill to all upon whom he operated, for its constitutional effect, and as the effect was some watery stools, the plausibility of the theory was sustained by these seeming choleraic discharges. But this Spanish quack was bowled out by a reporter who submitted to the application of the alleged vaccine and who instead of swallowing the pill retained it in his mouth and had it analyzed by a chemist. The active agent in the pill was found to be croton oil, and Ferran being put out of business by this disclosure admitted that his alleged vaccine contained the same substance which produced on the skin of THE QUEST OF THE GERM. 167 his victims its characteristic vesiculation. This ended Ferran. There have been methods of prophylactic treatment of cholera suggested and practiced by others which were conceived in honesty of purpose and promulgated for the benefit of man- kind. The only one of these methods with which we are fam- iliar is the one proposed by Dr. Reginald B. Leach of St. Paul, Minn. Dr. Leach terms his methods Arsenization. The prac- tice in carrying out his proposed method is to introduce into the system of the individual one-thirtieth of a grain of arsenic, by means of an aseptic ivory point, applied to a slight scarifi- cation of the cuticle. Dr. Leach has evolved a theory from a good many speculations of his own and a single observation of Virchow. He quotes Virchow as saying: "There are many cases of acute arsenical poisoning which are not distinguishable by their symptomatology and morbid anatomy from cases of epidemic cholera." Dr. Leach paraphrases that utterance in these words: "As Virchow says, arsenic produces a condition which may preclude a differential diagnosis between it and cholera." Dr. Leach bases his speculation on the delusion of similia similibus and is misled by Virchow's remark as to the similarity between cholera and acute arsenical poisoning. These two diseases-as they may be termed, do resemble each other somewhat as regards their symptoms, objective and subjective, but their morbid anatomy is certainly very dissimilar, for how could it be otherwise? A poisonous dose of arsenic produces acute inflammation of the stomach while in cholera post mortem reveals no sign of gastritis whatever-nothing but congestion and no person who knows anything about the morbid anatomy of gastritis produced by arsenic and the congestion of the stomach in cholera would have the hardihood to say that they could not be distinguished, the one condition from the other. The inclusion of "morbid anatomy" in his statement by Virchow is a deduction made hastily and through inadvertence. Arsenization does not commend itself therefore to the philo- 168 THE QUEST OF THE GERM. sophic mind as a feasible or practical method of prophylaxis. The theory must be assigned to the place where all brain-ooze finds itself eventually deposited. And so Dr. Leach you must relinquish your high hopes of fame from Arsenization and be content to accept the rational ganglionic theory of the learned Dr. Wood. Dr. Leach went to Congress and had the honor of having his memorial printed as a Senate document in 1898. He asked for an appropriation to test his method. Did he get it? Oh! No. But he still urges his pet theory and last year he wrote to Gov. Taft at Manila and sent him some printed matter which, as previously mentioned in these pages, was referred as a joke, to us by that fellow Carter. It is mighty funny how long a delusion will cling to a man's mind. Leach will cherish his as long as he lives and he can no more give it up and ac- cept the only rational theory of cholera ever propounded than he can fly. Such is the constitution of the human mind. The most positive proofs will not change religious beliefs. The same is true of medical beliefs. So we say of Leach: 1 ' Ephraim is joined to his idols; let him alone." We have had some experience with Congress also and we find that body very shy about ordering documents to be printed. A report may be made by some old stick-in-the-mud of an offi- cial which when presented to Congress is immediately ordered to be printed, although when examined it is found to be of no practical value whatever. For instance some years ago-more than twenty-five-some one who was at the time Surgeon Gen- eral of the navy prepared a report on cholera, which, when it was printed in very large type, made a volume about the size of Webster's quarto dictionary. How many copies were printed is unknown to us, but it is safe to say that not many of them are in existence today. Most of them have found their way to the junk-shop long ere this. A few may be found on some out-of-the way shelves in some of our large libraries, but as a book for any purpose except as junk it is wholly valueless. Its THE QUEST OF THE GERM. 169 publication cost, for its composition and printing, a goodly sum of money and it would not have found a publisher in any place on earth except in the government printing office, as an official report. But our experience with a measure proposed by us was different. We drew up "an act to abolish quarantine on account of cholera and yellow fever" of twenty-five lines and sent copies of it to a number of Senators and Congressmen. Only one member replied to our request to introduce our bill. (It will appear on a succeeding page). He wrote: "I think that there would be no hope of the passage of your proposed bill. The quarantine laws are based on the theory that Asiatic cholera is a contagious disease, which I understand is the theory accepted by the medical profession. If this theory were ad- mitted to be incorrect then perhaps the quarantine laws would follow the theory and be repealed. Until, however your views have been adopted by the profession, I can not see any hope for the passage of your bill." And he declined to introduce it in the House. In consequence of that letter we have under- taken a campaign of education, the beginning of which is the issuance of this book. The people must be taught the truth; the Eminences, the Hyas Tyhees and others of that ilk, the edi- tors of journals, the mere professors in the universities and col- leges and the word slingers and space writers in the newspapers -all who have contributed to the immeasurable incubus of the world-sludge-must learn the immutable truth that neither yel- low fever nor cholera are caused by germs. Then all will join in the glad refrain and swell the song until the whole land shall be filled with the music thereof: Down! Oh! Down with the germs, Down to the bottomless pit. For we have learned the truth, And the learned Dr. Wood is IT. It is our intention to keep at this work until all idea of the germs of those two diseases shall be eliminated from the minds 170 THE QUEST OF THE GERM. of mankind, until quarantine against them shall be abolished. We intend that the rays of illumination that proceed from our humble penny dip shall outshine the calcium lights and search- lights so ostentatiously and arrogantly waved aloft by the Eminences and Hyas Tyhees of medical science. If this book shall not accomplish that end we desire to give notice that we will publish another on the same lines and we will not give over until the world is convinced that the ganglionic theory rests on a basis of immutable truth. Then ignorance of these matters and superstition about them will be most effectually squelched. This is to be no spasmodic effort like the spasms of virtue and cleanli- ness that, at long intervals, move the Mayor of Chicago. The campaign of education herewith opened is to be a continuous per- formance. It is not to be supposed for an instant that we have inter- mitted our efforts to obtain the just award of the Breant Prize. Like Dr. Leach we tried to interest the officials of government in the matter and in Dec. 1903 addressed the following to The Hon. Secretary of War, Washington, D. C. A MEMORIAL. Sir: -The undersigned, your memorialist, has learned, from statements issued by the War Office, that more than sixty thou- sand persons died of cholera, during the past summer, in the Phillippine Islands, and he informs you, that, if proper means had been used, not sixty nor even six persons would have per- ished from that disease in those islands. Your memorialist states that twenty-five years ago he dis- covered a specific for cholera, and made it known by publishing the fact in the medical journals of that day, and in other ways, that is by letters written to the newspapers and to individuals. Your memorialist states that the specific discovered by him is the Bromide of Ammonium, which remedy, if administered in proper amount and at proper intervals to any person attacked THE QUEST OF THE GERM. 171 by the disease will have the effect of instantly relieving that person; and if the use of the remedy shall be continued the person will ultimately recover from the attack. Your memorialist states that he gives no credence to the popular notion that cholera is due to a specific microbe which has been assigned as the cause of the disease, and he contends that such belief is irrational, because no person has ever proved or will ever be able to prove the relation of cause and effect between any microbe and the disease known as cholera. Your memorialist states that he has evolved the correct theory of cholera and has expressed it in these words: '1 Cholera is acute, general, veno-motor gangasthenia, " and that condition is caused by "the environment of the individual," and he as- serts, affirms and asseverates it to be an incontrovertible fact that these few words contain the only rational theory of the cause, nature and pathology of the disease ever propounded in this irrational world of ours. Your memoralist states that his discovery is two-fold: he has discovered the cause and nature of cholera and a remedy which is indicated by every symptom of the disease: which is specifically adapted to the pathological condition underlying it, and which meets all indications at every stage of its progress; the one is the rational complement-the scientific correlative of the other, and the remedy fulfills the design of a specific in the most perfect manner imaginable. Your memorialist states that in 1849, a French gentleman, named Breant, left by will to the Paris Academy of Sciences four hundred thousand francs and directed that the sum be held as a prize, to be awarded to the person who would discover the cause or nature of Asiatic cholera or a remedy which would cure it in the immense majority of cases, and your memorialist having made such discoveries did file his claim to that prize with the Perpetual Secretary of the Paris Academy of Sciences and also filed copies of the same in the office of the Secretary 172 THE QUEST OF THE GERM. of State of the United States and in the archives of the United States Legation (now Embassy) at Paris in the year 1878-and subsequently he filed copies of his amended claim at each of the several places before named. Your memorialist states that during the past twenty-five years he has made every effort possible to him to demonstrate the truth of his doctrines relative to the nature of cholera and to promulgate the knowledge of the properties of Bromide of Ammonium in order that he might establish his claim to the Breant prize; that in pursuit of these objects he has solicited the aid of wealthy persons and the assistance of influential journals but has failed to find any one who would take any in- terest in the matter either for the benefit of humanity or for the advancement of science, and hence he addresses this mem- orial to you, in the hope that through you the government may be induced to adopt such measures as will result in effecting the objects which your memorialist has been unable to attain. Your memorialist would suggest that, in furtherance of the objects of this memorial, you would direct the Surgeon General of the Army to send to the Philippine Islands two (2) tons of Bromide of Ammonium, packed in bottles, each containing one pound, and having a label which shall set forth in concise terms the therapeutic properties of the remedy, together with such directions as he shall deem necessary-the quantity thus sent to be distributed to the different military posts and towns in the islands preparatory to and in anticipation of a recurrence of the cholera during the ensuing season. Your memorialist would further suggest that you direct the Surgeon General of the Army to adopt such other measures in the premises as he may deem advisable. And your memorial- ist will ever pray, etc. (Signed) Eugene H. Wood, M. D. National Home, Wis., December 30, 1902. THE QUEST OF THE GERM. 173 Now what do you suppose the Secretary of War did with that report? He simply referred it to the Surgeon General of the Army. About that time some important matters connected with the Philippine Islands were engrossing his attention. It seems that Gov. Taft had made a journey on horseback to some town in the interior about fifty miles distant from Manila and as he consists of nearly three hundred pounds-about four-fifths of which is water-with a large infusion of adipose tissue, and as he endured the unaccustomed method of transportation with- out any great amount of discomfort he cabled the facts to the Secretary of War as something of momentous importance and stated that he had stood the trip first rate. The Secretary of War cabled his congratulations on the fortunate experience and as a joke inquired how the horse stood the trip-which is sup- posed to be a jocose and covert allusion to Gov. Taft's aver- dupois. Thus do great men in office wile away the tedious hours devoted to official duty-cables paid for at so much per word. Obviously our memorial was forgotten by the Secretary of War and the Surgeon General of the Army in turn referred it to a pigeon hole in his desk. Then seeking to re-awaken interest in the matter we ad- dressed a letter to the President in which we used this language: (After detailing our efforts to obtain some action on the part of the officials we continued) "Now, You, Mr. President are a person who does things and so I appeal to you and ask you to issue an order directing the Surgeon General of the Army to put this matter to the test in a complete and thorough-going way. O'Reilly (thats the Surgeon General) has the reputation of being an old-stick-in-the-mud and the fool bacterists in his department will persuade him that there is nothing to our theory and no virtue in the remedy." Our letter and the ac- companying papers were referred by the President to the Sec- retary of War and by him they were referred to O'Reilly, Sur- geon General of the Army and by him they were sent to us with 174 THE QUEST OF THE GERM. the statement that they were returned "without remark." O'Reilly must have been too full for utterance or else he felt that he could not do the subject justice. Soon after this the Chief Justice of the Supreme Court of the Islands died at Ma- nila of cholera, and wre cut the despatch announcing the fact out of a newspaper and sent it to O'Reilly "without remark'' and explained that if "we might make any remarks they would have reference to the damned stupidity of medical men, who, when an actual specific for cholera has been pointed out to them, neglect to use it and thus allow their choleraic patients to die." We also sent some other papers to O'Reilly, al- ways "without remark". Then in the hope that we could force him into making some disclosures about the matter at our in- stance there was introduced in the House on Nov. 9, 1903, this CONCURRENT RESOLUTION Whereas Eugene H. Wood, doctor of medicine, an Amer- ican physician, a citizen of the United States, and late an as- sistant surgeon in the United States Army during the civil war, claims, and for more than twenty-five years has claimed, that he has propounded the only correct and rational theory of the cause and nature of Asiatic cholera, and that he has discovered a specific for the disease and in consequence of which enounce- ment and of which discovery he laid claim in eighteen hundred and seventy-eight to the Breant cholera prize of four hundred thousand francs, founded in eighteen hundred and forty-nine, which is in charge of the Academy of Sciences in Paris, France; all of which matters have been set forth in a memorial letter addressed by Doctor Wood to the Secretary of War, and by him referred to the Surgeon General of the Army; Therefore Resolved, The Senate concurring, that the Surgeon General of the Army is hereby directed to report to Congress what, if any, measures he resorted to in order to establish and confirm or to disprove the claims of the said Doctor Wood ■ and the Sur- THE QUEST OF THE GERM. 175 geon General of the Army, if he has ordered any test of the specific named by Doctor Wood to be made in the treatment of soldiers affected with cholera in the Philippine Islands, is re- quested to furnish the results of such test, and also any other information which he may possess on the subject of this con- current resolution. This resolution was "referred" to the Committee on Inter- state and Foreign Commerce and ordered to be printed, and there it has reposed ever since. It has received decent sepulture for it will never be reported back to the House with a recom- mendation that it do pass. But finding that our efforts to obtain a response from the Surgeon General of the Army were not to be successful we ven- tured on another tack. We drafted a proposal bill which pro- vided for the abrogation of the quarantine laws in these words: AN ACT TO ABOLISH QUARANTINE AGAINST YELLOW FEVER AND CHOLERA. Be it enacted by the Senate and House of Representatives of the United States in Congress assembled, That on and after the passage of this act whenever yellow fever or cholera shall be prevalent in any village, town or city of the United States or of its insular possessions, no person shall do anything to prevent freedom of intercourse, by travel and traffic, with the inhabitants of such village, town or city. 2. No vessel coming to any port of the United States or of its insular possessions from any other country in which yel- low fever or cholera is then prevalent, and no vessel arriving at any port of the United States or of its insular possessions and having yellow fever or cholera patients on board shall be placed in quarantine and the cargo of no such vessel shall be disinfected for the purpose of destroying the supposed germs of yellow fever 176 THE QUEST OF THE GERM. or of cholera: nor shall any such vessel be disinfected for such purpose. 3. Any person who shall violate the provisions of this act shall be deemed to have committed a misdemeanor and on con- viction thereof shall be punished by a fine of not more than $5,000, or by imprisonment not to exceed five years or by both such fine and imprisonment to be inflicted according to the best judgment of the trial judge. 4. All acts or parts of acts that conflict with the pro- visions of this act are hereby repealed. GANGLIONIC DISEASES. This class of diseases is not recognized (that I am aware of) in any work on medicine. Diseases are classed according to their location in the different tissues and organs of the body, but as yet no medical writer has classified the diseases of the ganglia; chiefly, perhaps, for the reason that it is just beginning to dawn upon the medical mind that these portions of the nervous system are the primary seat of disease. According to this view, then, a ganglionic disease is one in which the primal lesion is a disorder of the ganglia-and to this definition may be added the qualifying phrase-and in which the succeeding phenomena of the disease follow each other in accordance with the ganglionic theory. One disease has been accepted as belonging to this class, and there is the highest commandence for the statement. In his "Address on Medicine," before the American Medical As- sociation, on June 7, 1882, Dr. Octerlony said: "The original investigations published during the last year by Prof. Da Costa, trace the morbid processes of Bright's disease to the deep re- cesses of the nervous system and establish beyond much [any?] doubt that the renal lesions are induced by structural changes in the great abdominal [renal?] ganglia of the sympathetic/' These investigations by Prof. Da Costa consisted in the post mortem examination of the bodies of a number of patients who had suffered from Bright's disease. In every instance the renal 178 THE QUEST OF THE GERM. ganglia were found to have undergone structural change. Bright's disease is, then, scientifically speaking a ganglionic dis- ease. Prof. Da Costa's results prove that fact. The highest medical commandence in the land accepts the fact and notes it as a remarkable discovery. The renal lesions are the effect of the ganglionic lesions. I affirm that this is established beyond the shadow of a doubt. Furthermore, the ganglionic theory finds strong support and confirmation in the phenomena of this disease. The primal lesion is a disorder of the renal ganglia- gangasthenia-which is followed by the passive congestion of the kidney. As the disease advances changes take place in the structure of the ganglia, which are the resultant effect of the precedent disorder. The kidney undergoes degeneration on account of the cessation of the nerve force due to the lesions of the ganglia. The character of the blood becomes altered in ac- cordance with the kind of antecedent congestion. The three conditions, gangasthenia, passive congestion and albuminasmia, follow each other in natural sequence and pathogenic order. The disease can no longer be called albuminuria with any appropriateness for that is only a symptom, not alone of this, but of other diseases. Rightly interpreted albuminuria means albuminsemia, which signifies congestion of the kidneys and this indicates disorder or disease of the renal ganglia. The definition must then be modified thus: a ganglionic dis- ease is one in which the primal lesion is a disorder of the ganglia which, if not corrected, will terminate in structural changes in the ganglionic tissue. Now there are other diseases in which the ganglia have been found to have undergone changes. In typhus the abdom- inal ganglia have been observed to be "in a withered state of a shrunk and leatherlike toughness, while their natural color has altogether disappeared or has been changed to a rusty brown, yeast yellow, fawn or slate gray color." But we are debarred by the accepted dogmas from tracing THE QUEST OF THE GERM. 179 the morbid processes of typhus to the "deep recesses of the nervous system," because, forsooth, those dogmas hold that typhus is due to a specific poison and that the wasted degen- erative changes of the ganglia of this disease are consequences of the action of the poison and not the antecedents of all the phenomena present in the course of any given case. Either the renal ganglionic lesions are consequences in Bright's disease or the abdominal ganglionic lesions of typhus induce the phe- nomena of that disease. But our highest commandence asserts that the lesions of the kidney in Bright's disease are due to structural changes in the renal ganglia. By the same rule then the morbid conditions of typhus are wrought by the affected abdominal ganglia, or else there is a specific poison that causes Bright's disease which remains to be discovered. The same may be said of exopthalmie goitre, in which the cervical ganglia are affected, or of milk sickness in which the solar plexus is in- volved, or of any of the ganglionic diseases in which there is congestion of the ganglia (hyperaemia of the nervous centers) ; which condition may in this connection be regarded as a struc- tural change. It is possible that these views are erroneous and that each disease of this class may eventually be found to be caused by its specific bacillus. It is possible, too, that some of the diseases which are now attributed to a bacillus may be shown to be ganglionic. For instance, the doctrine has been propounded that tuberculosis is due to a microphyte that has been impaled upon the slide and whose likeness has been published. Now what more reasonable than the idea that tuberculosis is a gan- glionic disease; that the destruction of lung tissue is a process analogous to the degeneration of renal tissue in Bright's disease and which is due to antecedent changes in certain pulmonic ganglia? The truth of such speculation may one day be con- firmed by the careful investigations of some expert pathologist, 180 THE QUEST OF THE GERM. who will do for tuberculosis what Da Costa has done for Bright's disease. The ganglionic diseases are generally intolerant of opium, and do not yield to quinine. In them opium exerts none of its physiological effects, either as anodyne or hypnotic, and they are amenable to quinine only when complicated with the feature of periodicity, a condition which remains to be formulated. The use of all manner of so called antiseptics, to prevent the spread of the epidemic ganglionic diseases, has been proved to be utterly futile. It has not been established that certain of those diseases are either infectious or cantagious, in the sense in which those words are applied today. THE CONGENEITY OF THE GANGLIONIC DISEASES. The opinion used to prevail that diseases were "congener- ous"; that as to their source or origin they possessed the quality of " congeneracy. " But the words have become obso- lete. Diseases are no longer regarded as due to similarity of cause or as having a sameness of origin, and hence the idea has as have the words that expressed it, fallen into disuse. The ac- cepted doctrine of the day is that diseases are specific in their character; that they have specific origins and run specific courses, and have neither congeneity nor homogeneity. Hence most diseases of the ganglionic class are spoken of as "singular" or "curious" and are discussed singly as not being connected either eongeneically or pathologically with each other. While none of the ganglionic diseases, when their nature and causes come to be generally understood, can be termed "singular" with any propriety or accuracy, yet it is very singu- lar that some of them are regarded as specific and others of them as non-specific. The reason for this, obviously, is in the great diversity of views held by members of the medical pro- fession in regard to the nature of diseases and their phenomena. If the ganglionic diseases were recognized as such there would be no question as to their congeneity. In the present state of opinion their sameness of origin must be established, just as their specificity is supposed to have been, by argument-"the analogies" being omitted as of no account. 182 THE QUEST OF THE GERM. It is absolutely essential to a proper appreciation of any disease that its genesis shall be correctly understood. It is easy to say of a disease that it is due to a specific poison, but it is impossible to prove it by any process of reasoning, except in the case of those specific diseases about whose origin there can be no dispute, and which have no bearing on the point at issue. The question is a fundamental one, and its elucidation has been the source of much error in the elementary teachings of medicine. An historical case will illustrate this: "In 1860, Arabs to the number of 476 were shipped on the Schah Jehold, at Alexandria, to proceed to Liverpool to navigate a man-of- war thence to their original port. The passage from Malta oc- cupied thirty-two days, during which time the weather was cold and stormy and the hatches were battened down. The men, unaccustomed to the rigors of a northern climate, and not pro- vided with suitable clothing, huddled below for warmth and shelter. They were extremely crowded on board, the space be- low deck being insufficient for so large a number, and there were no means of properly ventilating their quarters. The per- sons and clothing of the men were filthy in the extreme. The between-decks soon became intolerably foul, for many of the men being landsmen were seasick on the voyage, and they dis- charged the contents of their stomachs and of their bowels all over the parts of the ship occupied by them. The stench and effluvia thereby engendered were so offensive that the vessel had to be sunk on her arrival at Liverpool. The rations served to the men were much below the proper standard as regards quantity." The author of the book from which the foregoing extract is quoted remarks that the case of these men, many of whom fell victims to typhus, furnishes the only instance to the then present generation to observe the phenomena of typhus be- cause the disease was of rare occurrence. This is a very unsophis- ticated remark, for typhus occurs sporadically in all countries and has, since the year 1860, occurred epidemically in many THE QUEST OF THE GERM. 183 places. The principal factor of the causation of the disease in the instance narrated was rebreathed air. If those men, thus confined in the 'tween-decks, could have been supplied with plenty of pure air, it is a safe assertion to make that-the depressing effect of rebreathed air being eliminated-the men could have endured all other discomforts of their environment and would have come out at the end of the trip unscathed by disease. The query arises on consideration of the case of these men, whether the specific poison of typhus was engendered by their surroundings, or whether the depressing agencies which consti- tuted their environment produced that form of gangasthenia which assumed the nosological shape of typhus? The specificists are at no loss to account for the action of a specific poison after assuming its generation. They say that it is inhaled or swallowed, and thus finding admission into the bodies of the healthy, it exercises its morbific influence on the blood. But they do not show that the blood is primarily af- fected, and disregarding this doctrine account for the symptoms of disease on the ground of a disturbance of the nervous system. The different specific poisons, however, have not yet been dis- played in separate form. They have been engendered by as- sumption and have been brought into the blood by "the anal- ogies." And yet the phenomena of disease are of nervous origin. It is more difficult to explain the connection between de* pressing agencies and their effects than it is to account for the entrance of a poison into the blood. There is the poison and there is the blood-and "the analogies" to bring them together so there is no difficulty about the matter whatever. But how do depressing agencies act upon the nervous system? They act in some cases directly and in others indirectly and as a matter of philosophic truth the method of their action can not be stated in words other than that depressing agencies do depress. Last summer a woman standing in the doorway of her 184 THE QUEST OF THE GERM. home in this village saw a thunder-bolt descend and strike a tree sixty rods distant from her. The sight so affected her that she was prostrated upon her bed and seized with vomiting. She recovered fully on the next day. The question does not arise whether there was an unseen and intangible poison pro- ceeding from that ball of electrical fluid, which permeated the atmosphere and invaded the system of this woman, and produced the physical disturbance from which she suffered. Because we know that fear, acting as a factor of depression, caused the dis- order that resulted in vomiting. Fear is classed with the emo- tions of the mind. The feeling has many phases which may be said to correspond with the objects exciting it, and thus each object would rouse the feeling in forms or degrees differing from each other, but agreeing in kind and intensity with its varying cause. In the case cited fear produced prostration and vomiting. As a feeling of insecurity on board ship it begets phenomena that are termed seasickness. A few years ago [date of article, 1883] a shoemaker in an obscure corner of a large southern city sickened and died. The dread terror his case in- spired caused the people of that city to flee as for their lives, crowding the cars and clinging with desperation to the windows and railings. Terror, dread, horror-the intensest forms of this immaterial feeling drove them from the city in panic stricken crowds. Those who were compelled to remain were none the less affected. As an expression of extreme and sudden fear we have the eyeballs starting from their sockets, or in medical language, exopthalmos. There is a "curious" disease which presents this expression in an exaggerated form as an objective symptom, giving an eye ball that literally protrudes, and known partly from this as exopthalmic goitre. As a subjective symptom ex- opthalmos exists in yellow fever, typhus and most so called malarious diseases. The eyes feel as though they bulged out- ward and when the feeling is severe in the graver maladies they THE QUEST OF THE GERM. 185 seem to the patient as though they would start from their sockets. In the emotion the expression is not due to a poison nor is the actual protrusion in the severer cases of exopthalmic goitre. In 1868 MM. Prevost and Jolyet showed that the forward move- ment of the globe of the eye produced under excitation of the superior end of the great sympathetic, after section of this nerve in the neck, presents the characters of movement, produced by the muscles of organic life, and depends on contraction of the smooth fibres which form part of the orbital aponeurosis. This aponeurosis, in fact, owing to the layer of smooth fibres with which it is covered, forms a fibro-muscular sheath, a kind of contractile covering, conical in form, and with a focal base di- rected forward, which by contracting, presses upon the posterior part of the globe and causes protrusion and the feeling of for- ward projection, which shows that exopthalmos, in whatever dis- ease it may occur, objectively or subjectively, is non-specific in its character and is wholly due to ganglionic disturbance. So in like manner it can be shown that the reflex pains of the different ganglionic diseases are non-specific; that the rachi- algia of scurvy and of dengue are due to identical causes; that the vomiting of cholera and seasickness are produced by the same nervous disorder; and in fine that all the symptoms of this class of diseases point to their homogeneity. Their pathology discloses the invariable presence of congestion, and recent re- search traces their primal origin to structural changes in the ganglia. But, say the specificists, we admit that the specific poisons attack the ganglia. Of course, and they do it by the law of elective affinity; certain poisons for certain ganglia! But is use- less to pursue the dividing absurdities further. The physician who treats a ganglionic disease with the idea that it is due to a specific poison, treats it neither rationally nor scientifically; but he who treats a ganglionic disease as one due to disorder of "the deep recesses of the nervous system," has 186 THE QUEST OF THE GERM. the correct conception of its nature. He will be able to recog- nize it in its incipiency and check it before irretrievable injury has been wrought. Remedies administered to eliminate a poi- son do not have the desired effect. Remedies given to restore the ganglia to their normal condition abate evidences of dis- eased action. "Which is the rational view and which the logical method i "MALARIA." The following article sets forth in substantial form out views on the nature of "Malaria." As a sub-title there ap- peared under the caption when the article was originally pub- lished in the Michigan Medical News, Vol. IV (1881) this sen- tence, "Extract from an unpublished lecture addressed to the graduating class of the Medical Department of the University of Michigan. ' ' Following this came a Note which read: "This lecture has never been delivered, but the writer stands ready to deliver it whenever he is desired to do so. The attention of the Professors of the Medical Department of the University is respectfully in- vited to this extract which is a good sample of the whole." "malaria/' Malaria delenda est. Young Gentlemen:-It is now nearly twenty-five years since I sat as one of a class where you are now sitting, about to receive the crowning honor of the curriculum, and heard the words of caution and advice which fell from the lips of a man who had grown gray in the service. It had fallen to his lot to have performed many of the toils, and to have received but few of the rewards of professional life. He has now gone to his final reward. He closed his address with this sentence: "Go forth, then, and glean in the fields of science, and bring your sheaves and lay them at the feet of your beloved Alma Mater. ' ' 188 THE QUEST OF THE GERM. In pursuance of that behest I have done my devoir for nearly a quarter of a century, and return now bringing with me my sheaf to lay at the feet of my Alma Mater; and I present it too as the cap-sheaf until it shall be capped by some more im- portant discovery in the field of medical science. Before I proceed further I desire that the professors will please to be seated on the front row of chairs. (In compliance with the request the professors, after a brief hesitation, de- scended from the stage and ranged themselves in front of the speaker.) And now I wish to ask the class a few questions: Do these gentlemen here, the professors, still teach that malaria is a poison of an unknown kind, generated in paludal regions and littoral districts by the action of the sun's rays on decaying vegetable matter; that it consists of spores or low vegetable organisms which are absorbed into the system and affect the blood? Do they still teach this as a doctrine to be believed as an infallible utterance ? (A voice: "They do.") Then, gentlemen, I have to announce to you that there is no such thing. That malaria is a miserable lie, a cheat, a fraud, a humbug, a myth, a delusion. That no such thing or substance has existence save and except in the imaginations of those who teach and of those who believe the doctrine. There is absolutely no such thing as malaria per se. There never was and there never will be. No one has ever seen malarious spores nor ever will. I presume that these gentlemen here, the professors, have taught you that the systems of human beings can be saturated with this poison, but that it will remain latent until circum- stances occur favorable to its development; that the poison can not ascend to the second story of a house, but will climb a mountain five hundred feet high, and have instructed you in all the other properties of this bizarre and erratic poison? THE QUEST OF THE GERM. 189 (A voice: "They have.") Miserable men! It is high time that a missionary had come among ye, for there is great need of his work in your midst. (The professors hang their heads. The students groan.) You taught me these self-same errors, and I started out in my pro- fessional career prepared, as I supposed, to encounter this mon- ster "Malaria." My first patient was a man who presented, as I conceived, a typical case, and I prescribed the regulation reme- dies. In a few days he returned and reported that he was feeling worse than before. (A laugh in the audience.) I con- vinced him that his trouble was malaria, and persuaded him to take some more of the same medicine. I did not see him again for some time but when I did I saw that he had com- pletely recovered. On inquiring I learned that after taking my medicine a day or two without benefit, a neighbor had ad- vised him to try "Snoozer's Bitters,"-one bottle of which had effectually cured him. My next case of "malaria" was one that seemed just like the first, and I thought it a good opportunity to make some reputation. I procured a bottle of "Snoozer's Bitters," and, adding a little something to disguise the taste and color, de- canted it into another bottle and gave it to No. 2 (Sensation). The code had no terrors for me then. I anxiously awaited results. The next day No. 2 came back, brandishing the bottle in his hand, he exclaimed, in an excited manner- "What's this?" I answered that it was medicine to cure him of his "ma- laria." "You're a of a doctor!" he ejaculated. "This is nothing but 'Snoozer's Bitters.' You can't fool me on that, I have a dozen empty bottles at home, and it does not do me a bit of good though I have been taking it regularly for a month." He wanted his money back, but I am happy to say, for the 190 THE QUEST OF THE GERM. honor of the profession, that he did not get it, and he went away in high dudgeon. Case No. 3 was a man who came to me in the spring time of the year, whose symptoms were decidedly malarial. I in- quired minutely into his condition and announced to him that he was suffering from the effects of 11 malaria. ' ' ' ' Malaria! ! where would I get malaria ? " he asked. I replied that he had been down into Egypt the previous fall and had got his system saturated with the poison, which had remained latent all winter and was just now making itself felt. "What is malaria, anyway?" he inquired. I explained the theory of "malaria" to him and he scouted the idea. "It is just a bug-a-boo of the doctors and they use the term to conceal their ignorance," he said, and went away to consult another physician, who treated him, as I afterward learned, for rheumatism. These cases set me to thinking that there might be some mistake about the matter, and on studying it up I found that occasionally some physicians had claimed the view that I now take, but were overborne by what was called the weight of opinion on the other side, and which I have come to regard as the densest of stupidity, for after all, stupidity is the great bane of the profession from the lowest to the highest. A year ago I was in New York and called on the Boss Conk- ling of Medicine. I propounded to him a new theory of the congestive diseases, and he simply glared at me and swelled up as though too full for utterance. "You infernal fool," I exclaimed, "I suppose you believe in malaria!" He recovered sufficiently to ring the bell for his servant and have me shown the door. My last remark was injury as well as insult. His income was $60,000 per annum, and "ma- 191 THE QUEST OF THE GERM. laria" brought him half of it. Believe in it? Of course he did -with every fibre of his being. It is a fitting climax to the simple use of the words mal aer by Lancisi in their proper sense-the meaning of which words has become broadened, widened, deepened and extended in every direction until in their modified form of "malaria" it includes everything that is uncon jecturable in pathology-it is a fitting climax, I say that his countrymen have discovered the veritable thing itself and have given it a name. And I presume these fellows here have taken up the story and re- tailed it, with the due embellishment of their fancies, until now you are perfectly familiar with the shape, size and every at- tribute of the bacillus malariae? (A voice: "They have.") Wretched men! Could you not at least have waited until you saw it yourselves, or must you, forsooth, copy and give currency to every pathological lie invented by foreigners? Is it not enough that you foist upon us their bad therapeutics? Ye are the high priests in this temple of Apollo; formulate the truth in this matter and promulgate it! Get out of this rut! To you, young men, I repeat the charge given to me: Go forth in the fields of science, and, having gleaned your sheaf, bring it and lay it at the feet of your Alma Mater. You can cap this sheaf of mine by formulating the condition which is now expressed by the term "malaria." Faugh! It makes the mouth taste bad to utter the word. (By this time the Professors were hanging their heads low in silent sorrow. The audience respected their grief and with- drew, while the band played the Dead March.) Note by the reporter-That evening there was a funeral on the University grounds. A pit-a deep, deep pit-had been dug and into this each member of the class assembled there cast from one hand a volume, each written by a different author, in favor of the pernicious and detestable doctrines of malaria, and with the other he strewed the grave with a handful of 192 THE QUEST OF THE GERM. printed words. These had been cut out of the text-books where- ever the words "malaria," "malarious" and "malarial" had occurred in their pages. The ceremony of interment was closed by the speaker of the day, who said: Malaria! In the name of Hygeia and of Therapeia I exorcise thee from the minds of men. Avaunt! Be gone and trouble them no more! The next day there was visible in a conspicuous place on the University grounds a stone bearing this inscription: SACRED to the PROGRESS OF MEDICINE Ilic J acet MALARIA The monster in whose name so many have been slain has at last perished. Erected by those who hold the doctrine in derision. Mourned by the Prophets. At each side of this large stone were two smaller stones, one bearing the word "Malarious," and the other the word "Malarial." Its offspring had perished with it. The Profesors wore the usual badge of mourning. They had lost one of their oldest, most respected and satisfactory friends. [This address seems to have been delivered.-Editor.] THE QUEST OF THE GERM. 193 SIR BROM-AM THIS IS SIR BROM-AM. HE HAS BEEN KNIGHTED BY THE LEARNED DR- WOOD; GIVEN THE ACCOLADE WITH A STEEL PEN. HE BEARS ALOFT THE TORCH OF SCIENCE AND CARRIES THE STANDARD OF GANGASTHENIA. THE LUNKHEADS OF SCIENCE. Prof. Pearson of England, a scientist of repute has made this profound reflection:- "What science needs at present is to get rid of most of its data and investigators with brains enough to interpret what is left. At least 50 per cent of the observations made and the data collected is worthless. In en- gineer's language we need to 'scrap-heap' about 50 per cent of the intellectual products of the nineteenth century labeled science. ' ' 194 THE QUEST OF THE GERM. The paradoxical title "Lunkheads of Science" is used to designate those who serve up the data of ignorance and label them science. Our brilliant friend Mr. Brom-Am has been in- vited to discourse to us on this interesting subject and he will now entertain us with some of his characteristic remarks. (RE-ENTER MR. BROM-AM.) {Loquitur) Ladies and Gentlemen, Your Eminences, Messieurs Hyas Tyhees and others of that ilk! At the request of the Learned Dr. Wood I appear before you again to point out to you a few of those collectors of the data of ignorance which they label science, and whose intellectual products are to be ' ' scrap-heaped. ' ' The damnedest lunkhead of science on the surface of the earth today is undoubtedly a fellow named Robert Koch of Berlin. He is the fellow who some years ago alleged that the comma bacillus discovered by him at Damietta in Egypt was the cause of cholera and all lunkheads gave credence to that statement. It will require many years of effort on the part of your true scientists to rid the world of that idiotic idea. Yet such alleged discoveries are accepted as evidence of the Progress of Medicine and are seldom disputed when made by the little tin-god of the bacterists. Some day Koch will find his comma bacillus on the "scrap- heap" along with most of his alleged discoveries, while the pro- found discovery made by the learned Dr. Wood will be hailed by the world as filling a vast hiatus in scientific knowledge, for the simple theory evolved by him, that cholera is acute general veno-motor gangasthenia will gain recognition in due season. But it is enough to cause M. Nobel to turn over in his coffin when that aggregation of lunkheads, the Caroline In- stitute of Stockholm last year awarded the Nobel Prize in medicine to Koch. And in the name of heaven! For what ? THE QUEST OF THE GERM. 195 "For researches looking to the prevention of tuberculosis" and of course these researches include that celebrated fiasco that Koch made some years ago over his reported discovery of a specific serum for the cure of that disease. So the announce- ment that the Nobel Prize was awarded to him jars the scien- tific world. It would be interesting to learn the views of M. Nobel about the extraordinary award of the prizes founded by him. Perhaps our spiritualistic friends can get in communica- tion with him and secure a message from him upon the subject. Meanwhile Koch smiles-in his sleeve-he has won the prize for no addition to human knowledge and in direct violation of the provisions of M. Nobel's will. However I am not done with Koch and will proceed to roast him some more. On May 3, 1903, the following com- munication from him was published in ' ' The Milwaukee Sentinel ' ': PROF. KOCH'S THEORY OF TYPHUS. PROF. KOCH, M. D. Note-The frequency of typhoid epidemics in the United States caused The Sentinel to cable its Berlin correspondent to obtain an opinion on the question "How to Fight Typhoid," from the greatest living authority on that disease. Prof. Koch. When the cable arrived the eminent doctor was on his way to Africa to continue his studies on the malaria germ, but he has now been heard from and his valuable counsel is appended. Special Correspondence. Berlin, April 23.-I propose to answer the question, "How to Fight Typhoid" in a broader sense than suggested, for what American newspapers describe as typhoid is undoubtedly often the more serious variety of typh fevers-typhus. True, in isolated cases the latter and typhoid are easily distinguished from one another, yet it is a fact that often they are so merged as to baffle even experts as to proper classification. While possessing only unprofessional reports- those of the daily press-respecting the present typhoid epidemics in the 196 THE QUEST OF THE GERM. United States, I do not hesitate to say that in numerous cases cited the word typhus should have been substituted for the term typhoid. This article being intended for laymen, it can not be my purpose to discuss the two diseases scientifically. I will, on the contrary, endeavor to bring forward only such arguments as appeal directly to everybody's understanding. Above all, which is typh fever's favorite stamping grounds? City or country? Every newspaper reader with a memory will answer: The country districts; and if he has access to medical statistics he will find that the mortality from typh fevers and the fre- quency of their occurrence in cities have decreased steadily during the last ten or fifteen years. Why are city people less subjected to these deadly diseases? Because sewerage, plenty of hot and cold water, facilities for bathing make them cleaner than the average country folks. If a typh fever epidemic is reported from a modern city look at the map of the place. You will find the hotbed of the disease either in the oldest quarters, having antiquated or in- adequate sewerage and water supply, or in the suburbs, added to the town for political reasons, but not yet blessed with city improvements. In the majority of cases such suburbs are "waiting" for sewerage, in the meanwhile getting along with cesspools, whereby every householder renders every other house- holder's premises dangerous for this reason: The typh fever's specific poison generates in the living human body, the dis- charges of which preserve the germs of the disease. Such will rise out of the cesspool through atmospheric or other agencies, or during the cleansing process, by overflowing or by impreg- nating the neighboring soil. The germ is hardy and whenever it enters a living body the disease is communicated. THE QUEST OF THE GERM. 197 If you live in an improved section, where at some former time cesspools flourished, avoid well water. The soil is liable to carry the disease into the wells. If you notice any defects in your sewer, leave the premises until same is attended to, for the virus of typh fevers may vitiate the air you breathe. An ill trapped closet should be condemned at once as a breeder of typh fever germs. I have found that typh-fever epidemics are often artifi- cially created by the unwarranted notion that the disease is not necessarily contagious, a false idea, not only held by lay- men and the ignorant generally, but even by doctors, some of whom do not hesitate to distribute typh-fevers patients in the general wards of hospitals. I warn everybody that typhus, as well as typhoid, is com- municated from man to man, that it is highly contagious-as contagious as cholera, for instance. Typhus and typhoid can be restricted and fought by the public health authorities and henceforth must be subjected to the rules and regulations that apply to cases of cholera and malaria. I spent three months in the typhus and typhoid districts about Treves, Germany, where unimproved towns and villages were alike affected with deadly results. "When I went there as government commissioner, I prepared statistics about each fever stricken household in order to keep track of the disease. In this way I learned that one case was propagated by another, despite ordinary sanitary precautions. First one person sick- ened, two or three weeks later a second, again after a few weeks a third, etc., etc.-a perfect chain! The disease was communi- cated by inhaling the patient's breath, by a handshake, by wiping his brow, by washing his linen in the same tub with the rest of the people, etc. In conclusion let me state briefly how the population of the Treves district was saved from being decimated by the 198 THE QUEST OF THE GERM. typhus and typhoid epidemic. The methods first introduced there and the good results had may easily be duplicated in any afflicted community the world over. No less than seven small towns and villages were afflicted, the number of patients being over 300 at the time when the government took the matter in hand. Previous to that 125 per- sons had died of typhoid or typhus in that district. I found thirty-two persons ill to the death, and removed them at once to a barrack lazaretto, set up on the hill outside the infected district. As a matter of course the soil conditions about the lazaretto had been fully investigated and were satis- factory in every way. The sick people left in the houses were completely isolated by trained nurses, sisters of charity, and a disinfector was ap- pointed for every two afflicted houses. The treatment was the usual one, but the additional precaution taken saved the lives of every one of our typhoid and typhus patients; not a single man, woman, or child died, while before that every third pa- tient had succumbed to the disease. Isolation did more; within three months the epidemic was completely stamped out, but we remained six weeks longer to observe whether it would or it would not raise its head again. That was so much time wasted, I am happy to say. No patient was sent away from the hospital, or released from isolation in the houses, unless his discharges had proved free from typhus by three successive bacteriological investiga- tions. At the end of the three months there was not a single typh-fever bacillus to be found in the villages which had been pronounced "doomed" on account of the epidemics. And this was achieved by absolute isolation of the sick and by observing ordinary hygienic rules with respect to the living. THE QUEST OF THE GERM. 199 Sewerage, cleanliness, isolation, then will stamp out typhus and typhoid. Let the health authorities treat these diseases, and fight them as they would cholera, and all is well. The learned Dr. Wood commented on Koch's screed in the following words: OLD ARMY SURGEON SCORES KOCH'S TYPHUS THEORY. I desire to express my dissent from the views and doc- trines set forth by Prof. Koch in The Sunday Sentinel of May 3, and to enter my protest against the dissemination in this country of the nescience promulgated by that scientific mounte- bank in his own. I will first pay my respects to him. He is an eminent physician in Germany, a man of note, who is recognized as a distinguished bacterist. But he has never, as far as I know, or as any other person knows, made any discovery in his special studies which is of the slightest practical value to medical science. He discovered a bacillus in the discharge of cholera patients, which he named from its shape the comma bacillus, and alleged that it is the cause of cholera; but its presence, if present in that disease, is incidental to or resultant from path- ological changes. The truth is that cholera is not caused by a microbe of any kind whatever, but is due to the environment of the individual; its epidemicity is due to the fact that many persons are subject to the same environment. I discovered the true nature of cholera more than twenty- five years ago, and pointed out the specific for its cure. But the much heralded comma bacillus announced by Koch as its cause overshadowed-completely adumbrated-my more bril- liant and profound discovery of the nature of the disease and 200 THE QUEST OF THE GERM. its specific. Besides medical men have become so thoroughly indoctrinated with the views and opinions of the bacterists, that they are content to believe what is set forth by these intellectual myopes rather than to dispute their conclusions. Hence bac- terical doctrines have gained such sway over the minds of the younger members of the medical profession that there is no one brave enough to dispute the irrational statements of the teachers of bacterism, and at this day it has come to pass that the present generation of doctors believe implicitly that all the different diseases are each due to a different species of microbe. Even pneumonia they believe to be caused by a microbe which bears the designation of pneumococcus, and no wilder vagary was ever seriously entertained by the human mind. This kind of science is a blind fetichism, and each particular microbe when brought into the field of vision immediately becomes a fetich to the observer. Bacterism is measurably and to a great extent a fad, and Prof. Koch is one of its chief faddists. It will be remembered that he announced some years ago with a great flourish of trumpets from his laboratory that he had succeeded in making a preparation which was a specific for consumption, and the thing turned out to be a most unmitigated failure, which proved him to be a man who traded on his reputation. Yet there are people who still swear by him and read with avidity such balderdash as the stuff from his pen that was published in the Sentinel of May 3, entitled, "How to Fight Typhoid." In his article Prof. Koch, referring to typhus and typhoid fevers, says: "In isolated cases they are easily distinguished from each other, yet it is a fact that often they are so merged as to baffle experts as to proper classification." This statement is utterly erroneous. The ordinary phy- sician can not distinguish between the two diseases, and typhus in isolated cases is almost always mistaken for typhoid by the generality of doctors. The disease termed typhoid is a fever, THE QUEST OF THE GERM. 201 but the disease known as typhus is a hyperthermy, and unless practitioners understand the mechanism of fever-as few of them do-they can not appreciate the distinction which marks the difference between the two. Now I am an expert, though not recognized as such, and a little thing like the problem set by Prof. Koch does not baffle me. But I much doubt if he understands the mechanism of fever, about which he discourses, so as to be able to tell me the distinguishing characteristics of fever and hyperthermy. Yet some years ago I drew up and published a schema [printed in preceding pages of this book] of the different symptoms of these two diseases, by the study of which any physician can readily make a differential diagnosis during the life of a patient and need not wait for the result of an autopsy to learn if he was mistaken or not. These mistakes have often been made in the past and will continue to be made in the future, and they will not be prevented by anything Prof. Koch has ever done or written or by any addition he has ever made to what we call the science of medicine. Mercedes, queen of Spain, died of typhus, which was diag- nosed "gastric fever with intestinal hemorrhage" by her phy- sicians. Palace or hovel, it makes no difference where the dis- ease may occur, the doctors can not distinguish between typhus and typhoid. In 1879 an epidemic of fever occurred in Denver, and the disease was termed typhoid by the city health officer and by the physicians of the city who treated any of the patients who were ill with the fever. One doctor alone, in a city of 40,000, where there were 300 other doctors, dissented from this opinion. And his opinion was correct, for all the published data estab- lished the fact that the epidemic was one of typhus. In 1846 Dr. Jenner, professor of pathology in University college, London, made sixty-six post mortem examinations of patients who had died of what had been recognized and treated 202 THE QUEST OF THE GERM. as typhoid fever. Of these, twenty-three presented the an- atomical sign of typhoid and forty-three were without this sign. Which is to say that forty-three cases of typhus were treated as cases of typhoid. Last summer (1904) there was an epidemic of what was called typhoid in Chicago. From what I was able to learn of the character of the disease I have no hesitancy in declaring my opinion that the epidemic was one of typhus and not of typhoid. Prof. Koch says the two diseases are often so merged as to baffle even experts to distinguish them. I do not under- stand what he means by their being "merged," and it would baffle an expert to find out. But if he means that the two diseases run into each other and become so blended that it is impossible to distinguish whether a patient is suffering from the one or the other, some of the preceding details given by me bear out his assertion. The reason for the inability of the ob- servers-even experts-to make the distinction is that they do not know how to distinguish between them, and it is the "know how" that constitutes the expert. The two diseases are, how- ever, as distinct as yellow fever and scarlet fever, and can be as readily distinguished as those two diseases-if one knows how. Prof. Koch still clings to the superstition that typhus is contagious-"as contagious as cholera, for instance," or say, as yellow fever. I help him to another example, for he un- doubtedly believes in the contagiousness of yellow fever. "One case was propagated by another," he says. In saying this he displays that he is a careless observer and lacks depth of mind, for his remark is more the result of preconceived ideas than of any profound study of the subject. He finds one person taken sick after another and he takes it for granted that the con- tagion from the first affected the second person. Now, the re- sults of the investigations and experiments made by the medical 203 THE QUEST OF THE GERM. officers of the United States army in Cuba has established the fact that yellow fever is neither contagious nor infectious and typhus is a disease of the same general nature, and it is just as certain that it, too, is neither contagious nor infectious. Prof. Koch may have found any number of bacilli in the dis- charges of the patients whose treatment he supervised, but he can not rationally attribute typhus to any specific microbe, for, like cholera and yellow fever, it is due to the environment of the individual. I wish to be understood that what I inveigh against particu- larly is the setting of this man upon a pedestal as an eminent scientist on account of alleged discoveries which have no prac- tical value and most of which are based on irrational methods or fraudulent procedures. Undoubtedly he is an educated phy- sician and understands the principles of medicine, in a measure, but while he has been elevated to the first rank on account of his alleged discoveries he is, in my opinion, a man of little more than ordinary attainments, who has become famous by reason of the exploitation of a specialty which is based on fake deduc- tions from erroneous observations. But there are others. I was in the office of The Chicago Chronicle in August 1905 in the sanctum of the Sunday editor. By the way the Chronicle prints more misfit medical stuff, al- leged to be information, than any ten daily newspapers ought to publish, in utter disregard of the proverb, ne sutor ultra cre- pidam, and thus gives circulation to numerous misconceptions of the nature of disease as in the letter which follows. Well, as I said I was in the Sunday editor's sanctum when to him enters the foreman of the composing room and said, "What am I to do with this stuff from that damned old stick-in-the-mud down at New Orleans?" 204 THE QUEST OF THE GERM. "Let me see?" said the editor. "Why this is from Dr. Holt, who has been quarantine officer of New Orleans for twenty-five years. Oh! this must go in the paper." "Any pictures to go in with it?" "Yes, take these and tag the letter to them," and he handed four pictures to the foreman. These pictures were taken at Thebes, Ill. One showed some men cleaning wells; a second showed an inspector flagging a train: the third showed a man fighting the ste-gom-YAH with oil: and the fourth exhibited the mayor of Thebes riding in a buggy directing the crusade against the yellow fever muss- kec-to. The whole-the letter and pictures-displays the care and discrimination exercised by the Sunday editor in selecting and arranging "the stuff" for the Sunday edition of his paper and this method of mixing a letter from New Orleans with illustrations from Thebes show that he is fully qualified to be classed under the caption of my discourse. Holt's letter follows: POISON OF YELLOW FEVER-NEW ORLEANS AUTHOR- ITY COMPARES IT TO RATTLESNAKE'S VENOM. - MOSQUITO INFECTION FOLLOWED BY SAME EFFECTS AS REPTILE'S BITE-USE OF DRUGS TO FORCE ORGANS TO RE- MEDIAL WORK MEANS DEATH. JOSEPH HOLT, M. D. In the course of my remarks on the treatment of yellow fever I mention to you now that for clearer illustration I may use mixed metaphor and, if so, you will know that it is in- tentional and no apology necessary. This subject is one that may be briefly epitomized or hugely extended. It may be condensed into a very small brochure or explained voluminously, according to literary proclivity. THE QUEST OF THE GERM. 205 One may have much to say in little or little in much. As for myself, I can better respond to your wish by repeating, while fresh in my mind and with some enlargement, my reply to a young physician a few evenings since who propounded these questions: "Doctor, please tell me, do you give quinine in yel- low fever and what do you consider the best treatment of the disease ? " My esteemed young friend, you are just entering the gate- way of experience and I hope you may find wisdom without paying overdear for its possession. As to quinine in yellow fever, I ask why, what has suggested it? "Well, Dr. Osler ad- vises it." Yes, my dear boy, and he further tells us that neither emetics nor purgatives are now employed, and when hemorrhage sets in to use perchloride of iron, all of which is enough to make a New Orleans physician collapse in fatal syn- cope. Let Dr. Osler pursue this course in Baltimore, where they have inhabitants, perhaps, overcrowded and to spare, but to advise it as permissible in New Orleans he merely declares to us that he passed his 40 mark by many decades, and for the sake of his yellow fever patients should have been chloroformed long ago. We send him a counter recommendation in the Kibby cot and ice water affusion. They will surely settle the busi- ness for Baltimore. GIVE NO DRUG. No sir! After your initial and preparatory measures give no drug, and, least of all, a nauseous one, when you know that the stomach already is moving on in dreadful haste in the di- rection of a supreme crisis, a disorganizing and hemorrhagic congestion, whose terminal may be black vomit and speedy death. Why do you speak of quinine, knowing that you are deal- ing with a poison possessed of the putrefactive virulence, in- 206 THE QUEST OF THE GERM. voking a like universal sepsis, a liquefying spoliation of the blood and hemorrhages, with rapid tissue changes and soften- ing of the fatty degenerative series such as characterize also the venom of the fer-de-lance and both alike touching the life of all the blood corruptibly? Did it ever flash into your mind, young gentleman, the close geographical kinship between yellow fever and the family crotalidae represented in the fer-de-lance, the moccasin and the rattlesnake? Of course, it is coincident, but is more than merely coincident. I call it a geographically localized creative ten- dency, as witness China-all things yellow and one pervasive, absolutely unique odor, and numerous even more striking evi- dences of such like qualitative kinships in nature, geographically limited. As to what you shall give in yellow fever, let me cover a wide field in a few words. But let me say to you right here that your duty is in behalf of your patient first and to the protection of your people second and not to the furtherance of pharmacological inquiry. In responding to this dual duty you must have the backing of your own strong integrity, of a courageous manhood and conduct yourself so clearly in your high office that you may command unquestioning confidence in the face of any trial. Quail not under a covert threat. Far better to forfeit your life in a glorious martyrdom for truth than to have your people to cry out in their distress, like Job, rising in his affliction: "But ye are forgers of lies, ye are all physicians of no value." SEARCH FOR SPECIFIC FUTILE. Concerning treatment, I tell you now that every known energy and substance, excepting, to date, the X-ray and radium, have been ransacked in the quest of a specific, and in that par- ticular we are today where we were 100 years ago. THE QUEST OF THE GERM. 207 In assuming the care of a case of yellow fever the phy- sician must have clearly defined a mental picture of the four stages of the disease, shading one into the other, in progressive unfolding; recognizing and interpreting each in the succession of symptoms. To do this makes the skilled diagnostician and without it there is no such thing as a masterful, a safe and judicious treatment. Right here lies the difference between the trustworthy yellow fever physician and the wholly unreliable physician, because not skilled in this bedside interpretation, so the whole question rests finally on this power. From observation I will boldly say that the most danger- ous allies of yellow fever, excepting, of course, first and always the man who chooses not to recognize the first cases when he sees them glaringly and suppresses information of the first sparks of pestilence from motives of cowardice or his own little rascally preferment-next to him, but far less criminal, is the charlatan and blatant ignoramus, with diploma or not; close behind is the educated physician, long in practice outside the yellow fever zone, simply because he brings his accumulated experience to bear in confident assurance in the one lone, abso- lutely unique malady, the most mysterious on the planet. ANALOGUE OF RATTLESNAKE. With a big heart and a generous, helping hand, a complete and sacrificial offering of self, he plunges into the treatment of an infection that holds its destructive sway in the unseen world of matter, in its operation the analogue of the rattlesnake among things visible. Named by its nature, it should be called Nolli me tangere, and no such dignified, warning name misapplied to a chronic ulcer. In every variegated diamond, in the triangular,' square- jawed head and sullen eye you see in the rattler written all over by the hand of nature Nolli me tangere, and so in the outward signs and inward working of yellow fever. "Provoke 208 THE QUEST OF THE GERM. me if you dare! I hold this patient and in me is the issue of life and death. Hands off!" In the symptomatic movement through its stages we note the chill, speedily followed by a fever of variable intensity and duration, let us say from twenty-four to seventy-two hours, declining abruptly or gradually into a listless stage of inter- mission or of marked remission. This is the treacherous vortex calm following the storm of primary assault of the true poison itself. PROGRESS OF DISEASE This calm may be final in death or convalescence, but usually on the third, fourth or fifth day comes the secondary storm, from a new direction, and due to septic and other toxic consequence, and the enormous obstructive accumulation of tis- sue debris. The successful elimination of these secondary tox- ines introduces the last stage, convalescence; its failure means death. Simply recognizing the composite detail of this picture: The gathering storm, the approaching crisis in destructive con- gestions and probable hemorrhages; the universal degenerative destructive tissue wreckage, this I picture before your eyes, the treatment of the disease suggests itself. First, last and all the time your defensive cry is, elimination. That one word and gentle ministration in hygienic care covers, with rare excep- tion, the whole field of your ability. "For whatsoever is more than these cometh of evil." A firm self-control and a strict interpretation of symptom- atic evidence is your panoply in the fight. To have a strong or reasonable hope of success the treat- ment must begin early, certainly- within the first twenty-four hours. Later than that the precious time is forfeited. Your initial step is eliminative without irritation. Accord- ing to age, physique and urgency, from five to fifteen grains of THE QUEST OF THE GERM. 209 calomel, but no bicarbonate of soda, given preferably in a tea- spoonful of fine ice. Four hours later a full dose of an active but mild purgative, such as the stomach is most likely to bear; no pills. The old time infusion of senna, manna and salts or a full dose of castor oil, made as agreeable as possible, or an active saline water. This may be supplemented by a large enema if not unduly exciting to the patient. EMETIC IS FIRST REMEDY. Where the stomach is gorged with a recent meal or things hard of digestion empty quickly wuth an emetic, first thing. When the stomach has been cleared and the bowels freely re- lieved of their entire contents, you have reached your limit of vigorous medication, and, like Paul in the tempestuous Euro- clydon: ' ' When the ship was caught and could not bear up into the wind we let her drive." Go on favoring elimination, and your safe friend is water, cool or cold, plain so or any modification, as a light lemonade. Apollinaris, vichy, the light, pure fruit juice additions or Buf- falo lithia ad libitum. For high fever a large bowl of warm water and free wet toweling of the body, but never ice or any- thing cold applied externally. The guarded ice bag to the hemorrhagic stomach is the only exception. To further aid in control of high fever small one or two grain doses of phenacetin or acetanelide or such like, according to preference, may be given and repeated in two hours if re- quired. Invoke only the gentle effect. Everything gentle and nonirritant is all that you do. Comfort is itself a powerful remedy. The calm stage calls for absolute rest. A little Ducros' elixir, with ice or water, if acceptable, or panopepton and water 210 THE QUEST OF THE GERM. if preferred. The use of a small, soft cathete is sometimes im- perative; watch for retention. WHEN DANGER LINE IS REACHED. In the fourth, fifth or sixth day we reach a danger line in the resumption of nourishment. The state of the stomach and its ability to bear must be our guide. Until the red edged and pointed tongue and the oral mucous membrane and gums have paled from their appearance of acute erythema you must pro- ceed with exceeding caution in nourishing your patient; a little haste in premature feeding, giving too much or too rich or any kind of solid may readily irritate and rush an other- wise well progressing case into gastric hemorrhage and into uncontrollable recurrent fever, or the tornado from another quadrant, let me rather say. For such hemorrhage, actual or threatened, I give ice freely, sometimes with an eighth or twelfth of a grain of cocaine hydrochlorate. Here I use ice as a poultice over the stomach, carefully guarding against excessive refrigerating by one, two or three thicknesses of flannel or towel between ice bag and skin. Iced champagne is sometimes grateful, but often soon tired of; Ducro's elixir is generally liked better, panopepton or sometimes a little weak, very fine brandy. As the evidences of acute inflammatory action subside be- gin with three or four teaspoonfuls of iced milk with one-fourth of lime water, or milk and vichy half and half. Repeat in an hour or two and the next day increase the quantity, alternate with a delicately prepared chicken broth cooked with a little rice or barley, strained out. Then go on and nourish as you would a mild or desperate case of typhoid fever. I allow no preparation of beef. No fresh meat the balance of the season. The secondary fever on the third or fourth day means ob- structed elimination, usually intestinal, and calls for a very gentle but thorough purgative, aided by mild enemata. THE QUEST OF THE GERM. 211 DEPRESSION OF PULSES. Depression of pulse below 50 calls for strychina, one-thir- tieth to a sixtieth of a grain, hypodermically, but not always so, and repeated according to your judgment. Be cautious with alcoholic stimulation, knowing the fatty changes in the liver, the acute and subacute inflammation of the gastro-intestinal tract. Alcoholic subjects generally die; big meat eaters close behind. Concerning the kidneys, pathologically, you know that they, too, are in a state of profound degeneration and with such epithelial disintegration and the crowding of tubules with toxine and combustion products you are not surprised at the interference and often complete annihilation of function, the uremic convulsions and death. This condition plainly tells you to refrain from drugs, in the hope of forcing function. They simply will not functionate under your rude command. Be persuasive, keep the bowels freely opened and remember that wrater is your kindest friend. A light, cold whey with seltzer or vichy does a double work in nourishing and elimination. The number of things given and done more than this are, in the face of this pathology, irrational, fussy and often harmful. In using them you must confessedly say you do not really and sincerely know what you are about. I am not talking about your notions and a case you once saw recover; our case has reached a climax, for better or for worse, and drugs are not going to solve it. Now, dear fellow, this is all I have to say. Professional tact and experience will fill in the finer touches of detail. If you will do just a few things with masterful precision and self- restraint and patiently watch with hopeful expectation and a fair confidence in the regenerating power of nature you will have done all the things you ought to have done and will have 212 THE QUEST OF THE GERM. left undone the things you ought not to have done, and wisdom is justified in her son. Well! Of all the I wonder if words will fail me in commenting on this screed of a New Orleans doctor who was for twenty-five years quarantine officer of that city and who shows by this letter, written for the benefit of physicians of the north, where yellow fever never prevails, that he does not know a little bit about that disease. He details some conversation with a young medical friend who asks: "Do you give quinine in yellow fever?" and the re- ply is: "What has suggested it?" and the young man says: "Dr. Osler advises it." Ah! Indeed! Pray who is Osler and what does he know about yellow fever that he should assume to advise the ad- ministration of quinine to patients suffering from that disease. He also advises the use of perchloride of iron when hemorrhages set in. Great God! What shocking ignorance! A bas Osler! To the scrap-heap with his writings. Holt's writing is so bombastic, so arrogant and has so little sequence that a logical mind has difficulty in following his line of thought. "First, last and all the time," he says. "Your defensive cry is elimination. ' ' Of what ? Oh! prince of phy- sicians tell us what is to be eliminated and by what means? Of the poison instilled into the veins by the sting of the ste- gom-YAH-a poison as virulent as that of the fer-de-lance. Pshaw! Why this is nothing but the braying of an ass. Poison! Why there is no poison. Holt says as regards a specific for the disease we are where we were 100 years ago. Small wonder, when men supposedly intelligent adopt the mosquito theory of the disease. "To have a strong or reasonable hope of success the treat- ment must begin early, certainly within the first twenty-four THE QUEST OF THE GERM. 213 hours," he says. That is he waits until the disease has de- clared itself. This is what cost poor Chapelle his life. His physician waited until the disease declared itself and then be- gan treatment. This waiting is what costs every yellow fever patient his life. Ob st a principiis is the rule here. The patients sleep poorly for a week, their appetites fail and they do not complain. At length symptoms become pronounced and when the doctor is called he waits until he is sure of his diagnosis. Then he begins the treatment that ought to have been begun two or three days previously. This delay is what cost Chapelle his life and what costs the life of every yellow fever patient who dies of that disease. Holt says:-"Every known substance has been ransacked in the quest of a specific and today we are where we were 100 years ago." This is difficult to understand. But he evidently means that no specific has been found for yellow fever. This shows that he knows nothing whatever of ME and of MY thera- peutic virtues. The most emphatic language indulged in by Holt and which shows that he knows nothing about yellow fever is when he remarks of it that "it is the one lone, absolutely unique malady, the most mysterious on the planet. ' ' Rot! The doctor who believes in the doctrine that yellow fever is due to a poison introduced into the blood by a mosquito or from any source is a consummate ass. The doctor who will not accept the theory propounded by the learned Dr. Wood that yellow fever is acute general arterio-motor gangasthema is also a consummate ass. The doctor who will not begin his treat- ment of yellow fever with appropriate doses of ME is a consum- mate ass. And there you are. The chuckle-headed-chump who went from St. Paul to New Orleans and tried to treat the disease with small doses of ar- 214 THE QUEST OF THE GERM. senic on the principle of similia similibus was convinced and convinced everybody else that he knew no more about the nature of yellow fever than old Holt did. And Holt's letter is convincing enough that though he has had opportunities for twenty-five years to study and treat the disease he knows nothing about it and he nor anybody else will know until they accept and adopt the theory of the learned Dr. Wood and learn how to use ME and employ MY therapeutic virtues. Vale Holt. He may go off the face of the earth whenever he is ready. For twenty-five years he has been paid for knowledge that he never possessed and he may now crawl into his hole and disappear. Let us call up again our old friend Georgie Sternberg. He wrote in some one of the journals of the day. It is of no im- portance which one: "It is evident that in view of our present knowledge relating to the transmission of yellow fever the pre- ventive measures which have heretofore been considered most important i. e. isolation of the sick, disinfection of clothing and bedding and municipal sanitation are either of no avail or of comparatively little value." Right you are Georgie, but it has taken a long time for these ideas to enter your brain. You say that the germ of yel- low fever is ultra-microscopical. Georgie I thank you for that beautiful compound word, "ultra-microscopical." That means if the germ of yellow fever were magnified one million times it would not be visible. Which is the same as an admission that there is no germ of yellow fever and Georgie you will please to refer to preceding pages of this book in which the learned Dr. Wood has set forth that fact in unmistakable lan- guage and I may state that he will be glad to admit you to the ranks of the anti-baeterists and to membership in the com- pany of those who do not accept the mosquito theory of disease. THE QUEST OF THE GERM. 215 But there are others, as witness. The learned Dr. Wood wrote to Luke E. Wright, Governor of the Philippine Islands, under date of January 25, 1904, advising him of a specific for cholera. Under date of March 8, 1904, Gov. Wright acknowl- edged the doctor's "very courteous communication'' and stated that it had been referred "to the Attending Physician and Surgeon for Civil Officers and Employees." On March 21, 1904, the report of that official was forwarded by A. W. Fer- guson, Executive Secretary, to Dr. Wood and it reads as fol- lows: "It is my opinion that this drug [bromide of ammonium] would be impracticable of administration, and if it were its effect would be of no value in this disease [cholera]. I do not believe that its exhibition in cholera would do much harm, if any, but this gentleman [the learned Dr. Wood] does not men- tion method of use or dosage. There being no cholera in Man- ila at this time it is impossible to demonstrate its value." Is not that a delicious morceau compounded of ignorance and stupidity. I would like to know that fellow's name so that I might impale him on the tenter-hooks of scientific opinion for his slurs on ME. It seems impossible that so much of ignorance could be crowded into so few words. I'll bet a Manila cheroot, 3-fers, that the typewriter was obliged to correct the ortho- graphy of that fellow's report. Scrap-heap for him! "Oh, my prophetic soul!" I knew some other lunkhead would take up the prophetic strain. Hear him. He writes in "The World Today" under date of Oct. 1905 and his name is C. Arthur Williams. His prophecy is immense. He says: "Perfect immunity may be had in the future by getting rid of the Ste-gom-YAH. It is a difficult task. [Sure it is, Brer. Williams] but it can be done." ["How? Oh! how? Brer. Williams. Tell us and earn the undying gratitude of millions of your fellow citizens.] Williams continues: "The advantages 216 THE QUEST OF THE GERM. of control by the government has been demonstrated and the need of uniform quarantine regulations painfully apparent. [Brer. Williams don't you know that if quarantine regulations were abolished such action would be more painful than their present enforcement to those officials who have been authorized to enforce them. Why all of those fellows would be affected with a three-cornered pain-the very worst kind of pain-if they could not continue to occupy a large space in the public eye as strenuous fighters of the Ste-gom-YAH. Their occupation would be gone and they would suffer largely from this variety of pain - a very irritating, depressing exasperating and regretting pain.] But Brer. Williams takes heart and further says: "Lessons have been taught even if at a heavy cost and it is the firm belief of experts that if they are put to proper account the south need never have another experience with the dreaded malady" Jes-so! But there are others. Let us hear what they have to say. At New Orleans in Sept. 1905 it was announced that the yellow fever germ had actually been discovered again by Dr. P. E. Achinard, Dr. J. Birney Guthrie and Prof. J. C. Smith, the latter is said to be a biologist of world-wide fame, [Smith? Smith? never heard of him before.] This is said to be "be- yond question one of the most radically important discoveries in the field of medicine for fifty years. Pshaw! a dozen differ- ent germs of yellow fever have been discovered and the Ste- gom-YAH has put them all out of business as causes. Another one. On Feb. 11, 1905, the steamer Orizaba ar- rived at New York from Colon, having a yellow fever patient on board. The ship was not detained at quarantine but the man was removed to a hospital. Dr. Doty, health officer of the port, who is nothing if not an expert, justified his action by saying: "It is now so well recognized that yellow fever is com- THE QUEST OF THE GERM. 217 municable only by mosquitos that vessels bringing cases to this port are no longer detained at quarantine, except when they arrive within five days from an infected port. The Orizaba had been out seven days from Colon." But say, Doty, as an expert, please to tell us if it would have made any difference in your action if the Orizaba arriving in midwinter had been out only three days from an infected port? You see your excuse is one of those cheap and nasty sophistications that such experts as you are in the habit of employing. Next time give scientific reasons for your action. Here is another. Paris Feb. 11, 1905. (Special Cable- gram.) Professor Chantemesse read a paper before the Acad- emy of Medicine this week declaring that European countries are less liable to yellow fever since the advent of fast sailing ships. He believes mosquitos are responsible for the spread of the dis- ease, but says their transmission is impossible except in slow sailing wooden vessels. What an infernal muff this fellow must be to select such a silly subject and write a paper on it to be read before a learned body of men like the Paris Acad- emy of Medicine. What arrant nonsense it must have been. Per contra hear thisWashington, D. C., May 24, 1905. It has been officially stated that there is some fear that the Panama canal may become a factor in introducing yellow fever into the Philippines and the entire orient. [This bears the ear-marks of the surgeon-generals office. Surely such stuff would not be given out officially by any other aggregation in. Washington.] Dr. R. H. Strong, director of the biological laboratory iii Manila, [a scientist of world-wide fame in the same class with Smith of New Orleans] in his report to the Philippine com- 218 THE QUEST OF THE GERM. mission shows that the Hawaiian Islands, Guam and the Philip- pines will be exposed to the importation of the mosquito that carries the fever. The disease often follows the lines of com- mercial maritime travel and close relationship exists between commerce and yellow fever. He declares that an infected mosquito is capable of carry- ing the disease at least fifty-one days. [Holy Moses! Fifty-one days! Just think of it. Think of that poor devil of a mosquito, stowed away in the hold of one of those steamers, loaded down with the virus of yellow fever. Oh! horrors] after biting a person suffering with the fever and says that a case (?) reach- ing Manila would find every chance in favor of its spread. So they have scientists in Manila. Well we will just scrap-heap his data. This is the limit. What a far-fetched howl it is. Fifty-one days! Oh! Lord! They seem to have a choice col- lection of doctors in Manila. Per contra again:-Here is something from a truly scien- tist. His name is F. B. Hillman and he hails from May- wood, Ill. He wrote a letter to the Chicago Daily News last summer ('95) and in this connection it is worth hearing. The letter follows:- "Over the signature of 'Dr. J. L. E.' a physician recently wrote to the. Daily News about mosquitos and yellow fever. After reading this communication I am impressed with the idea that if the medical profession would discard its theories and fads it might easily arrive at the cause of this dread dis- ease. I do not believe in germs and I know from experience that yellow fever has various causes, its principal helper be- ing a malarial climate. Diet has a great deal to do with its development. While personal cleanliness should be observed by every person, yet it is no protection from the disease. THE QUEST OF THE GERM. 219 "The first signs of yellow fever's approach are a slimy sen- sation in the mouth and a disposition to yawn, followed by chills. Then comes a gradually rising fever similar to that occurring after an ague. At this stage of the disease the patient's first duty is to secure a physician and his next step is to interview the undertaker. "If when the slimy taste appears in the mouth the pa- tient should take a strong purgative there is no doubt in the writer's mind that nine-tenths of the afflicted could escape fatal results. I had the yellow fever in 1873 and escaped death by avoiding the doctors. "I took occasion to visit the stricken district in 1878 and to study the disease from a common sense standpoint, nursing several patients, not one of whom needed a wooden overcoat. The majority of the writers on the subject of yellow fever are like the editor of the poultry journal who wouldn't know a hen if he met one in the street." There is a scientist. That man ought to be elected Pro- fessor of Yellow Fever in some medical college. All the lunk- heads of science that ever observed a case of the disease have looked at it with unintelligent eyes-which is to say the eyes of faith. But here is a man who looked at his own case and the cases of others with the eyes of reason and his observations will override all the observations of all the lunkheads that ever saw or treated a case because they were based on reason and judgment and not on belief. We will place this man on the pedestal alongside of Peter A. Grotjan who has stated that when he had the disease he "contracted it in the natural way." Now that I have the class before me I will ask them to answer this question: When Grot j an said he had contracted the fever in the natural way, what did he mean by that? One at a time. Ah! here is a little fellow on the front bench. Why! 220 THE QUEST OF THE GERM. it is Watty Wyman holding up his hand. Well, Wyman, what do you say? and he pipes out "I know, he was bitten by a mus-kee-to. " That will do Watty. You may go away back and sit down and I will give you as escorts to the rear Johnnie White and Billy Rucker, who may also sit down. The three of you may put porous plasters over your mouths and give all your attention to the study of the book known as the The Quest of the Germ, written by the learned Dr. Wood and al- low the ideas contained in that book to percolate in your brains. You will then be prepared to take your place among the true scientists and then you may emerge from your retiracy. But think of the PROGRESS OF MEDICINE in 100 years. From Grotjan's profound insight into the method by which he contracted yellow fever in 1805 to the persistent efforts of the lunkheads to fasten the idiotic idea on the minds of the world that it is propagated by the Ste-gom-YAH. And now comes Hillman in 1905 and confirms Grotjan after a 100 years. Ten thousand opinions from ten thousand lunkheads can not eon- .trovert the convincing views of these two men. In the south very few persons accept the mosquito theory. I was down there last summer during the prevalence of the disease out in the country among the "crackers" and I heard one of those ignoramuses say to one of his boys:- "Here son, take dad's old rifle and load it up with buck- shot and go down to the corner. They've got yellow jack up to Slabtown and if any person comes from that direction warn 'em to go back and if they do not go back blow 'em full of holes." To the other boy he said:- Here Johnnie, take your dad's double-barrel and load it up to the muzzle and guard the other corner. They have yel- THE QUEST OF THE GERM. 221 low jack down to Punkinville and if any fellow conies from that-a-way tell him to go back and if he won't do it riddle him with shot. We-uns don't want no yellow jack around here. Your ma will take your dinners out to you. Keep a sharp look out." That is what they call shotgun quarantine in the South. The honored gentleman who sits at the seat of government and who is supposed to have the interests of all the people of his state at heart issues a document proclaiming quarantine against all persons from other states whenever yellow fever pre- vails in those states. This honorable man, who is reported to be educated and intelligent displays the same ignorance of the cause and nature of yellow fever as does the low-down ' ' cracker ' ' who can neither read nor write but who thinks he is entitled to protect himself and family from the invasion of disease with a shotgun. This same opinion engendered of ignorance and superstition was entertained by all the people of the South until recently. Now many persons have adopted the mosquito theory and think all that is necessary to do is to protect themselves from the bite of the mosquito. The lunkheads of science have stum- bled on the fact that yellow fever is not due to a germ. They have stumbled on the theory that it is due to the mosquito. Here they have the true cause and nature of the disease set forth in this book. Will the lunkheads accept and adopt it? Not on your life! A more damned irrational being than a medi- cal lunkhead can not be found on this earth except in the case of a theological lunkhead. These are on a par and it is as im- possible to drive the superstitions out of the minds of the one class as it is out of the minds of the other. Selah! I will next call your attention to a very extensive and ex- pensive work in twenty volumes published by my friends Wm. 222 i THE QUEST OF THE GERM. Wood & Co. of New York, entitled: "Twentieth Century Prac- tice, An International Encyclopedia of Modern Medical Science by Leading Authorities of Europe and America. Edited by Thos. L. Stedman, M.D. These twenty volumes purchased for a considerable sum may be found in the reference room of the public library of Milwaukee. The volumes are kept under lock and key and are consulted probably about once in six months by the physicians of the city. The learned Dr. Wood asked Dr. Peckham, the librarian, to subscribe for a copy of this book but he declined to do so, alleging as a reason that no medi- cal works were purchased for the library. Thereupon the learned doctor instanced this encyclopedia of twenty volumes, Dr. Peckham replied that the work was an exceptional one. Now I propose to give it a little "knock." The work contains a chapter on Yellow Fever by a "Leading Authority" named Woolford Nelson of nearly one hundred pages. Bear in mind that the work was published late in the last century and so one need not expect to find that any mention of the mosquito theory of yellow fever is made therein because that theory was produced by the lunkheads at a date subsequent to the publica- tion of the work. But it might appear in a second edition of the work-if a second edition might ever be issued. However, to guard against such contingency I hereby "scrap-heap" the entire chapter on yellow fever contained in the International Encyclopedia of Modern Medicine. Vale Nelson! Good luck to ye! Here is another lunkhead that I picked up in Chicago. He read a paper before the Academy of Medicine in that city in which he propounded the theory that NOISE is the cause of tuberculosis. You would think that a lunkhead would have some sense but when a fellow deliberately writes a paper and deliberately gets up and reads it to an aggregation of men who 223 THE QUEST OF THE GERM. know a little something about the so-called science of medicine and propounds so silly a theory it is plain to the most casual observer that such a fellow lacks tertianation. It is also plain to the casual observer that this fellow's normal position is in the faculty of Jawn D's university, where men are accepted solely on the basis of the originality of their views-at least prior to the death of the lamented Dr. Wm. Harper. I commend this very rare and exceptional view of the cause of tuberculosis to those who have charge of the free exhibit of matters connected with the "Great White Plague." Yes, I fondly commend it to their careful consideration, and I do this without any swear words because they would not do the subject justice. Are there any other lunkheads in Chicago? Yes! Lots of 'em. Still they come. It is reported from the city of Mexico that one Dr. A. [ndrew] J. [ackson] Smith has been investigating fevers in the tropical regions for several months. "For several months," think of that! The man who investigates a subject for several months ought to find out something about it. So ac- cordingly we learn that as a result of his investigations Dr. A-J-Smith announces it to be his opinion that bedbugs are the means of carrying yellow fever as well as mosquitos. "Of course," said this particular Dr. Smith, "a mosquito can carry the disease as well as any other animal that becomes infected with it, but yellow fever is contagious in the same way that any other fever of the same type (?) is contagious, and there is not one case in a hundred that is contracted through mosquito bites. I have studied the disease closely both in the United States and Mexico and I have known any number of cases (how many? 100? 1,000? 10,000? Oh! Smithee, you poor fool! You don't know what you are talking about) which were contracted from the atmosphere which had been poisoned by 224 THE QUEST OF THE GERM. the germs. I consider the mosquito theory, that is generally believed in the same light as such theories as the nebular hypoth- esis, which is nothing more than a superficial explanation of a problem that has not been solved." Why, Smithee, you have some sense after all. But you must drop the bedbug theory and the germ theory. Will Dr. Watty Wyman and Dr. Georgie Sternberg and some of those other fellows please to labor with this benighted brother and bring him to see the error of his ways? Here comes another one. This one seems to be an editor which need not surprise anybody, for he is one of Walsh's editors and works on The Chicago Chronicle. Referring to the pre- valence of yellow fever in the south in 1905 he says the lesson of the situation is that national quarantine is necessary. He argues that if such a system had prevailed the disease would have been speedily extirpated at New Orleans. Not at all, son- ny. The thing to prevail is not a system of quarantine but knowledge, definite knowledge, specific knowledge of the cause and nature of yellow fever, and that is to be found only within the covers of this book which facts constitute the encouraging feature of the situation. And in conjunction with this article, side by side with it, is another article on "Belief" which in a sense is the paradox of the other. The editor says, "There is close relation between belief and reasoning, but there is no greater error than to suppose that reasoning is the only thing that can produce beliefs and that all of our beliefs are the result of reasoning." "A belief may be perpetuated from generation to generation in an ever-widening circle for thousands of years and even become universal without having a particle of fact or logic for its basis. ' ' As you say, sonny, "Sich is life." But when you find your- self in error as you are in regard to national quarantine lift THE QUEST OF THE GERM. 225 your hat tome and acknowledge the matter. My son, there is no need of quarantine against cholera or yellow fever, either local or general and it must be abolished and when this idea at length penetrates your noddle it will be your duty to advocate the abolishment of such restriction on travel and traffic; so that hereafter people may come and go and traffic shall not be in- terrupted by damned fools with shotguns in their hands or by other damned fools with proclamations. This my dictum, the result of knowledge and profound reasoning is addressed to all my children who occupy the tripod. If any disobey my man- dates which are commandent, they will receive deserved castiga- tion from me. Well they are approaching the views of the learned Dr. Wood even in congress, a body that acts on the principle of festina lente, except in an emergency. The quarantine bill has been much changed in committee. In regard to interstate com- merce through states during a quarantine its effect is to pre- vent interruption of through passengers or freight, but to give state authorities jurisdiction to control or prevent the de- barkation of passengers or unloading of freight contrary to the regulations of the local authorities. This is merely a sop. How the damned superstition lingers. The whole must eventually be granted and quarantine be abolished everywhere in these United States against yellow fever and cholera. The medical officials on the isthmus are taking such steps as they deem proper to conserve the health of the laborers on the canal. They have purchased for the use of the doctors twenty-three tons of chloride of iron, fifty-two tons of sulphur and fourteen tons of insect powder. There are two species of mosquitoes to contend with in that country; the anopheles and the Ste-gom-YAH. If the physicians in charge can not extirpate 226 THE QUEST OF THE GERM. the first they are advised to invite Dr. Ronald Ross of Liver- pool, who made the discovery that malaria is conveyed chiefly by mosquitos, for which alleged discovery he was awarded by that aggregation of lunkheads at Stockholm the Nobel prize for 1902, for consultation as to how to get rid of malaria on the isthmus. As to how to prevent other diseases they can best do that by dissolving the chloride of iron in water and sprinkling the isthmus with the solution every day, and by using the "Cyclone" bellows designed for the distribution of the insect powder for the dissemination of the sulphur to disinfect sus- pected places. It will be necessary to employ a small army of men for this purpose. Men may get sick with all of these precautions and many will die. Let 'em die. The doctors do not care for results except in the mortality tables and I am getting tired of recommending myself or I might say to those fellows: add to your supplies one ton of ME and whenever you encounter gangasthenia in any form administer of me. q. s. If you art a lot of damned lunkheads I predict that you will not take my advice but will pursue your own damned fool methods and may God have mercy on your miserable souls! I desire to refer to one of the saddest cases in history, and the results might have been, indeed ought to have been different. Would have been different too but for the blindness of the damned lunkheads of medicine who are Blind as never bat was blind With a burning bloodshot blindness of the mind A swimming swollen senselessness of soul. I refer to the case of Robert Louis Stevenson. For years he was afflicted with pulmonary hemorrhage. He was dosed secundum artem with all sorts of styptics and astringents. He was moved from one climate to another and buoyed up with THE QUEST OF THE GERM. 227 hope; for a while he seemed to improve, when suddenly and seemingly without cause came another gush of red, hot arterial blood from his congested lungs and the poor fellow was again prostrated, and again dosed and dosed again and moved to an- other climate until at length he repaired to the islands of the Pacific where his life was suddenly ended by cerebral hemor- rhage. His was a sad, sad, sad case, for he might have lived for years to delight the world with the products of his genius. And what would have been more delightful to contemplate than such a lovable man in a serene old age, with silvery hair and crowned with the honors of a noble career. The saddest words of tongue or pen, Are these-It might have been. And I who address you, Sir-Brom-Am, declare that Robert Louis Stevenson's pulmonary hemorrhage might have been stop- ped, checked, ended by the administration of AIE in proper and sufficient doses. And if those doctors who treated him for that disorder shall ever encounter a similar case, having first as- similated the principles enunciated in this volume and shall follow the rules laid down herein they will be astonished, and if they are true physicians, gratified at the results. As it is the life of one of the most brilliant geniuses the world has ever produced, of one of the most amiable men that ever lived was sacrificed to nescience-to the stupidity of the lunkheads. Don't let it happen again. I understand from press notices that a new dictionary of the English language in twenty volumes is in course of pre- paration in Philadelphia and as what the compilers need is words to fill those volumes I beg leave to suggest a few to help them out. These words are derivatives of ganglia. They are kindergarten words and have no significance whatever but that 228 THE QUEST OF THE GERM. need not prevent their being introduced into the new dictionary and being assigned to honorable places in the vocabulary with proper definitions attached. These words are gangliab, gangliad, gangliaf, gangliag, gangliaj, gangliak, gangliam, ganglian, gan- gliap, gangliaque, ganglias, gangliat, gangliav, gangliaw, gan- gliax, gangliaz. The compilers may leave all these words out of their new dictionary but I warn them that if they omit the word GANGASTHENIA with the elision of the "li" they will do so at peril of incurring the deep displeasure of the learned Dr. Wood. And they must see to it that that word is correctly defined under still direr peril. This is no idle threat. In the Scientific American of Feb. 11, 1905, it is stated that the Paris Academy of Sciences offers the Breant prize of 100,000 francs for the discovery of an absolute specific against Asiatic cholera or to point out in an irrefutable manner the causes of Asiatic cholera so that the suppression of the disease will follow. Well of all the exasperating propositions ever published to the world this is the most exasperating. It is enough to make a man rave and tear his hair. But keep cool my learned master. We will make that close corporation the Paris Acad- emy of Sciences "cough up" the entire sum bequeathed by M. Breant together with the interest that has been misappropriated these many years since your claim was filed. M. Breant left 400,000 francs to be awarded as a prize and now the prize has been reduced to 100,000. Why, when and by what authority has M. Breant's will been thus in- validated ? That prize belongs to the learned Dr. Wood and has so belonged for many years but owing to lunkheadism he has not received it. THE QUEST OF THE GERM. 229 I have termed him "learned" in my discourses and in my opinion the scientist who forms a new class of diseases, and who has made clear the cause and nature of two of the most deadly diseases that affect mankind is entitled to that appellation. He will in course of time demand his rights from the Paris Academy of Sciences. Then I ask "WILL YOU BE GOOD?" and will you COUGH UP THE BREANT PRIZE TO ITS RIGHTFUL OWNER? Exit SIR BROM-AM. Red Fire. Curtain. Note by the Editor.-So the noble Knight of Science, Sir Brom-Am sallies forth into the world to shed his light over the dark places of the earth. He will puncture the inflated con- ceits of the lunkheads and we will hear from him more. Books by Dr. Eugene H. Wood- The Quest of the Germ Just published. Price paper, 75 cents. Cloth $1.50. Usual discount to libraries. (IN PREPARATION) Gangasthenia and the Bromide of Ammonium. This volume will consist of a collection of articles, written some years ago by Dr. Wood. They constitute too valuable a contribution to medical science to be allowed to lapse into oblivion. They have been amended and those who used to enjoy reading the Doctor's articles, will be pleased to get them in complete form. With much additional matter in the author's trenchant style. In cloth only, $1.50. (IN CONTEMPLATION) Pneumonia : A Monograph. This book will be written on the lines laid down in this volume and the results will be to place in the hands of every practitioner a rational method of treating this disease thus wiping out the reproach of the pro- fession that it is more deadly than the White Plague. Price, cloth $1.50. (OUT OF PRINT) Religion and Authority. A small volume of only 100 pages, of great originality and profundity. One hundred and fifty copies of the book were printed and then the plates were destroyed.