Disease and Its Causes, William Thomas Councilman [best historical fiction books of all time .txt] 📗

the mosquito multiplication by sexual differentiation takes place. Under no conditions is multiplication so rapid as with the bacteria, and in general the simpler the form of organism the more rapid is the multiplication. It is common to all of the protozoa to develop forms which have great powers of resistance, this being due in some cases to encystment, in which condition a resistant membrane is formed on the outside, in others to the production of spores. A fluid environment is essential to the life of the protozoa, but the resistant forms can endure long periods of dryness or other unfavorable environmental conditions. The universal distribution of the protozoa is due to this; the spores or cysts can be carried long distances by the wind and develop into active forms when they reach an environment which is favorable. Their distribution in water depends upon the amount of organic material this contains. In pure drinking water there may be very few, but in stagnant water they are very numerous, living not on the organic material in solution in this, but on the bacteria which find in such fluid favorable conditions for existence. The food of protozoa consists chiefly of other organisms, particularly bacteria, and they are classed with the animals. The protozoa are the most widely distributed and the most universal of the parasites. The infectious diseases which they produce in man, although among the most serious are less in number than those produced by bacteria. So marked is the tendency to parasitism that they are often parasitic for each other, smaller forms entering into and living upon the larger. Variation does not seem to be so marked in the protozoa as in the bacteria, though this is possibly due to our greater ignorance of them as a class. We are not able, except in rare instances, to grow them in pure culture, and study innumerable generations under changes in the environment, as the bacteria have been studied.

If we regard the living things on earth from the narrow point of view as to whether they are necessary or useless or hostile to man, the protozoa must be regarded as about the least useful members of the biological society. It is very possible that such a conclusion is due to ignorance; so closely are all living things united, so dependent is one form of cell activity upon other forms that it is impossible to foretell the result of the removal of a link. The protozoa do not seem to be as necessary for the life of man as are the bacteria; they produce many of the diseases of man, many of the diseases of animals on which man depends for food; they cause great destruction in plant life, and in the soil they feed upon the useful bacteria. It is well to remember, however, that fifty years ago several of the organs of the body whose activity we now recognize as furnishing substances necessary for life were regarded as useless members and, since they became the seat of tumors, as dangerous members of the body. The only organ which now seems to come into such a class is the vermiform appendix, and its lowly position among organs is due merely to an unhappy accident of development.

The class of organisms known as the filterable viruses or the ultra-microscopic or the invisible organisms have a special interest in many ways. The limitation in the power of the microscope for the study of minute objects is due not to a defect in the instrument but to the length of the wave of light. It is impossible to see clearly under the microscope using white light, objects which are smaller in diameter than the length of the wave which gives a limit of 0.5µ. or 1/125,000 of an inch. By using waves of shorter length, as the ultra-violet light, objects of 0.1µ. or 1/250000 of an inch can be seen; but as these methods depend upon photography for the demonstration of the object the study is difficult. The presence of objects still smaller than 0.1 m. can be detected in a fluid by the use of the dark field illumination and the ultra-microscope, the principle of which is the direction of a powerful oblique ray of light into the field of the microscope. The objects are not visible as such, but the dispersion of the light by their presence is seen.

The demonstration that infectious diseases were produced by organisms so small as to be beyond demonstration with the best microscopes was made possible by showing, that some fluid from a diseased animal was infectious; and capable of producing the disease when inoculated into a susceptible animal. The fluid was then filtered through porcelain filters which were known to hold back all objects of the size of the smallest bacteria and the disease produced by inoculating with the clear filtrate. There are a number of such filters of different degrees of porosity manufactured, and they are often used to procure pure water for drinking, for which use they are more or less, generally however, less efficacious. The filter has the form of a hollow cylinder and the liquid to be filtered is forced through it under pressure. For domestic use the filter is attached by its open end to the water tap and the pressure from the mains forces the water through it. In laboratory uses, denser filters of smaller diameters are used, and the filter is surrounded by the fluid to be tested. The open end of the filter passes into a vessel from which the air is exhausted and filtration takes place from without inward. The test of the effectiveness of the filter is made by adding to the filtering fluid some very minute and easily recognizable bacteria and testing the filtrate for their presence. These filters have been studied microscopically by grinding very thin sections and measuring the diameter of the spaces in the material. These are very numerous, and from 1/25000 to 1/1000 of an inch in diameter, spaces which would allow bacteria to pass through, but they are held back by the very fine openings between the spaces and by the tortuosity of the intercommunications. When the coarser of such filters have been long in domestic service in filtering drinking water, bacteria may grow in and through them giving greater bacterial content to the supposed bacteria-free filtrate than in the filtering water.

That an animal disease was due to such a minute and filterable organism was first shown by Loeffler in 1898 for the foot and mouth disease of cattle. This is one of the most infectious and easily communicable diseases. The lesions of the disease take the form of blisters which form on the lips and feet and in the mouths of cattle, and inoculation with minute quantities of the fluid in the blisters produces the disease. Loeffler filtered the fluid through porcelain filters, hoping to obtain a material which inoculated into other cattle would render them immune, and to his surprise found that the typical disease was produced by inoculating with the filtrate. Naturally the first idea was that the disease was caused by some soluble poison and not by a living organism, but this was disproved in a number of ways. The most powerful poison known is obtained from cultures of the tetanus bacillus of which 0.000,000,1 of a gram (one gram is 15.43 grains) kills a mouse, or one gram kills ten million mice. Loeffler found that 1/30 gram of the contents of the vesicles killed a calf of two hundred kilograms weight, and assuming that the essential poison was present in the fluid in one part to five hundred it would be several hundred times more powerful than the tetanus poison. Further, the disease produced by inoculation of the filtrate was itself inoculable and could be transmitted from animal to animal. It was also found that when the virus was filtered several times it ceased to be inoculable, showing that each time the fluid was passed through the filter some of the minute organisms contained in it were held back.

It is not known whether these organisms belong to the bacteria or protozoa, and naturally nothing is known as to their form, size and structure. Up to the present about twenty diseases are known to be due to a filterable virus, and among these are some of the most important for animals and for man. Among the human diseases, yellow fever, poliomyelitis, and dengue are so produced; of the animal diseases in addition to foot and mouth disease, pleuropneumonia, cattle plague, African horse sickness, several diseases of fowls and the mosaic disease of the tobacco plant have all been shown to be due to a filterable virus. Of these organisms the largest is that which produces pleuropneumonia in cattle, and this alone has been cultivated. It gives a slight opacity to the culture fluids, and when magnified two thousand diameters appears as a minute spiral or round or stellate organism having a variety of forms. Its size is such that it passes the coarse, but is held back by the finer, filters and it is possible that this does not belong to the same class with the others.8 The diseases produced by the filterable viruses taken as a class show much similarity. They run an acute course, are severe, and the immunity produced by the attack endures for a long time.

Considered in its biological relations, infection is the adaptation of an organism to the environment which the body of the host offers. It is rather singular that variations in organisms represented by such adaptation do not more frequently arise, in which case new diseases would frequently occur. It cannot be denied that new diseases appear, but there is no certain evidence that they do, and there is equally no evidence that diseases disappear. From the meagre descriptions of diseases, usually of the epidemic type, which have come down to us from the past, it is difficult to recognize many of the diseases described. The single diseases are recognized by comparing the causes, the lesions and the symptoms with those of other diseases, and new diseases are constantly being separated off from other diseases having more or less common features. Many new diseases have been recognized and named, but it is always more than probable that previously they were confounded with other diseases. Smallpox is such a characteristic disease that one would think it would have been recognized as an entity from the beginning, but although the description of some of the epidemics in remote times conform more or less to the disease as we know it, the first accurate description is in the eighth century by the Arabian physician Rhazes. Cerebro-spinal meningitis was not recognized as a separate disease until 1803, diphtheria not until 1826, and the separation between typhoid and typhus fever was not made before 1840. Nor is it sure that any diseases have disappeared, although there seems to have been a change in the character of many. It is difficult to reconcile leprosy as it appears now with the universal horror felt towards it, due to the persistence of the old traditions. It is possible, however, that the disease has not changed its character, but that such diseases as smallpox, syphilis, and certain forms of tuberculosis were formerly confounded with leprosy, thus giving a false idea of its prevalence.

In certain cases the adaptation of the organism is for a narrow environment; for example, the parasitism may extend to a simple species only, in others the adaptation may extend to a number of genera. In certain cases the adaptation is mutual, extending to both parasite and host and resulting in symbiosis, and this condition may be advantageous for both. Certain of the protozoa harbor within them cells of algæ utilizing to their own advantage the green chlorophil of the algæ in obtaining energy from sunlight and in turn giving sustenance to the algæ.