H. Charlton Bastian.

The beginnings of life: being some account of the nature, modes of origin and transformations of lower organisms online

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generated de novo as either of the others, although much
more capable than they are of being disseminated by means
of contagion.

If we reject this notion, what remains for us ? The germ-
theory is quite untenable — the analogy which has been
thought to exist between the causes and nature of certain
diseases and the specific and unalterable characters of living
organisms is erroneous in both its aspects. And even if the
diseases are now only propagable by contagion — just as the
higher living things are propagable by reproduction — they
must nevertheless have originated once ; and, if once, why
not now? Or, declining to admit even so much, shall we
refuse to bear our own burdens ? Shall we shift the difficulty,
and suppose that the poisons of syphilis, measles, scarlet
fever, small-pox, and other diseases, have been evolved
amidst the unknown conditions obtaining upon the surface
of an unknown world, whose disruption has scattered them
broadcast, and conveyed them to us, with other never-dying
.germs, upon the verdant surface of a * moss-grown frag-
ment ' ? With such alternatives, surely our choice cannot be
doubtful.

If we turn to a sober survey of the facts which lie before

VOL. n. k



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cxlvi



THE BEGINmNGS OF LIFE,



US concerning the infective diseases as a class, our difficulties
will be much diminished : simple and obvious conclusions
will appear.



MoMyo/tMtm
capable of
arising de



Parasitic Disbasbs afpbcting—

[External (cutaneous) surface^
Internal (mucous) surfaces.
Closed (serous) cavities.
Tissues of organs or parts. (Psaroi/er m i^,
Cystictrci NemaMtU, etc J
Blood, {fiatteridia in ' Malignant Pustule,'
Psoro^^ermim in ' p^Mne,' etc)



Apparent^

caused and

propagated by the

presence and

seff-multipttcatioo

of living units.



TISSUE Disbasbs

A. Diseases of tntertuil Formed Tissues and

V Mucous Membranes,



AUimtatlaUe

and capable iff

arising de

novo.



nbro-plastic growths.
Cancerous growths.
Tubercular growths.
Glanders.
SyphQis.
uonorrhoea.
Purulent ophHiahnia.
Diphtheria and Croup.



B. Diseases <if the Blood {pristcipaU^.



Alt contarioMs

and cafabU qf

aristng de

novo.



Contagiousness
either absent,
little marked,
or more or less
•virulent I aU
frobabl^ capaiU
Lansing At
nova



Erysipelas.

Puerperal fever.

Surgical fever.

lyoctnia.

Hospital gangrene.

Rabies.

Rheumatic fever.

a. Dengue.

b. Sweating Sickness.
Intermittent fever.

a. Remittent fever.
*. Yellow fever.
Summer diarrfacea.

a. Choleraic diarrhoea.

b. Cholera.
Dysentery.
Influenza.
Mumps.

Relapsing fever.
TyphoidTevor.
Tsrphus fever.

a. Cerebro-spinal me*

ningitkf

b. Plague.
Varicella.
Hooping-cough.
Measles.
Scarlet fever.
Small-pox.



PrincipaUy
sporadic.



Principal^
endemic.



Onen
epidemic.



propagated by

chemico-physical

agencies, and

not by the

multiplication of

Uvmg ^itit^



In the first place, we find a group of diseases due to the
presence upon or within the body of parasitic organisms.
These are partly local and partly general affections, the latter
being intensely contagious, and on that account frequently
confounded with other general infectious diseases in which
living organisms do not occur. These general parasitic
diseases are propagated by the presence and multiplication



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APPENDIX E. cxlvii



of living units, whilst those of the next great class are not *.
The tendency in the former is towards death ; the tendency
in the latter towards recovery. The non-parasitic infective
or specific diseases are also partly locaj and partly general
affections. The local affections are closely allied to other
morbid states, such as cancer and tubercle, with which they
are not usually classed. Many of these local diseases tend
to become general diseases. Similar morbid growths spring
up in various parts of the body, and the blood itself becomes
affected. They are also more or less apt to spread from
individual to individual. All are capable of being generated
de novo. Such local affections are united by the closest
bonds of similarity to the more general zymotic diseases,
amongst which all degrees of contagiousness are manifested.
The members of the whole series, however, are intimately
related to one another; and their mode of propagation is
essentially similar, even though the readiness with which
contagion occurs is variable. Very many of them are un-
doubtedly generable de novo; and the others are probably
also capable of arising * spontaneously,' though the proof of
this, on account of their highly contagious nature, is dif&cult
to establish.

All these latter diseases, therefore, are dependent upon
local perverted modes of growth, or upon chemical changes
of a definite, though unknown, character taking place in the
blood — ^partly under the influence of general causes, and
pardy owing to the initiation of chemical changes induced
by contact-action of contagious particles or fluids. As with
diseases in general, so with these, two sets of factors are



* A more complete investigation (since the delivery of this lecture)
of the facts known concerning parasitic diseases has led me to make
certain important modifications in the view above expressed as to the
rdlt of the parasites in these affections, as may be seen by reference to
Chap. xix.

k2



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cxlviii THE BEGINNINGS OF LIFE,

frequentiy concerned in their production. There are the
'predisposing causes' pertaining to the condition and ten-
dencies (either inherited or acquired) of the individual, and
there are the ' excitipg causes ' or external influences (usual
or unusual) at the time operative upon this individual. The
combined influence of these causes of disease are often
called into play in the production of the infective malady,
just as much as they are influential in the origination of
non-infective diseases. But predisposing causes may, in
conjunction with ordinary external agencies, suflfice in some
cases ; just as, in other cases, the exciting cause or causes
may be capable of initiating the affections in the average
healthy individual, without the aid of any predisposition.

Unless we entertain opinions of this kind, facts, which are
admitted by all, seem quite incapable of being explained —
whether having reference to the * generalisation' of morbid
growths within the body, or to the spread of infectious dis-
eases amongst the community. Cancerous particles in the
circulation are wholly inoperative in certain- individuals in
inducing the growth of cancer in distant parts, whilst they are
only partially operative in many other individuals, however
numerously they may exist. Contact with the contagia of
ophthabnia or diphtheria will excite the disease in some per-
sons and not in others. Yellow fever and cholera are * conta-
gious ' only when certain favouring conditions are present to
facilitate the operation of the specific poisons of these diseases.
Rabies cannot be communicated to certain dogs. Professor
Gamgee * mentions a case in which a pointer did not con-
tract the disease although it was bitten seventeen times by
mad dogs. And even the most contagious affections —
those in which the poison is usually sufficiently potent to
act upon the average individual — do not seem capable
of being communicated to some persons. Do we not see
* In Reynolds's * System of Medicine,' vol. i. p. 717.



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APPENDIX E, cxlix



individuals fully exposed to the contagion of measles, scarlet
fever, and small-pox, who yet fail to contract the disease ?
Facts of this kind are familiar to all medical men. Sir
Thomas Watson has referred to the case of * an old woman
who for years had been in the habit of going from village to
village as a nurse ; and of nursing a great number of persons
laboiuing under small-pox, which she had never had, and
against which she (naturally enough) believed herself proof:'
but, he adds, * at length she was taken ill, and died of small-
pox in the eighty-fourth year of her age/ Again, he says :
* In 1845, a lady with whom I am acquainted went through
an attack of measles, that disease being prevalent in the
village where she was then residing. She had never had
the measles previously ; yet she had long before personally
tended eleven of her twelve children when ill of the same
complaint \'

Such facts are quite inexplicable in accordance with the
vital or 'germ-theory' of causation of these diseases, but
they become much more easy to xmderstand in accordance
with the views which have just been enunciated. They are,
further, thoroughly harmonious with the results of experi-
ments made by myself and others with reference to the causes
of fermentation. These results have led me to reject, as
too narrow and exclusive, the * vital theory ' of Pasteur, and
to adopt the broader physico-chemical doctrines of Liebig,
which appear to be harmonious with all the facts. In en-
deavouring to explain the initiation of fermentation in any
particular fluid which has been boiled, we have also to
consider the influence of intrinsic tendencies in the fluid,
in combination with the exciting or external agencies to
which it is subjected. In some cases the intrinsic ten-
dencies may of themselves be potent enough to initiate
the process; whilst in other instances the mere contact-
' * Principles and Practice of Physic,' voL ii. p. 783.
^3



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cl THE BEGINNINGS OF LIFE.

action of an unheated organic fragment combines with
weaker inherent tendencies to incite the fermentative pro-
cess. Fermentations may be associated wi^ the presence
of organisms, or they may occur independently. The
ordinary zymotic diseases are comparable with fermenta-
tions of the latter class ^; and their several contagia act
after the fashion of the mere dead organic fragment upon
the fermentable fluid *.

' It is, however, quite conceivable that, in certain cases, the changes
in the blood might, in the last stages of the disease, assume such a
character as to lead to the evolution of Bacteria in this fluid. Such a
change, which may occasionally occur during life, does undoubtedly
occur very soon after death, in some diseases. In two cases, one of
rheumatic fever and one of tvphoid fever, in which the temperature
had gone up to 108-110° Fahr. a few hours before death, I fotmd
the vessels of the brain and of other parts of the body containing
myriads of Bacteria even within forty hours after death, and whilst the
temperature of the air had not been over 65° Fahr. The blood was
blackish and fluid, the organs were much blood-stained, and, in addition
to other marks of putremction, bubbles of gas were abundant in the
meshes of the pia mater. The blood of such, and of other similar
patients examined during life, has never revealed to me the least trace
of Bacteria, Dr. Burdon Sanderson, moreover, has ascertained that the
blood and other fluids of the body do not generally exhibit any zymotic
tendencies (see 'Thirteenth Report of Medical Officer of Privy Council*).
Some of the Bacteria which were found after death, I believe to have
been evolved de novo, whilst others were descendants of those which had
so arisen in the putrescent blood. No other view seems to me to be so
tenable as this. The fluids in a pysemic abscess may occasionally be on
the road towards similar results, and, even if no Bacteria exist, such
fluids might exhibit * zymotic' properties.

' Look, again, at the great moral epidemics which were so prevalent
in the middle ages, and which in their most marked form have extended
almost to our own times. Here, also, we have a changed mode of
action in certain parts of the body, brought about partly by 'predis-
posing,' and partly by 'exciting* causes. We may read in Hecker
(• Epidemics of the Middle Ages,' p. 14a) as follows : — * In a Methodist
chapel in Redruth, a man, during divine service, cried out with a loud
voice, " What shall I do to be saved " ? at the same time manifesting
the greatest uneasiness and solicitude respecting the condition of his
souL Some other members of the congregation followed his example,
cried out in the same form of words, and seemed shortly after to simer
the most excruciating bodily pain. This strange occurrence was soon
publicly known ; and hundreds of people who had come thither, either
attracted by curiosity or by a desire, from other motives, to see the
sufferers, fell into the same state. The chapel remained open for some

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APPENDIX E, Cli



Some boiled fluids are quite incapable by themselves of
initiating a fermentative process; but this tells no more
against the positive abilities of other fluids, than the fact
that certain diseases are unable to spring up amongst a
particular community, tells against the circumstance that they
do so arise amongst other communities where a number of
unhygienic surroundings, previously absent, are also opera-
tive in producing the result *.

Amongst the ' exciting ' causes of disease, there must be
many which are to us at present utterly obscure. More
especially is this the case with epidemic diseases. There are,
undoubtedly, 'epidemic influences' concerning which we
know scarcely anything, but whose existence is only too
surely attested by the history of the great epidemic and epi-
zootic affections. As Fleming says, in his * Animal Plagues,'

days and nights, and from that point the new disorder spread itself, with
the rapidity of lightning, over the neighbouring towns of Camborne,
Helston, Truro, Penryn, and Fahnouth, as well as over the villages
in the vicinity. Whilst thus advancing, it decreased in some measure
at the place where it had first appeared, and it confined itstlf tbrougbout
to the Methodist cbapel. It was only by the words wbieb have been men-
tioned [contagia] that it was excited, and it seized none but people oftbe
lowest education. Those who were attacked betrayed the greatest anguish,
and fell into convulsions. . . . According to a moderate computation
4,000 people were within a very short time affected with this convulsive
malady.' The various signs and symptoms of the malady are then
described.

* There is, however, a great tendency to draw such conclusions ; just
as there is a tendency with others to conclude that Bacteria do not arise
de novo, because there is no evidence of such an occurrence when dealing
With Pasteur's solution or a few other fluids, different from those in
which the process is stated to occur. Let any person, for instance,
repeat Dr. Sanderson's thirteenth experiment (* Thirteenth Report of the
Medical Officer of the Privy Council ') with a strong infusion of hay or
turnip, rather than with Pasteur's fluid, and then sudi results will occur
that, from Dr. Sanderson's data, he will have no option but to admit
that Bacteria do arise de novo. It is surprising that such an experiment
was not tried in the face of all that has been said concerning the produc-
tivity of such fluids. The real laws by which contagion is regulated can
never be adequately understood, unless one knows whether me contagia
with which one is concerned can, under any circumstances, arise de novo.
This seems to me to be the point which should be first ascertained.



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clii THE BEGINNINGS OF LIFE,

* It has been a matter of common observation from the earliest
times, and om- history will testify to its accuracy, that wide-
spread pestilence in plants, and mmrain in animals, have
frequently either preceded, accompanied, or followed closely
on those visitations which caused mortality and mourning in
the habitations of men ; showing an identity of causation or
affinity which strongly tempts the inquirer to solve the secret
of their joint production \' * Causes ' of this kind, however
obscure, are undoubtedly none the less real. Whilst we
may hope, therefore, that increasing knowledge will ultimately
enable us to throw more lig^t upon their nature, we may at
least feel assured that the efficacy of these ' causes ' may be
increased or diminished by us at will. * Exciting ' causes of
all ordinary severity require to be supplemented by the action
of 'predisposing' causes existing in the individual himself
before disease can be generated. It is true that we are com-
paratively powerless to rectify mere individual idiosjrncrasies,
of the very nature and existence of which we may be ignorant,
but they constitute a mere fractional part of the predisposing
causes which favour the spread of epidemic affections.
These are, in the main, produced in the individual by
the operation of the more general exciting causes of
disease, such as bad or insufficient food, bad water, and im-
pure air; or they are dependent upon more special causes,
such as depressing emotions, excessive muscular exercise,
or the occurrence of any unusual amount of degenerative



^ If additional reasons were needed to enforce the vast importance of
the fiillest knowledge concerning these diseases, they are not wanting.
The same author vmtes: — *The losses from only two exotic bovine
maladies ("contagious pleuropneumonia," and the so-called "foot-and-
mouth disease '*) have been estimated to amount, during the thirty
years that have elapsed since our ports were thrown open to foreign
cattle, to 5.549,780 head, roughly valued at £83,616,834. The late in-
vasion of ** cattle plague,** w£ch was suppressed withm two years of its
introduction, has been calculated to have caused a money loss of from
five to eight millions of pounds.'



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APPENDIX E. cliii



changes within the body. As Dr. Carpenter pointed out,
nearly twenty years ago, in a very able article on the * Pre-
disposing Causes of Epidemics V these causes are reducible
to one or other of three categories: — * (i) those which tend
to introduce into the system decomposing matter that has
been generated in some external source; (2) those which
occasion an increased production of decomposing matter in
the system itself ; and (3) those which obstruct the elimination
of the decomposing matter, normally or excessively generated
within the system^ or abnormally introduced into it from
without.' Now the common characteristic here is that * any
one of these causes will tend to produce an accumtdatton of
disintegrating azotised compounds, in a state of change^ in the
circulating current'; and observation seems to tell us that
either of the causes leading to such a result may, when
potent, suffice to assist the spread of epidemic diseases,
though two or more in combination lead to much more cer-
tain results. Much has been done to diminish the prevalence
of these conditions — which act only too surely upon the
individual in giving rise to 'predisposing' causes of disease —
though far more still remains to be done* Happily, however,
public attention is now becoming (though slowly) aroused to
the importance of pure air, pure water, efficient drainage, and
wholesome food, as instruments for maintaining the health of
the community.

But let us not be blinded by any narrow or exclusive
theories which would teach us that epidemic and infective
diseases cannot arise de novo. Let us, instructed by a broader
survey of the facts, assign no such limits to natural possi-
bilities, and not lightly accept theories which lead to supine-
ness when we ought to be stimulated to exertion. Whilst

* * British and Foreign Medico-Chirurgical Review/ 1853, vol. xi.
p. 175.



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cliv THE BEGINNINGS OF LIFE,

accepting to the full all doctrines which inculcate the necessity
of diminishing the chances of contagion by every available
means, let us, full of hope, diligently seek also for the causes
which engender even the most contagious of diseases. Pre-
vention of disease is the grand end and aim of medicine ; if,
then, we have learned from the sad lessons of experience
that scarlet fever and small-pox are virulendy contagious dis^
eases ; if, even in ninety-nine cases out of a hundred, or even
in a still larger ratio, both of these diseases are acquired by
contagion, then is it all the more important that we should
strive to ascertain what are the invariable and immediately
antecedent sets of conditions, or states of system, which
suffice actually to engender these maladies. In such cases
knowledge and power are most frequentiy convertible terms.
Next to typhus fever, the most fatal of the infective diseases
which occur in this coimtry are scarlet fever', small-pox,
measles, and hooping-cough. The ravages of typhus in our
crowded cities and in our jails have been enormously curtailed
— not so much because of its diminished spread by contagion,
but rather because we have learned what are the causes
which engender it, and are therefore better al^e to prevent

' Mr. J. Netten Raddiffe says (Ranking's * Abstract,* vol. xli. 1865),
• The Registrar-General's returns of scarlet fever for the whole of England,
include two periods of five and sixteen years respectively. The first
period extends from 1838 to 1842, and the second from 1847 ^^ >86a
mclusive. The total number of deaths registered from the disease in
the twenty-one years was 310,730 ; the annual average mortality for the

whole series of years was 14,706 The history of the progress of

scailet fever in the metropolis differs firom that of the entire kin^om in
this, that it shows a great augmentation of the mortality from the dis-
ease in the last quarter of a century. The annual average mortality
from the malady in London during the past twenty-six years was 83 per
100,000 population. The average varied from 3 a in 1841 to no less
than 174 in 1863. In the quinquennium 1839-43 the annual averajge
was 78 ; in the quinquenniiun 1844-48 it increased to 88 ; in the quin-
quennium 1859-03 it advanced to 115. The death-rate of 1863 (174)
was more than double the annual average of the twenty-six years,
1838-64.*



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APPENDIX E, dv



its occurrence. Left us strive, then, to acquire a similar
knowledge concerning scarlet fever, small- pox, measles,
hooping-cough, and other contagious affections, and thus en-
deavour, in the most efficient manner possible, to check the
ravages of these wide-spread and persistently pestilential dis-
eases, which are at all times and seasons undermining the
health and cutting short the lives of so large a proportion of
the human race.



The Index will be found at page xxi of vol. I.



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By the same Author.



(Preparing,)



A MANUAL OF THE DISEASES OF THE BRAIN,
SPINAL CORD, AND NERVES. Crown 8vo.



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Online LibraryH. Charlton BastianThe beginnings of life: being some account of the nature, modes of origin and transformations of lower organisms → online text (page 54 of 54)