Disease and Its CausesCouncilman, W. T. (William Thomas)
Science
Disease and Its Causes
Councilman, W. T. (William Thomas)
Diseases -- Causes and theories of causation
Tuberculosis is also one of the best examples of what is known as
latent infection. In this the infectious organisms enter the body and
produce primary lesions in which the organisms persist but do not
extend owing to their being enclosed in a dense and resistant tissue,
or to the production of a local immunity to their action. Dr. Head has
recently examined the children of households in which there was open
tuberculosis in some member of the household. By open tuberculosis is
understood a case from which bacilli are being discharged. He found
with scarcely an exception that all the children in such families
showed evidences of infection. The detection of slight degrees of
tuberculous infection is now made easy by certain skin reactions on
inoculation of the skin with a substance derived from the tubercle
bacilli. Such latent infections may never become active and in the
majority of cases do not. When, however, in consequence of some
intercurrent disease or conditions of malnutrition the general
defences of the body become weakened extension follows. Such latent
infections explain the enormous frequency of tuberculosis in prisons.
Under the general prison conditions infection in the prisons probably
does not take place to any extent, and the disease is as common when
the prisoners are kept in individual cells as in common prisons. It is
probable that in these cases the prisoners have latent tuberculosis
when entering, and the disease becomes active under the moral and
physical depression which prison life entails.
For the extension of infection from one individual to another the
infecting organisms must in some way be transferred. The most
important of the conditions influencing this are the localization of
the disease and the character of the infectious organisms,
particularly with regard to their resistance to the conditions met
with outside of the body. The seat of disease influences the discharge
of organisms; thus, if the disease involve any of the surfaces the
organisms become mingled with the secretions of the surface and are
discharged with these. If the seat of disease be in the lungs, the
throat or the mouth, the sputum forms the medium of extension, which
can take place in many ways. The sputum may become dried, forms part
of the dust and the organisms enter with the inspired air. The
organisms which cause most of the diseases in which the sputum becomes
infectious are quickly destroyed by conditions in the open, such as
the sunlight and drying; street dust does not play so prominent a part
in extension as is generally supposed. Organisms find much more
favorable conditions within houses. It is now generally recognized
that infection with tuberculosis does not take place in the open, but
in houses in which the bacilli on being discharged are not destroyed.
The hands, the clothing and surroundings even with the exercise of the
greatest care may become soiled with the saliva.
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