Preventable Diseases

by Woods Hutchinson

It gave one a distinct shock at the meeting of the British Medical Association devoted to tuberculosis, some ten years ago, to hear Sir Clifford Allbutt, one of the most brilliant and eminent physicians of the English-speaking world, remark, on opening his address, "Probably most of us here have had tuberculosis and recovered from it."

Here is evidently an asset of greatest and most practical value, which changes half the face of the field. Instead of saving, as best we may, from half to two-thirds of those who have allowed the disease to get the upper hand and begin to overrun their entire systems, it places before us the far more cheering task of building up and increasing this natural resisting power of the human body, until not merely seventy per cent of all who are attacked by it will throw it off, but eighty, eighty-five, ninety! We can plan to stop consumption by preventing the consumptive. A very small additional percentage of vigor or of resisting power—such as could be produced by but a slight improvement in the abundance of the food-supply, the lighting and ventilating of the houses, the length and "fatiguingness" of the daily toil—might be the straw which would be sufficient to turn the scale and prevent the tuberculous individual from becoming consumptive.

Here comes in one of the most important and valuable features of our splendid sanatorium campaign for the cure of tuberculosis, and that is the nature of the methods employed. If we relied for the cure of the disease upon some drug, or antitoxin, even though we might save as many lives, the general reflex or secondary effect upon the community might not be in any way beneficial; at best it would probably be only negative. But when the only "drugs" that we use are fresh air, sunshine, and abundant food, and the only antitoxins those which are bred in the patient's own body; when, in fact, we are using for the cure of consumption precisely those agencies and influences which will prevent the well from ever contracting it, then the whole curative side of the movement becomes of enormous racial value. The very same measures that we rely upon for the cure of the sick are those which we would recommend to the well, in order to make them stronger, happier, and more vigorous.

If the whole civilized community could be placed upon a moderate form of the open-air treatment, it would be so vastly improved in health, vigor, and efficiency, and saved the expenditure of such enormous sums upon hospitals, poor relief, and sick benefits, that it would be well worth all that it would cost, even if there were no such disease as tuberculosis on earth.

This is coming to be the real goal, the ultimate hope of the far-sighted leaders in our tuberculosis campaign,—to use the cure of consumption as a lever to raise to a higher plane the health, vigor, and happiness of the entire community.

Enormously valuable as is the open-air sanatorium as a means of saving thousands of valuable and beloved lives, its richest promise lies in its function as a school of education for the living demonstration of methods by which the health and happiness of the ninety-five per cent of the community who never will come within its walls may be built up. Every consumptive cured in it goes home to be a living example and an enthusiastic missionary in the fresh-air campaign. The ultimate aim of the sanatorium will be to turn every farmhouse, every village, every city, into an open-air resort. When it shall have done this it will have fulfilled its mission.

Our plan of campaign is growing broader and more ambitious, but more hopeful, every day. All we have to do is to keep on fighting and use our brains, and victory is certain. Our Teutonic fellow soldiers have already nailed their flag to the mast with the inscription:—

"No more tuberculosis after 1930!"

So much for the serried masses of the centre of our anti-tuberculosis army, upon which we depend for the heavy, mass fighting and the great frontal attacks. But what of the right and the left wings, and the cloud of skirmishers and cavalry which is continually feeling the enemy's position and cutting off his outposts? Upon the right stretch the intrenchments of the bacteriologic brigade, with the complicated but marvelously effective weapons of precision given us by the discovery of the definite and living cause of the disease, the Bacillus tuberculosis. Upon the left wing lie camp after camp of native regiments, whose loyalty until of very recent years was more than doubtful,—heredity, acquired immunity, and the so-called improvements of modern civilization, steam, electricity, and their kinsmen.

To the artillerymen of the bacteriologic batteries appears to have been intrusted the most hopeless task, the forlorn hope,—the total extermination of a foe so tiny that he had to be magnified five hundred times before he was even visible, and of such countless myriads that he was at least a billion times as numerous as the human race. But here again, as in the centre of the battle-line, when we once made up our minds to fight, we were not long in discovering points of attack and weapons to assault him with.