Preventable Diseases

by Woods Hutchinson

My first direct experience with this feature of our "household pets" was on the Pacific Coast. All the old settlers told me of a dread pestilence which had preceded the coming of the main wave of invading civilization, sweeping down the Columbia River. Not merely were whole clans and villages swept out of existence, but the valley was practically depopulated; so that, as one of the old patriarchs grimly remarked, "It made it a heap easier to settle it up quietly." So swift and so fatal had been its onslaught that villages would be found deserted. The canoes were rotting on the river bank above high-water mark. The curtains of the lodges were flapped and blown into shreds. The weapons and garments of the dead lay about them, rusting and rotting. The salmon-nets were still standing in the river, worn to tatters and fringes by the current. Yet, from the best light that I was able to secure upon it, it appeared to have been nothing more than an epidemic of the measles, caught from the child of some pioneer or trapper and spreading like wildfire in the prairie grass. A little later I had an opportunity to see personally an epidemic of mumps in a group of Indians, and I have seldom seen fever patients, ill of any disease, who were more violently attacked and apparently more desperately ill than were sturdy young Indian boys attacked by this trifling malady. Their temperatures rose to one hundred and five or one hundred and six degrees, they became delirious, their faces were red and swollen, they ached in every limb, and the complications that occasionally follow mumps even in civilized patients were frequent and exceedingly severe. In like manner, influenza will slay its hundreds in a tribe of less than a thousand members. Chicken-pox will become so virulent as to be mistaken for smallpox. Several of the epidemics of alleged smallpox that have occurred among Indians and other savage tribes are now known to have been only measles. At first, pathologists were inclined to receive these reports with some degree of skepticism, and to regard them either as travelers' tales, or as instances of exceptional and accidental virulence in that particular tribe, the high death-rate due to bad nursing or horrible methods of voodoo treatment.

But from all over the world came ringing in the same story, not merely from scores of travelers, but also from army surgeons, medical missionaries, and medical explorers, until it has now become a definitely established fact that the mild, trifling diseases of infancy, "colds" and influenzas of civilized races, leap to the proportions of a deadly pestilence when communicated to a savage tribe. Whether that tribe be the Eskimo of the Northern ice-sheet or the Terra del Fuegian of the Southern, the Hawaiian of the islands of the Pacific or the Aymarás of the Amazon, all fall like grain before the scythe under the attack of a malady which is little more than the proverbial "little 'oliday" of three days in bed to civilized man. Evidently civilized man has acquired a degree and kind of immunity that uncivilized man has not. Either the disease has grown milder or civilized man tougher with the ages.

The probability is that both of these explanations are true. These diseases may originally have been comparatively severe and serious; but as generation after generation has been submitted to their attack, those who were most susceptible died or were so crippled as to be seriously handicapped in the race of life and have left fewer and less vigorous offspring. So that, by a gradual process of weeding out the more susceptible, the more resisting survived and became the resistant civilized races of to-day.

On the other hand, any disease which kills its victim so quickly that it has not time to make sure of its transmission to another one before his death, will not have so many chances of survival as will a milder and more chronic disorder. Hence, the milder and less fatal strains of germs would stand the better chance of survival. This, of course, is a very crude outline, but it probably represents something of the process by which almost all known diseases, except a few untamable hyenas, like the Black Death, the cholera, and smallpox, have gradually grown milder with civilization. If we escape the attack of these attenuated diseases of infancy until fifteen or sixteen years of age, we can usually defy them afterward; though occasionally an unusually virulent strain will attack an adult, with troublesome consequences.

At all events, whatever explanation we may give, the consoling fact stands out clearly that civilized man is decidedly more resistant to these pests of civilization than is any half-civilized race, and there is good reason to believe that this is a typical instance of his comparative vigor and endurance all along the line.

If this view of the original character and taming of these diseases be correct, it also accounts for the extraordinary and otherwise inexplicable cases where they suddenly assume the virulence of cholera, or yellow fever, and kill within forty-eight or ninety-six hours, not merely in children but also in adults.

To group these three diseases together simply because they all happen to occur in children would appear scarcely a rational principle of classification. Yet, practically, widely different as they are in their ultimate results and, probably, in their origin, they have so many points in common as to their method of spread, prevention, and general treatment, that what is said of one will with certain modifications apply to all.

I said "probably" of widely different origin, because, by one of those strange paradoxes which so often confront us in real life, though the infectiousness and the method of spread of all these diseases is as familiar as the alphabet and as firmly settled, the most careful study and innumerable researches have failed to identify positively the germ in any one of them. There are a number of "suspects" against which a great deal of circumstantial evidence exists: a streptococcus in scarlet fever, a bacillus in whooping-cough, and a protozoan in measles; but none of these have been definitely convicted. The principal reason for our failure is a very common one in bacteriological research, whose importance is not generally known, and that is, that there is not a single species of the lower animals that is subject to the diseases or can be inoculated with them. This unfortunate condition is the greatest barrier which can now exist to our discovery of the causation of any disease. We were absolutely blocked, for instance, by it in smallpox and syphilis until we discovered that our nearest blood relatives, the ape and the monkey, are susceptible to them; and then the Cytoryctes Variolæ and the Treponema pallida were discovered within comparatively a few months. Some lucky day, perhaps, we may stumble on the animal or bird which will take measles, scarlet fever, or whooping-cough, and then we will soon find out all about them.

But, fortunately, our knowledge of these little diseases, like Mercutio's wound, is "not so deep as a well, nor so wide as a church door; but 't is enough" for all practical purposes. The general plan of treatment in all of them might be roughly summed up as, rest in bed in a well-ventilated room; sponge-baths and packs for the fever; milk, eggs, bread, and fruit diet, with plenty of cool water to drink, either plain, or disguised as lemonade or "fizzy" mixtures; mild local antiseptic washes for nose and throat, and mild internal antiseptics, with laxatives, for the bowels and kidneys. There is no known drug which is specific in any one of them, though their course may be made milder and the patient more comfortable by the intelligent use of a variety of remedies, which assist nature in her fight against the toxin. Not knowing the precise cause, we have as yet no reliable antitoxin for any.

Now very briefly as to the earmarks of each particular member of this children's group. It may be said in advance that the "openings" of all of them (as chess-players call the first moves) are very much alike. All of them are apt to begin with a little redness and itching of the mucous membranes of the nose, the throat, and the eyes, with consequent snuffling and blinking and complaints of sore throat. These are followed, or in severe, swift cases may be preceded, by flushed cheeks, complaints of headache or heaviness in the head, fever, sometimes rising very quickly to from one hundred and four to one hundred and five degrees, backache, pains in the limbs, and, in very severe cases, vomiting. In fact, the symptoms are almost identical with those of an attack of that commonest of all acute infections, a bad cold, and probably for the same reason, namely, that the germs, whatever they may be, attack and enter the system by way of the nose and throat.