W. T. Councilman

“ A tumor is a mass of newly formed tissue which in structure, in growth, and the relations which it forms with adjoining tissues departs to a greater or less degree from the type of the tissue to which it is related in structure or from which it originates. It is an independent structure which, like a parasite, grows at the expense of the body, contributing nothing to it, and its capacity for growth is unlimited. A tumor cannot be considered as an organ, its activities not being coordinated with those of the body. ”

“ No other living organism is so resistant to changes in environment as is man, and to this resistance he owes his supremacy. By means of his intelligence he can change the environment. He is able to resist the action of cold by means of houses, fire and clothing; without such power of intelligent creation of the immediate environment the climatic area in which man could live would be very narrow. Just as disease can be acquired by an unfavorable environment, man can so adjust his environment to an injury that harmony will result in spite of the injury. ”

“ He was the first to recognize the specificity of the epidemic diseases, and argued from this that each disease must have a specific cause. "Just as a certain plant comes from the seed of the same plant and not from any plant at will, so each contagious disease must be propagated from a similar disease and cannot be the result of any other disease." Further he says, "It is necessary to assume that during the prevalence of an epidemic the contagious material undergoes an enormous increase, and this is compatible only with the assumption that it is a living substance." ”

“ The knowledge which has come from the study of infectious disease has served also to broaden our conception of disease and has created preventive medicine; it has linked more closely to medicine such sciences as zoölogy and botany; it has given birth to the sciences of bacteriology and protozoölogy and in a way has brought all sciences more closely together. Above all it has made medicine scientific, and never has knowledge obtained been more quickening and stimulating to its pursuit. ”

“ Lack of resistance to injury, incapacity for adaptation, whether it be due to a congenital defect or to an acquired condition, is not in itself a disease, but the disease is produced by the action on such an individual of external conditions which may be nothing more than those to which the individuals of the species are constantly subject and which produce no harm. ”

“ 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. ”

“ This discussion of injury and repair leads to the question of old age. Old age, as such, should not be discussed in a book on disease, for it is not a disease; it is just as natural to grow old and to die as it is to be born. Disease, however, differs in many respects in the old as compared with the young and renders some discussion of the condition necessary. Changes are constantly taking place in the body with the advance of years, and in the embryo with the advance of days. ”

“ Although insanity is determined by the social relations of man, that part of the social organization which is termed Society, and which has been developed by the idle as a diverting game, is a fertile source of nervous disease and even of insanity, affecting particularly females. The strenuosity of the life, the nervous excitement alternating with ennui, the lack and improper times of sleep, the lack of rest and particularly of restful occupation, the not infrequent use of alcohol in injurious amounts, are all factors calculated to make a defect operative. ”

“ Tumors form one of the most common causes of death (after the age of thirty-five one in every ten individuals dies of tumor) ; medical and surgical resources are, in many cases, powerless to afford relief and the tumor stands as a bar to the attainment of the utopia represented by a happy and comfortable old age, and a quiet passing. Every possible resource should be placed at the disposal of the scientific investigation of the subject, for with knowledge will come power to relieve. ”

“ The new cell which is formed by the union of the male and female sexual cells and which constitutes a new organism, contains the number of chromosomes characteristic of the species and parts of all the chromatin of the undifferentiated cells of male and female ancestors. As a result of this the most complicated mechanism in nature, it is evident that in a strict sense there can be no heredity of a disease because heredity in the mammal is solely a matter of the chromosomes and these could not convey a parasite. ”

“ Living matter occurs always in the form of small masses called "cells," which are the living units. The cells vary in form, structure and size, some being so large that they can be seen with the naked eye, while others are so small that they cannot be distinctly seen with the highest power of the microscope. The living thing or organism may be composed of a single cell or, in the case of the higher animals and plants, may be formed of great numbers of cells, those of a similar character being combined in masses to form organs such as the liver and brain. ”

“ If we consider the influence of the game in other respects as conducing to lack of moral sense, to alcoholic abuse (for without the seeming stimulation, but which is really the blunting of impressions which alcohol brings, the game would not be possible) , to discontent, to mental enfeeblement, it is all bad. Curiously enough the game is one which in all periods has been played by the idle, but its evil influence is greater now than before when it was the game of royalty chiefly, because there are now more people living from the work of others. ”

“ It is evident that this conception of disease is inseparable from the idea of life, since only a living thing can become diseased. In any dead body there has been a preëxisting disease or injury, and, in consequence of the change produced, that particular form of activity which constitutes life has ceased. Changes such as putrefaction take place in the dead body, but they are changes which would take place in any mass similarly constituted, and are not influenced by the fact that the mass was once living. Disease may also be thought of as the negation of the normal. ”

“ There are endemic foci of the disease where it exists in animals, the present epidemic having started from such a focus in Northern China, in which region the Tarabagan, a small fur-bearing animal of the squirrel species, was infected. Rats are easily infected, the close social habits of the animal, the vermin which they harbor, and the habits of devouring their dead fellows favor the extension of infection. The disease extends from the rat to man chiefly by means of the fleas which contain the bacilli, and in cases of pneumonic plague from man to man by means of sputum infection. ”

“ It is evident from such an experiment that when a living organism is subject to an environment to which it has not become adapted and which is unfavorable, such alterations in its structure may be produced that it is incapable of living even when it is again returned to the conditions natural to it. Such alterations of structure or injuries are called the lesions of disease. We have seen that in certain individuals the injury was sufficient to inhibit for a time only the usual manifestations of life ”

“ Certain habits, on the other hand, such as kissing, which probably represents the extension of a habit of sexual origin, are disadvantageous and infection is often transmitted in this way. In syphilitic infection the mouth forms one of the most common localizations of the disease and may contain the causal organisms in great numbers. This, the spirochæta pallida, is an organism of great virulence, and man is the most susceptible animal. The disease, like gonorrhoea, is essentially a sexual disease, the primary location is in the sexual organs, and it is transmitted chiefly by sexual contact. ”

“ Those tumors which grow rapidly and invade and destroy the surrounding tissue are called malignant tumors or cancers, but in a strict sense no tumor can be regarded as benign, for none can serve a useful purpose. A tumor after a period of slow growth can begin to grow rapidly. Tumors may arise in any part of the body, but there are certain places of preference particularly for the more malignant tumors. These are places where the cells naturally have a marked power of growth, and especially where growth is intermittent as in the uterus and mammary gland. ”

“ One of the most evident alterations is a general diminution in the fluid of the tissues, to which is chiefly due the lack of plumpness, the wrinkles of age. The facial appearance of age is given to an infant when, in consequence of a long-continued diarrhoea, the tissues become drained of fluid. Every market-man knows that an old animal is not so available for food, the tissues are tougher, more fibrous, not so easily disintegrated by chewing. This is due to a relative increase in the connective tissue which binds all parts together and is represented in the white fibres of meat. ”

“ There is no limit to the growth of a tumor save by the death of the individual who bears it, thus cutting off the supply of nutrition. The cells of tumors peculiar to man show a narrow range of adaptation. They will grow only in the body of the individual to whom the tumor belongs, and die when grafted on another individual. In the case of tumors which arise in animals, pieces of the tumor when grafted on another animal of the same species will grow, and in this way the growth capacity of the tumor cells has been estimated. ”

“ Wealth is on the whole more advantageous from the narrow point of view of disease than is poverty, but if we regard its influence on the race its advantages are not so evident. Nothing can be worse for a race than that it should die out, and wealthy families have never reproduced themselves. Conditions always tending to destruction are a necessary part of the environment of poverty ”

“ It is chiefly by means of their activity that other sorts of substances are removed. They often contain dead cells or cell fragments, and when hæmorrhage takes place in a tissue they enclose and remove the granules of blood pigment which result. They often join together, forming connected masses, and surround such a foreign body as a hair, or a thread which the surgeon places in a wound to close it. They may destroy living cells, and do this seemingly when certain cells are in too great numbers and superfluous in a part, their action tending to restore the cell equilibrium. ”