Tobacconist

“ It is with tobacconists as ’tis with demoniacs under an exorcism, they fume and vapour, but the devil sticks to them still. Many there are that make a very idol of it; they admire, they adore it, tempting and persecuting all people to take it, and the bare mention of it puts them into an ecstasy. In the smoke it is a probation for hell, where another day they must endure smoking ”

“ Besides the frequent use of Tobacco, which doubtless in time of Plague may be profitable for them that can take it; others, and also Tobacconists, at sometimes should be furnished with something to smell to when they pass through infected Places. Wormwood and Rue, Galbanum, Castor and Vinegar are good: The vulgar practice of putting Mithridate, or Treacle, or Tar in their Nostrils, may be very useful ”

“ The small Turkish leaf is famous throughout the world. Some of the finest flavoured tobaccos are produced in the regions around Cavalla in Macedonia and ancient Ephesus in Asia Minor. The cultivation of Turkish tobaccos has been taken up in various parts of the world, e.g. South Africa, and to maintain the standard of the produce fresh supplies of seed were obtained annually from Turkey. To guard against this competition, the export of tobacco seed from Turkey was prohibited in 1907. The method of cultivation in Turkey is simple, and the plants are set out close together. ”

“ TOBACCO, in the state that we see it, is a narcotic drug formed from the dried leaves of an annual plant (Nicotiana tabacum, Fig. 11) that is principally cultivated in North America, The stalk of the tobacco plant is erect, strong, round, and hardy. The leaves are large, oblong, pointed, clammy, and of pale green colour. The flowers, which terminate the stem and branches in loose clusters, are of reddish colour, and funnel shaped, with a long hairy tube; and the seed vessel is oval, and divided into two cells, that contain many rounded seeds. ”

“ It is true that the toxin of the tubercle bacillus has the definite effect of stimulating its victims so that they are likely to be hopeful, but very often this hopefulness is vague and does not tempt them to eat and to live in the open air, the two things that make their continued resistance to the disease possible. I find that the knowledge of how bravely and how successfully other sufferers from the disease resisted its invasion and succeeded in doing a good life's work is the very best tonic that sufferers from tuberculosis can have. ”

“ It is of historical interest to note that these experiments were being conducted by Tappeiner three years before Robert Koch made the now classical announcement to the scientific world that he had succeeded in identifying, isolating, and in cultivating outside the human body the specific cause of consumption in the shape of the now familiar bacillus tuberculosis. The opinion expressed by Koch at the Congress on Tuberculosis recently held in London, that human and bovine tuberculosis are distinct diseases, is still the subject of contention and experimental investigation. ”

“ Thus when we are together we are only to be distinguished by our pipes; but any one of us in the company of persons who smoke other tobaccos would be considered highly original. He would be a pigtail in Europe. ”

“ According to Metchnikoff’s hypothesis, a natural vaccination takes place among us against tuberculosis which would explain the resistance of the majority of human beings in spite of the enormous diffusion of the disease. He concluded that some attenuated breeds of microbes become introduced into our organism during our childhood, thus vaccinating us against the virulent tuberculous bacillus. This supposition seemed to him plausible, for he had long ago found that some micro-organisms (Cienkovsky’s bacillus, the cholera bacillus, etc.) ”

“ It is evident, therefore, that those people with the tuberculous variation who, even under the present circumstances, manage to contribute their quota to the population, would, were the bacillus tuberculosus altogether exterminated, contribute more than their share, and the type would become more common. And let it be remembered that this type, apart from the action of the bacillus, is a delicate and fragile one and liable to other affections, and the effect of giving the type any advantage in the struggle for life would surely imperil the well-being of the future of the race. ”

“ CHAPTER XXIV. NOT THE ARCADIA. Those who do not know the Arcadia may have a mixture that their uneducated palate loves, but they are always ready to try other mixtures. The Arcadian, however, will never help himself from an outsider's pouch. Nevertheless, there was one black week when we all smoked the ordinary tobaccos. Owing to a terrible oversight on the part of our purveyor, there was no Arcadia to smoke. ”

“ As a matter of fact, Bacillinum contains in its elements everything that a cavity of a tuberculous lung is capable of containing; that is to say, many other things besides Koch's bacillus. The bacillus of Koch is feebly pyogenetic, and the purulent contents of the cavities include pyogenetic staphylococci and streptococci, to say nothing of the organic products which play a large part in the production of the hectic fever of tuberculosis. It is a combination of toxins, then, which constitutes Bacillinum, and especially of toxins of a purulent nature. ”

“ The time may come when science will give us some tuberculin, or serum, or antitoxin, or antiseptic, that will kill the tubercle bacillus in its hidden lair, act its poisonous products, or reinforce the phagocytes in their attacks on it, but meanwhile sanatorial treatment gives expectations of recovery greater than those of any other kind of treatment that is known to us, and it seems to me inexpedient to say anything which may discourage the benevolent from putting it within reach of the poor and needy, or hinder the poor and needy, stricken with tuberculosis, from taking advantage of it. ”

“ Tuberculin failed of its prime purpose, but it does seem to have marked the initiative of a campaign against consumption which has already proved of incalculable benefit, and bids fair to put that omnipresent disease toward the foot of the list of causes of death. We have made substantial advances in our knowledge of the disease, and we no longer regard it as incurable. We have learned that it is communicable from one person to another, but also that its communication can easily be prevented, so that there is no reason to shrink from association with tuberculous persons. ”

“ When the abscess is allowed to burst, or is opened and becomes infected with pyogenic bacteria, there is not only the risk of aggravation of the disease and persistent suppuration, but there is a greater liability to general tuberculosis. ”

“ Of course, I presuppose that we understand by tuberculosis only those morbid conditions which are caused by the tubercle bacillus. In by far the majority of cases of tuberculosis the disease has its seat in the lungs, and has also begun there. From this fact it is justly concluded that the germs of the disease—i. e., the tubercle bacilli—must have got into the lungs by inhalation. As to the question where the inhaled tubercle bacilli have come from, there is also no doubt. On the contrary, we know with certainty that they get into the air with the sputum of consumptive patients. ”

“ Under the last I understand all the conditions necessary to bring the virus to such a part of the living organism as will enable it to enter either into the circulation or into other body juices.
Every human individual is by nature susceptible to the action of tubercle bacilli which have entered his body juices. This is true not only of human but also of bovine tubercle bacilli. I emphasize this now but shall give my proofs later. But not every tubercular infection of the tissues leads to consumption. ”

“ Without the tubercle bacillus there can be no tuberculosis, but for tuberculosis to develop, many factors of great complexity and as yet but little understood must facilitate the implantation of the bacillus and augment its growth. It is true that though we may emphasize the rôle of the bacillus, still we cannot completely ignore those personal factors that contribute to make the infection fruitful, and likewise though we focus our attention upon individual resistance, still we cannot keep out of sight the invader that is being resisted. ”

“ The bacillus of human sputum often produces only localized tuberculosis in the ox. Even in the same species and individual the pathogenesis often varies materially. Nothing is more familiar than the slow progress of tuberculosis in the bones and lymph glands of man, on the one hand, and its frequently rapid progress in the lungs, liver and brain, on the other. As inoculated on the lower animals bacilli from the lungs of man are usually more virulent than those from the lymph glands (Creighton, Arloing, F. Craven Moore, Courmont and Denis) . ”

“ In the next stage the cells forming the tubercle undergo the degenerative change known as "caseation," which merely means that they assume in the mass an appearance something like cheese. In point of fact, they die. This degeneration is believed to be directly caused by a toxin produced by the bacilli. The further progress of the disease varies greatly, probably in accordance with the resisting power of the individual. ”

“ The terrible disease tuberculosis is the most serious and deadly enemy which the human body has to face. It kills every year, in the United States, over a hundred and fifty thousand men, women, and children—more lives than were lost in battle in the four years of our Civil War. It is caused by a tiny {157}germ—the tubercle bacillus—so called because it forms little mustard-seed-like lumps, or masses, in the lungs, called tubercles, or "little tubers." ”

“ B. also displays various compulsory mannerisms, the meaning of which becomes obvious once we appreciate that, in his case, ‘tuberculosis’ really means ‘homosexuality.’ As he walks upon the City streets he meets a man coming his way. While still at a distance he steps aside or crosses on the other side; he no longer shakes hands with any man, not even with his friends; one may become infected with tubercle bacilli in that way. All places where men are seen naked or in partial undress, such as gymnasia or bathing resorts, are breeding spots for tubercular infection. ”

“ The bacillus attacks every organ and tissue of the body, but some much more frequently than others. The commonest seats of tuberculous disease are the lungs, lymphatic glands, bones, serous membranes, mucous membranes, intestines and liver. Before the discovery of the bacillus its effects in different parts of the body received separate names and were classified as distinct diseases. For instance, tuberculosis of the lung was called "consumption" or "phthisis," of the bones and lymphatic glands "struma" or "scrofula," of the skin "lupus," or the intestinal glands "tabes mesenterica." ”

“ Nowadays the term tuberculosis is applied to everything which constitutes a change in the organism excited by the entrance into it of tubercle bacilli. In statistics, galloping consumption is thus classed with tubercular local infection of a joint, gland, abdominal organ, of a little nodule in the skin of the face, etc. Calcified as well as other remains of previous lesions are classed as tubercular. [Pg 4] We have every reason to praise as a great scientific advance the discovery that in manifestations so varied in their importance to life and health the etiological factor is the same. ”

“ IN a population of about one million, seventeen hundred persons died of tuberculosis in this state in the year 1911—a reduction in thirty years of nearly 50 per cent. A generation has changed completely our outlook on one of the most terrible scourges of the race. It is simply appalling to think of the ravages of this disease in civilized communities. Before the discovery by Robert Koch of the bacillus, we were helpless and hopeless; in an Oriental fatalism we accepted with folded hands a state of affairs which use and wont had made bearable. Today, look at the contrast! ”

“ On the contrary, no matter how healthful the surroundings or the salubrity of the atmosphere, for poorly nourished and feeble persons, from whatever cause, there is no immunity from tuberculosis. For no one who even approximately comprehends the universality of microbic life—and of none more than tubercle bacilli—can fail to perceive that, however much we may be able to modify the external relations bearing upon liability to tuberculosis, nevertheless every individual, no matter where his dwelling place, is more or less subject to tubercle bacilli ”

“ The subject of bovine tuberculosis and of bovine tubercle bacilli is among the most important of all the questions relating to the suppression of tuberculosis. The admirable studies of Theobald Smith established the distinction in type subsisting between certain bacilli of human and of bovine origin. We have come now to regard these types as separate and not to be transmuted, at least not readily under artificial conditions of cultivation, into each other. ”

“ This is the method which several leaders in bacteriology, including Behring (of antitoxin fame) , believe to be the principal source and method of infection of the human species. The large majority, however, of [Pg 158] bacteriologists and clinicians are of the opinion that ninety per cent of all cases of human tuberculosis are contracted from some human source. ”

“ Other bacteria than the acid-fast group are stained blue by Gabbet's method. Those most commonly found are staphylococci, streptococci, and pneumococci. Their presence in company with the tubercle bacillus constitutes mixed infection, which is much more serious than single infection by the tubercle bacillus. It is to be remembered, however, that a few of these bacteria may reach the sputum from the upper air-passages. Clinically, mixed infection is evidenced by fever. ”