electric shock were one in five hundred, we would turn the wheels of progress back twenty years rather than allow an electric light or a trolley car to threaten our safety. No pains and no expense are thought too great in maintaining a quarantine against cholera, smallpox—which the sensible part of the community is already vaccinated against—diphtheria, and the like. Large appropriations are made that there may be tried a yet unproved defense against diphtheria, but to the insidious enemy that numbers its dead by hundreds where these other open foes count theirs by scores we are blind. It is time that the veil should be drawn from the loathsomeness of "the great white scourge," that the false sentiment which poetry and prose have thrown over infection, blood poisoning, suppuration, and decay should be dissipated.
In the case of a disease so fatal and so general as tuberculosis, the considerations of cause and prevention become all-important, especially since few cases are curable. The most sanguine authority on the subject—a New York physician whose patients can command every means of relief, and who usually seek medical advice at the first suspicion of illness—claims to cure only one consumptive out of six. Most physicians would consider this an extremely high proportion, while with regard to well-established cases there is no question that all or nearly all end in death.
It has been demonstrated by the experimental inoculation of guinea-pigs and other animals that the tubercle bacillus needs no dormant period outside the body—such as is requisite for certain other germs—but that the disease is directly transmissible. There are two factors in the establishment of any disease the presence of the germ and a certain predisposition. It is not a metaphor but a plain statement of fact to compare the former to the planting of a vegetable, the latter to the adaptability of the soil. Some germs will thrive only under the most favorable conditions, others will grow in almost any person. In other words, some diseases are liable to occur only under definite circumstances of predisposition, and these may be readily prevented, while others are virulent, attacking whole communities at once. Fortunately, the latter usually "exhaust the soil," so that if the patient recovers from one attack he is not liable to a second, though there are exceptions to all such rules. Measles, scarlet fever, smallpox in fact, nearly all the eruptive fevers—find the proper soil in almost every body, but the something on which they thrive is exhausted, so that thereafter an immunity exists. Tuberculosis never "exhausts the soil." Even if the patient recovers as not infrequently happens in surgical cases, hip-joint disease, inflammation of bones, etc. he is always liable to a subsequent attack of tubercular disease, not necessarily in the same organ. On the face of the matter it would seem that a germ that kills a fifth or, to give
