QR56 C76s Southern Branch of the University of California Los Angeles Form L-l This book is DUE on the last date stamded below m-g 1 5 1933 APR 2 7 1934 J rjtfi, MAY 1 9 193b MAR 6 -1958 Form L-9-5m-7,'22 VARIOUS KINDS OF BACTERIA. . To the left the common hay bacillus (Bacillus subtilis) to the right a Spirit lum. B. A Coccus form (Planococcus\ C, D, E. Species of Pseudomonas. f, G. Species of Bacillus. F being that of typhoid fever. H. Microspira. /, A", Z, M. Species of Spirillum. (After Engler and Prantl.) THE STORY OF GERM LIFE BY H. W. CONN PROFESSOR OF BIOLOGY AT WESLEYAN UNIVERSITY, AUTHOR OF EVOLUTION OF TO-DAY, THE LIVING WORLD, ETC. WITH ILLUSTRATIONS NEW YORK MCMXII COPYRIGHT, 1897, Bv D. APPLETON AND COMPANY. *' '' ' Prihfecf ftf the "United States* o! America PREFACE. (P THE rapid progress of discovery in the last few years has created a very general interest in ^~ bacteria. Few people who read could be found to-day who have not some little idea of these organisms and their relation to disease. It is, \* however, unfortunately a fact that it is only their relation to disease which has been impressed upon O the public. The very word bacteria, or microbe, - conveys to most people an idea of evil. The last few years have above all things emphasized the j importance of these organisms in many relations ( entirely independent of disease, but this side of j the subject has not yet attracted very general attention, nor does it yet appeal to the reader with any special force. It is the purpose of the following pages to give a brief outline of our r\ knowledge of bacteria and their importance in \ | the world, including not only their well-known agency in causing disease, but their even greater importance as agents in other natural phenomena, It is hoped that the result may be to show that these organisms are to be regarded not primarily in the light of enemies, but as friends, and thus to correct some of the very general but erroneous ideas concerning their relation to our life. MIDDLETOWN, April i, 1897. 3 CONTENTS. CHAPTER PACK I. BACTERIA AS PLANTS 9 Historical. Form of bacteria. Multiplication of bac- teria. Spore formation. Motion. Internal structure. Animals or plants ? Classification. Variation. Where bacteria are found. II. MISCELLANEOUS USES OF BACTERIA IN THE ARTS. 41 Maceration industries. Linen. Jute. Hemp. Sponges. Leather. Fermentative industries. Vine- gar. Lactic acid. Butyric acid. Bacteria in tobacco curing. Troublesome fermentations. III. BACTERIA IN THE DAIRY 66 Sources of bacteria in milk. Effect of bacteria on milk. Bacteria used in butter making. Bacteria in cheese making. IV. BACTERIA IN NATURAL PROCESSES . . .94 Bacteria as scavengers. Bacteria as agents in Nature's food cycle. Relation of bacteria to agriculture. Sprout- ing of seeds. The silo. The fertility of the soil. Bac- teria as sources of trouble to the farmer. Coal forma- tion. V. PARASITIC BACTERIA AND THEIR RELATION TO DISEASE 128 Method of producing disease. Pathogenic germs not strictly parasitic. Pathogenic germs that are true para- sites. What diseases are due to bacteria. Variability 6 THE STORY OF GERM LIFE. CHAPTER PACK of pathogenic powers. Susceptibility of the individual. Recovery from bacteriological diseases. Diseases caused by organisms other than bacteria. VI. METHODS OF COMBATING PARASITIC BACTERIA . 165 Preventive medicine. Bacteria in surgery. Preven- tion by inoculation. Limits of preventive medicine. Curative medicine. -Drugs. Vis medicatrix naturae. Antitoxines and their use. Conclusion. LIST OF ILLUSTRATIONS. FIGURE FACE Various kinds of bacteria . . . Frontispiece 1. General shapes of bacteria 18 2. Method of multiplication of bacteria. ... 19 3. Micrococci 19 4. Streptococci 19 5. Sarcina 2O 6. Separate rods showing variations in size ... 20 7. Rod-forms united to form chains .... 20 8. Various types of spiral bacteria 21 9. Various shaped rods 23 10. Bacteria surrounded by capsules .... 23 11. Various types of bacteria "colonies" ... 24 12. Endogenous spores 26 13. So-called arthrogenous spores 27 14. Formation of spores in unusual forms (Crenothrix) . 28 15. Bacteria provided with flagella 29 16. Internal structure of bacteria 30 17. Threads of Oscillaria 32 1 8. Bacillus acetieum, of vinegar ..... 53 19. Bacillus acidi lactici, of sour milk . . . . 7 1 20. Dairy bacterium producing red milk .... 73 21. Dairy bacterium producing pleasant flavours in butter 80 22. Dairy bacterium producing pleasant aroma in butter 81 23. Dairy bacterium producing pleasant flavour in butter 83 24. Dairy bacterium producing " swelled " cheese . . 92 25. Diagram illustrating Nature's food cycle ... 99 7 8 LIST OF ILLUSTRATIONS. FIGURE PAGE 26. Soil bacteria which produce nitrification . . . 103 27. Soil bacteria which produce tubercles on the toots of legumes IO8 28. Diphtheria bacillus 134 29. Tetanus bacillus 135 30. Typhoid bacillus ....... 136 31. Tuberculosis bacillus 137 32. Anthrax bacillus 138 33. White blood corpuscles and other phagocytes . . 152 34. Malarial organism 161 THE STORY OF GERM LIFE. CHAPTER I. BACTERIA AS PLANTS. DURING the last fifteen years the subject of bacteriology* has developed with a marvellous rapidity. At the beginning of the ninth decade of the century bacteria were scarcely heard of outside of scientific circles, and very little was known about them even among scientists. To- day they are almost household words, and every- one who reads is beginning to recognise that they have important relations to his everyday life. The organisms called bacteria comprise simply a small class of low plants, but this small group has proved to be of such vast importance in its relation to the world in general that its study has little by little crystallized into a science by itself. It is a somewhat anomalous fact that a special branch of science, interesting such a large number of people, should be developed around a small group of low plants. The impor- tance of bacteriology is not due to any importance bacteria have as plants or as members of the vegetable kingdom, but solely to their powers of * The term microbe is simply a word which has been coined to include all of the microscopic plants commonly in- cluded under the terms bacteria and yeasts. 9 10 THE STORY OF GERM LIFE. producing profound changes in Nature. There is no one family of plants that begins to compare with them in importance. It is the object of this work to point out briefly how much both of good and ill we owe to the life and growth of these microscopic organisms. As we have learned more and more of them during the last fifty years, it has become more and more evident that this one little class of microscopic plants fills a place in Nature's processes which in some respects bal- ances that filled by the whole of the green plants. Minute as they are, their importance can hardly be overrated, for upon their activities is founded the continued life of the animal and vegetable kingdom. For good and for ill they are agents of neverceasing and almost unlimited powers. HISTORICAL. The study of bacteria practically began with the use of the microscope. It was toward the close of the seventeenth century that the Dutch microscopist, Leeuwenhoek, working with his sim- ple lenses, first saw the organisms which we now know under this name, with sufficient clearness to describe them. Beyond mentioning their ex- istence, however, his observations told little or nothing. Nor can much more be said of the stud- ies which followed during the next one hundred and fifty years. During this long period many a microscope was turned to the observation of these minute organisms, but the majority of observers were contented with simply seeing them, marvel- ling at their minuteness, and uttering many excla- mations of astonishment at *he wonders of Nature. A few men of more strictly scientific natures paid BACTERIA AS PLANTS. II some attention to these little organisms. Among them we should perhaps mention Von Gleichen, Miiller, Spallanzani, and Needham. Each of these, as well as others, made some contributions to our knowledge of microscopical life, and among other organisms studied those which we now call bacteria. Speculations were even made at these early dates of the possible causal connection of these organisms with diseases, and for a little the medical profession was interested in the sugges- tion. It was impossible then, however, to obtain any evidence for the truth of this speculation, and it was abandoned as unfounded, and even forgot- ten completely, until revived again about the mid- dle of the ipth century. During this century of wonder a sufficiency of exactness was, how- ever, introduced into the study of microscopic or- ganisms to call for the use of names, and we find Miiller using the names of Monas, Proteus, Vibrio, Bacillus, and Spirillum, names which still continue in use, although commonly with a different signifi- cance from that given them by Miiller. Miiller did indeed make a study sufficient to recognise the several distinct types, and attempted to clas- sify these bodies. They were not regarded as of much importance, but simply as the most minute organisms known. Nothing of importance came from this work, however, partly because of the inadequacy of the microscopes of the day, and partly because of a failure to understand the real problems at issue. When we remember the minuteness of the bacteria, the impossibility of studying any one of them for more than a few moments at a time only so long, in fact, as it can be followed under a microscope; when we remember, too, the imperfection of the 12 THE STORY OF GERM LIFE. compound microscopes which made high powers practical impossibilities ; and, above all, when we appreciate the looseness of the ideas which per- vaded all scientists as to the necessity of accurate observation in distinction from inference, it is not strange that the last century gave us no knowl- edge of bacteria beyond the mere fact of the ex- istence of some extremely minute organisms in different decaying materials. Nor did the igth century add much to this until toward its middle. It is true that the microscope was vastly improved early in the century, and since this improvement served as a decided stimulus to the study of mi- croscopic life, among other organisms studied, bacteria received some attention. Ehrenberg, Dujardin, Fuchs, Perty, and others left the im- press of their work upon bacteriology even before the middle of the century. It is true that Schwann shrewdly drew conclusions as to the relation of microscopic organisms to various processes of fermentation and decay conclusions which, al- though not accepted at the time, have subse- quently proved to be correct. It is true that Fuchs made a careful study of the infection of " blue milk," reaching the correct conclusion that the infection was caused by a microscopic organ- ism which he discovered and carefully studied. It is true that Henle made a general theory as to the relation of such organisms to diseases, and pointed out the logically necessary steps in a dem- onstration of the causal connection between any organism and a disease. It is true also that a general theory of the production of all kinds of fermentation by living organisms had been ad- vanced. But all these suggestions made little impression. On the one hand, bacteria were not BACTERIA AS PLANTS. 13 recognised as a class of organisms by themselves were not, indeed, distinguished from yeasts or other minute animalculae. Their variety was not mistrusted and their significance not conceived. As microscopic organisms, there were no reasons for considering them of any more importance than any other small animals or plants, and their extreme minuteness and simplicity made them of little interest to the microscopist. On the other hand, their causal connection with fermentative and putrefactive processes was entirely obscured by the overshadowing weight of the chemist Lie- big, who believed that fermentations and putre- factions were simply chemical processes. Liebig insisted that all albuminoid bodies were in a state of chemically unstable equilibrium, and if left to themselves would fall to pieces without any need of the action of microscopic organisms. The force of Liebig's authority and the brilliancy of his expositions led to the wide acceptance of his views and the temporary obscurity of the re- lation of microscopic organisms to fermentative and putrefactive processes. The objections to Liebig's views were hardly noticed, and the force of the experiments of Schwann was silently ig- nored. Until the sixth decade of the century, therefore, these organisms, which have since be- come the basis of a new branch of science, had hardly emerged from obscurity. A few micros- copists recognised their existence, just as they did any other group of small animals or plants, but even yet they failed to look upon them as forming a distinct group. A growing number of observations was accumulating, pointing toward a probable causal connection between fermenta- tive and putrefactive processes and the growth of 2 14 THE STORY OF GERM LIFE. microscopic organisms; but these observations were known only to a few, and were ignored by the majority of scientists. It was Louis Pasteur who brought bacteria to the front, and it was by his labours that these or- ganisms were rescued from the obscurity of scien- tific publications and made objects of general and crowning interest. It was Pasteur who first suc- cessfully combated the chemical theory of fer- mentation by showing that albuminous matter had no inherent tendency to decomposition. It was Pasteur who first clearly demonstrated that these little bodies, like all larger animals and plants, come into existence only by ordinary methods of reproduction, and not by any sponta- neous generation, as had been earlier claimed. It was Pasteur who first proved that such a com- mon phenomenon as. the souring of milk was pro- duced by microscopic organisms growing in the milk. It was Pasteur who first succeeded in dem- onstrating that certain species of microscopic or- ganisms are the cause of certain diseases, and in suggesting successful methods of avoiding them. All these discoveries were made in rapid succes- sion. Within ten years of the time that his name began to be heard in this connection by scien- tists, the subject had advanced so rapidly that it had become evident that here was a new subject of importance to the scientific world, if not to the public at large. The other important discoveries which Pasteur made it is not our pur- pose to mention here. His claim to be consid- ered the founder of bacteriology will be recog- nised from what has already been mentioned. It was not that he first discovered the organisms, or first studied them ; it was not that he first sug- BACTERIA AS PLANTS. 15 gested their causal connection with fermentation and disease, but it was because he for the first time placed the subject upon a firm foundation by prov- ing with rigid experiment some of the suggestions made by others, and in this way turned the atten- tion of science to the study of micro-organisms. After the importance of the subject had been demonstrated by Pasteur, others turned their at- tention in the same direction, either for the pur- pose of verification or refutation of Pasteur's views. The advance was not very rapid, however, since bacteriological experimentation proved to be a subject of extraordinary difficulty. Bacteria were not even yet recognised as a group of organ- isms distinct enough to be grouped by themselves, but were even by Pasteur at first confounded with yeasts. As a distinct group of organisms they were first distinguished by Hoffman in 1869, since which date the term bacteria, as applying to this special group of organisms, has been coming more and more into use. So difficult were the investigations, that for years there were hardly any investigators besides Pasteur who could suc- cessfully handle the subject and reach conclu- sions which could stand the test of time. For the next thirty, years, although investigators and in- vestigations continued to increase, we can find little besides dispute and confusion along this line. The difficulty of obtaining for experiment any one kind of bacteria by itself, unmixed with others (pure cultures), rendered advance almost impossible. So conflicting were the results that the whole subject soon came into almost hopeless confusion, and very few steps were taken upon any sure basis. So difficult were the methods, so contradictory and confusing the results, because 10 THE STORY OF GERM LIFE. of impure cultures, that a student of to-day who wishes to look up the previous discoveries in almost any line of bacteriology need hardly go back of 1880, since he can almost rest assured that anything done earlier than that was more likely to be erroneous than correct. The last fifteen years have, however, seen a wonderful change. The difficulties had been mostly those of methods of work, and with the ninth decade of the century these methods were simplified by Robert Koch. This simplification of method for the first time placed this line of investigation within the reach of scientists who did not have the genius of Pasteur. It was now possible to get pure cultures easily, and to obtain with such pure cultures results which were uni- form and simple. It was now possible to take steps which had the stamp of accuracy upon them, and which further experiment did not dis- prove. From the time when these methods were thus made manageable the study of bacteria in- creased with a rapidity which has been fairly startling, and the information which has accumu- lated is almost formidable. The very rapidity with which the investigations have progressed has brought considerable confusion, from the fact that the new discoveries have not had time to be properly assimilated into knowledge. To- day many facts are known whose significance is still uncertain, and a clear logical discussion of the facts of modern bacteriology is not possible. But sufficient knowledge has been accumulated and digested to show us at least the direction along which bacteriological advance is tending, and it is to the pointing out of these directions that the following pages will be devoted. BACTERIA AS PLANTS. 1 7 WHAT ARE BACTERIA ? The most interesting facts connected with the subject of bacteriology concern the powers and influence in Nature possessed by the bacteria. The morphological side of the subject is interest- ing enough to the scientist, but to him alone. Still, it is impossible to attempt to study the powers of bacteria without knowing something of the organisms themselves. To understand how they come to play an important part in Nature's processes, we must know first how they look and where they are found. A short consideration of certain morphological facts will therefore be necessary at the start. FORM OF BACTERIA. In shape bacteria are the simplest conceivable structures. Although there are hundreds of dif- ferent species, they have only three general forms, which have been aptly compared to billiard balls, lead pencils, and corkscrews. Spheres, rods, and spirals represent all shapes. The spheres may be large or small, and may group themselves in va- rious ways; the rods may be long or short, thick or slender; the spirals may be loosely or tightly coiled, and may have only one or two or may have many coils, and they may be flexible or stiff ; but still rods, spheres, and spirals comprise all types (Fig. i). In size there is some variation, though not very great. All are extremely minute, and never visible to the naked eye. The spheres vary from 0.25 /i to 1.5 /A (0.000012 to 0.00006 inches). The rods may be no more than 0.3 p in diameter, or may be as wide as 1.5 /* to 2.5 /*, and in length i8 THE STORY OF GERM LIFE. vary all the way from a length scarcely longer than their diameter to long threads. About the same may be said of the spi- ral forms. They are decid- edly the smallest living or- ganisms which our micro- scopes have revealed. In their method of grcnvth we find one of the most char- acteristic features. They universally have the power of multiplication by simple division or fission. Each in- dividual elongates and then divides in the middle into FIG. i.-GeneraT shapes tw similar halves, each of of bacteria: a, Spheri- which then repeats the pro- cai forms ; b, Rod- ces s. This method of mul- rKms? 1 31 c ' Sp " tiplication by simple division is the distinguishing mark which separates the bacteria from the yeasts, the latter plants multiplying by a process known as budding. Fig. 2 shows these two methods of multiplication. While all bacteria thus multiply by division, certain differences in the details produce rather striking differences in the results. Considering first the spherical forms, we find that some species divide, as described, into two, which separate at once, and each of which in turn divides in the op- posite direction, called Micrococcus, (Fig. 3). Other species divide only in one direction. Frequently they do not separate after dividing, but remain attached. Each, however, again elongates and di- vides again, but all still remain attached. There are thus formed long chains of spheres like strings BACTERIA AS PLANTS. of beads, called Streptococci (Fig. 4). Other species divide first in one direction, then at right angles to the first division, and a third division follows at right angles to the plane of the first two, thus producing solid groups of fours, eights, or sixteens (Fig. 5), called Sarcina. Each different spe- cies of bacteria is uniform in its method of division, and HI these differen- ces are there- fore indica- tions of differ- ences in spe- cies, or, according to our present method of classification, the different methods of division FIG. 2. Method of multiplication of bacte- ria : a and b, Bacteria dividing by fis- sion ; c, A yeast multiplying by budding. FIG. 3. Micrococci. FIG. 4. Streptococci. represent different genera. All bacteria produ- cing Streptococcus chains form a single genus Strep* 20 THE STORY OF GERM LIFE. tococcus, and all which divide in three division planes form another genus, Sarcina, etc. FIG. 5. Sarcina. FIG. 6. Separate rods showing variations in size, magnified about looo diameters. The rod-shaped bacteria also differ somewhat, but to a less extent. They almost always divide in a plane at right angles to their longest dimen- sion. But here again we find some species sepa- rating immediately after division, and thus always appearing as short rods (Fig. 6), while others remain attached after division and form long chains. Some- times they ap- pear to continue to increase in length without showing any signs of divis- FIG. 7. Rod-forms united to form chains, ion, and in this way long threads are formed (Fig. 7). These threads are, however, potentially at least, long chains of short rods, and under proper conditions they will break up into such short rods, as shown in Fig. 7 a. Occasion- ally a rod species may divide lengthwise, but this is rare. Exactly the same may be said of the BACTERIA AS PLANTS. spiral forms. Here, too, we find short rods and long chains, or long spiral filaments in which can be seen no division into shorter elements, but which, under cer- tain conditions, break up into short sections (Fig. 8). RAPIDITY OF MULTIPLICATION. It is this power of multiplication by di- vision that makes bac- teria agents of such significance. Their minute size would make them harmless enough if it were not for an extraordinary power of multiplica- tion. This power of growth and division is almost incredible. Some of the species which have been care- fully watched under the microscope have been found under favourable conditions to grow so rapidly as to divide every half hour, or even less. The number of offspring that would result in the course of twenty-four hours at this rate is of course easily computed. In one day each bacterium would produce over 16,500,000 descendants, and in two days about 281,500,000,000. It has been further calculated 3. Various types of spiral bacteria. 22 THE STORY OF GERM LIFE. that these 281,500,000,000 would form about a solid pint of bacteria and weigh about a pound. At the end of the third day the total descendants would amount to 47,000,000,000,000, and would weigh about 16,000,000 pounds. Of course these numbers have no significance, for they are never actual or even possible numbers. Long before the offspring reach even into the millions their rate of multiplication is checked either by lack of food or by the accumulation of their own ex- creted products, which are injurious to them. But the figures do have interest since they show faint- ly what an unlimited power of multiplication these organisms have, and thus show us that in dealing with bacteria we are dealing with forces of al- most infinite extent. This wonderful power of growth is chiefly due to the fact that bacteria feed upon food which is highly organized and already in condition for ab- sorption. Most plants must manufacture their own foods out of simpler substances, like carbonic dioxide (CO 2 ) and water, but bacteria, as a rule, feed upon complex organic material already pre- pared by the previous life of plants or animals. For this reason they can grow faster than other plants. Not being obliged to make their own foods like most plants, nor to search for it like animals, but living in its midst, their rapidity of growth and multiplication is limited only by their power to seize and assimilate this food. As they grow in such masses of food, they cause certain chemical changes to take place in it, changes doubtless directly connected with their use of the material as food. Recognising that they do cause chemical changes in food material, and re- membering this marvellous power of growth, we BACTERIA AS PLANTS. are prepared to believe them capable of producing changes wherever they get a foothold and begin to grow. Their power of feeding upon com- plex organic food and producing chemi- cal changes therein, together with their marvellous power of assimilating this ma- terial as food, make them agents in Na- ture of extreme portance. FIG. 9. Showing various shaped rods. DIFFERENCES BETWEEN DIFFERENT SPECIES OF BACTERIA. While bacteria are thus very simple in form, there are a few other slight varia- tions in detail which assist in dis- a tinguishing them. The rods are some- times very blunt at the ends, almost as if cut square across, while in other species they are more rounded and occasionally slightly tapering (Fig. 9). Some- times they are sur- d, Bacteria showing the supposed roun d e d t)V a thin structure in which x is the nucleus, , and v the protoplasm. layer of some gelat- FIG. 10. Bacteria surrounded by cap- sules : a and b represent zoogloea ; c, Chains of cocci with a capsule ; THE STORY OF GERM LIFE. inous substance, which forms what is called a capsule (Fig. 10). This capsule may connect them and serve as a cement, to prevent the separate elements of a chain from falling apart (Fig. 10 c). Sometimes such a gelatinous se- cretion will unite great masses of bacteria into clusters, which may float on the surface of the liquid in which they grow or may sink to the bottom. Such masses are called zooglcea, and their general appear- ance serves as one of the char- acters for distin- guishing differ- ent species of FIG. ii. Various types of bacteria "colo- bacteria (Fig. IO, nies " formed when growing in nutrient a and A). When gelatine. Each different type of colony orowino-in cnliH is produced by a different species of Sowing in SOlld bacterium. media, such as a nutritious liquid made stiff with gelatine, the different species have different methods of spreading from their central point of origin. A single bacterium in the midst of such a stiffened mass will feed upon it and pro- duce descendants rapidly; but these descendants, not being able to move through the gelatine, will remain clustered together in a mass, which the BACTERIA AS PLANTS. 25 bacteriologist calls a colony. But their method of clustering, due to different methods of growth, is by no means always alike, and these colonies show great differences in general appearance. The differences appear to be constant, however, for the same species of bacteria, and hence the shape and appearance of the colony enable bac- teriologists to discern different species (Fig. n). All these points of difference are of practical use to the bacteriologist in distinguishing species. SPORE FORMATION. In addition to their power of reproduction by simple division, many species of bacteria have a second method by means of spores. Spores are special rounded or oval bits of bacteria protoplasm capable of resisting adverse conditions which would destroy the ordinary bacteria. They arise among bacteria in two different methods. Endogenous spores. These spores arise inside of the rods or the spiral forms (Fig. 12). They first appear as slight granular masses, or as dark points which become gradually distinct from the rest of the rod. Eventually there is thus formed inside the rod a clear, highly refractive, spherical or oval spore, which may even be of a greater diameter than the rod producing it, thus causing it to swell out and become spindle formed (Fig. 12 c]. These spores may form in the middle or at the ends of the rods (Fig. 12). They may use up all the protoplasm of the rod in their formation, or they may use only a small part of it, the rod which forms them continuing its activities in spite of the formation of the spores within it. They are always clear and highly refractive from contain- THE STORY OF GERM LIFE. ing little water, and they do not so readily absorb staining material as the ordinary rods. They ap- pear to be covered with a layer of some substance which resists the stain, and which also enables them to resist vari- ous external agen- cies. This protect- ive covering, to- gether with their small amount of water, enables them to resist almost any amount of drying, a high degree of heat, and many other adverse con- ditions. Common- ly the spores break out of the rod, and the rod producing them dies, although sometimes the rod may continue its activity even after the spores have been produced. A r t h r ogenous spores (?). Certain species of bacteria not produce spores as just described, but FlG. 12. Endogenous spores: a and b, Spores forming at intervals in the rods ; c, Spores forming in the middle of the rods and causing the middle to swell ; d, Spores form- ing at the end of the rods and causing the end to swell. do may give rise to bodies that are sometimes called arthrospores. These bodies are formed as short segments of rods (Fig. 130). A long rod may sometimes break up into several short rounded elements, which are clear and appear to have a somewhat increased power of resisting adverse BACTERIA AS PLANTS. b 13. So - called arthrogenous spores : a, Forming as segments of rods ; b, As segments of a chain of cocci. conditions. The same may happen among the spherical forms, which only in rare instances form endogenous spores. Among the spheres which .form a chain of streptococci some may occasionally be slightly different from the rest. They are a little larger, and have been thought to have an increased resisting power like that of true spores (Fig. 13 FIG. b}. It isquite doubt- ful, however, wheth- er it is proper to re- gard these bodies as spores. There is no good evidence that they have any special resisting power to heat like endogenous spores, and bac- teriologists in general are inclined to regard them simply as resting cells. The term arthrospores has been given to them to indicate that they are formed as joints or segments, and this term may be a convenient one to retain although the bodies in question are not true spores. Still a different method of spore formation occurs in a few peculiar bacteria. In this case ([Fig. 14) the protoplasm in the large thread breaks into many minute spherical bodies, which finally find exit. The spores thus formed may not be all alike, differences in size being noticed. This method of spore formation occurs only in a few special forms of bacteria. The matter of spore formation serves as one THE STORY OF GERM LIFE. of the points for distinguishing species. Some species do not form spores, at least under any of the conditions in which they have been studied. Others form them readily in almost any condition, and others again only under special conditions which are adverse to their life. The method of spore formation is always uni- form for any single species. Whatever be the method of the formation of the spore, its purpose in the life of the bacterium is al- ways the same. It serves as a means of keeping the species alive under condi- tions of adversity. Its power of resisting heat or drying enables it to live where the ordinary active forms would be speedily killed. Some of these spores are capable of re- sisting a heat of 180 C. (360 F.) for a short time, and boiling water they can resist for a long time. Such spores when subsequently placed under fa- vourable conditions will germinate and start bac- terial activity anew. FIG. 14. Formation of spores in unusual forms (Crenothrix). MOTION. Some species of bacteria have the power of active motion, and may be seen darting rapidly to and fro in the liquid in which they are grow- ing. This motion is produced by flagella which protrude from the body. These flagella (Fig. 15) BACTERIA AS PLANTS. 29 arise from a membrane surrounding the bacterium, but have an intimate connection with the proto- FlG. 15. Bacteria provided with flagella : a, Single flagellum ; b, Two flagella ; c, A tuft of flagella at one end ; d, Tufts of flagella at both ends ; e, Uniform covering of flagella ; f, Showing the origin of flagella from the outer layer of the body. plasmic content. Their distribution is different in different species of bacteria. Some species 3 30 THE STORY OF GERM LIFE. have a single flagellum at one end (Fig. 150). Others have one at each end (Fig. 15 b). Others, again, have, at least just before dividing, a bunch at one or both ends (Fig. 15 c and d), while others, again, have many flagella distributed all over the body in dense profusion (Fig. 15 for instance, do not really in- FlG. ^.-Diphtheria bacillus. vade the body. They grow in the throat, attached to its walls, and are confined to this external location or to the superficial tissues: This bacillus is, in short, only found in the mouth and throat, and is practically confined to the so-* PARASITIC BACTERIA. 135 called false membranes. It never enters any of the tissues of the body, although attached to the mucous membrane. It grows vigorously in this membrane, and there secretes or in some way produces extremely violent poisons. These poisons are then absorbed by the body and give rise to the general symptoms of the disease. Much the same is true of the bacillus which causes tetanus or lockjaw YIG. ^.-Tetanus bacillus, (Fig. 29). This bacillus is commonly inoculated into the flesh of the victim by a wound made with some object which has been lying upon the earth where the bacillus lives. The bacillus grows readily after being in- oculated, but it is localized at the point of the wound, without invading the tissue to any extent. It produces, however, during its growth several poisons which have been separated and studied. Among them are some of the most violent poi- sons of which we have any knowledge. While the bacillus grows in the tissues around the wound it secretes these poisons, which are then absorbed by the body generally. Their poison- ing effects produce the violent symptoms of the disease. Of much the same nature is Asiatic cholera. This is caused by a bacillus which is able to grow rapidly in the intestines, feeding perhaps in part on the food in the intestines and perhaps in part upon the body secretions. To a slight extent also it appears to be able to in- vade the tissues of the body, for the bacilli are found in the walls of the intestines. But it is not a proper parasite, and the fatal disease it 136 THE STORY OF GERM LIFE. produces is the result of the absorption of the poisons secreted in the intestines. It is but a step from this to the true parasites. Typhoid fever, for example, is a disease produced by bacteria which grow in the intestines, but which also invade the tissues more extensively than the cholera germs (Fig. 30). They do not invade the body gen- erally, however, but become somewhat localized in special glands like the liver, the spleen, etc. Even here they do not appear to find a very favourable condition, for they do not grow extensively in these places. They are likely to be found in the spleen in small groups or centres, but stained, showing the not generally distributed cSres^b staged tnrou g h it: - Wherever they toshowthe'flageiTa! grow they produce poison, which has been called typho toxine, and it is this poison chiefly which gives rise to the fever. Quite a considerable number of the patho- genic germs are, like the typhoid bacillus, more or less confined to special places. Instead of distributing themselves through the body after they find entrance, they are restricted to special organs. The most common example of a para- site of this sort is the tuberculosis bacillus, the cause of consumption, scrofula, white swelling, lupus, etc. (Fig. 31). Although this bacillus is very common and is able to attack almost any organ in the body, it is usually very restricted in PARASITIC BACTERIA. 137 growth. It may become localized in a small gland, a single joint, a small spot in the lungs, or in the glands of the mesentery, the other parts of the body remaining free from infection. Not infrequently the whole trouble is thus confined flG. 31. Tuberculosis bacillus: a, As seen in lung tissue ; b, More magnified ; c, As sometimes seen in sputum of con- sumptive patients. to such a small locality that nothing serious re- sults. But in other instances the bacilli may after a time slowly or rapidly distribute themselves from these centres, attacking more and more of the body until perhaps fatal results follow in the end. This disease is therefore commonly of very slow progress. Again, we have still other parasites which are not thus confined, but which, as soon as they enter the body, produce a general infection, at- tacking the blood and perhaps nearly all tissues simultaneously. The most typical example of this sort is anthrax or malignant pustule, a disease fortunately rare in man (Fig. 32). Here the bacilli multiply in the blood, and very soon a general and fatal infection of the whole body arises, resulting from the abundance of the ba- THE STORY OF GERM LIFE. cilli everywhere. Some of the obscure diseases known as blood poisoning appear to be of the same general nature, these diseases re- sulting from a very general invasion of the whole body by certain pathogenic bacteria. In general, then, we see that the so- called germ diseas- es result from the FIG. v.-Antkrax bacillus (splenic aCt j n , U P n . the fever). body of poisons produced by bac- terial growth. Differences in the nature of these poisons produce differences in the character of the disease, and differences in the parasitic pow- ers of the different species of bacteria produce wide differences in the course of the diseases and their relation to external phenomena. WHAT DISEASES ARE DUE TO BACTERIA? It is, of course, an extremely important matter to determine to what extent human diseases are caused by bacteria. It is not easy, nor indeed possible, to do this to-day with accuracy. It is no easy matter to prove that any particular dis- ease is caused by bacteria. To do this it is neces- sary to find some particular bacterium present in all cases of the disease ; to find some method of getting it to grow outside the body in culture media; to demonstrate its absence in healthy ani- mals, or healthy human individuals if it be a hu- PARASITIC BACTERIA, 139 man disease ; and, finally, to reproduce the disease in healthy animals by inoculating them with the bacterium. All of these steps of proof present difficulties, but especially the last one. In the study of animals it is comparatively easy to re- produce a disease by inoculation. But experi- ments upon man are commonly impossible, and in the case of human diseases it is frequently very difficult or impossible to obtain the final test of the matter. After finding a specific bac- terium associated with a disease, it is usually pos- sible to experiment with it further upon animals only. But some human diseases do not attack animals, and in the case of diseases that may be given to animals it is frequently uncertain wheth- er the disease produced in the animal by such in- oculation is identical with the human disease in question, owing to the difference of symptoms in the different animals. As a consequence, the proof of the germ nature of different diseases varies all the way from absolute demonstration to mere suspicion. To give a complete and correct list of the diseases caused by bacteria, or to give a list of the bacteria species pathogenic to man, is therefore at present impossible. The difficulty of giving such a list is rendered greater from the fact that we have in recent years learned that the same species of pathogenic bac- terium may produce different results under differ- ent conditions. When the subject of germ dis- ease was first studied and the connection between bacteria and disease was first demonstrated, it was thought that each particular species of pathogenic bacteria produced a single definite disease ; and conversely, each germ disease was supposed to have its own definite species of bac- 140 THE STORY OF GERM LIFE. terium as its cause. Recent study has shown, however, that this is not wholly true. It is true that some diseases do have such a definite rela- tion to definite bacteria. The anthrax germ, for example, will always produce anthrax, no matter where or how it is inoculated into the body. So, also, in quite a number of other cases distinct specific bacteria are associated with distinct dis- eases. But, on the other hand, there are some pathogenic bacteria which are not so definite in their action, and produce different results in ac- cordance with circumstances, the effect varying both with the organ attacked and with the condi- tion of the individual. For instance, a consider- able number of different types of blood poison- ing, septiccemia, pycemia, gangrene, inflammation of wounds, or formation of pus from slight skin wounds indeed, a host of miscellaneous trou- bles, ranging all the way from a slight pus forma- tion to a violent and severe blood poisoning all appear to be caused by bacteria, and it is impos- sible to make out any definite species associated with the different types of these troubles. There are three common forms of so-called pus cocci, and these are found almost indiscriminately with various types of inflammatory troubles. More- over, these species of bacteria are found with al- most absolute constancy in and around the body, even in health. They are on the clothing, on the skin, in the mouth and alimentary canal. Here they exist, commonly doing no harm. They have, however, the power of doing injury if by chance they get into wounds. But their power of doing injury varies both with the condition of the indi- vidual and with variations in the bacteria them- selves. If the individual is in a good condition PARASITIC BACTERIA. 141 of health these bacteria have little power of in- juring him even when they do get into such wounds, while at times of feeble vitality they may do much more injury, and take the occasion of any little cut or bruise to enter under the skin and give rise to inflammation and pus. Some people will develop slight abscesses or slight in- flammations whenever the skin is bruised, while with others such bruises or cuts heal at once without trouble. Both are doubtless subject to the same chance of infection, but the one resists, while the other does not. In common parlance, we say that such a tendency to abscesses indi- cates a bad condition of the blood a phrase which means nothing. Further, we find that the same species of bacterium may have varying powers of producing disease at different times. Some species are universal inhabitants of the alimentary canal and are ordinarily harmless, while under other conditions of unknown char- acter they invade the tissues and give rise to a serious and perhaps fatal disease. We may thus recognise some bacteria which may be compared to foreign invaders, while others are domestic enemies. The former, like the typhoid bacillus, always produce trouble when they succeed in entering the body and finding a foothold. The latter, like the normal intestinal bacilli, are al- ways present but commonly harmless, only under special conditions becoming troublesome. All this shows that there are other factors in deter- mining the course of a disease, or even the exist- ence of a disease, than the simple presence of a peculiar species of pathogenic bacterium. From the facts just stated it will be evident that any list of germ diseases will be rather un- 10 142 THE STORY OF GERM LIFE. certain. Still, the studies of the last twenty years or more have disclosed some definite relations of bacteria and disease, and a list of the diseases more or less definitely associated with distinct species of bacteria is of interest. Such a list, including only well-known diseases, is as follows : Name of disease. Name of bacterium producing the disease. Anthrax (Malignant pustule). Bacillus anthracis. Cholera. Croupous pneumonia. Diphtheria. Glanders. Gonorrhoea. Influenza. Leprosy. Relapsing fever. Tetanus (lockjaw). Tuberculosis (including con- sumption, scrofula, etc.) Typhoid fever. Spirillum cholera asiatica. Micrococcus pneumonia croufoseE. Bacillus diphtheria. Bacillus mallei. Micrococcus gonorrhoea. Bacillus of influenza. Bacillus lepra. Spirillum Obermeieri. Bacillus tetani. Bacillus tuberculosis. Bacillus typhi abdominalis. Various wound infections, including ^/fc^/mia, pyaemia, acute abscesses, ulcers, erysipelas, etc., are pro- duced by a few forms of micrococci, resembling each other in many points but differing slightly. They are found almost indiscriminately in any of these wound infections, and none of them appears to have any definite relation to any special form of disease unless it be the micrococcus of erysip- elas. The common pus micrococci are grouped under three species, Staphylococcus pyogenes aureus, Staphylococcus pyogenes, and Streptococcus pyogenes. These three are the most common, but others are occasionally found. In addition to these, which may be regarded as demonstrated, the following diseases are with more or less certainty regarded as caused by dis- tinct specific bacteria : Bronchitis, endocarditis, PARASITIC BACTERIA. 143 measles, whooping-cough, peritonitis, pneumonia, syphilis. Still another list might be given of diseases whose general nature indicates that they are caused by bacteria, but in connection with which no distinct bacterium has yet been found. As might be expected also, a larger list of animal diseases has been demonstrated to be caused by these organisms. In addition, quite a number of species of bacteria have been found in such material as faeces, putrefying blood, etc., which have been shown by experiment to be capable of producing diseases in animals, but in regard to which we have no evidence that they ever do produce actual disease under any normal con- ditions. These may contribute, perhaps, to the troubles arising from poisonous foods, but can not be regarded as disease germs proper. VARIABILITY OF PATHOGENIC POWERS. As has already been stated, our ideas of the relation of bacteria to disease have undergone quite a change since they were first formulated, and we recognise other factors influencing dis- ease besides the actual presence of the bac- terium. These we may briefly consider under two heads, viz., variation in the bacterium, and variation in the susceptibility of the individual. The first will require only a brief consideration. That the same species of pathogenic bacteria at different times varies in its powers to produce disease has long been known. Various con- ditions are known to affect thus the virulence of bacteria. The bacillus which is supposed to give rise to pneumonia loses its power to produce the 144 THE STORY OF GERM LIFE. disease after having been cultivated for a short time in ordinary culture media in the laboratory. This is easily understood upon the suggestion that it is a parasitic bacillus and does not thrive except under parasitic conditions. Its patho- genic powers can sometimes be restored by pass- ing it again through some susceptible animal. One of the most violent pathogenic bacteria is that which produces anthrax, but this loses its pathogenic powers if it is cultivated for a con- siderable period at a high temperature. The micrococcus which causes fowl cholera loses its power if it be cultivated in common culture media, care being taken to allow several days to elapse between the successive inoculations into new culture flasks. Most pathogenic bacteria can in some way be so treated as to suffer a dimi- nution or complete loss of their powers of pro- ducing a fatal disease. On the other hand, other conditions will cause an increase in the virulence of a pathogenic germ. The virus which produces hydrophobia is increased in violence if it is inoculated into a rabbit and subsequently taken from the rabbit for further inoculation. The fowl cholera micrococcus, which has been weak- ened as just mentioned, may be restored to its original violence by inoculating it into a small bird, like a sparrow, and inoculating a second bird from this. A few such inoculations will make it as active as ever. These variations doubtless exist among the species in Nature as well as in artificial cultures. The bacteria which produce the various wound infections and abscesses, etc., appear to vary under normal con- ditions from a type capable of producing violent and fatal blood poisoning to a type producing PARASITIC BACTERIA. 145 only a simple abscess, or even to a type that is entirely innocuous. It is this factor, doubtless, which in a large measure determines the severity of any epidemic of a bacterial contagious dis- ease. SUSCEPTIBILITY OF THE INDIVIDUAL. The very great modification of our early views has affected our ideas as to the power which individuals have of resisting the invasion of pathogenic bacteria. It has from the first been understood that some individuals are more susceptible to disease than others, and in attempt- ing to determine the significance of this fact many valuable and interesting discoveries have been made. After the exposure to the disease there follows a period of some length in which there are no discernible effects. This is followed by the onset of the disease and its development to a crisis, and, if this be passed, by a recovery. The general course of a germ disease is divided into three stages: the stage of incubation, the development of the disease, and the recovery. The susceptibility of the body to a disease may be best considered under the three heads of Inva- sion, Resistance, Recovery. Means of Invasion. In order that a germ dis- ease should arise in an individual, it is first ne- cessary that the special bacterium which causes the disease should get into the body. There are several channels through which bacteria can thus find entrance ; these are through the mouth, through the nose, through the skin, and occasionally through excretory ducts. Those which come through the mouth come with the 146 THE STORY OF GERM LIFE. food or drink which we swallow ; those which enter through the nose must be traced to the air; and those which enter through the skin come in most cases through contact with some infected object, such as direct contact with the body of an infected person or his clothing or some objects he has handled, etc. Occasionally, perhaps, the bacteria may get into the skin from the air, but this is certainly uncommon and confined to a few diseases. There are here two facts of the utmost importance for every one to understand: first, that the chance of disease bacteria being carried to us through the air is very slight and confined to a few diseases, such as smallpox, tuberculo- sis, scarlet fever; etc., and, secondly, that the un- injured skin and the uninjured mucous membrane also is almost a sure protection against the in- vasion of the bacteria. If the skin is whole, without bruises or cuts, bacteria can seldom, if ever, find passage through it. These two facts are of the utmost importance, since of all sources of infection we have the least power to guard against infection through the air, and since of all means of entrance we can guard the skin with the greatest difficulty. We can easily render food free from pathogenic bacteria by heating it. The material we drink can similarly be rendered harmless, but we can not by any known means avoid breathing air, nor is there any known method of disinfecting the air, and it is impos- sible for those who have anything to do with sick persons to avoid entirely having contact either with the patient or with infected clothing or utensils. From the facts here given it will be seen that the individual's susceptibility to disease produced PARASITIC BACTERIA. 147 by parasitic bacteria will depend upon his habits of cleanliness, his care in handling infectious material, or care in cleansing the hands after such handling, upon his habit of eating food cooked or raw, and upon the condition of his skin and mucous membranes, since any kind of bruises wjll increase susceptibility. Slight ailments, such as colds, which inflame the mucous mem- brane, will decrease its resisting power and ren- der the individual more susceptible to the entrance of any pathogenic germs should they happen to be present. Sores in the mouth or decayed teeth may in the same way be prominent factors in- the individual's susceptibility. Thus quite a number of purely physical factors may contribute to an individual's susceptibility. Resisting Power of the Body. Even after the bacteria get into the body it is by no means cer- tain that they will give rise to disease, for they have now a battle to fight before they can be sure of holding their own. It is now, indeed, that the actual conflict between the powers of the body and these microscopic invaders begins. After they have found entrance into the body the bac- teria have arrayed against them strong resisting forces of the human organism, endeavouring to destroy and expel them. Many of them are rapid- ly killed, and sometimes they are all destroyed without being able to gain a foothold. In such cases, of course, no trouble results. In other cases the body fails to overcome the powers of the invaders and they eventually multiply rapidly. In this struggle the success of the invaders is not necessarily a matter of numbers. They are sim- ply struggling to gain a position in the body, where they can feed and grow. A few individuals may 148 THE STORY OF GERM LIFE. be entirely sufficient to seize such a foothold, and then these by multiplying may soon become in- definitely numerous. To protect itself, therefore, the human body must destroy every individual bacterium, or at least render them all incapa- ble of growth. Their marvellous reproductive powers give the bacteria an advantage in the bat- tle. On the other hand, it takes time even for these rapidly multiplying beings to become suf- ficiently numerous to do injury. There is thus an interval after their penetration into the body when these invaders are weak in numbers. Dur- ing this interval the period of incubation the body may organize a resistance sufficient to ex- pel them. We do not as yet thoroughly understand the forces which the human organism is able to array against these invading foes. Some of its meth- ods of defence are, however, already intelligible to us, and we know enough, at all events, to give us an idea of the intensity of the conflict that is going on, and of the vigorous and powerful forces which the human organism is able to bring against its invading enemies. In the first place, we notice that a majority of bacteria are utterly unable to grow in the human body even if they do find entrance. There are known to bacteriologists to-day many hundreds, even thousands of species, but the vast majority of these find in the human tissues conditions so hostile to their life that they are utterly unable to grow therein. Human flesh or human blood will furnish excellent food for them if the individual be dead, but living human flesh and blood in some way exerts a repressing influence upon them which is fatal to the growth of a vast majority of spe- PARASITIC BACTERIA. 149 cies. Some few species, however, are not thus destroyed by the hostile agencies of the tissues of the animal, but are capable of growing and multiplying in the living body. These alone are what constitute the pathogenic bacteria, since, of course, these are the only bacteria which can pro- duce disease by growing in the tissues of an ani- mal. The fact that the vast majority of bacteria can not grow in the living organism shows clearly enough that there are some conditions existing in the living tissue hostile to bacterial life. There can be little doubt, moreover, that it is these same hostile conditions, which enable the body to resist the attack of the pathogenic species in cases where resistance is successfully made. What are the forces arrayed against these in- vaders ? The essential nature of the battle ap- pears to be a production of poisons and counter poisons. It appears to be an undoubted fact that the first step in repelling these bacteria is to flood them with certain poisons which check their growth. In the blood and lymph of man and other animals there are present certain products which have a direct deleterious influence upon the growth of micro-organisms. The existence of these poisons is undoubted, many an experiment having directly attested to their presence in the blood of animals. Of their nature we know very little, but of their repressing influence upon bac- terial growth we are sure. They have been named alexines, and they are produced in the living tis- sue, although as to the method of their pro- duction we are in ignorance. By the aid of these poisons the body is able to prevent the growth of the vast majority of bacteria which get into its tissues. Ordinary micro-organisms 150 THE STORY OF GERM LIFE. are killed at once, for these alexines act as anti- septics, and common bacteria can no more grow in the living body than they could in a solution containing other poisons. Thus the body has a perfect protection against the majority of bac- teria. The great host of species which are found in water, milk, air, in our mouths or clinging to our skin, and which are almost omnipresent in Nature, are capable of growing well enough in or- dinary lifeless organic foods ; but just as soon as they succeed in finding entrance into living human tissue their growth is checked at once by these antiseptic agents which are poured upon them. Such bacteria are therefore not pathogenic germs, and not sources of trouble to human health. There are, on the other hand, a few species of bacteria which may be able to retain their lodg- ment in the body in spite of this attempt of the individual to get rid of them. These, of course, constitute the pathogenic species, or so-called " disease germs." Only such species as can over- come this first resistance can be disease germs, for they alone can retain their foothold in the body. But how do these species overcome the poi- sons which kill the other harmless bacteria ? They, as well as the harmless forms, find these alexines injurious to their growth, but in some way they are able to counteract the poisons. In this general discussion of poisons we are dealing with a subject which is somewhat obscure, but apparently the pathogenic bacteria are able to overcome the alexines of the body by producing in their turn certain other products which neu- tralize the alexines, thus annulling their action. These pathogenic bacteria, when they get into PARASITIC BACTERIA. 151 the body, give rise at once to a group of bodies which have been named lysines. These lysines are as mysterious to us as the alexines, but they neutralize the effect of the alexines and thus overcome the resistance the body offers to bac- terial growth. The invaders can now multiply rapidly enough to get a lasting foothold in the body and then soon produce the abnormal symp- toms which we call disease. Pathogenic bacteria thus differ from the non-pathogenic bacteria primarily in this power of secreting products which can neutralize the ordinary effects of the alexines, and so overcome the body's normal re- sistance to their parasitic life. Even if the bacteria do thus overcome the alexines the battle is not yet over, for the indi- vidual has another method of defence which is now brought into activity to check the growth of the invading organisms. This second method of resistance is by means of a series of active cells found in the blood, known as white blood-cor- puscles (Fig. 33 a, fr). They are minute bits of protoplasm present in the blood and lymph in large quantities. They are active cells, capable of locomotion and able to crawl out of the blood- vessels. Not infrequently they are found to take into their bodies small objects with which they come in contact. One of their duties is thus to en- gulf minute irritating bodies which may be in the tissues, and to carry them away for excretion. They thus act as scavengers. These corpuscles certainly have some agency in warding off the at- tacks of pathogenic bacteria. Very commonly they collect in great numbers in the region of the body where invading bacteria are found. Such invading bacteria exert upon them a strong attrac- THE STORY OF GERM LIFE. Pie. 33. White blood corpuscles and other phagocytes : a, A sta- tionary form ; b, Motile form ; c, Phagocyte with a bacterium half engulfed ; d, Phagocytes containing bacteria either dead or alive ; e, Phagocyte loaded with bacteria. PARASITIC BACTERIA. 153 tion, and the corpuscles leave the blood-vessels and sometimes form a solid phalanx completely surrounding the invading germs. Their collec- tion at these points may make itself seen exter- nally by the phenomenon we call inflammation. There is no question that the corpuscles en- gage in conflict with the bacteria when they thus surround them. There has been not a little dis- pute, however, as to the method by which they carry on the conflict. It has been held by some that the corpuscles actually take the bacteria into their bodies, swallow them, as it were, and subse- quently digest them (Fig. 33 c, d, e). This idea gave rise to the theory of phagocytosis, and the corpuscles were consequently named phagocytes. The study of several years has, however, made it probable that this is not the ordinary method by which the corpuscles destroy the bacteria. Ac- cording to our present knowledge the method is a chemical one. These cells, when they thus col- lect in quantities around the invaders, appear to secrete from their own bodies certain injurious products which act upon the bacteria much as do the alexines already mentioned. These new bod- ies have a decidedly injurious effect upon the multiplying bacteria ; they rapidly check their growth, and, acting in union with the alexines, may perhaps entirely destroy them. After the bacteria are thus killed, the white blood-corpuscles may load themselves with their dead bodies and carry them away (Fig. 33 d, e). Sometimes they pass back into the blood stream and carry the bacteria to various parts of the body for elimination. Not infrequently the white corpuscles die in the contest, and then may ac- cumulate in the form of pus and make their way 1 54 THE STORY OF GERM LIFE. through the skin to be discharged directly. The battle between these phagocytes and the bacteria goes on vigorously. If in the end the phagocytes prove too strong for the invaders, the bacteria are gradually all destroyed, and the attack is re- pelled. Under these circumstances the individual commonly knows nothing of the matter. This conflict has taken place entirely without any con- sciousness on his part, and he may not even know that he has been exposed to the attack of the bacteria. In other cases the bacteria prove too strong for the phagocytes. They multiply too rapidly, and sometimes they produce secretions which actually drive the phagocytes away. Com- monly, as already noticed, the corpuscles are at- tracted to the point of invasion, but in some cases, when a particularly deadly and vigorous species of bacteria invades the body, the secretions pro- duced by them are so powerful as actually to drive the corpuscles away. Under these circum- stances the invading hosts have a chance to mul- tiply unimpeded, to distribute themselves over the body, and the disease rapidly follows as the result of their poisoning action on the body tissues. It is plain, then, that the human body is not helpless in the presence of the bacteria of disease, but that it is supplied with powerful resistant forces. It must not be supposed, however, that the outline of the action of these forces just given is anything like a complete account of the matter; nor must it be inferred that the resistance is in all respects exactly as outlined. The subject has only recently been an object of investigation, and we are as yet in the dark in regard to many of the facts. The future may require us to modify to some ex- tent even the brief outline which has been given. PARASITIC BACTERIA. 155 But while we recognise this uncertainty in the de- tails, we may be assured of the general facts. The living body has some very efficacious resist- ant forces which prevent most bacteria from growing within its tissues, and which in large measure may be relied upon to drive out the true pathogenic bacteria. These resistant forces are in part associated with the productions of body poisons, and are in part associated with the active powers of special cells which have been called phagocytes. The origin of the poisons and the exact method of action of the phagocytes we may well leave to the future to explain. These resisting powers of the body will vary with conditions. It is evident that they are natural powers, and they will doubtless vary with the general condition of vigour of the individual. Robust health, a body whose powers are strong, well nourished, and vigorous, will plainly furnish the conditions for the greatest resistance to bac- terial diseases. One whose bodily activities are weakened by poor nutrition can offer less resist- ance. The question whether one shall suffer from a germ disease is not simply the question whether he shall be exposed, or even the question whether the bacteria shall find entrance into his body. It is equally dependent upon whether he has the bodily vigour to produce alexinesin proper quantity, or to summon the phagocytes in suffi- cient abundance and vigour to ward off the attack. We may do much to prevent disease by sanitation, which aids in protecting the individual from at- tack ; but we must not forget that the other half of the battle is of equal importance, and hence we must do all we can to strengthen the resist- ing forces of the organism. 156 THE STORY OF GERM LIFE. RECOVERY FROM GERM DISEASES. These resisting forces are not always sufficient to drive off the invaders. The organisms may retain their hold in the body for a time and eventually break down the resistance. After this they may multiply unimpeded and take entire possession of the body. As they become more numerous their poisonous products increase and begin to produce direct poisoning effects on the body. The incubation period is over and the dis- ease comes on. The disease now runs its course. It becomes commonly more and more severe until a crisis is reached. Then, unless the poisoning is so severe that death occurs, the effects pass away and recovery takes place. But why should not a germ disease be always fatal ? If the bacteria thus take possession of the body and can grow there, why do they not always continue to multiply until they produce sufficient poison to destroy the life of the individual ? Such fatal results do, of course, occur, but in by far the larger proportion of cases recovery finally takes place. Plainly, the body must have another set of resisting forces which is concerned in the final recovery. Although weakened by the poisoning and suffering from the disease, it does not yield the battle, but somewhat slowly organizes a new attack upon the invaders. For a time the multi- plying bacteria have an unimpeded course and grow rapidly ; but finally their further increase is checked, their vigour impaired, and after this they diminish in numbers and are finally expelled from the body entirely. Of the nature of this new re- sistance but little is yet known. We notice, in PARASITIC BACTERIA. 15 the first place, that commonly after such a recov- ery the individual has decidedly increased resist- ance to the disease. This increased resistance may be very lasting, and may be so considerable as to give almost complete immunity from the disease for many years, or for life. One attack of scarlet fever gives the individual great immu- nity for the future. On the other hand, the re- sistance thus derived may be very temporary, as in the case of diphtheria. But a certain amount of resistance appears to be always acquired. This power of resisting the activities of the para- sites seems to be increased during the progress of the disease, and, if it becomes sufficient, it finally drives off the bacteria before they have produced death. After this, recovery takes place. To what this newly acquired resisting power is due is by no means clear to bacteriologists, al- though certain factors are already known. It appears beyond question that in the case of cer- tain diseases the cells of the body after a time produce substances which serve as antidotes to the poisons produced by the bacteria during their growth in the body antitoxines. In the case of diphtheria, for instance, the germs growing in the throat produce poisons which are absorbed by the body and give rise 'to the symptoms of the dis- ease; but after a time the body cells react, and themselves produce a counter toxic body which neutralizes the poisonous effect of the diphtheria poison. This substance has been isolated from the blood of animals that have recovered from an attack of diphtheria, and has been called diphthe- ria antitoxine. But even with this knowledge the recovery is not fully explained. This antitoxine neutralizes the effects of the diphtheria toxine, 11 158 THE STORY OF GERM LIFE. and then the body develops strength to drive off the bacteria which have obtained lodgment in the throat. How they accomplish this latter achieve- ment we do not know as yet. The antitoxine developed simply neutralizes the effects of the toxine. Some other force must be at work to get rid of the bacteria, a force which can only exert itself after the poisoning effect of the poison is neutralized. In these cases, then, the recovery is due, first, to the development in the body of the natural antidotes to the toxic poisons, and, second, to some other unknown force which drives off the parasites. These facts are certainly surprising. If one had been asked to suggest the least likely theory to explain recovery from disease, he could hardly have found one more unlikely than that the body cells developed during the disease an antidote to the poison which the disease bacteria were pro- ducing. Nevertheless, it is beyond question that such antidotes are formed during the course of the germ diseases. It has not yet been shown in all diseases, and it would be entirely too much to claim that this is the method of recovery in all cases. We may say, however, in regard to bacte- rial diseases in general, that after the bacteria en- ter the body at some weak point they have first a battle to fight with the resisting powers of the body, which appear to be partly biological and partly chemical. These resisting powers are in many cases entirely sufficient to prevent the bacteria from obtaining a foothold. If the invading host overcome the resisting powers, then they begin to multiply rapidly, and take possession of the body or some part of it. They continue to grow until either the individual dies or something oc- PARASITIC BACTERIA. 159 curs to check their growth. After the individual develops the renewed powers of checking their growth, recovery takes place, and the individual is then, because of these renewed powers of re- sistance, immune from a second attack of the dis- ease for a variable length of time. This, in the merest outline, represents the rela- tion of bacterial parasites to the human body. But while this is a fair general expression of the matter, it must be recognised that different dis- eases differ much in their relations, and no general outline will apply to all. They differ in their method of attack and in the point of attack. Not only do they produce different kinds of poisons giving rise to different symptoms of poisoning ; not only do they produce different results in dif- ferent animals ; not only do the different patho- genic species differ much in their power to de- velop serious disease, but the different species are very particular as to what species of animal they attack. Some of them can live as parasites in man alone; some can live as parasites upon man and the mouse and a few other animals; some can live in various animals but not in man ; some appear to be able to live in the field mouse, but not in the common mouse ; some live in the horse; some in birds, but not in warm-blooded mammals ; while others, again, can live almost equally well in the tissues of a long list of animals. Those which can live as parasites upon man are, of course, especially related to human disease, and are of particular interest to the physician, while those which live in animals are in a similar way of interest to veterinarians. Thus we see that parasitic bacteria show the widest variations. They differ in point of attack, 160 THE STORY OF GERM LIFE. in method of attack, and in the part ot the body which they seize upon as a nucleus for growth. They differ in violence and in the character of the poisons they produce, as well as in their power of overcoming the resisting powers of the body. They differ at different times in their powers of producing disease. In short, they show such a large number of different methods of action that no general statements can be made which will ap- ply universally, and no one method of guarding against them or in driving them off can be hoped to apply to any extended list of diseases. DISEASES CAUSED BY OTHER ORGANISMS THAN BACTERIA. Although the purpose of this work is to deal primarily with the bacterial world, it would hardly be fitting to leave the subject without some refer- ence to diseases caused by organisms which do not belong to the group of bacteria. While most of the so-called germ diseases are caused by the bacteria which we have been studying in the previous chapters, there are some whose inciting cause is to be found among organisms belonging to other groups. Some of these are plants of a higher organization than bacteria, but others are undoubtedly microscopic animals. Their life habits are somewhat different from those of bacteria, and hence the course of the diseases is commonly different. Of the diseases thus pro- duced by microscopic animals or by higher plants, one or two are of importance enough to deserve special mention here. Malaria. The most important of these dis- eases is malaria in its various forms, and known PARASITIC BACTERIA. 161 under various names chills and fever, autumnal fever, etc. This disease, so common almost everywhere, has been studied by physicians and scientists for a long time, and many have been the causes assigned to it. At one time it was thought to be the result of the growth of a bacte- rium, and a distinct bacillus was described as pro- ducing it. It has finally been shown, however, to be caused by a microscopic organism belong- ing to the group of unicellular animals, and some- FlG. 34. Malarial organism : Figs, a to g show the growth of the parasite within the blood corpuscle ; o is the organism in all cases ; s, the spores. Fig. i is the so-called cresentic body which develops through Fig. 2, into the flagellate form, shown at 3. The significance of i, 2, and 3 are not known. what closely related to the well-known amoeba. This organism is shown in Fig. 34. The whole history of the malarial organism is not yet known. The following statements comprise the most im- portant facts known in regard to it, and its rela- tion to the disease in man. Undoubtedly the malarial germ has some home outside the human body, but it is not yet very definitely known what this external home is; nor do we know from what source the human para- 162 THE STORY OF GERM LIFE. site is derived. It appears probable that water serves in some cases as its means of transference to man, and air in other cases. From some ex- ternal source it gains access to man and finds its way into the blood. Here it attacks the red blood-corpuscles, each malarial organism making its way into a single one (Fig. 34 a). Here it now grows, increasing in size at the expense of the substance of the corpuscle (Fig. 34 a-f). As it becomes larger it becomes granular, and soon shows a tendency to separate into a number of irregular masses (Fig. 34 /). Finally it breaks up into many minute bodies called spores (Fig. 34^). These bodies break out of the corpuscle and for a time live a free life in the blood (Fig. 34 ti). After a time they make their way into other red blood-corpuscles, develop into new malarial amoeboid parasites, and repeat the growth and sporulation. This process can ap- parently be repeated many times without check. These organisms are thus to be regarded as parasites of the red corpuscles. It is, of course, easy to believe that an extensive parasitism and destruction of the corpuscles would be disastrous to the health of the individual, and the severity of the disease will depend upon the extent of the parasitism. Corresponding to this life history of the organism, the disease malaria is commonly characterized by a decided intermittency, periods of chill and fever alternating with periods of in- termission in which these symptoms are abated. The paroxysms of the disease, characterized by the chill, occur at the time that the spores are escaping from the blood-corpuscles and floating in the blood. After they have again found their way into a blood-corpuscle the fever diminishes, PARASITIC BACTERIA. 163 and during their growth in the corpuscle until the next sporulation the individual has a rest from the more severe symptoms. There appears to be more than one variety of the malarial organism, the different types differ- ing in the length of time it takes for their growth and sporulation. There is one variety, the most common one, which requires two days for its growth, thus giving rise to the paroxysm of the disease about once in forty-eight hours ; another variety appears to require three days for its growth ; while still another variety appears to be decidedly irregular in its period of growth and sporulation. These facts readily explain some of the variations in the disease. Certain other ir- regularities appear to be due to a different cause. More than one brood of parasites may be in the blood of the individual at the same time, one producing sporulation at one time and another at a different time. Such a simultaneous growth of two independent broods may plainly produce al- most any kind of modification in the regularity of the disease. The malarial organism appears to be very sensitive to quinine, a very small quantity being sufficient to kill it. Upon this point depends the value of quinine as a medicine. If the drug be present in the blood at the time when the spores are set free from the blood-corpuscle, they are rapidly killed by it before they have a chance to enter another corpuscle. During their growth in the corpuscle they are far less sensitive to qui- nine than when they exist in the free condition as spores, and at this time the drug has little effect. The malarial organism is an animal, and can not be cultivated in the laboratory by any arti- 1 64 THE STORY OF GERM LIFE. ficial method yet devised. Its whole history is therefore not known. It doubtless has some home outside the blood of animals, and very likely it may pass through other stages of a meta- morphosis in the bodies of other animals. Most parasitic animals have two or more hosts upon which they live, alternating from one to the other, and that such is the case with the malarial para- site is at least probable. But as yet bacteriolo- gists have been unable to discover anything very definite in regard to the matter. Until we can learn something in regard to its life outside the blood of man we can do little in the way of devis- ing methods to avoid it. Malaria differs from most germ diseases in the fact that the organisms which produce it are not eliminated from the body in any way. In most germ diseases the germs are discharged from the patient by secretions or excretions of some kind, and from these excretions may readily find their way into other individuals. The malarial organ- ism is not discharged from the body in any way, and hence is not contagious. If the parasite does pass part of its history in some other animal than man, there must be some means by which it passes from man to its other host. It has been suggested that some of the insects which feed upon human blood may serve as the second host and become inoculated when feeding upon such blood. This has been demonstrated with start- ling success in regard to the mosquito (Anopheles), some investigators going so far as to say that this is the only way in which the disease can be com- municated. Several other microscopic animals occur as parasites upon man, and some of them are so definitely associated with certain diseases as to COMBATING PARASITIC BACTERIA. 165 lead to the belief that they are the cause of these diseases. The only one of very common occur- rence is a species known as Amoeba coli, which is found in cases of dysentery. In a certain type of dysentery this organism is so universally found that there is little doubt that it is in some very intimate way associated with the cause of the dis- ease. Definite proof of the matter is, however, as yet wanting. On the side of plants, we find that several plants of a higher organization than bacteria may become parasitic upon the body of man and pro- duce various types of disease. These plants be- long mostly to the same group as the moulds, and they are especially apt to attack the skin. They grow in the skin, particularly under the hair, and may send their threadlike branches into some of the subdermal tissues. This produces irrita- tion and inflammation of the skin, resulting in trouble, and making sores difficult to heal. So long as the plant continues to grow, the sores, of course, can not be healed, and when the organ- isms get into the skin under the hair it is fre- quently difficult to destroy them. Among the diseases thus caused are ringworm, thrush, alopecia, etc. CHAPTER VI. METHODS OF COMBATING PARASITIC BACTERIA. THE chief advantage of knowing the cause of disease is that it gives us a vantage ground from which we may hope to find means of avoiding its evils. The study of medicine in the past history 1 66 THE STORY OF GERM LIFE. of the world has been almost purely empirical, with a very little of scientific basis. Great hopes are now entertained that these new facts will place this matter upon a more strictly scientific foun- dation. Certainly in the past twenty-five years, since bacteriology has been studied, more has been done to solve problems connected with dis- ease than ever before. This new knowledge has been particularly directed toward means of avoid- ing disease. Bacteriology has thus far borne fruit largely in the line of preventive medicine, although to a certain extent also along the line of curative medicine. This chapter will be de- voted to considering how the study of bacteriol- ogy has contributed directly and indirectly to our power of combating disease. PREVENTIVE MEDICINE. In the study of medicine in the past centuries the only aim has been to discover methods of curing disease ; at the present time a large and increasing amount of study is devoted to the methods of preventing disease. Preventive medi- cine is a development of the last few years, and is based almost wholly upon our knowledge of bacteria. This subject is yearly becoming of more importance. Forewarned is forearmed, and it has been found that to know the cause of a disease is a long step toward avoiding it. As some of our contagious and epidemic diseases have been studied in the light of bacteriological knowledge, it has been found possible to deter- mine not only their cause, but also how infection is brought about, and consequently how conta- gion may be avoided. Some of the results which COMBATING PARASITIC BACTERIA. 167 have grown up so slowly as to be hardly appre- ciated are really great triumphs. For instance, the study of bacteriology first led us to suspect, and then demonstrated, that tuberculosis is a contagious disease, and from the time that this was thus proved there has been a slow, but, it is hoped, a sure decline in this disease. Bacterio- logical study has shown that the source of chol- era infection in cases of raging epidemics is, in large part at least, our drinking water ; and since this has been known, although cholera has twice invaded Europe, and has been widely distributed, it has not obtained any strong foothold or given rise to any serious epidemic except in a few cases where its ravages can be traced to recognised carelessness. It is very significant to compare the history of the cholera epidemics of the past few years with those of earlier dates. In the epi- demics of earlier years the cholera swept ruth- lessly through communities without check. In the last few years, although it has repeatedly knocked at the doors of many European cities, it has been commonly confined to isolated cases, except in a few instances where these facts con- cerning the relation to drinking water were ig- nored. The study of preventive medicine is yet in its infancy, but it has already accomplished much. It has developed modern systems of sanitation, has guided us in the building of hospitals, given rules for the management of the sick-room which largely prevent contagion from patient to nurse; it has told us what diseases are contagious, and in what way ; it has told us what sources of conta- gion should be suspected and guarded against, and has thus done very much to prevent the j68 THE STORY OF GERM LIFE. spread of disease. Its value is seen in the fact that there has been a constant decrease in the death rate since modern ideas of sanitation began to have any influence, and in the fact that our general epidemics are less severe than in former years, as well as in the fact that more people escape the diseases which were in former times almost universal. The study of preventive medicine takes into view several factors, all connected with the method and means of contagion. They are the following : The Source of Infectious Material. It has been learned that for most diseases the infectious ma- terial comes from individuals suffering with the disease, and that except in a few cases, like ma- laria, we must always look to individuals suffering from disease for all sources of contagion. It is found that pathogenic bacteria are in all these cases eliminated from the patient in some way, either from the alimentary canal or from skin se- cretions or otherwise, and that any nurse with common sense can have no difficulty in deter- mining in what way the infectious material is eliminated from her patients. When this fact is known and taken into consideration it is a com- paratively easy matter to devise valuable precau- tions against distribution of such material. It is thus of no small importance to remember that the simple presence of bacteria in food or drink is of no significance unless these bacteria have come from some source of disease infection. The Method of Distribution. The bacteria must next get from the original source of the disease to the new susceptible individual. Bacteria have no independent powers of distribution unless they COMBATING PARASITIC BACTERIA. 169 be immersed in liquids, and therefore their pas- sage from individual to individual must be a pas- sive one. They are readily transferred, however, by a number of different means, and the study of these means is aiding much in checking contagion Study along this line has shown that the means by which bacteria are carried are several. First we may notice food as a distributor. Food may become contaminated by infectious material in many ways; for example, by contact with sewage, or with polluted water, or even with eating uten- sils which have been used by patients. Water is also likely to be contaminated with infectious material, and is a fertile source for distributing typhoid and cholera. Milk may become contam- inated in a variety of ways, and be a source of dis- tributing the bacteria which produce typhoid fever, tuberculosis, diphtheria, scarlet fever, and a few other less common diseases. Again, in- fected clothing, bedding, or eating utensils may be taken from a patient and be used by another individual without proper cleansing. Direct con- tact, or contact with infected animals, furnishes another method. Insects sometimes carry the bacteria from person to person, and in some dis- eases (tuberculosis, and perhaps scarlet fever and smallpox) we must look to the air as a distribu- tor of the infectious material. Knowledge of these facts is helping to account for multitudes of mysterious cases of infection, especially when we combine them with the known sources of con- tagious matter. Means of Invasion. Bacteriology has shown us that different species of parasitic bacteria have different means of entering the body, and that each must enter the proper place in order to get 170 THE STORY OF GERM LIFE. a foothold. After we learn that typhoid infec- tious material must enter the mouth in order to produce the disease; that tuberculosis may find entrance through the nose in breathing, while types of blood poisoning enter only through wounds or broken skin, we learn at once funda- mental facts as to the proper methods of meeting these dangers. We learn that with some diseases care exercised to prevent the swallowing of infec- tious material is sufficient to prevent contagion, while with others this is entirely insufficient. When all these facts are understood it is almost always perfectly possible to avoid contagion ; and as these facts become more and more widely known direct contagion is sure to become less frequent. Above all, it is telling us what becomes of the pathogenic bacteria after being eliminated from the body of the patient; how they may exist for a long time still active ; how they may lurk in filth or water dormant but alive, or how they may even multiply there. Preventive medicine is tell- ing us how to destroy those thus lying in wait for a chance of infection, by discovering disinfect- ants and telling us especially where and when to use them. It has already taught us how to crush out certain forms of epidemics by the proper means of destroying bacteria, and is lessening the dangers from contagious diseases. In short, the study of bacteriology has brought us into a condition where we are no longer helpless in the presence of a raging epidemic. We no longer sit in helpless dismay, as did our ancestors, when an epidemic enters a community, but, knowing their causes and sources, set about at once to remove them. As a result, severe epidemics are becoming comparatively short-lived. COMBATING PARASITIC BACTERIA. 171 BACTERIA IN SURGERY. In no line of preventive medicine has bacteri- ology been of so much value and so striking in its results as in surgery. Ever since surgery has been practised surgeons have had two difficulties to contend with. The first has been the shock resulting from the operation. This is dependent upon the extent of the operation, and must always be a part of a surgical operation. The second has been secondary effects following the operation. After the operation, even though it was success- ful, there were almost sure to arise secondary complications known as surgical fever, inflamma- tion, blood poisoning, gangrene, etc., which fre- quently resulted fatally. These secondary com- plications were commonly much more serious than the shock of the operation, and it used to be the common occurrence for the patient to recover entirely from the shock, but yield to the fevers which followed. They appeared to be entirely unavoidable, and were indeed regarded as neces- sary parts of the healing of the wound. Too fre- quently it appeared that the greater the care taken with the patient the more likely he was to suffer from some of these troubles. The soldier who was treated on the battlefield and nursed in an improvised field hospital would frequently re- cover, while the soldier who had the fortune to be taken into the regular hospital, where greater care was possible, succumbed to hospital gangrene. All these facts were clearly recognised, but the surgeon, through ignorance of their cause, was helpless in the presence of these inflammatory troubles, and felt it always necessary to take them into consideration. 172 THE STORY OF GERM LIFE. The demonstration that putrefaction and de- cay were caused by bacteria, and the early proof that the silkworm disease was produced by a micro-organism, led to the suggestion that the in- flammatory diseases accompanying wounds were similarly caused. There are many striking sim- ilarities between these troubles and putrefaction, and the suggestion was an obvious one. At first, however, and for quite a number of years, it was impossible to demonstrate the theory by finding the distinct species of micro-organisms which pro- duced the troubles. We have already seen that there are several different species of bacteria which are associated with this general class of diseases, but that no specific one has any particular relation to a definite type of inflammation. This fact made discoveries in this connection a slow matter from the microscopical standpoint. But long before this demonstration was finally reached the theory had received practical application in the form of what has developed into antiseptic or aseptic surgery. Antiseptic surgery is based simply upon the attempt to prevent the entrance of bacteria into the surgical wound. It is assumed that if these organisms are kept from the wound the healing will take place without the secondary fevers and inflammations which occur if they do get a chance to grow in the wound. The theory met with de- cided opposition at first, but accumulating facts demonstrated its value, and to-day its methods have been adopted everywhere in the civilized world. As the evidence has been accumulating, surgeons have learned many important facts, fore- most among which is a knowledge of the common sources from which the infection of wounds oc- COMBATING PARASITIC BACTERIA. 173 curs. At first it was thought that the air was the great source of infection, but the air bacteria have been found to be usually harmless. It has ap- peared that the more common sources are the surgeon's instruments, or his hands, or the cloth- ing or sponges which are allowed to come in con- tact with the wounds. It has also appeared that the bacteria which produce this class of troubles are common species, existing everywhere and uni- versally present around the body, clinging to the clothing or skin, and always on hand to enter the wound if occasion offers. They are always pres- ent, but commonly harmless. They are not for- eign invaders like the more violent pathogenic species, such as those of Asiatic cholera, but may be compared to domestic enemies at hand. It is these ever-present bacteria which the surgeon must guard against. The methods by which he does this need not detain us here. They consist essentially in bacteriological cleanliness. The operation is performed with sterilized instruments under most exacting conditions of cleanliness. The result has been a complete revolution in surgery. As the methods have become better understood and more thoroughly adopted, the in- stances of secondary troubles following surgical wounds have become less and less frequent until they have practically disappeared in all simple cases. To-day the surgeon recognises that when inflammatory troubles of this sort follow simple surgical wounds it is a testimony to his careless- ness. The skilful surgeon has learned that with the precautions which he is able to take to-day he has to fear only the direct effect of the shock of the wound and its subsequent direct influence; but secondary surgical fevers, blood poisoning, 12 174 THE STORY OF GERM LIFE. and surgical gangrene need not be taken into con- sideration at all. Indeed, the modern surgeon hardly knows what surgical gangrene is, and bac- teriologists have had practically no chance to study it. Secondary infections have largely dis- appeared, and the surgeon is concerned simply with the effect of the wound itself, and the power of the body to withstand the shock and subse- quently heal the wound. With these secondary troubles no longer to disturb him, the surgeon has become more and more bold. Operations formerly not dreamed of are now performed without hesitation. In former years an operation which opened the abdominal cavity was not thought possible, or at least it was so nearly certain to result fatally that it was re- sorted to only on the last extremity; while to-day such operations are hardly regarded as serious. Even brain surgery is becoming more and more common. Possibly our surgeons are passing too far to the other extreme, and, feeling their power of performing so many operations without inconven- ience or danger, they are using the knife in cases where it would be better to leave Nature to her- self for her own healing. But, be this as it may, it is impossible to estimate the amount of suffer- ing prevented and the number of lives saved by the mastery of the secondary inflammatory trou- bles which used to follow surgical wounds. Preventive medicine, then, has for its object the prevention rather than the cure of disease. By showing the causes of disease and telling us where and how they are contracted, it is telling us how they may to a large extent be avoided. Unlike practical medicine, this subject is one which has a direct relation to the general public. COMBATING PARASITIC BACTERIA. 175 While it may be best that the knowledge of cura- tive methods be confined largely to the medical profession, it is eminently desirable that a knowl- edge of all the facts bearing upon preventive medicine should be distributed as widely as pos- sible. One person can not satisfactorily apply his knowledge of preventive medicine if his neighbour is ignorant of or careless of the facts. We can not hope to achieve the possibilities lying along this line until there is a very wide distribu- tion of knowledge. Every epidemic that sweeps through our communities is a testimony to the crying need of education in regard to such sim- ple facts as the source of infectious material, the methods of its distribution, and the means of ren- dering it harmless. PREVENTION IN INOCULATION. It has long been recognised that in most cases recovery from one attack of a contagious disease renders an individual more or less immune against a second attack. It is unusual for an individual to have the same contagious disease twice. This belief is certainly based upon fact, although the immunity thus acquired is subject to wide varia- tions. There are some diseases in which there is little reason for thinking that any immunity is ac- quired, as in the case of tuberculosis, while there are others in which the immunity is very great and very lasting, as in the case of scarlet fever. Moreover, the immunity differs with individuals. While some persons appear to acquire a lasting immunity by recovery from a single attack, others will yield to a second attack very readily. But in spite of this the fact of such acquired immu- 176 THE STORY OF GERM LIFE. nity is beyond question. Apparently all infec- tious diseases from which a real recovery takes place are followed by a certain amount of pro- tection from a second attack ; but with some dis- eases the immunity is very fleeting, while with others it is more lasting. Diseases which pro- duce a general infection of the whole system are, as a rule, more likely to give rise to a lasting immunity than those which affect only small parts. Tuberculosis, which, as already noticed, is commonly quite localized in the body, has lit- tle power of conveying immunity, while a disease like scarlet fever, which affects the whole system, conveys a more lasting protection. Such immunity has long been known, and in the earlier years was sometimes voluntarily ac- quired ; even to-day we find some individuals making use of the principle. It appears that a mild attack of such diseases produces immunity equally well with a severe attack, and acting upon this fact mothers have not infrequently intentionally exposed their children to certain diseases at seasons when they are mild, in or- der to have the disease " over with " and their children protected in the future. Even the more severe diseases have at times been thus vol- untarily acquired. In China it has sometimes been the custom thus to acquire smallpox. Such methods are decidedly heroic, and of course to be heartily condemned. But the principle that a mild type of the disease conveys protection has been made use of in a more logical and defensible way. The first instance of this principle was in vac- cination against smallpox, now practised for more than a century. Cowpox is doubtless closely re- COMBATING PARASITIC BACTERIA. 177 lated to smallpox, and an attack of the former conveys a certain amount of protection against the latter. It was easy, therefore, to inoculate man with some of the infectious material from cowpox, and thus give him some protection against the more serious smallpox. This was a purely empirical discovery, and vaccination was practised long before the principle underlying it was understood, and long before the germ nature of disease was recognised. The principle was re- vived again, however, by Pasteur, and this time with a logical thought as to its value. While working upon anthrax among animals, he learned that here, as in other diseases, recovery, when it occurred, conveyed immunity. This led him to ask if it were not possible to devise a method of giving to animals a mild form of the disease and thus protect them from the more severe type. The problem of giving a mild type of this extraor- dinarily severe disease was not an easy one. It could not be done, of course, by inoculating the animals with a small number of the bacteria, for their power of multiplication would soon make them indefinitely numerous. It was necessary in some way to diminish their violence. Pas- teur succeeded in doing this by causing them to grow in culture fluids for a time at a high tem- perature. This treatment diminished their vio- lence so much that they could be inoculated into cattle, where they produced only the mildest type of indisposition, from which the animals speedily recovered. But even this mild type of the dis- ease was triumphantly demonstrated to protect the animals from the most severe form of an- thrax. The discovery was naturally hailed as a most remarkable one, and one which promised 178 THE STORY OF GERM LIFE. great things in the future. If it was thus possi- ble, by direct laboratory methods, to find a means of inoculating against a serious disease like anthrax, why could not the same principle be .applied to human diseases ? The enthusiasts be- gan at once to look forward to a time when all diseases should be thus conquered. But the principle has not borne the fruit at first expected. There is little doubt that it might be applied to quite a number of human diseases if a serious attempt should be made. But several objections arise against its wide application. In the first place, the inoculation thus necessary is really a serious matter. Even vaccination, as is well known, sometimes, through faulty methods, re- sults fatally, and it is a very serious thing to experiment upon human beings with anything so powerful for ill as pathogenic bacteria. The seri- ousness of the disease smallpox, its extraordinary contagiousness, and the comparatively mild results of vaccination, have made us willing to undergo vaccination at times of epidemics to avoid the somewhat great probability of taking the disease. But mankind is unwilling to undergo such an op- eration, even though mild, for the purpose of avoiding other less severe diseases, or diseases which are less likely to be taken. We are un- willing to be inoculated against mild diseases, or against the more severe ones which are uncommon. For instance, a method has been devised for rendering animals immune against lockjaw, which would probably apply equally well to man. But mankind in general will never adopt it, since the danger from lockjaw is so small. Inoculation must then be reserved for diseases which are so severe and so common, or COMBATING PARASITIC BACTERIA. 179, which occur in periodical epidemics of so great severity, as to make people in general willing to submit to inoculation as a protection. A further objection arises from the fact that the immunity- acquired is not necessarily lasting. The cattle inoculated against anthrax retain their protective- powers for only a few months. How long similar immunity might be retained in other cases we can not say, but plainly this fact would effectually prevent this method of protecting mankind from being used except in special cases. It is out of the question to think of constant and repeated inoculations against various diseases. As a result, the principle of inoculation as an aid in preventive medicine has not proved of very much value. The only other human disease in which it has been attempted seriously is Asiatic cholera. This disease in times of epidemics is so- severe and the chance of infection is so great as to justify such inoculation. Several bacteriolo- gists have in the last few years been trying to discover a harmless method of inoculating against this disease. Apparently they have succeeded,, for experiments in India, the home of the chol- era, have been as successful as could be antici- pated. Bacteriological science has now in its possession a means of inoculation against chol- era which is perhaps as efficacious as vaccination is against smallpox. Whether it will ever be used to any extent is doubtful, since, as already pointed out, we are in a position to avoid cholera epidemics by other means. If we can protect our commu- nities by guarding the water supply, it is not likely that the method of inoculation will ever be widely used. Another instance of the application of pre- 180 THE STORY OF GERM LIFE. ventive inoculation has been made, but one based upon a different principle. Hydrophobia is cer- tainly one of the most horrible of diseases, al- though comparatively rare. Its rarity would ef- fectually prevent mankind from submitting to a general inoculation against it, but its severity would make one who had been exposed to it by the bite of a rabid animal ready to submit to almost any treatment that promised to ward off the disease. In the attempt to discover a means of inoculating against this disease it was necessary, therefore, to find a method that could be applied after the time of exposure i. e., after the individual had been bitten by the rabid ani- mal. Fortunately, the disease has a long period of incubation, and one that has proved long enough for the purpose. A method of inocula- tion against this disease has been devised by Pas- teur, which can be applied after the individual has been bitten by the rabid animal. Apparently, however, this preventive inoculation is dependent upon a different principle from vaccination or in- oculation against anthrax. It does not appear to give rise to a mild form of the disease, thus pro- tecting the individual, but rather to an acquired tolerance of the chemical poisons produced by the disease. It is a well-known physiological fact that the body can become accustomed to tolerate poisons if inured to them by successively larger and larger doses. It is by this power, apparently, that the inoculation against hydrophobia produces its effect. Material containing the hydrophobia poison (taken from the spinal cord of a rabbit dead with the disease) is injected into the indi- vidual after he has been bitten by a rabid animal. The poisonous material in the first injection is COMBATING PARASITIC BACTERIA. 181 very weak, but is followed later by a more powerful inoculation. The result is that after a short time the individual has acquired the power of resisting the hydrophobia poisons. Before the incubation period of the original infectious matter from the bite of the rabid animal has passed, the inoculated individual has so thoroughly acquired a tolerance of the poison that he successfully resists the attack of the infection. This method of inoculation thus neutralizes the effects of the disease by anticipat- ing them. The method of treatment of hydrophobia met with extraordinarily violent opposition. For sev- eral years it was regarded as a mistake. But the constantly accumulating statistics from the Pas- teur Institute have been so overwhelmingly on one side as to quiet opposition and bring about a general conviction that the method is a success. The method of preventive inoculation has not been extensively applied to human diseases in ad- dition to those mentioned. In a few cases a similar method has been used to guard against diphtheria. Among animals, experiment has shown that such methods can quite easily be obtained, and doubt- less the same would be true of mankind if it was thought practical or feasible to apply them. But, for reasons mentioned, this feature of preventive medicine will always remain rather unimportant, and will be confined to a few of the more violent diseases. It may be well to raise the question as to why a single attack with recovery conveys immunity. This question is really a part of the one already discussed as to the method by which the body cures disease. We have seen that this is in part due to the development of chemical substances 1 82 THE STORY OF GERM LIFE. which either neutralize the poisons or act as germicide upon the bacteria, or both, and perhaps due in part to an active destruction of bacteria by cellular activity (phagocytosis). There is little reason to doubt that it is the same set of activi- ties which renders the animal immune. The forces which drive off the invading bacteria in one case are still present to prevent a second attack of the same species of bacterium. The length of time during which these forces are active and sufficient to cope with any new invaders determines the length of time during which the immunity lasts. Until, therefore, we can answer with more exact- ness just how cure is brought about in case of disease, we shall be unable to explain the method of immunity. LIMITS OF PREVENTIVE MEDICINE. With all the advance in preventive medicine we can not hope to avoid disease entirely. We are discovering that the sources of disease are on all sides of us, and so omnipresent that to avoid them completely is impossible. If we were to apply to our lives all the safeguards which bac- teriology has taught us should be applied in order to avoid the different diseases, we would surround ourselves with conditions which would make life intolerable. It would be oppressive enough for us to eat no food except when it is hot, to drink no water except when boiled, and to drink no milk except after sterilization ; but these would not satisfy the necessary conditions for avoiding disease. To meet all dangers, we should handle nothing which has not been sterilized, or should follow the handling by immediately sterilizing the COMBATING PARASITIC BACTERIA. 183; hands; we should wear only disinfected clothes; we should never put our fingers in our mouths or touch, our food with them ; we should cease to ride in public conveyances, and, indeed, should cease to breathe common air. Absolute prevention of the chance of infection is impos- sible. The most that preventive medicine can hope for is to point out the most common and prolific sources of infection, and thus enable civilized man to avoid some of his most common troubles. It becomes a question, therefore, where we will best draw the line in the employment of safeguards. Shall we drink none except sterilized milk, and no water unless boiled ? or shall we put these occasional sources of danger in the same category with bicycle and railroad accidents, dan- gers which can be avoided by not using the bicycle or riding on the rail, but in regard to which the remedy is too oppressive for application ? Indeed, when viewed in a broad philosophical light it may not be the best course for mankind to shun all dangers. Strength in the organism comes from the use rather than the disuse of our powers. It is certain that the general health and vigour of mankind is to be developed by meeting rather than by shunning dangers. Resistance to disease means bodily vigour, and this is to be de- veloped in mankind by the application of the principle of natural selection. In accordance with this principle, disease will gradually remove the individuals of weak resisting powers, leaving those of greater vigour. Parasitic bacteria are thus a means of preventing the continued life of the weaker members of the community, and so tend to strengthen mankind. By preventive med- icine many a weak individual who would other- 1 84 THE STORY OF GERM LIFE. wise succumb earlier in the struggle is enabled to live a few years longer. Whatever be our humani- tarian feeling for the individual, we can not fail to admit that this survival of the weak is of no benefit to the race so far as the development of physical nature is concerned. Indeed, if we were to take into consideration simply the physical nature of man we should be obliged to recom- mend a system such as the ancient Spartans de- veloped, of exposing to death all weakly individ- uals, that only the strong might live to become the fathers of future generations. In this light, of course, parasitic diseases would be an assist- ance rather than a detriment to the human race. Of course such principles will never again be dominant among men, and our conscience tells us to do all we can to help the weak. We shall doubtless do all possible to develop preventive medicine in order to guard the weak against para- sitic organisms. But it is at all events well for us to remember that we can never hope to develop the strength of the human race by shunning evil, but rather by combating it, and the power of the human race to resist the invasions of these or- ganisms will never be developed by the line of action which guards us from attack. Here, as in other directions, the principles of modern humanity have, together with their undoubted favourable influence upon mankind, certain tendencies toward weakness. While we shall still do our utmost to develop preventive medicine in a proper way, it may be well for us to remember these facts when we come to the practical question of determining where to draw the limits of the application of methods for preventing infectious diseases. COMBATING PARASITIC BACTERIA. 185 CURATIVE MEDICINE. Bacteriology has hitherto contributed less to curative than to preventive medicine. Neverthe- less, its contributions to curative medicine have not been unimportant, and there is promise of much more in the future. It is, of course, unsafe to make predictions for the future, but the accom- plishments of the last few years give much hope as to further results. It was at first thought that a knowledge of the specific bacteria which cause a disease would give a ready means of finding specific drugs for the cure of such disease. If a definite species of bacterium causes a disease and we can cultivate the organism in the laboratory, it is easy to find some drugs which will be fatal to its growth, and these same drugs, it would seem, should be valu- able as medicines in these diseases. This hope has, however, proved largely illusive. It is very easy to find some drug which proves fatal to the specific germs while growing in the culture media of the laboratory, but commonly these are of little or no use when applied as medicines. In the first place, such substances are usually very deadly poi- sons. Corrosive sublimate is a substance which destroys all pathogenic germs with great rapidity, but it is a deadly poison, and can not be used as a drug in sufficient quantity to destroy the parasitic bacteria in the body without at the same time producing poisonous effects on the body itself. It is evident that for any drug to be of value in thus destroying bacteria it must have some spe- 1 86 THE STORY OF GERM LIFE. cially strong action upon the bacteria. Its germi- cide action on the bacteria should be so strong that a dose which would be fatal or very injurious to them would be too small to have a deleterious influence on the body of the individual. It has not proved an easy task to discover drugs which will have any value as germicides when used in quantities so small as to produce no injurious effect on the body. A second difficulty is in getting the drug to produce its effect at the right point. A few diseases, as we have noticed, are produced by bacteria which distribute themselves almost indiscriminately over the body ; but the majority are somewhat definitely localized in special points. Tuberculosis may attack a single gland or a single lobe of the lung. Typhoid germ is localized in the intestines, liver, spleen, etc. Even if it were possible to find some drug which would have a very specific effect upon the tuber- culosis bacillus, it is plain that it would be a very questionable method of procedure to introduce this into the whole system simply that it might have an effect upon a very small isolated gland. Sometimes such a bacterial affection may be local- ized in places where it can be specially treated, as in the case of an attack on a dermal gland, and in these cases some of the germicides have proved to be of much value. Indeed, the use of various dis- infectants connected with abscesses and super- ficial infections has proved of much value. To this extent, in disinfecting wounds and as a local application, the development of our knowledge of disinfectants has given no little aid to curative medicine. Very little success, however, has resulted in the COMBATING PARASITIC BACTERIA. 187 attempt to find specific drugs for specific diseases, and it is at least doubtful whether many such will ever be found. The nearest approach to it is qui- nine as a specific poison for malarial troubles. Malarious diseases are not, however, produced by bacteria but by a microscopic organism of a very different nature, thought to be an animal rather than a plant. Besides this there has been little or no success in discovering specifics in the form of drugs which can be given as medicines or inocu- lated with the hope of destroying special kinds of pathogenic bacteria without injury to the body. While it is unwise to make predictions as to future discoveries, there seems at present little hope for a development of curative medicine along these lines. VIS MEDICATRIX NATURAE. The study of bacterial diseases as they pro- gress in the body has emphasized above all things the fact that diseases are eventually cured by a natural rather than by an artificial process. If a pathogenic bacterium succeeds in passing the outer safeguards and entering the body, and if it then succeeds in overcoming the forces of resist- ance which we have already noticed, it will begin to multiply and produce mischief. This multi- plication now goes on for a time unchecked, and there is little reason to expect that we can ever do much toward checking it by means of drugs. But after a little, conditions arise which are hos- tile to the further growth of the parasite. These hostile conditions are produced perhaps in part by the secretions from the bacteria, for bacteria are unable to flourish in a medium containing much of their own secretions. The secretions 1 88 THE STORY OF GERM LIFE. which they produce are poisons to them as well as to the individual in which they grow, and after these have become quite abundant the fur- ther growth of the bacterium is checked and finally stopped. Partly, also, must we conclude that these hostile conditions are produced by active vital powers in the body of the individual attacked. The individual, as we have seen, in some cases develops a quantity of some substance which neutralizes the bacterial poisons and thus prevents their having their maximum effect. Thus relieved from the direct effects of the poisons, the resisting powers are recuperated and once more begin to produce a direct destruction of the bac- teria. Possibly the bacteria, being now weakened by the presence of their own products of growth, more readily yield to the resisting forces of the cell life of the body. Possibly the resisting forces are decidedly increased by the reactive effect of the bacteria and their poisons. But, at all events, in cases where recovery from parasitic diseases occurs, the revived powers of resistance finally overcome the bacteria, destroy them or drive them off, and the body recovers. All this is, of course, a natural process. The recovery from a disease produced by the invasion of parasitic bacteria depends upon whether the body can resist the bacterial poisons long enough for the recuperation of its resisting powers. If these poisons are very violent and produced rap- idly, death will probably occur before the resisting powers are strong enough to drive off the bacteria. In the case of some diseases the poisons are so violent that this practically always occurs, recov- ery being very exceptional. The poison produced by the tetanus bacillus is of this nature, and recov- COMBATING PARASITIC BACTERIA. 189 ery from lockjaw is of the rarest occurrence. But in many other diseases the body is able to with- stand the poison, and later to recover its resisting powers sufficiently to drive off the invaders. In all cases, however, the process is a natural one and dependent upon the vital activity of the body. It is based at the foundation, doubtless, upon the powers of the body cells, either the phagocytes or other active cells. The body has, in short, its own forces for repelling invasions, and upon these forces must we depend for the power to produce recovery. It is evident that all these facts give us very little encouragement that we shall ever be able to cure diseases directly by means of drugs to destroy bacteria, but, on the contrary, that we must ever depend upon the resisting powers of the body. They teach us, moreover, along what line we must look for the future development of curative medicine. It is evident that scien- tific medicine must turn its attention toward the strengthening and stimulating of the resist- ing and curative forces of the body. It must be the physician's aim to enable the body to re- sist the poisons as well as possible and to stimu- late it to re-enforce its resistant forces. Drugs have a place in medicine, of course, but this place is chiefly to stimulate the body to react against its invading hosts. They are, as a rule, not spe- cific against definite diseases. We can not hope for much in the way of discovering special medi- cines adapted to special diseases. We must sim- ply look upon them as means which the physician has in hand for stimulating the natural forces of the body, and these may doubtless vary with dif- ferent individual natures. Recognising this, we 13 I pO THE STORY OK GERM LIFE. can see also the logic of the small dose as com- pared to the large dose. A small dose of a drug may serve as a stimulant for the lagging forces, while a larger dose would directly repress them or produce injurious secondary effects. As soon as we recognise that the aim of medicine is not to destroy the disease but rather to stimulate the resisting forces of the body, the whole logic of therapeutics assumes a new aspect. Physicians have understood this, and, espe- cially in recent years, have guided their practice by it. If a moderate dose of quinine will check malaria in a few days, it does not follow that twice the dose will do it in half the time or with twice the certainty. The larger doses of the past, intended to drive out the disease, have been everywhere replaced by smaller doses designed to stimulate the lagging body powers. The mod- ern physician makes no attempt to cure typhqid fever, having long since learned his inability to do this, at least if the fever once gets a foothold ; but he turns his attention to every conceivable means of increasing the body's strength to resist the typhoid poison, confident that if he can thus enable the patient to resist the poisoning effects of the typhotoxine his patient will in the end re- act against the disease and drive off the invading bacteria. The physician's duty is to watch and guard, but he must depend upon the vital powers of his patient to carry on alone the actual battle with the bacterial invaders. ANTITOXINES. In very recent times, however, our bacteriolo- gists have been pointing out to the world certain COMBATING PARASITIC BACTERIA. 191 entirely new means of assisting the body to fight its battles with bacterial diseases. As already noticed, one of the primal forces in the recovery, from some diseases, at least, is the development in the body of a substance which acts as an anti- dote to the bacterial poison. So long as this anti- toxine is not present the poisons produced by the disease will have their full effect to weaken the body and prevent the revival of its resisting powers to drive off the bacteria. Plainly, if it is possible to obtain this antitoxine in quantity and then inoculate it into the body when the toxic poisons are present, we have a means for de- cidedly assisting the body in its efforts to drive off the parasites. Such an antidote to the bac- terial poison would not, indeed, produce a cure, but it would perhaps have the effect of annulling the action of the poisons, and would thus give the body a much greater chance to master the bac- teria. It is upon this principle that is based the use of antitoxines in diphtheria and tetanus. It will be clear that to obtain the antitoxine we must depend upon some natural method for its production. We do not know enough of the chemical nature of the antitoxines to manufacture them artificially. Of course we can not deny the possibility of their artificial production, and cer- tain very recent experiments indicate that per- haps they may be made by the agency of elec- tricity. At present, however, we must use natural methods, and the one commonly adopted is sim- ple. Some animal is selected whose blood is harmless to man and that is subject to the dis- ease to be treated. For diphtheria a horse is chosen. This animal is inoculated with small quantities of the diphtheria poison without the 192 THE STORY OF GERM LIFE. diphtheria bacillus. This poison is easily ob- tained by causing the diphtheria bacillus to grow in common media in the laboratory for a while, and the toxines develop in quantity ; then, by proper filtration, the bacteria themselves can be removed, leaving a pure solution of the toxic poison. Small quantities of this poison are inocu- lated into the horse at successive intervals. The effect on the horse is the same as if the animal had the disease. Its cells react and produce a considerable quantity of the antitoxine which remains in solution in the blood of the animal. This is not theory, but demonstrated fact. The blood of a horse so treated is found to have the effect of neutralizing the diphtheria poison, al- though the blood of the horse before such treat- ment has no such effect. Thus there is developed in the horse's blood a quantity of the antitoxine, and now it may be used by physicians where needed. If some of this horse's blood, properly treated, be inoculated into the body of a person who is suffering from diphtheria, its effect, pro- vided the theory of antitoxines is true, will be to counteract in part, at least, the poisons which are being produced in the patient by the diphtheria bacillus. This does not cure the disease nor in itself drive off the bacilli, but it does protect the body from the poisons to such an extent as to enable it more readily to assert its own resisting powers. This method of using antitoxines as a help in curing disease is very recent, and we can not even guess what may come of it. It has apparently been successfully applied in diphtheria. It has also been used in tetanus with slight success. The same principle has been used in obtaining an COMBATING PARASITIC BACTERIA. 193 antidote for the poison of snake bites, since it has appeared that in this kind of poisoning the body will develop an antidote to the poison if it gets a chance. Horses have been treated in the same way as with the diphtheria poison, and in the same way they develop a substance which neu- tralizes the snake poison. Other diseases are being studied to-day with the hope of similar results. How much further the principle will go we can not say, nor can we be very confident that the same principle will apply very widely. The parasitic diseases are so different in nature that we can hardly expect that a method which is satis- factory in meeting one of the diseases will be very likely to be adapted to another. Vaccination has proved of value in smallpox, but is not of use in other human diseases. Inoculation with weak- ened germs has proved of value in anthrax and fowl cholera, but will not apply to all diseases. Each of these parasites must be fought by special methods, and we must not expect that a method that is of value in one case must necessarily be of use elsewhere. Above all, we must remember that the antitoxines do not cure in themselves; they only guard the body from the weakening effects of the poisons until it can cure itself, and, unless the body has resisting powers, the anti- toxine will fail to produce the desired results. One further point in the action of the anti- toxines must be noticed. As we have seen, a recovery from an attack of most germ diseases renders the individual for a time immune against a second attack. This applies less, however, to a recovery after the artificial inoculation with anti- toxine than when the individual recovers without such aid. If the individual recovers quite inde- 194 THE STORY OF GERM LIFE. pendently of the artificial antitoxine, he does so in part because he has developed the antitoxines for counteracting the poison by his own powers. His cellular activities have, in other words, been for a moment at least turned in the direction of production of antitoxines. It is to be expected, therefore, that after the recovery they will still have this power, and so long as they possess it the individual will have protection from a second attack. When, however, the recovery results from the artificial inoculation of antitoxine the body cells have not actively produced antitoxine. The neutralization of the poisons has been a passive one, and after recovery the body cells are no more engaged in producing antitoxine than be- fore. The antitoxine which was inoculated is soon eliminated by secretion, and the body is left with practically the same liability to attack as before. Its immunity is decidedly fleeting, since it was dependent not upon any activity on the part of the body, but upon an artificial inocu- lation of a material which is rapidly eliminated by secretion. CONCLUSION. It is hoped that the outline which has been given of the bacterial life of Nature may serve to give some adequate idea of these organisms and correct the erroneous impressions in regard to them which are widely prevalent. It will be seen that, as our friends, bacteria play a vastly more important part in Nature than they do as our enemies. These plants are minute and extraor- dinarily simple, but, nevertheless, there exists a large number of different species. The number COMBATING PARASITIC BACTERIA. 195 of described forms already runs far into the hun- dreds, and we do not yet appear to be approach- ing the end of them. They are everywhere in Nature, and their numbers are vast beyond con- ception. Their powers of multiplication are in- conceivable, and their ability to produce profound chemical changes is therefore unlimited. This vast host of living beings thus constitutes a force or series of forces of tremendous significance. Most of the vast multitude we must regard as our friends. Upon them the farmer is dependent for the fertility of his soil and the possibility of continued life in his crops. Upon them the dairyman is dependent for his flavours. Upon them important fermentative industries are de- pendent, and their universal powers come into action upon a commercial scale in many a place where we have little thought of them in past years. We must look upon them as agents ever at work, by means of which the surface of Nature is enabled to remain fresh and green. Their power is fundamental, and their activities are necessary for the continuance of life. A small number of the vast host, a score or two of spe- cies, unfortunately for us, find their most favour- able living place in the human body, and thus become human parasites. By their growth they develop poisons and produce disease. This small class of parasites are then decidedly our enemies. But, taken all together, we must regard the bac- teria as friends and allies. Without them we should not have our epidemics, but without them we should not exist. Without them it might be that some individuals would live a little longer, if indeed we could live at all. It is true that bac- teria, by producing disease, once in a while cause 196 THE STORY OF GERM LIFE. the premature death of an individual ; once in a while, indeed, they may sweep off a hundred or a thousand individuals; but it is equally true that without them plant and animal life would be im- possible on the face of the earth. INDEX. Acetic acid, 51. Alcohol, 48. Alexines, 149. Amoeba coh, 165. Animals or plants ? 31. Anthrax, 137, 177. Antitoxmes, 157, 100. Aroma of butter, 76. Bacillus acidi lactici, 71. Bacillus, definition of, 33. Bacteria, defined by Hoffman, 15. Beer, bacteria in the manufacture of, 50. Blood poisoning, 138, 140. Blue milk, 72. study of, by Fuchs, 12. Bitter milk, 72. Butter making, 75, 78. Butyric acid, 56. Canning industry, 64. < Capsule around bacteria, 24. Cheese ripening, 86 ; bacteria in, 90. Cholera Asiatica, 133. Cholera, fowl, 144. Classification of bacteria, 33, 36. Cleavage products, 41. Coal, relation of bacteria to, 123. Cocoanut fibre, 44. Colony of bacteria, 25. Compost heap, 118. Cream ripening, 75, 77. Curative medicine. 185. Cure of disease by natural processes, 187. D. Dairy industry, 66. Decomposition products, 41. Diphtheria, 134. Disease, method of production, 130. Diseases produced by bacteria, 139, Distribution of disease germs, 168. Division of bacteria, method of, 18, rapidity of, 21. Drugs in germ diseases, 185. Dysentery, 165. F. Farmer's life, relation to bacteria, 121. Fermentative industries, 48. Fermentation, theory of Liebig, 13. Fertilizers, ripening of, 117. Flagella, 29. Flavour of butter, 76 ; of cheese, 88. Food cycle of Nature, 97. Food, relation of bacteria to, 22. G. Generic names, 37. Green manuring, 120. H. Habitat of bacteria, 38. Hemp, 44. Henle, general theory of disease, 12. Hydrophobia, 180. 198 INDEX. I. Pathogenic bacteria, abundance of, Indigo, preparation of, 57. Inflammation in surgery, 153. Internal structure of bactena, 30. Invasion, means of, 145, 169. 129. Pathogenic bacteria not true para- sites, 131. Phagocytes, 151. Poisons produced by bacteria, 130, J- 132. Preventive inoculation, 175. Jute, 44. Preventive medicine, 166 ; limits of, K. 182. Products of bacterial life, 41, 47. Koch, contribution to bacteriology, Pure cultures, 15 ; in vinegar mak- 16. butter making, 82 ; in cheese mak- L. 'ng, 93- Pus, 153 ; pus cocci, 142. Lactic acid, 55. Leather, 46. R. Leeuwenhoek, studies of, 10. Legumes in nitrogen fixation, 108. Liebig, theory of fermentation, 13. Limits of preventive medicine, 182. Recovery from germ diseases, 156. Red milk, 72. Resistance to disease, 147. Linen, 42. Lockjaw, 135. S. Lysines, 151. Sarcina, defined, 19. Sauer Kraut, 65. M. Scavengers, bacteria as, 95, 101. _ Maceration industries, 42. Schwann, studies on fermentation, Maceration of skeletons, 46. 12. Malaria, 160. Malignant pustule, 137. Microbe, definition of, 9. Micrococcus, defined, 18. Seeds, sprouting of, in. Shape of bactena, 17. Silo, bacteria in, 112. Size of bacteria, 17. Milk bacteria, 67, 70. Milk, effect of bacteria on, 70. Milk handling, 74. Mosquitoes and malaria, 164. Motion of bacteria, 28. Muller. studies of, n. Multiplication, rapidity of, 21. Mycoderma aceti, 52. Skeletons, 46. Slimy milk, 72. Snuff, preparation of, 59. Soapy milk, 72. Soil, fertility of, 114. Sources of infectious material, 168. Souring of milk, 70. Species, differences between, 23, 34 ; N. Sponges, 45. Spores, 25. Nitrate beds, 116. Nitrifying bacteria, 103. Nitrogen fixation, 107. Nitrogen loss, 104. O. Staphylococcus pyogenes, 142. Streptococcus, defined, 19. Streptococcus pyogenes, 142. Surgery, bactena in, 171. Susceptibility of the individual, 145. Opium, 63. Oscillaria?, as allies of bacteria, 32. T. Tainted milk, 72. p Tetanus, 135. Tobacco curing, 58. Parasitic bacteria, 134. Pasteur, contributions of, 14. Troublesome fermentations, 63, 121. Tuberculosis, 136. Typhoid fever, 136. Vaccination, 176. INDEX. 199 W. Wine, bacteria in manufacture of, Variation among bacteria, 35. 50. Vinegar, 51. Y. Virulence of pathogenic germs, 140, I Yellow milk, 72. Vis inedicatrix naturae, 187. I Zougloea, 24. (16) 000 871 061 8 VCH UN!' CALIFORNIA ARY LC