itaria tarda, and thinks that the actively developing tissues of the child restrain or inhibit the development of the germs. That the predisposition to tuberculosis is inherited can not be doubted, but as Fagge says, "The fact that the children and relatives of tuberculous individuals are more exposed to the infection than others, makes it difficult to differentiate between heredity and accidental infection."

TRANSMISSION OF TUBERCULOSIS.

BY F. R. GARLOCK, M. D., OF RACINE.

If tuberculosis is hereditary, then the ultimate germ or bacillus must pass directly from the parent to the system of the unborn child, and after a certain period of germination or incubation, result in the full development of the disease. If the child possesses great vigor of constitution, or lives under excellent hygienic conditions, he might be able to resist the subtle influences for some time, but ultimately he must die of tuberculosis in some of its varied forms. This has been the theory as advanced by the older pathologists and the theory of heredity has been based upon this, which is no doubt false. I have heard that an eminent German physician and pathologist has traced the tuberculous bacillus, in the case of a tuberculous mother, to the placental structures, but no further. I have not yet learned that the tuberculous bacillus has ever been traced to or been discovered in the structures, circulation or tissues of the new-born infant. If this be so then the older pathology of this multifarious disease has been misunderstood, and all the treatments which have been so long in use, have been in vain and are false. If the older pathologists were correct, then the more modern theory of a germ called the tubercular bacillus is also false, and the modern teaching in our colleges is incorrect and misleading. There is no doubt that a child born of tuberculous parentage does inherit the tubercular diathesis, but not the germinal elements of the disease. The bacilli do not exist

in the substance and tissues of the new-born infant, nor does it originate de novo in his system, unless he catches it so to speak, or it gains an entrance into his system from without. If one who has inherited the tubercular diathesis chance to

reside in an insalubrious location or climate, or resides in a house in which the disease has been an occupant, or in a room illy ventilated and the air inhaled is impure, as we find in any illy ventilated house, or in one in which many persons live compactly together, then any person may get the disease, and the more easily if the individual has inherited the tuberculous diathesis from ancestors. The germ must come from without and is not carried all through youth and the years of early maturity, from parents, remaining undeveloped to burst forth at a certain period. It does not necessarily follow, that, because my father died from tuberculosis, I too must die from the same cause. I contend that this does not necessarily hold good, any more than that if my father fell from a roof and was killed, I must also terminate my existence in the I hold that tuberculosis cannot be transmitted to offspring unless the individual lives under the proper conditions to develop the disease. The conditions which predispose to tuberculosis are various. It may be transmitted as the result of bad hygienic conditions. It may be food, improper in quality, or deficient in quantity. long continued exhaustive exertions, labor beyond one's strength; in fact any thing which depresses the mind or which causes long excitement, or long continued strain of mind, all of which in an individual who has inherited the tubercular diathesis predisposes to the disease.

same way.

Or it may be

It may result in some other affection, as disease of the bones when the bacilli are deposited in bony tissue. Or it may result in glandular disease, and some forms of cancer are mistakenly designated as cancer when the real disease is but the result of tuberculosis. They may come of impure water in the household, in which the tubercular germs have found lodgment, or they may be taken into the system through the medium of food which has been exposed to these germs by reason of not being properly protected in a house in which the disease.

20-S. M.S.

exists. The truth is, these germs must get into the system from without just as the germs of measles, scarlet fever, or smallpox get into the system from without. I am a firm believer that the law of the State ought to control the habits and conduct of the diseased individual just as it does those afflicted with other infectious diseases. The theory which I have above advanced is not generally held tenable and possibly may not be acceptable to all, but if it helps to start a train of thought or should induce some one to pursue a course of investigation, it will have accomplished its end. Too many of us are ready to subscribe to theories which are old and have no other recommendation than their antiquity. To properly discuss this important subject in all its parts would take many papers. longer than the present ten minute article to develop but a faint idea of its importance.

DISINFECTION OF SPUTA IN TUBERCULOSIS.

BY E. F. WOODS, M. D., OF JANESVille.

In the report of the commission appointed by the Congress of Tuberculosis, read before the Academy of Medicine at Paris, July, 1889, we find the following:

"Of all the agents of transmission of tuberculosis, the sputa is the most formidable. There is danger to the public in discharging the sputa upon the earth, carpets, hangings, curtains, napkins, handkerchiefs, clothes and coverings. Not dangerous while moist, it becomes when dried the chief means of the spread of the disease."

How can we prevent this? One of the eastern States has tried to solve the question by legislative means, prohibiting all spitting upon the floor of public conveyances and places of resort. This is a move in the right direction but one difficult to carry out. Besides, it only touches part of the question. Spitting upon the earth, etc., remains.

The one thing we can do as physicians, is to use all our influence and authority over tuberculous patients.

Sick people are selfish and care little for the welfare of others. But we may use as a potent argument the danger of self-inoculation. An individual well on the road to recovery, unless he takes care of the sputa, greatly diminishes his chances of recovery.

We must persuade him, when at home. to use a cuspidor in which it is well to keep a solution of bichloride; this should be emptied daily into the fire, and then well washed out with boiling water.

In these days of steam-heat, gas stoves, etc., this often becomes difficult, and if obliged to empty into sewers, be sure a solution of bichloride is always used.