By G.V. Poore, M.D.. Lecture III
The information which modern methods of research have given us with regard to the floating matter in the air is of an importance which cannot be overestimated.
That the air is full of organic particles capable of life and growth is now a matter of absolute certainty. It has long been a matter of speculation, but there is a great difference between a fact and a speculation. An eminent historian has recently deprecated the distinction which is conventionally drawn between science and knowledge, but, nevertheless, such a distinction is useful, and will continue to be drawn. A man's head may be filled with various things. His inclination may lead him, for example, to study archaic myths in the various dialects which first gave them birth; he may have a fancy for committing to memory the writings of authors on astrology, or the speculations of ancient philosophers, from Aristotle and Lucretius downward. Such a one may have a just claim to be considered a man of learning, and far be it from me to despise the branches of knowledge toward which his mind has a natural bent. But in so far as his knowledge is a knowledge of fancies rather than facts, it has no claim to be called science.
Fancies, however beautiful, cannot form a solid basis for action or conduct, whereas a scientific fact does. It is all very well to suppose that such and such things may be, but mere possibilities, or even probabilities, do not breed a living faith. They often foster schism, and give rise to disunited or opposed action on the part of those who think that such and such things may not be.
When, however, a fancy or a speculation becomes a fact which is capable of demonstration, its universal acceptance is only a matter of time, and the man who neglects such facts in regulating his actions or conduct is rightly regarded as insane all the world over.
The influence of micro-organisms on disease is emerging more and more, day by day, from the regions of uncertainty, and what once were the speculations of the few are now the accepted facts of the majority.
Miquel's experiments show very clearly that the number of microbes in the air corresponds with tolerable closeness to the density of population. From the Alpine solitudes of the Bernese Oberland to the crowded ward of a Parisian hospital, we have a constantly ascending ratio of microbes in the air, from zero to 28,000 per cubic meter. Their complete absence on the Alps is mainly due to the absence of productive foci. Organic matter capable of nourishing microbes is rare, and the dryness and cold prevent any manifestation of vitality or increase. Whence come the large number of microbes in the crowded places and in hospitals?
Every individual, even in health, is a productive focus for microbes; they are found in the breath, and flourish luxuriantly in the mouth of those especially who are negligent in the use of the tooth brush. When we speak of "flourishing luxuriantly," what do we mean? Simply that these microbes, under favorable circumstances, increase by simple division, and that one becomes about 16,000,000 in twenty-four hours.
The breath, even of healthy persons, contains ammonia and organic matter which we can smell. When the moisture of the breath is condensed and collected, it will putrefy. Every drop of condensed moisture that forms on the walls of a crowded room is potentially a productive focus for microbes. Every deposit of dirt on persons, clothing, or furniture is also a productive focus, and production is fostered in close apartments by the warmth and moisture of the place. In hospitals productive foci are more numerous than in ordinary dwellings.
If microbes are present in the breath of ordinary individuals, what can we expect in the breath of those whose lungs are rotten with tubercular disease? Then we have the collections of expectorated matter and of other organic secretions, which all serve as productive foci. Every wound and sore, when antiseptic precautions are not used, becomes a most active and dangerous focus, and every patient suffering from an infective disease is probably a focus for the production of infective particles. When we consider, also, that hospital wards are occupied day and night, and continuously for weeks, it is not to be wondered at that microbes are abundant therein.
I want especially to dwell upon the fact that foci, and probably productive foci, may exist outside the body. It is highly probable, judging from the results of experiments, that every collection of putrescible matter is potentially a productive focus of microbes. The thought, of a pit or sewer filled with excremental matters mixed with water, seething and bubbling in its dark warm atmosphere, and communicating directly (with or without the intervention of that treacherous machine called a trap) with a house, is enough to make one shudder, and the long bills of mortality already chargeable to this arrangement tell us that if we shudder we do not do so without cause. As an instance of the way in which dangers may work in unsuspected ways, I may mention the fact that Emmerich, in examining the soil beneath a ward of a hospital at Amberg, discovered therein the peculiar bacillus which causes pneumonia, and which had probably been the cause of an outbreak of pneumonia that had occurred in that very ward.
The importance of "Dutch cleanliness" in our houses, and the abolition of all collections of putrescible matter in and around our houses, is abundantly evident.
It will not be without profit to examine some well-known facts, by the aids of the additional light which has been thrown upon them by the study of the microbes which are in the media around us.
There is no better known cause of a high death rate than overcrowding. Overcrowding increases the death rate from infectious diseases, especially such as whooping cough, measles, scarlet fever, diphtheria, small-pox, and typhus. The infection of all these diseases is communicable through the air, and where there is overcrowding, the chance of being infected by infective particles, given off by the breath or skin, is of course very great. Where there is overcrowding, the collections of putrescible filth are multiplied, and with them probably the productive foci of infective particles. Tubercular disease, common sore throat, chicken-pox, and mumps, are also among the diseases which are increased by overcrowding.
To come to details which are more specific, let us consider the case of some diseases which are definitely caused by floating matter in the air. First, let us take one which is apparently attributable to pollen.