The Boston Medical and Surgical Journal, March 12, 1924, in an editorial entitled "New Conceptions of Disease and Treatment," discusses the trend away from bacteriology and the laboratory specialist and toward bio-chemistry and a return to clinical methods and says: "The reason, therefore, of an eclipse or partial eclipse of bacteriology may be found in the belief that this branch of medicine, if it has not come exactly to a blind alley, has at least come to a halt ***. There are signs, more or less vague as yet, that new conceptions of disease are arising, although such views are themselves nebulous. It is thought by some that there is more or less fundamental unity of disease, and that many of the nosological labels attached to them are superfluous and confusing."
If there is a "fundamental unity of disease," as we have proclaimed for over a hundred years, there are no specific "diseases" requiring specific germs to cause them. With the recognition of the unity of pathology all ideas of specific causation will die a natural death.
There seems also to be a fundamental unity of bacterial life. The many forms of bacteria known are easily transmuted back and forth into one form or another. It has long been known that so-called "pathogenic bacteria are not organisms with special features, but that each is a member of a group of organisms possessing closely allied characters." Their characters are not stable and comparatively slight changes in their environment cause modifications in them. The cultural and microscopic character of "pathogenic" and non-pathogenic bacteria of the same group are so similar that differentiating them is often extremely difficult. The "pathogenic" bacteria have "acquired" their "pathogenic" properties "in many instances" to a very slight degree and some of these characters are not permanent. So-called specific germs are "specific" only so long as their food supply is specific.
Prof. J. G. Adami, perhaps the greatest pathologist of his time, issued a book in 1918 under the title, Medical Contributions to the Study of Evolution, in which he advanced the theory that all bacteria change with their environment so that the "most virulent disease-creating microbe," "fatal to humanity," may develop into a harmless or perfectly innocuous one and vice-versa, by feeding it upon different food stuffs in different surroundings. He says, "We can take a culture of streptococci so weak that only the most susceptible animals are influenced by it, and so augment the virulence that eventually the 100th or 1000th of a drop of a twelve-hour culture, or even much less than this, may cause the death of strong adults in six hours or less."
Dr. Rosenow, of the Mayo Foundation, performed some work with bacteria that is to the point. His transmutation of the organism of the pneumococcus group is a classic. He succeeded over and over again in bringing about a change from a streptococcus organism to a pneumococcus organism, and back again to a streptococcus; or he could run these around through any one of a number of different strains, or even types, and then bring them back to the type they were before, by following a routine of culture and animal inoculations. It is, therefore, possible to have a streptococcus of one type in an original "focus," which may produce somewhere else in that same body, perhaps, a pneumococcus or a streptococcus of a different type.
Sir Wm. Power, British Medical Officer of the Local Government Board, was asked before the Royal Commission on Vivisection what he meant by "a definite specific organism." He replied, "A definite organism which will react always in a certain way to a certain series of culture tests." When asked what "diseases" are associated with organisms for which such a test has been established, he replied: "I cannot say that we have got to that stage with any one of them."
Before a convention of the Association of American Physicians, Atlantic City, May 16, 1938, Dr. Hobart A. Reinmann, professor of Medicine at Jefferson Medical College, Philadelphia, described his observations of the activities of an organism known as micrococcus tetragenus for a period of four years, during which time this germ turned itself into fifteen distinct forms, when its food supply was changed. Allbutt and Rolleton say, "It is thus possible that the pathogenic bacteria have all been derived from non-pathogenic forms."--System of Medicine, Vol. II, part 2.
Should not such a discovery as this shake the structure of the specificity of the so-called "germ diseases" to its very foundation? There is nothing strange or mysterious in the discovery of these simple truths by the learned germ theorists, but why do they reach no simple or logical conclusion from them? Is it because they are prepossessed with an illogical premise to begin with, and are blinded by the glare of their own spotlight?
When the history of microbes is finally written, it will reveal that the many varieties of bacteria now described are all derived from one or a few basic forms which are changed by changes in their food, temperature, etc. We believe that the countless varieties of practically all the "pathogenic bacteria" of today will finally be traced back to two or three common every-day ancestors. We are fully con vinced that the multitude of species and types are but children of one union, sent out into their respective fields of activity to change their forms according to the demands of necessity and environmental dictates ; that after their peculiar mission is fulfilled, they disappear, or assume the likeness and individuality of their prepotent sires, by retracing their steps successively by the same paths that were taken into their first field of operation.
We favor the view that the type of "disease" determines the morphology of the germ present and not vice-versa. Also, it is our contention that germs take on a form and character in keeping with the chemistry of their environment and that their supposed "specific" character and toxicity depend on their environment. There is every reason to believe that non-toxic bacteria become toxic in a septic environment. They derive their characteristics of virulence or innocence from their environment. Non-toxic bacteria become toxic in a septic environment and vice versa. For instance, Sir Richard Douglas Powell, a leading English bacteriologist, stated a few years ago, that if tetanus and gas gangrene germs are washed clean and freed from their environment, they are quite harmless. It has been found impossible to "infect" animals with the spirochseta pallida, the supposed cause of "syphilis." Infection can occur only when virus from a lesion is employed.
A germ is either toxic or it is not, and the fact that the supposed most malignant germs are found devoid of toxicity compels the conclusion that their toxicity is accidental and that its cause must be sought outside of themselves. When toxic germs become non-toxic the cause must be in their environment. When germs that are" ordinarily innocuous suddenly become actively virulent, it must be due to the fact that they have come in contact with an environment that evolves toxicity. "The incidence of contagion or communicability can be explained in this way."