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Vol. 60, 1909 - University of North Carolina at Chapel Hill

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74<br />

THE CHARLOTTE MEDICAL JOURNAL.<br />

shown to produce disease in man,—in the certain diseases were not apt to have them<br />

lower animals the number <strong>of</strong> p<strong>at</strong>hogenic again, <strong>at</strong> least not within a compar<strong>at</strong>ively<br />

forms is slightly larger,—but the study <strong>of</strong> short time. But the reasons for this immunthese<br />

micro-organisms <strong>of</strong>fers an interesting ity, n<strong>at</strong>ural or acquired, are still but parfield<br />

for further investig<strong>at</strong>ion,<br />

tially known.<br />

P<strong>at</strong>hogenic micro-organisms may be con- Whenever the power <strong>of</strong> resistance is lost<br />

sidered to cause disease either by their me- or diminished, however,—and anything<br />

chanical presence in the tissues, by the poi- which lowers the general or local vitality <strong>of</strong><br />

sons produced by tkeir growth, by the with- the tissues, such as hunger or poor food,<br />

drawal from the body <strong>of</strong> necessary food bad hygienic surroundings, exhaustion from<br />

substances, or possibly by other ways as yet over-exertion, mental depression, exposure<br />

unknown. Although injury is probably to cold, the deleterious effects <strong>of</strong> poisons,<br />

caused by all these different means, it is bacterial or chemical, acute and chronic<br />

now believed to be chiefly due to the reac- diseases, vicious habits, drunkenness and<br />

tion upon the body cells <strong>of</strong> the poisons excesses <strong>of</strong> all kinds, etc., reduces the<br />

elabor<strong>at</strong>ed from the tissues by the germs in power <strong>of</strong> resistance,—whenever this power<br />

their growth. Each variety <strong>of</strong> germ proba- is lost or diminished, we run a grave risk <strong>of</strong><br />

bly produces one or more specific as well as contracting disease.<br />

general poisons, some <strong>of</strong> which have been i It may be well to st<strong>at</strong>e here in parenthepartially<br />

isol<strong>at</strong>ed and studied, as in tetanus sis, th<strong>at</strong> in discussing the theories <strong>of</strong> imand<br />

diphtheria. Bacteria cannot grow and munity and infection it should be rememmultipiy<br />

either in the living body nor out- bered th<strong>at</strong>, however interesting or plausible<br />

side <strong>of</strong> it without proper nourishment and they may be, they are only theories and<br />

suitable conditions, such as adeciu<strong>at</strong>e mois- may be shown to be untrue. )<br />

ture, light, temper<strong>at</strong>ure and air; nor can But granted th<strong>at</strong> somehow or other the<br />

they develop without changing the sub- micro-organisms have gained entrance into<br />

stances upon which they grow. Outside the body and th<strong>at</strong> infection has taken place,<br />

the body this activity gives rise to the pro- let us endeavor to trace briefly and clearly<br />

cesses <strong>of</strong> ferment<strong>at</strong>ion, putrefaction, etc., wh<strong>at</strong> is thought to occur. Between the<br />

inside the body to disease. time when the bacteria effect a lodgment<br />

There are many complex factors influenc- and th<strong>at</strong> in which the disease manifests iting<br />

the susceptibility <strong>of</strong> the body to infec- self the p<strong>at</strong>ient simply is troubled with m<strong>at</strong>ion<br />

from any germ, only a few <strong>of</strong> which laise, he feels languid and out <strong>of</strong> sorts.<br />

are as yet completely understood. The This is the stage <strong>of</strong> incub<strong>at</strong>ion, and it is<br />

most important, however, and perhaps the during this stage th<strong>at</strong> the blood and tissues<br />

all-embracing, one is the condition <strong>of</strong> the are deeply engaged in the effort to repel the<br />

body <strong>at</strong> the time <strong>of</strong> infection, whether it is <strong>at</strong>tacks <strong>of</strong> the invading germs. These niulfavorable<br />

or unfavorable for the growth <strong>of</strong> tiply, however, with varying speed throughthe<br />

organism,—whether the soil is suitable out the body generally, or they may be <strong>at</strong><br />

or not for the development <strong>of</strong> the seed. For first localized, or even remain localized, as<br />

without the existence <strong>of</strong> proper conditions in tetanus, all through the disease. Growno<br />

germ can produce disease. In the living ing in the tissues, they gener<strong>at</strong>e in increasbody<br />

the conditions are n<strong>at</strong>urally unfavor- ing amounts their poisons or toxins, which<br />

able for the growth <strong>of</strong> bacteria, even after soon cause pr<strong>of</strong>ound changes in the body;<br />

they have penetr<strong>at</strong>ed the epithelial invest- the p<strong>at</strong>ient becomes really ill and shows<br />

ments <strong>of</strong> the skin and mucous membranes, signs <strong>of</strong> unmistakable infection,<br />

wliich so long as they remain intact protect Wh<strong>at</strong> then happens? Does the body give<br />

the interior from bacterial invasion. Xor- up the fight entirely? No indeed; the white<br />

mal blood has <strong>of</strong> itself, to a considerable blood cells, the wandering cells and the<br />

extent, a bactericidal power; and the tissue cells <strong>of</strong> the tissues most affected still keep<br />

cells <strong>of</strong> the body in general show a similar up an unequal comb<strong>at</strong>. From the lymaction,<br />

depending upon the different cell ph<strong>at</strong>ic glands and spleen, armed hosts <strong>of</strong><br />

groups, st<strong>at</strong>e <strong>of</strong> health, robustness, and white blood cells rush to the front and <strong>at</strong>period<br />

<strong>of</strong> life <strong>of</strong> the individual <strong>at</strong>tacked, tempt to destroy the foe, but all in vain.<br />

This resistance to or protection against in- perhaps; the disease runs its course, to end<br />

fection varies in different Individ- either in de<strong>at</strong>h or recovery. But if the case<br />

uals toward the same bacteria, and in termin<strong>at</strong>es in recovery, how are the microdifferent<br />

degrees in the same individual organism finally overcome? This question<br />

toward different bacteria,—which resistance involves many complic<strong>at</strong>ed processes, which<br />

may be either n<strong>at</strong>ural or acquired. Long time will not permit us to go into in detail,<br />

before bacteria were discovered a difference but the main principles are as follows;<br />

in individual susceptibility, or refractoriness As has been previouslv noted, once the<br />

to different diseases, was recognized. It was bacteria obtain a firm foothold in the body<br />

also noticed th<strong>at</strong> persons who contracted it is subjected to the action <strong>of</strong> gener<strong>at</strong>ed

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