As an illustration of legitimate and even heroic experiment, the trial made with cholera bacilli by Dr. Von Pettenkofer of Munich on himself during the cholera epidemic of 1891 deserves permanent record.[19] It is of importance as showing the fallacy that may be involved in the exaggerated search for bacilli, as the chief cause of disease, which is the favourite theory and practice of the present day.
Dr. Von Pettenkofer (in opposition to the common medical belief) asserts that the diffusion of the cholera germ or cholera bacillus is not the chief cause of cholera. He states that there are two other absolutely necessary conditions, without which no outbreak of cholera is possible, and if these conditions are not present, the cholera germ may be breathed with no production of cholera.
The first condition is the unhealthy state of the soil or locality. But even this does not produce an outbreak if the second condition does not exist—viz., individual predisposition; and he shows that neither the cholera germ nor the insanitary locality, nor both combined, will produce cholera if this individual predisposition does not exist. He further states that no experiments upon the lower animals can be relied on; the only proof in relation to cholera must be from the experience of human beings.
Dr. Von Pettenkofer proceeded to experiment on himself, choosing Munich, in daily communion with Hamburg (where the epidemic was raging), as the place of operations, and sent to Hamburg for the cholera germs. On October 7 he swallowed a centimetre of fresh cholera culture, in the presence of witnesses—i.e., infinitely more than could be taken in by touching the lips with contaminated fingers, a cubic centimetre of culture being calculated as containing a thousand million microbes. He in no way changed his manner of living, eating accustomed food, including fruit, cucumbers, and other forbidden articles of diet. During the following week his physiological condition, pulse, temperature, etc., were carefully noted. Nothing unusual occurred but a little internal rumbling and slight diarrhœa, which passed away of itself. Two skilled bacteriologists, MM. Peiffer and Emerich, carefully examined the secretions during this experiment.
M. Von Pettenkofer himself thus states the results:
‘The comma bacilli not only prospered in my digestive tube, but had so multiplied in it that it was evident they found a congenial soil. They were found there in quantities, and in a state of pure culture. But on October 14 all the secretions were normal, only containing a few isolated microbes, which had entirely disappeared on the 18th.
‘Now, most bacteriologists assert that the cholera bacilli remaining in the intestines secrete there a poison, which, being absorbed, produces the cholera. But what a quantity of poison must have been secreted by these milliards of bacilli during the eight days’ sojourn in my intestines! Yet I felt perfectly well, had an excellent appetite, felt neither indigestion nor fever, etc., and I attended every day to my usual occupations. Whence I conclude that the comma bacillus, though it may cause a little diarrhœa, produces neither European nor Asiatic cholera.
‘Now, it must not be imagined that I am the adversary of the cholera bacillus; but it is erroneous to suppose that when a specific microbe has been discovered in the secretions of an infectious disease that the means of fighting it has also been discovered. The discovery of the bacillus of consumption was just as interesting as the discovery of the cholera bacillus, but since its discovery phthisis has destroyed neither one man less nor one man more.
‘These (bacteriological) methods for protection against cholera rest purely upon theory, and it seems to be thought that henceforth cholera, etc., ought to behave according to the prevalent theory, instead of theory being modified according to the cholera. Instead of trying to catch the comma bacillus and draw a cordon around it, the essential thing is to make all the dwelling-places of man healthy.’
Such is the vigorous and genuinely scientific experiment of a distinguished medical investigator.
Other experimenters have confirmed Dr. Von Pettenkofer’s observations. On October 17 Dr. Emerich made a similar experiment on himself, with like results.
Since then, experiments have been made in the Vienna Pathological Institute, with the following results: Six persons partook of the comma bacillus in no mean quantity, and not one of them has had the disease. The six are two doctors, the servant of the Institute, two medical students, and a private gentleman. Professor Stricker treated them all. Two did not feel their health impaired at all; one had headache, was slightly feverish, and could not sleep; two had slight attacks of diarrhœa; and only one was really ill, but recovered at the end of a week. These experiments inspire medical men with serious misgivings as to the theory which considers the comma bacillus as the cause of all cholera.
The supremacy of sanitation is the lesson which is being gradually taught by such humane scientific experiments. Dirt in its largest sense, as matter in the wrong place, whether in air, water, food, clothing, habitation, soil, or contact, is undoubtedly a main physical cause of disease.
But in all epidemic disease the emotion of fear must be recognised as a most potent predisposing cause. The great fact of mind or emotion is a powerful influence in producing, in preventing, or in curing disease.
This psychological side of medicine is only beginning to receive due attention. As the fallacies which arise in animal experimentation from the production of fear, pain, and coma have not yet been fully recognised, so the inevitable influence of mind in modifying physical conditions has never yet been studied scientifically in human medicine. Yet facts exist in unsuspected abundance which need to be collected, verified, tabulated, and their laws of action diligently studied.
It is known that even that strong muscle the heart may be ruptured by the agony of intense emotion. At Blackburn the daughter of a woman charged with theft became dumb with horror at her mother’s sudden arrest. Hydrophobia, cholera, and even small-pox, appear to have been caused by fear.
The extent to which even the so-called microbes of infectious diseases may be produced by fear acting on idiosyncrasy demands very serious investigation; for as it is now generally conceded that morbid micro-organisms do not exist ab æterno, it is essential to know by what unhealthy conditions the micro-organisms, or living particles that always surround us, become disease germs.
One of our most distinguished London physicians has full records of the following noteworthy case, which is given, not as scientifically proved, but as indicating a line of research which it is folly to ignore or refuse to investigate.
This gentleman attended a patient some years ago in an attack of confluent small-pox under these remarkable circumstances: This patient had always exhibited a morbid horror of the disease, refusing to hear anything about it or to allow it to be referred to in his presence. A friend on one occasion brought a very fine collection of anatomical plates to show him, sent over from France. Amongst them was a representation of confluent small-pox in a woman. No sooner had this gentleman beheld it than he cried, ‘Take it away! I cannot look at it; it makes me ill!’ The next day his son sent for the doctor to see his father, who had felt unwell ever since the shock of seeing the pathological plate. He was found suffering from the first symptoms of an illness which proved to be an attack of confluent small-pox. The most searching inquiry failed to discover any traces of the disease, either in the neighbourhood or in any connection whatever with the patient. The cause of this illness, one of the most severe cases the doctor had ever met with, remained a mystery.
It has become of vital importance to investigate ‘how far the mental attitude determines or permits the onset of infectious disease.’