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Full text of "The plague in India : an impeachment and an appeal"

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THE 

PLAGUE IN INDIA 



AN IMPEACHMENT 

AND 

AN APPEAL 



BY 

C GODFREY 



Author of: " Natural Immunity against Cholera " 

and of: " Common- Salt : Its Use and Necessity for the 

Prevention of Disease." 



LONDON : 

SWAN SONNENSCHEIN & CO., Limited. 

CALCUTTA & BOMBAY: 

THACKER & CO. 

1899. 



Pettitt & Cox, 

Printers, 

Frith Street, Shaftesbury Avenue, 

London, W. 



'^TBRAflp^ 



^ JUN 4 2001 o, 



THE PLAGUE IN INDIA. 



SINCE September, 1896, has the bubonic-plague now 
been raging in India, and has defied all efforts of the 
doctors and the Government. In the Bombay Presidency 
alone the victims of the scourge can be counted by 100,000 ; 
and the means employed, to combat the epidemic, have 
proved futile — whilst throwing a heavy financial burden upon 
the Indian Government and upon the various Municipalities, 
the end of which is at present not discernible. 

The object of the following remarks is the endeavour to 
demonstrate, that the attempts of preventing and curing the 
malady, have not met with any decided success ; and that 
another prophylactic means, which has a strong scientific 
basis and many important features for its recommendation — 
urgently demands a practical trial. 

The whole dissertation tends to prove, that the greatest 
safeguard against an attack of plague is a " Natural 
Immunity " ; and that all efforts should be directed to the 
discovery of the nature and the cause of this immunity, with 
the ultimate aim, of imparting the latter to the susceptible 
portion of the people — thus preventing the individual out- 
break and checking the spread of the disorder — in fact : 
stamping out the epidemic. 



Of all epidemic diseases, which periodically attack 
mankind, none is more dreaded than the ** plague." The 



rs '^ rw <* 



celerity in the development of the symptoms and the high 
percentage of mortality, have stamped it as the most terrible 
of all morbid afflictions ; and history records the despair and 
hopeless resignation, which an outbreak of this pestilence 
produced among the inhabitants ol various countries or 
towns during the Middle Ages. 

Not only the suddenness, with which an attack over- 
powers the sufferer ; but also the virulence of the symptoms 
and the almost certainty of a fatal issue, must fill the mind 
of everyone with awe and alarm — which is augmented by 
the utter helplessness of the physician, from whom alone 
relief is expected. 

No doubt, the Government is fully aware of the 
magnitude of the calamity ; and not only appoints " plague- 
doctors " for service in India ; but a *' Royal Commission " 
has been sent out ..." containing " (to repeat Lord Lister's 
announcement at the anniversary meeting of the Royal 
Society) '* a majority of scientific experts, to inquire into the 
subject of the plague . . . Their chief duty will be, to 
"sift and report upon the somewhat heterogeneous and 
" scattered pieces of evidence already published by various 
** observers as to the nature and mode of transmission of the 
" complaint, and the best means of dealing with it." 

But the plague is not a new disease ; and it does not 
appear that great vigilance has actuated the Government in 
sending out a Commission to report upon the best means of 
dealing with it, after the disease has raged for two years, 
and has spread over a considerable part of India. Previous 
epidemics in various parts of Eastern Europe and Asia must 
have given ample opportunity for medical men to obtain 
precise knowledge of the disorder ; its distinctive character, 
and the effective means for preventing and curing it. From 
the reports of the various Commissions, sent by the Austrian, 
German, Italian, and Russian Governments in 1897, it must 
appear, that this belated British Commission will prove 



futile in its results. It will probably bring home a mass of 
evidence, about : — the number of cases and the percentage 
of mortality; — the probable way in which the infection 
spread ; — how it travelled from house to house, from street 
to street, from one community to another ; — how the poison 
was conveyed by rats, or by travellers, or by merchandise in 
ships or along trading routes ; — how many experiments were 
made on monkeys, rats, mice or other animals ; — and lastly, 
about the competitive trials of various forms of plague-serum, 
invented or prepared by Haffkine, Yersin, Lustig, Galliotti 
or other serum-injecters ; with a formidable array of figures 
to prove their respective efficacy. 

All such investigations and reports (excepting the serum 
injection, about which more immediately), deal with the 
extra-corporeal conditions of the infected persons ; and how- 
ever desirable and absolutely necessary — not only for reasons 
of hygiene, but also for humanity's sake — the suggested 
municipal and domestic improvements will be, to promote 
the health and welfare of a community — the whole inquiry 
leaves out of account the principal factor in the development 
of the individual case, and thus in the spread of the epidemic, 
namely : the susceptibility — the predisposition — of some 
human beings, to succumb to an attack of the pathogenic 
poison ; and on the other hand : the immunity from the 
disease, possessed by the majority of people^ but for which, 
epidemic diseases would have exterminated mankind long ago. 
To this factor for the prevention of plague — the natural 
individual immunity against the disease — and its neglect by 
those in authority, the following remarks will direct attention, 
in the hope, that some action will be taken in the practical 
application of the prophylactic principles involved. 



For the object of this treatise it is not necessary to give 
a minute detailed account of all the symptoms of the malady; 
a short description of the principal phenomena will suffice. 



Bubonic Plague (pestis orientalis) is a febrile infectious 
disease, which is distinguished by the appearance of buboes, 
or swellings, in various parts — especially in the groins and 
the armpits — of the human body, accompanied by a 
gangrenous inflammation of the lymphatic glands. 

The external appearance of the sufferer would indicate 
" Typhus " ; which has led to the name ' of " Bubonic 
Typhus " being given to this disorder. The disease spreads 
through infection, and breaks out usually from two to five 
days after the invasion of the contagion. The symptoms 
assume a manifold character. After the patient has felt very 
weak and depressed, a violent fever attacks him with severe 
delirium ; and. after this has lasted several days, the boils 
and glandular swellings are formed. In favourable cases, 
these latter break, and discharge pus and matter ; and after 
a copious perspiration, convalescence follows. In unfavour- 
able cases the general symptoms assume a more violent 
character ; the central nervous system is seriously affected 
and symptoms of blood-poisoning supervene until, after two 
or three days, death ends the suffering. (Brockhaus's 
Lexicon\. 

Dr. Gavin Milroy (in Reynolds' System of Medicine, I. 
pp. 322-7), unfolds for us the following picture: "There are 
"the prodromal" (fore-running) "phenomena of lassitude, 
" rigor, nausea, head-ache and vertigo ; . . . anxiety rand 
" restlessness, with a heavy stupid expression of countenance, 
" and a muddy and suffused state of the eyes. Then follow 
"heat of the skin and great thirst, frequent vomiting, a 
" coated tongue and fetid breath ; a rapid weak and irregular 
* pulse, prostration with perhaps tendency to syncope . . 
"The matter vomited is sometimes nearly black . . . 
" Haemorrhage from the mouth, stomach and bowels, or from 
"the respiratory passages, is not an unfreqaent accom- 
"paniment. The necroscopic appearances . . . showed 
" . . that all the viscera were loaded with Jluid dark bloody 
'' and were generally much more lax and softened in texture, 



" than they are in health. The blood, whether drawn from life, 
" or observed after death, has generally been found to be darker 
^^ and more fluid than in health . . . etc." 

In fact, the disease is a complete dissolution and decom- 
position (if not really putrefaction) of the living body. 

The mortality is correspondingly high ; mostly from 60 
to 80 per cent, of the attacked ; so that on an average one, 
out of four patients, recovers. 



What deserves our special attention — when considering 
these phenomena — is the fact : that the disease does not always 
kill. 

Of those attacked, some recover — may be after greatly 
suffering for a longer or shorter period. 

Others again pass through the malady without the 
symptoms assuming a mortal character, and the patients regain 
their usual health. 

And finally : there are human beings, on whom the poison 
has no effect; it may invade their system, but it passes harm- 
lessly through the latter. 

It has been incontestably proved to be so in the case of 
cholera and diphtheria ; as also, without doubt in all other 
infectious diseases. And that the plague makes no exception, 
is borne out by Sir Arthur Brooks Faulkner in his treatise on 
that malady. He states (p. 18 1): ''Contagion is (most 
"fortunately) not governed by a necessity of exerting its 
" influence upon all individuals alike who come in contact 
" with the subjects of contamination. This would be contrary 
"to experience, not only in regard to the plague, but to every 
" other disease, which is admitted to owe its propagation to 
"this cause. We do not, in fact, know in any contagious 
" disease what it is that constitutes the susceptibility of the 
" human subject, etc." 



8 

" The many instances, which occurred during the plague " 
— at Malta — " of whole families escaping the contamination 
" after having lived long in the most intimate communication 
"with the infected, prove, to what a great extent non- 
" susceptibility may exist." 

With regard to the assumption, that dirt and dirty habits 
are predisposing causes of an attack of plague, Sir Arthur 
relates in his work (p. 190) : " Several cases were known to me 
" of individuals, labouring under the greatest violence of the 
" disorder, being taken from the very bosom of their families, 
" without communicating to them any injury — children from 
" their parents, and husbands from their wives. Yet these 
" families had used no kind of precaution whatever ; indeed, 
" in most instances, not so much as an attention to common 
" cleanliness. . . . My own calesseman and two of his 
*' children died of the plague, but his wife was never infected, 
'* nor his brother-in-law, though constantly attending on the 
" family in their illness. These people were also very 
" neglectful of personal cleanliness, and used no kind of 
" precaution whatever." 

Dr. Arnott* relates as an instance of his experience in 
Bombay : " An old woman returned after having buried her 
" son, who died from plague, to her home in Hotgi, where she 
" stayed with her son-in-law, three other women and two 
" children. She took ill and died, and two of the women and 
*' one child died." The son, one woman and one child (three 
" out of seven) escaped. 

It is evident from these accounts that the chief factor for the 
development of plague is — as in other diseases — an individual 
susceptibility; and this is tacitly admitted by Lord Lister 
when he assured the Royal Society, that : " . . . if we 
" consider how few of the medical men and nurses, who have 
** for a long time past been engaged in actual attendance on 

* Brigade Surgeon Lieutenant-Colonel James Arnott, M.D., Ind. Med. S. — On 
Plague. See "The Scottish Medical and Surgical Journal," January and February, 



" plague-stricken patients, have fallen victims to the disease, 
" we may dismiss from our minds the idea of any serious risk 
" to the commissioners." It is hence an incontestable fact, 
that a protection against the disease is found in a natural 
immunity. 

This once admitted — truly it would be in violence of all 
evidence and reason not to do so — one cannot escape the 
further admission, that for stamping out the disease our 
energies should be directed towards the discovery of the cause 
of this immunity, and then apply the necessary remedy, to 
impart that immunity to the susceptible portion of mankind. 

There is no absolute law of nature, in virtue of which the 
human cell should not have as strong — if not a stronger vitality, 
than the pathogenic intruder — the bacillus; and this is confirmed, 
not only by those patients, who easily and safely pass through 
an attack ; but also by the frequently observed occurrence, 
that the disease-germ has been found in the body of healthy 
persons, without having produced any symptoms of the specific 
disorder. 

That such immunity is not the result of accident is 
evidenced by the phenomena observed in Cholera-epidemics ; 
and it is not leaving the ground of fair reasoning, by applying 
the experience in Cholera to the conditions and the phenomena 
underlying and surrounding the plague. 

Dr. Mitra's report of the Cholera-epidemic in Kashmir 
will serve as an illustration : 

"The Kashmirs are notoriously filthy, and 125,000 of 
*' them are crowded into the city of Srinagar — the capital of 
" Kashmir. The city is built on both sides of the river Yhelum, 
" and through the city also runs a canal — the Nalla Mar — which 
" was once used as a water supply, but is now a string of 
" cesspools. The population is crowded into 25,000 low dirty 
" houses, built irregularly in narrow lanes and alleys, which 
" are used as latrines. There is no drainage, and the storm - 
" water washes the filth and ordure into the Nalla Mar and 



" into the river, from which the drinking water is obtained ; 
" the beds and clothes of patients, and the bodies of the dead, 
" are washed in the river and the canal, from which water 
" was drawn for drinking and domestic purposes ; and the 
" dejecta of many cases (of cholera) in the boats on the river 
" were thrown into the water, while drinking water for the 
" patients was taken from the same spot almost simul- 
" taneously." 

It will be almost impossible either to find naturally, or 
to produce artificially, more favourable conditions for the 
development of the disorder than those stated above, and it is 
a wonder that not all the inhabitants of Srinagar succumbed 
to the epidemic. Instead of this, Q3 per cent, escaped, and 
the disease died out with, no doubt, plenty of bacilli left in the 
bodies of the survivors. Of the total population of Srinagar 
only 7*2 per cent, were attacked and 4*6 per cent. died. 

The decline of the epidemic was due not to any absence of 
filth and of disease-germs, hut simply to the fact that the disease 
had carried off all the persons who were susceptible to it. 

But all our accepted ideas of the infectious nature of 
plague and of the almost certainty, that " dirt," that is : the 
presence of plague-poison, is the immediate cause of the 
individual attack and of the epidemic spread of the disorder 
— are completely upset, when reading the report of the 
Imperial Austrian Plague Commission. 

The late much-lamented Dr. MuUer — whose life was 
sacrificed to his professional ardour in his attendance upon 
a plague-patient in Vienna — informs us in that report, "that 
" the medical men in Bombay practically escaped ; which 
" cannot cause surprise, when it is remembered, that constant 
'* care was bestowed on cleanliness and on disinfection." 

The assumed cause of this immunity is, however, com- 
pletely controverted by Dr. Miiller's description of the scenes 
in the Arthur Road Hospital, which, for its real importance, 
deserves to be reproduced uncurtailed. He says : " It must 



II 



" be considered as most remarkable, that the * ward-boys ' 
" and the * sweepers ' in the hospital were immune from the 
" plague ; although the former had to attend the sick, change 
" bandages, and during this process touched the open 
" buboes ; whilst the latter were engaged in the removal of 
" fecal and other deposits ; cleaning the floor and the utensils ; 
" transporting of the dead and assisting in the operations on 
" the corpses. Only one was subject to an attack, previous 
" to our arrival ; but he recovered ; and during our stay in 
" Bombay two ' ward-boys ' sickened, but were able after a 
" few days to resume work. 

" The * ward-boys ' and ' sweepers ' went about bare- 
" footed, sometimes with bleeding cracks in their feet, and 
** often showed rends in their fingers. One sweeper moved 
" about the wards with a deep wound in the sole of his foot ; 
" and the boots, which we bought for him, he only wore half- 
*' a-day, to save them. It will be more than remarkable to 
" learn, that these incredibly dirty sweepers cleaned the 
" utensils, which contained the sputum, urine and faeces, 
'* with their bare, wounded fingers ; and walked about with 
•' naked feet on the floor, which was constantly soiled through 
" the sputum and the evacuations, dropped by delirious and 
** other patients — and yet they escaped infection. 

''Moreover — : with the object of allaying suspicion, the 
" relatives and friends were permitted to remain constantly 
'* at the bedside of the sufferers. For whole days a family of 
" adults and children, would squat round the bed, not to lose 
" a moment in removing the corpse to a place ot cremation. 
" I — (Dr.Miiller) — have seen numerous cases, in which relatives 
" and fi-iends have repeatedly touched the bubo or carbuncle, 
" without washing their hands previous to leaving ; — how, 
*' in the cases of pneumonic plague, the friends and visitors 
" have wiped away with their finger the bloody sputum 
" (which is in truth a pure culture of the plague bacillus) 
" from the mouth of the sufferer ; or — to save the patient the 



** painful exertion of turning over, have received the expec- 
" toration in their hand. The hand would then be wiped 
" either on the floor or their dress. Never have I seen these 
" people wash their hands ; and without any attempt at 
" cleanliness, they would take their food with the dirty 
" fingers. And yet — according to the ofiicial report of the 
" Arthur Road Hospital, not one of these bare-footed visitors 
" to the bedside of these plague-patients, has been attacked 
" by the disease." 

Dr. Miiller adds: ''To come to any conclusion from 
" the escape of people, who are so intimately and so directly 
" exposed to infection, is almost impossible ; since we have 
" here to deal with a congenital — (?-natural) immunity." 

It may well be asked : of what value are sanitation and 
serum-injection, in face of such experience ? 

On the other hand it is impossible not to see in these 
facts the evident proof that the principal factor for the develop- 
ment of the individual case, and for the propagation of an 
infectious disease, is the individual susceptibility — the predis- 
position for the disorder ; in other words : that a natural 
individual immunity is the most effective weapon in the combat 
with an epidemic. 



Before entering upon the consideration of the nature of 
this immunity, and of the best means for applying or impart- 
ing it to the susceptible portion of the community — it will be 
appropriate here to refer to the efforts which have been made 
to treat the developed case of plague and to stem the spread 
of the epidemic. The result will show that we are as far from 
a satisfactory solution of this problem as we were two or 
twenty years ago ; that the pestilence still demands our full 
attention, and that hence further researches are not only 
justified but demanded. 



13 

Referring to the Bombay epidemic, Mr. Birdwood gives 
us, in his paper before the Society of Arts, the following 
information under the heading : 

"Treatment of Plague-Cases. 

"As regarded the medical treatment of plague-cases . . . 
" I ought to state the opinion of so competent an authority 
" as Dr. Arnott, that no remedy has been discovered, which can 
" be relied upon. Dr. Childe says, that many methods have 
" been tried in Bombay, but * none with certain success.' 
** Some of the results of treatment with Monsieur Yersin's 
" serum at the Parel Hospital ; and with Professor Lustig's 
** serum at the Arthur-road Hospital, are given in Dr. Weir's 
" and in Dr. Choksy's report on plague-cases treated at the 
" latter Hospital, where a serum, prepared by Professor 
" Haffkine was also tried. Speaking from a full experience, 
" Dr. Choksy says, that all that the means at our command 
" can do, is simply to tide the patients over the most critical 
" period and to assist nature in recovering her original sway 
" over the system." 

Dr. Arnott (cited above) further adds, that : — 

" Antiseptics, and especially carbolic acid and iodine 
" and liq. hydrarg. perchlor. were diligently tried, but with- 
" out success. I also tried liq. chlori., which 1 thought did 
" well, but in the experience of others it was unreliable. 
*• Local injections of antiseptics, such as iodine and also 
" perchloride were tried, but unsuccessfully. And in the end 
" the treatment was symptomatic and stimulating, with the 
" most careful nursing and feeding." 

This is a candid admission of the inability of practical 
medicine, either — to prevent, or to check, or to cure the 
developed case of the disorder ; and — whether the attack ends 
in recovery or in death is simply the result of the recuperative 
powers of the individual sufferers. This inability of medical 
art to influence the zymotic diseases, has been well expressed 



14 

long ago by Sir John Forbes (in his : Nature and Art in the 
Cure of Disease, 2nd ed. p. 109), when he says : — '* In the 
*' zymotic or poisonous eruptive fevers . . it is now universally 
*' admitted to be impossible to check their course, and all our 
" most enlightened practitioners agree, that the terminations, 
*' whether favourable or unfavourable, are only slightly 
** modifiable by treatment" . . ; and Dr. Milroy honestly 
confesses under the head of " Curative Treatment of Plague," 
that " there is little on this head in medical writings at all 
" satisfactory or encouraging in respect of recovery of the 
" sick, but much, that is admonitory as to the baneful effects 
** of an over-active and meddlesome medication." 

There is no gleam of light out of all the endeavours to 
build up an effective therapeutic system against the plague ; 
the susceptible portion of the community is attacked and 
recovers or dies, according as the individual constitution 
either overpowers the disease or succumbs ; meantime the 
efforts of the doctors seem to be concentrated on the search 
for the bacillus — not with the object of curing the malady, 
but for the purpose of diagnosis only. The patient may have 
all other symptoms, which formerly were considered as 
constituting in the aggregate the disease called plague ; but 
now the doctor says : — if the bacillus is not present or cannot 
be found in or about the body — the attack is not one of true 
plague. But whether true plague or not, the treatment is 
equally helpless ; and the patient recovers or dies, whatever the 
diagnosis. 

These reflections will enable us to judge and appreciate 
the following (General Gatacre's) 

" Report on the Bubonic-Plague, Chapter III." 

which, the "Lancet" (of 22nd Jan., 1898, p. 250) declares, 
" gives a very excellent summary of the medical aspecr of 
" plague, derived from the views, expressed by the medical 
** officers working under the committee." 



15 

" Reviewing opinions generally, the following is a 
'< rational classification of forms of plague : — 

"ist. — With enlarged glands (gravity according to 
" symptoms and severity of attack), femoral, 
" inguinal, axillary, cervical, tonsillar. 

"2nd. — Without enlarged glands (almost always fatal), 
" septicaemic, pneumonic, mesenteric, enteric 
" or gastro-intestinal, nephritic, cerebral." 

*' The signs and symptoms of these various forms are 
" then given, followed by a section on a : Ready method of 
" diagnosing plague." 

It would be difficult to assert, that the author of the 
above report was conscious of the object he had in view, 
when compiling this " rational '' classification of symptoms ; 
for: if even it enabled him to make a true diagnosis, to 
decide, whether the form of the disease was *' inguinal " or 
" axillary " — whether it assumed a " pneumonic " or " mesen- 
teric " character — was there any specific medicine or any 
special treatment for each form of the malady, which insured 
the saving of the life of the patient r — which after all 
should be the chief object and aim of medical efforts. The 
report may answer : 

"It is difl5.cult to recommend any particular line of 
" treatment with confidence ; for, it is often seen, that a plan 
*'of treatment, which succeeds in one case" — {phen the 
patient has the strength to overpower the poison) — " totally fails 
" in another." 

The inutility of such "rational" classification is pointed 
out by Dr. Milroy (p. 323), when he says : " To describe at 
" length the different varieties of the plague, which have been 
"enumerated by authors, would be very unprofitable, and 
"only serve to obscure a subject, which has often been made 
" unnecessarily intricate by extreme verbiage in the attempt 
" at over-subtle distinctions." 



i6 

It is hence impossible to deny, that all attempts, of in- 
fluencingthe course of the disease by diagnostic investigations 
and by a super-scientific classification of the symptoms — have 
proved futile and a v/aste of energy ; not a single patient's 
life has been saved thereby — all the various assertions to the 
contrary notwithstanding. The Epidemic continues to stride 
over the land to mock our endeavours. 



Unable to cope with the disease, when once it has 
attacked its victim, medical men have very naturally 
directed their attention to the Prevention — first : of the 
individual outbreak; and secondly: of the spread of the 
infection. This latter has in many cases been partially 
achieved by ''special plague-hospitals" and by '* segregation- 
camps " ; but — as with the application of quarantine against 
the spread of cholera — so has this proved by no means 
eifective, to prevent the propagation of the disorder. 

How far these, what may be called : " extra-corporeal " 
steps, have been successful, is answered by the propagation 
of the epidemic since its first appearance in iSgb. 

In an article in the "Nineteenth Century" (June, 1898), 
entitled: "Fighting the Bubonic-Plague in India" — Miss K. 
Marion Hunter (late plague-medical officer, Poona), refers 
to these preventive measures in the following remarks 
(p. loio) : " With the apparent end of the epidemic in June, 
" 1897, the system of house-to-house visitation was allowed 
" to lapse and corpse-inspection by medical ofiicers took its 
'* place. That this was insufficient, the rapid strides, made 
'* by the disease in the early autumn-months showed." 

Corpse-inspection was not effective ; how could it be ? 
But even with house-to-house visitation, the epidemic spread, 
and became more murderous than before. No wonder, that 
Miss Hunter complains (p. 1016) ; and suggests: "The 
" efforts, to stamp out the disease, having been so compara- 
" tively unsuccessful, one is inclined to think more radical 



17 

** measures should be adopted. The suggestion to burn 
" down insanitary areas . . . may have to be seriously 
" considered. , . An adequate and efficient staff of medical 
" officers, with special qualifications for sanitary work ; 
" notification of infectious diseases and certificates of cause 
" of death, must in time come to be looked upon as necessary 
*' for the safety of the Indian Empire." 

Such suggestions place medical science and art in their 
worst light ; and if such ideas pervaded the minds of the 
medical staff, working under the Plague-Committee — is it a 
wonder, that the efforts, lo stamp out the disease have been 
unsuccessful ? 

It appears, however, that such opinions are shared by 
the " British Medical Journal," the editor and staff of which 
may be considered as among the best informed authorities 
on medical questions. It declares (2nd Oct., 1897), that 
*' the outbreak in India has made it evident, that plague 
" occurs as a result of insanitation ; but that — given money 
" and power — an epidemic can be checked — nay stamped out 
" — even in a large city . . . any relaxation in watchful- 
'* ness will be followed by a recurrence, which may last for 
** years." 

Dr. Millingen's remarks (article "Plague" in " Curiosities 
of Medical Experience," p. 182), in reference to the controversy 
about the contagiousness of the pestilence, may appropriatel)' 
be applied in illustration of the absence of sanitation : *' If 
" the stamping out of the disease depended upon sanitary 
'' measures, its ravages would never cease in those countries, 
*' where it is thoroughly neglected ; as for instance in Turkey, 
*• where no precautions are resorted to ; there would be no 
" cessation of the disease, until it had swept away the whole 
*' of the population." 

If even the burning down of insanitary areas should 
check the spread of the malady in the city of Bombay — how 
will this local destruction protect adjacent or distant parts of 

B 



i8 

the country against the invasion of the pestilence, the germ 
of which may be carried away by immune and perfectly 
healthy people ? 

That epidemic diseases find their victims in crowded and 
dirty cities or districts, and in badly ventilated tenements 
(chiefly — but not only) — is owing to the fact, that in such 
environments are to be found poorly-nourished and ill-tended 
beings, who have in their improperly-fed body the great 
susceptibility for the disease. It is this lowered state of their 
system, which makes them, fall a prey to the pathogenic 
poison ; and not their dirty surroundings, as shown by Sir 
Arthur Brooks Faulkner at Malta, and by Dr. Mitra at 
Srinagar. 

By all means, give the poor people a better habitation, 
more fit for human beings, with free access of fresh air and 
pure water ; but let us not think, that our enquiry has had a 
satisfactory result, when landing it in side issues, which have 
only an indirect connection with the cause of the calamity. 



As distinct from all hygienic — and sanitary — (extra 
corporeal) measures for combating the plague, medical men 
directed their efforts to a possible means for protecting the 
individual-being against an outbreak of the disorder. 

Guided by observed facts in the case of other infectious 
diseases (although not always applicable or pathologically 
deducible) — it was assumed, that one attack, if safely recovered 
from, protects against a second ; in other words : that one 
attack confers immunity against the plague. To obtain this 
immunity, it was suggested, that each human being, exposed 
to the infection, should have the disorder implanted into the 
system through the injection into his circulation, of a serum, 
which contains the plague-bacillus or only its pathogenic 
poison. 

This is not the place, to enter into a disquisition upon 
the theory of this proceeding — whether it is the formation of 



^9 

an anti-toxin e, or whether it is the adaptation of the system 
to the poison, which is to protect the human body against 
the disease ; but it may be of assistance in forming an 
estimate of the serum-treatment, to learn, what results have 
been achieved by it in its application to other maladies 

In the case of tuberculosis it ended in a sad and grievous 
disappointment to many sufferers, as it did not fulfil the 
promises of its originator and his disciples. 

In its application to cholera it was based upon a mis- 
conception of the nature of the disease, and hence could not 
but end in failure. " One might pale before a science, which 
" proposes to apply such means to a hundred persons, in order 
"that three* of them may be saved from an attack of the 
" disease and half of these from an untimely death ; especially 
*' so, since a second inoculation is deemed necessary to deprive 
"the first of its life-endangering character." (See "Natural 
"Immunity against Cholera," Williams & Norgate, p. i6; 
as also: Dr. Haftkine on "Vaccination against Cholera." 
Fortnightly Review^ March, 1893. 

In the treatment of Diphtheria not any better record can 
be offered. The Medical Superintendents of the Metro- 
politan Asylums Board — in their report for the year 1895 — 
express the opinion, to which all the medical officers of the 
hospitals subscribed their names, that : — " We are further of 
" opinion that in antitoxin-serum we possess a remedy of 
" distinctly greater value in the treatment of diphtheria, than 
"any otherwithwhich we are acquainted" ("Daily Chronicle," 
lith April, 1896). But in the year 1897 there occurred in 
London alone, 2262 deaths from that disease, at a death-rate 
of i7"7 percent.; which latter falls well within the natural 
fluctuation of the mortality, if taken for a number of years. f 
This low mortality may be owing, as has been pointed out 
by a continental practitioner — to the fact, that with the 

* This number refers to the percentage of people that have a predisposition for 
cholera. 

f'The British Medical Journal," 2nd April, 1898, p. 926, reports for the week preceding 
its issue a mortality of 25 per cent. 

B 2 



20 

introduction of the serum-injection, there ceased the most 
destructive treatment with drugs, which to a very great 
extent paralysed the recuperative powers of the system, and 
caused as many, if not more deaths, than the disease itself. 
To this must be added, that the serum - injection is not 
absolutely without undesirable after-effects. (See " Common 
Salt,"* pp. 241 to 269.) 

So far then •. the serum-treatment is not ot a nature to 
encourage and justify its employment for the protection 
against plague ; and when it is now further discovered, that 
the very fundamental principle, upon which it is based, does 
not exist — that, namely, one attack does not protect against a 
second — it is impossible to accept serum-injection as an 
effective prophylactic. 

This absence of protection is attested to by several 
authors on the subject. In the " Cyclopaedia of Practical 
Medicine " it is pointed out, that there is no analogy between 
plague and eruptive diseases, to cause it to be ranked among 
diseases, which attack persons but once in the course of their 
lives. "An English physician (Dr. Whyte) died of the 
"natural disease, six months after an attack, which he had 
** inflicted upon himself by inoculation." 

" A Chevalier Schabhals . . . was attacked with the 
" disease, indicated by violent fever, a bubo in the groin and 
"three carbuncles, from which he had the good fortune to 
" recover. He . . was however again attacked five weeks 
" after his complete convalescence with the malady, of which 
" he died before the sixth day. 

" A sufficient number of such cases have been noticed by 
"judicious observers to warrant our concluding, that plague 
" does not impart that kind of security from second invasion, 
"which is afforded by small-pox and other exanthemata." 

* " Common-Salt. — Its Use and its Necessity for the Prevention of Disease." Swan 
Sonnenschein & Co., Ltd., 1898. 



I 



21 



Sir Thomas Watson (Principles and Practice of Medicine, 
vol. ii., p. 913) in his remarks about the plague, describes it as 
" not furnishing apparently any sure or permanent security 
*' against its future recurrence." 

Miss Hunter, in the above cited article on the Bombay 
epidemic, states that *' Convalescence was slow, and unfor- 
" innately one attack is not protective against a seconds This is 
a plain admission of the inutility of the serum-treatment for 
prophylactic purposes. And having failed in this latter, the 
serum-injection has been the subject of experiments to 
establish its curative effect upon the developed case of the 
disease ; the results are, however, very dubious. 

That medical men are very anxious to cope with this 
calamity and discover some effective means for stamping out 
the disease — for their own credit as well as for the lives of 
those, entrusted to their care — admits of not the slightest 
doubt ; and if the accounts of the success of the serum- 
treatment are at times very promising and are reported in 
most hopeful language — it is but human ; (the wish is father 
to the thought). Nevertheless, the enormous stakes at issue — 
the lives of another 100,000 of our fellow creatures — enjoin us 
in all soberness to avoid self-deception, and courageously 
acknowledge our short-comings. Looking at the reports of 
the curative application of the serum, issued from time to 
time, it is evident, that the favourable and the un-favourable 
reports balance each other. 

It is not necessary, to quote largely and extensively, for 
the purpose of confirming the above. Dr. Robert Koch — a 
bacteriologist of European fame — was at the head of the 
German Commission in India, making experiments and 
observations about the curative effect of plague-serum. 

He reports (Reise-Berichte, Berlin, 1898, p. 54), that, 
"judging from experiments on monkeys, he could undoubtedly 
" assign some curative properties to the serum. But he would 
" not say, that similar effect could be obtained with human 
*' beings." 



"In the Parel Hospital 24 patients had plague-serum 
"injected, and of these 13 died; certainly, a low mortality, 
" which might be accepted in favour of serum-injection. This 
"favourable result, he states, was, however, only apparent, 
" since only such cases were selected for the serum-treatment, 
" which had been admitted during the first or second day of the 
" attack, and were looked upon as — : with not a bad prognosis. 
" Besides, according to the opinion of the attending physicians, 
"these cases might not have shown a greater mortality 
"without the serum-injection." 

And while Dr. Koch admits, " that Haffkine's serum has 
"a high protective effect — he must also declare, that the 
"protection is by no means absolute (p. 42) ; and plenty of 
" cases occur, which prove the uncertainty of the process." 
He very significantly remarks, that, " in order to combat the 
" epidemic successfully by serum-injection, it has to be per- 
" formed throughout the community ; and this can only be 
" done by compulsion. People only submit to it voluntarily, 
" when the epidemic has assumed a severe character ; and 
" then it is too late." 

The medical commission, sent by the Russian Govern- 
ment, expressed a want of confidence in both — Dr. Haftkine's 
and Dr. Yersin's plague-serum ; and the Austrian commission 
in its report — (which the "Times" correspondent declares 
to be " one of the most comprehensive works on the bubonic- 
" plague, which has yet appeared " and of which the " Times " 
of November 28th, 1898, contains a condensed account) — gives 
an elaborate discourse on the plague, but does not touch upon 
the possible means, by which the disease can be cured and 
human life can be saved. The object of the commission was : 
" to study the plague in its etiological, pathological, anatomic 
"and clinical aspect"; hence we have "tables, giving the 
" variation of temperature, of the pulse and of the respiration 
"of a number of patients." It raises questions, whether 
Griesinger or MuUer was correct; makes comparisons 
between the observations of a number of physicians ; and 



23 

informs us, that Dr. Muller differed from Dr. Choksy in 
regard to a symptomatic alteration in the patient's voice ; on 
the time of the appearance of the bubo, etc. but nothing about 
the best and most effective means of saving human life. 

In support of the remark made above, about the im- 
portance of the individual susceptibility, the Austrian report 
contains the significant statement, " that, on the whole, the 
" delegates enjoyed good health. After a short time however, 
**they all suffered from a slight but painful swelling of the 
"lymphatic glands in the axillary region. They" (the 
members of the commission) " were convinced, that this was 
" due to infection ; although, doubtless, of the mildest form of 
" the plague." Let us add : not because the plague-bacilli 
acted considerately towards the kind Europeans, and had 
sufficient compassion upon them not to display their full 
virulence — but: because the bodies of the delegates possessed 
a stronger vitality than the plague-poison. 

Dr. Muller further showed by his untimely death, that 
this infection — what may be called a natural inoculation — 
did not protect him against a second attack, which ended 
fatally. He expressed himself to the effect, that " the 
** question, whether the organism will triumph over the disease, 
" depends upon the degree of its natural power of resistance to the 
'■^poison of the plagued 

Metschnikoff (from the Pasteur's Institute, in Paris, in 
a discourse at the Moscow Medical Congress, August, 1897) 
states : that he found the protection from Haffkine's serum- 
injection ot short duration ; as in three cases of the inoculated 
an attack occurred on the 12th up to the 42nd day after the 
injection ; and he suggests a repetition of the process after 
ten to fifteen days. This, he adds, has no detrimental effect 
on the inoculated. 

Against this statement must be cited Dr. Arnott's 
information, about the effect of Haffkine's " preventive," 
that : " the action of the remedy is disagreeable, and in 



24 

** larger doses may be dangerous. It causes considerable 
" red and painful swelling ; there is fever sometimes rising 
"as high as 104° or 105*, and in some cases rigor, vomiting, 
•* purging, vertigo or faintness, and in some enlarged glands 
" — in fact, the person is always ill, and sometimes very ill 
«' with symptoms resembling plague, and it is not likely, that 
" it will be generally used, except by the educated and 
' intelligent ; or in the presence of great danger." 

Dr. Arnott's " wife and as many servants as could be 
"persuaded, were inoculated with Haffkine's preventive. 
" The dhobie (washerman), who had not been inoculated, 
" contracted plague, and died of it in hospital, where he was 
" treated by Yersin ; and later a groom, who had been 
" inoculated by Hafifkinej contracted it and recovered. Thre^ 
<' other grooms^ who had NOT been inoculated, did not sicken." 

Dr. Arnott further informs us, that : Prof. HafFkine, 
besides his preventive, also prepared a curative serum ; but 
it did not give satisfactory results. Anti-streptococcus serum 
was tried in the case of nurse E. J., but with no appreciable 
results. 

And nurse Pecha, in Vienna, succumbed to the malady, 
notwithstanding a daily injection of anti-plague serum. 

Nor is the evidence tendered to the Royal Commission 
in India — as reported by the " Times " correspondent (during 
November and December, 1898, and January, 1899) — any 
more encouraging in favour of the serum-injection. 

Dr. Haffkine describes the preparation of his prophy- 
lactic serum, and claims from 80 to 90 per cent, of recovery 
(November 30th). 

Surgeon-General Bainbridge contends, that sanitary and 
other measures should be placed before inoculation. Dr. 
Galliotti describes a process of making curative serum, which 
cured 75 per cent, of the patients treated (December ist). 

Major Deane declared, that Yersin's serum was useless, 
Hafikine's serum he said, conferred a temporary immunity, hut 



I 



25 



not to the extent supposed. Colonel McGann stated, that 
HafFkine's prophylactic had been found valuable. [The 
same issue of the "Times" reports, that "The plague is 
again increasing in Bombay." Dec. 12th.] 

Colonel Dobson, Capt. Leumann, Dr. Willis, etc., 
explained the plague-measures, that had been taken, and 
gave details as to the inoculation. There was no racial 
immunity. More Hindus were inoculated than Mahomedans ; 
but there was a greater percentage of deaths among the Hindus. 
The explanation was, that the Hindus were poorer, and that 
they lived in worse condition. (Dec. 13th.) 

[This is strong evidence of the futility of serum-injection 
in the presence of a natural susceptibility ; the former proved 
powerless against the latter.] 

Col. Benson stated : most {i.e. not all) of the cases were 
among the poor. (Dec. 14th.) 

Col. King : Inoculation was not a reasonable substitute 
for sanitation, but a valuable aid. Major Bannerman — 
vaccination-inspector — contended : that Haffkine's serum was 
cheap and effective. In Madras City, although there was no 
plague, inoculation was performed upon 5,366 persons in two 
months. (Dec. 15th.) 

Colonel Lawrie, plague commissioner in Hyderabad, 
declared that: HafFkine's fluid was not a serum, but a 
putrescent organic liquid, containing micrococci of putrefac- 
tion and occasionally pathogenic organisms. It was there- 
fore directly against modern medicine and anti-septic surgery 
to inject the fluid. Inoculation had not been adopted. [Has 
Hyderabad, under Col. Lawrie's supervision fared worse, 
through non - inoculation ? Mr. Stevens, deputy - com - 
missioner, said, that . . the classes most affected were 
low-caste Hindus. Mahomedans were not so liable to 
infection, nor were the herdsmen, who lived in the open air. 

Colonel Johnson described experiments, which had been 
made to determine, whether living organisms were found in 



26 

HafFkine's fluid. Out of six bottles, five showed a distinct 
growth ; the other was doubtful. Col. Lawrie (recalled) 
expressed his willingness to use HafFkine's fluid, if it were 
rendered sterile, provided it was proved to retain its 
prophylactic power under those conditions. He admitted, 
that the fluid as now used, afforded considerable protection, 
but denied, that it gave immunity. Sterilization, he thought 
might render it useless. [Col. Lawrie is evidently well 
acquainted with the experience of continental anti-serum- 
injectors. (See: " Common - Salt," pp. 245-8.) As an 
apparent elucidation of Col. Lawrie's evidence the "Times" 
reports, that: The plague-returns last week showed di ftirther 
rise for Bombay-city and district, and also for Madras and the 
Central Provinces. Dec. 20th.] 

Dr. Cook, health-ofiicer of the corporation in Calcutta, 
stated, that : The plague stopped in Calcutta of its own accord. 
It was not affected by the measures taken. Major Green, special 
health-officer to the corporation, stated : the </(^crease of 
mortality in Calcutta from May to August (during which 
time the plague was present) was 3*5 upon the average of 
the same months in the previous five years ; and he considered 
the low mortality due to the exodus during the scare in 
April last, and to the year of plenty following the several years of 
drought culminating in the famine of 1897. There was also a 
^(jcrease in Hugli, Howrah and Krishagar. (Dec. 29th.) 
[It will be expedient, to compare this decreased mortality in 
Calcutta, where, during this year of plenty, when the people 
were better fed — the plague stopped of its own accord — with 
the great increase previous to the appearance of the plague in 
other parts of India. We shall have to revert to this later 
on.] 

Col. Harris, ofiiciating principal of the medical college, 
said, that not any curative ag'ents have proved beneficial. 
Dr. Clemow, district medical officer, considered plague a 
filth- disease. . . He had inoculated fifty cases with 
Yersin's serum. He took alternate cases as checks. The 



27 

results were negative ; forty died and ten recovered in each 
group. ,. . Thirteen patients were inoculated with Lustig's 
serum . . the symptoms were not affected ; ten died. He 
mentioned two cases of a second attack of plague ; both 
died. (Dec. 30th.) 

It will be useless, to add further extracts from the 
evidence given before the Commission ; it cannot alter or 
modify the impression produced by the above citations — 
namely : that the whole inquiry into the means for preventing 
and curing the plague, has not met with any definite 
solution. 

But assuming even, that general sanitary improvements 
could be carried out, as they are applied in England, it would 
mean — according to a statement of Surgeon-General Harvey, 
before the Plague Commission (" Times," Jan. 4) — an annual 
outlay of ;^ 53,000,000. 

And if all the inhabitants of India (for : it would be futile 
to confine the process to localities, without checking personal 
intercourse and travelling) could be protected by inoculation — 
were this to prove itself really effective — it would probably 
involve an expense of about ^1,000,000 for one injection, 
with the prospect of a repetition in about two weeks time. 

The result of our inquiry so far shows, that either : as 
effectual means, or in their practical application for stamping 
out the Plague in India — neither sanitation nor serum- 
injection give any hope of success. 



It must excite astonishment, that so little regard is 
generally paid in medical questions to the fact, that different 
human beings show different susceptibilities to disease- 
producing agents and influences. 

Of, let us say, three people, exposed to a current of cold 
air, one becomes dangerously ill, contracts perhaps influenza, 
which brings him to death's door and after serious sufferings 



28 

for several weeks, remains with a shattered constitution. 
Another escapes with a severe cold, but recovers without any- 
further consequences ; whilst the third has not felt the least 
inconvenience from it, but, on the contrary, feels invigorated- 
It was certainly not the cold air, which determined the effect 
in each case ; but it was the susceptibility of the respective 
individual. 

As with the current of cold air, so it is with all 
pathogenic influences, including the plague-poison ; and in 
the previous pages there are already recorded a number 
of opinions expressed by those, who are considered as 
authorities on the question before us — that there are human 
beings, who are not susceptible to the disorder. We must 
naturally conclude, that there is something— either present 
or absent — in their system, which enables them to overpower 
the plague-bacillus. This latter passes through their bodies 
without doing any harm. 

That this is not accidental, we have overwhelming 
evidence. The members of the Austrian commission suffered 
from lymphatic swellings, without any other morbid 
symptoms; and Dr. Milroy stated (p. 32.3) that: ** During an 
" epidemic, many persons have often been affected with 
" glandular swellings and pains, and occasionally also with 
" carbuncles, but with so little febrile disturbance, that they 
" have been able to follow their occupations, and have speedily 
" got well." 

So also Dr. Arnott : " In those persons in whom the vis 
* ' medicatrix natura — the resistance of the tissues to the microbe 
** is sufficient, the bacillus is arrested and destroyed in the 
" glands." 

To what an extent bodily susceptibility entered as a 
factor in the plague-epidemic in Bombay and other parts of 
India, can be learnt from . . *' The Report of Brigade- 
Surgeon-Lieutenant-Colonel Dr. Weir— Municipal Health 



29 

Officer of Bombay — dated September 1897." (See the 
"Lancet," Dec. i8th, 1897.) It states: 

" At the time of the appearance of plag-ue, the death-rate 
" of Bombay was abnormally high. This has been ascribed 
" to un-recorded cases of plague ; but — Brigade-Surgeon- 
" Lieutenant-Colonel Dr. Weir points out : that synchronously 
"with the increase in the total mortality in Bombay, there 
"was an increase in the mortality in a number of places 
" outside the city, which could not be put down to plague. 
" From the Tana, Surat, Poona, and Kurrachee districts this 
" increase in mortality was reported, where as yet plague was 
" unknown. It is interesting, however, to note that all these 
" places, reported upon, as showing a high rate of mortality, 
" were subsequently attacked by plague in an epidemic form." 
It is quite evident from these facts, that the population was 
subject to temporary conditions, which weakened the human 
organism against the attack of other pathogenic agents, 
previous to the outbreak ot plague ; and that it was this 
decreased power of resistance, which imparted the high 
susceptibility for the plague. 

All evidence, all experience and all facts seem to force 
our attention to the inquiry into the state of the human system, 
which underlies this tendency to susceptibility ; and then — 
as a corollary — into the means by which this predisposition 
can be avoided or cured. In other words : we must endeavour 
to discover the cause of the natural Immunity against the 
plague, possessed by a certain class of human beings. 



First we must remember, what has already been stated 
above, and what may be considered as a biological axiom, 
that : " There is no law of nature, by virtue of which the ' human 
" celt' should not have as great, if not a greater vitality, than the 
'■'pathogenic bacillus.'" We can truly speak of the human cell, 
since our body is not only built-up of cells, but the body's life 
is the aggregate of the life of the cells. There is no life in 



30 

the serum or the lymph ; but there is vitality in the blood- 
cells (Lehmann, II., pp. 274-5) in the white as well as in the 
red ; — in the cells of the nervous system ; — of the various 
glands ; — and of all secreting and active organs ; and by 
giving a strong vitality to the various cells, we give it to the 
human body. 

This vitality may be described as an organic stability, 
which resists abnormal influence to change ; and is evidenced 
by a strong power of assimilation. All cells of which the 
human body is built up, are formed from material, which has 
been prepared for it in the process of digestion. A strong 
digestion produces stable " peptons "; and the strong vitality 
of these peptons accompanies them into the body, and in the 
various parts in which they serve the life of the organism — 
unless other defects, either local or constitutional, counteract 
or destroy the vitality of the living protoplasm. At all 
events — the first step towards a strong vitality is a healthy 
normal digestion. 

What now constitutes a healthy normal digestion — in so 
far as the stability of the product " the peptons " comes in 
question ? Answer : it is the chemical action of a properly 
constituted gastric juice on the nitrogenous ingredients of 
our food ; and this properly constituted gastric juice must 
contain 0-5 per cent, of hydrochloric acid ; otherwise the result 
of the digestion will be an un-stable product, liable to 
putrefaction, which latter commences already in the intestinal 
canal. We have every reason to believe that this liability 
to decomposition or putrefaction — this want of stability and 
of vitality accompanies the un-stable product throughout its 
life and activity in the organism. This will make us 
comprehend how an abnormal digestion, if existing for any 
considerable time — without showing any immediate dangerous 
symptoms, can yet gradually undermine the healthiest con- 
stitution. The cells of the human body constantly change 
their substance, take up this unstable protoplasm for their 
nourishment and thus lower and ultimately destroy their own 
vitality. 



31 

It must be further considered, that the formation of 
lactic-acid — so frequently met with in the stomach, when this 
is loaded with amylaceous food — is an abnormal fermentation 
and thus an unhealthy phenomenon, caused by the want of 
common-salt in the system ; and that this lactic-acid cannot 
by any means take the place of the mineral — the hydrochloric 
— acid. This latter is one of the most " powerful means of 
" preventing and checking putrefaction — the strongest anti- 
** septic" (Prof. Bunge) ; and the chief ingredient for the 
formation of this acid is Common-Salt. It is a well-known 
fact that : when this salt is not supplied to the system in 
sufficient quantity, one of the first symptoms is : the absence 
of hydrochloric acid in the gastric juice, of which direct 
evidence has been obtained by means of the stomach pump ; 
and it is only an indolent and ignorant mind which cannot 
comprehend how so simple a fact can have in its train a series 
of morbid and ultimate mortal effects. [This subject has been 
fully worked out in a treatise on " Common-Salt," to which 
the reader is referred for further information, especially to the 
anti-putrefactive action of hydrochloric acid (pp. 109-114).] 

There is another aspect of this part of our discourse, 
which is : that — as Liebig declares— we can even digest 
organic poisons, such as the Small-pox poison, in our stomach, 
as the hydrochloric acid destroys its disease-producing powers. 
But it is very important to add : when the acid is present. A 
healthy normal gastric juice no doubt destroys pathogenic 
germs, which may find their way into our digestive organs ; 
and thus the presence of Common-Salt in the system in 
sufficient quantity, assists indirectly to impart to the human 
body a resisting power to pathogenic influences. [Roux in 
"La Sem. Med.," 1897, p. 27, declares that infection takes 
place — besides wounds — also through the digestive canalj. 

Dr. Milroy (cited above) informs us that all the viscera of 
the plague-corpse were generally much more lax and softened 
than in health; and Dr. Arnott observed (in post-mortem 
examinations) that the right side of the heart was abnormally 



32 

dilated, and its muscles very soft. But also the symptoms of 
haemorrhage, vomiting of sanguinous fluid and the diffusion 
of black fluid blood through the various organs — are all 
indicative of a laxity and a weakness in the connective tissue, 
which directly influences the heart and the arteries, seriously 
impairs the blood circulation and thus contributes to the 
fatal issue of the attack. 

Such lax and weakened condition is mostly due to a 
watery state of the tissues ; and Prof. INIax von Pettenkofer, 
and after him Dr. G. Jaeger, have pointed out that this 
presence of water in the system above the normal proportion 
imparts to the human body a predisposition for infectious 
diseases. The counteracting ingredient in the animal 
economy against such a state of the system is : Common-Salt. 
It abstracts the water out of the muscles and out of the viscera 
generally ; acts as a diuretic and thus assists in imparting to 
the organism an immunity against disease . (See : " Common- 
Salt," p. 125-9.) 

The various symptoms of the disorder indicate the 
primary seat for the growth and multiplication of the plague- 
bacillus to be the lymphatic glands — those organs which 
contribute to the change of the white into the red corpuscles ; 
and an enfeebled lymphatic system would thus offer suscep- 
tibility for the development of the disease. 

MetschnikofF considers the swellings of the lymphatic 
glands — the pest-buboes — as a defensive process of the affected 
organism. He found the white corpuscles to act as " defence 
cells." It is highly probable that these white corpuscles form 
the pabulum for the growth and multiplication of the bacilli ; 
and if the former are of low vitality they become a prey to the 
pathogenic microbe. Here comes in the protective effect of 
the hydrochloric acid in the digestive process, in affording 
the white corpuscles the vitality to combat the poisonous 
intruder. 

Whether the disease germ, after entering the human 
body, can grow and multiply — and produce a malignant or a 



33 

mild form of the disease — may depend upon the difference in 
the vitality of the intruder ; but there can be little doubt that 
the food which the germ finds in the system — will have a 
great, if not the greatest, influence upon the issue. 

How true is Dr. Gottstein's remark on our assumption of 
a constanc)'- of the virulence of the pathogenic bacillus, and 
the disregard shown to the susceptibility of the human 
organism, when he says : ** We estimate the morbid symptoms 
" in an animal body by the virulence of the bacillus : while 
" at the same time we measure the virulence of the bacillus 
" by the morbid symptoms of the diseased organism." 

And whether the bacilli increase at the cost of the white 
corpuscles or of the lymph-plasma — and whether the bacilli 
(which is doubtful during life), or only their poisonous product 
can be found in the blood, and thus to act on the nervous 
system — the ingredient in the organism, which above all 
others would afford protection against these morbid changes 
is " Sodium-chloride." 

Furthermore : as common-salt is looked upon outside the 
human body as imparting to organic substances the power of 
resisting fermentative-and putrefactive changes — so there is 
every reason to assume that its presence in the plasma of the 
blood and of the lymph, should confer a similar faculty to 
those liquids of the human body. It would thus impede the 
growth and multiplication of the bacteria, and assist and 
strengthen — in another direction — the natural immunity 
against the plague. 



When considering the symptoms, presented to us in the 
case of plague, in all their aspects, and inquiring into the 
immediate cause of the extinction of life, it must appear 
evident that the bubonic swellings are not directly contribu- 
table to the fatal issue — unless blood-poisoning supervenes, 
and thus brings death to the seat of life — to the nervous 
system. 

c 



34 

It can only be either the heart or the brain (probably 
more correctly the medulla-oblongata), which in their 
failure would cause death. The activity of the nervous 
system and the circulation of the oxygenated blood are the 
factors, which immediately influence our vital existence. 
The first : the nervous system, may be morbidly and 
mortally affected by a poison contained in the blood ; and of 
this the headache, one of the earliest symptoms, gives 
evidence. Yet this does not appear to lead to a serious issue, 
and is not of a nature to cause immediate death, as it would 
show its effect more suddenly. But the maintenance of life 
in the nervous system, and the latter' s continued activity 
depend, during every moment of the body's existence, upon 
a supply of oxygen. If this fails, more or less — such 
symptoms as vertigo, coma, insensibility, convulsions, etc., 
can be observed ; if it fails altogether — syncope, apoplexy, 
etc., follow and death is the result. 

It is, therefore, an incontestable fact, that the life of 
the patient depends primarily upon the circulation of a 
sufiiciently oxygenated blood ; but this circulation itself — 
i.e.y the action of the heart — is only possible, when the blood 
can supply the oxygen to the nerve-centres of that vital 
organ. 

'■'■Deficiency of Oxygen is gradual Death to the Heart." 
(See: " Common Salt," pp. 72-76.) 

Is, however, the blood of a plague-victim capable of 
absorbing the oxygen, even if this were offered in an 
undiluted, pure state ? 

All evidences distinctly indicate that this is not the 
case ; that the blood is in a dissolved condition — its fluid, 
black serous state, points to a destruction of the blood- 
corpuscles, and this makes the absorption of oxygen in the 
lungs difficult — if not impossible. [This important question 
is fully worked out in " Common Salt," pp. 67-71.] 



35 

As a result : the heart, through the deficient natural 
stimulus, beats quick, soft, and feeble ; the circulation 
becomes languid and the nervous system shows the symptoms 
of a waning life. 

Says Dr. Arnott : " In connection with the rapid and 
"weak pulse, is to be noted great weakness of the hearty' 
(the former being, no doubt, the result of the latter) " making 
" it dangerous to sit up in bed, or to go to stool, even when 
"the other symptoms seem not unfavourable. Several of 
"our cases died suddenly in that way." 

Miss Hunter (cited above) remarks, that " the most 
^* common cause of death is heart failure" — which she considers 
" as a result of the high temperature." 

[That high temperature in itself is not the cause of 
heart-failure is fully reasoned out in " Common Salt," 
pp. 278-286.] 

Dr. Miiller (in the report of the Austrian Plague Com- 
mission) lays special stress on heart-weakness as the cause 
of a fatal issue in plague. In fact, he seems to consider 
weakness of the heart as the principal symptom, which 
leads to death. 

He states (p. 174), **The course and prognosis of an 
" attack of plague is dependent upon the strength of the 
" heart ; the power of the heart controls the course of the disease 
" The patient dies of heart -weakness." (Dr. Mailer 
emphasises this statement by making it appear in large 
type). 

And repeatedly he refers to this symptom and its 
primary importance (p. 175). "The period of the attack at 
" which heart-failure supervened, varied greatly ; but it 
" always determined the length of life, left to the patient." 
(p. 176.) "When looking through the history of the cases" 
(contained in the previous pages of the report), " and when 
" inspecting the diagrams '' (which give a record of the 
duration of the attack, and of the pulse, the temperature and 

C 2 



§6 

the respirations)— " there cannot remain any doubt, that 
" the condition of the hearty and the earlier or later appearance 
" of heart-failure : determine the course and the prognosis of the 
** disease." 

Dr. Miiller then expresses his surmise of the heart's 
failure being caused by a poison affecting either the heart- 
muscles direct, or that part of the nervous system connected 
with the heart. When it is remembered in how many fatal 
cases of heart-failure, syncope, apoplexy, or sunstroke, there 
can be no question of a morbid poison having invaded the 
system— there will be no need to ascribe these phenomena 
to any other cause than a deficient oxygenation of the blood. 
And this would find support in Dr. Miiller's statement (p. 176), 
that : " The remarkable increase in the frequeitcy of breathings 
*" is typical in all cases, even in those which end in recovery. 
" The increase of the frequency of breathing is generally 
" dependent upon the weakness of the heart ; much less upon 
" the height of the fever." 

Dr. Miiller further believes, that even the nervous system 
has less influence on the course of an attack than the state of 
the heart. He says: "Yamagiva has given great importance 
" to the presence or absence of nervous symptoms. But 
" according to my opinion these nervous symptoms cannot 
" claim to exercise great influence in the prognosis. I have 
" seen a number of cases which developed rapidly with 
** freedom from, or only slight nervous ailments, and ended 
" in death ; whilst others, with severe disturbance of the 
" nervous system— even with delirium, recovered." 

Why then look for any other origin, when so evident a 
cause as a destroyed blood is forced upon our attention. 
"The blood," says Dr. Milroy, "whether drawn from life, or 
" observed after death, has generally been found to be 
" darker or more fluid, than in health." 

It must further be noticed, that even in cases which are 
considered as of a quickly fatal issue, the body struggles 



37 

between life and death not for minutes or even hours — but 
for two or three days — which might be taken as pointing to a 
gradual destruction ; or if recovery follows, as a revivification 
of the blood. 

Here again, our attention is directed to Common-Salt as 
the factor for a strong blood, i.e. : a blood with healthy 
blood-corpuscles of normal shape., capable of fulfilling their 
important function of absorbing oxygen from the inhaled 
atmosphere and distributing it through the organism for the 
nourishment and the activity (^.6. the life) of the nervous 
system — including the heart. The full exposition of this 
question the reader will find in "Common-Salt," where it is 
supported by scientific facts, which to repeat here would be a 
waste of time and space. On the whole, that work should be 
read concurrently with this dissertation. 

Finally: Dr. Jabolsky (Deutsche Medicische Wochen- 
schrift 1897, No. 27) reports as the result of his investigations, 
that he found an agglutinating tendency of the blood- serum 
in cases of plague. This agglutinating or coagulating 
tendency would point to a deficiency of Common-Salt in the 
blood, as the salt keeps the albumen in a dissolved condition. 

And Giaxa and Gosio (Jahresbericht iiber Hygiene 1897, 
p. 369) found, that animals with a natural immunity, when 
subjected to hi-cnger, became susceptible to plague. This may 
be accepted as an indication, that the digestive process has, 
even during a few days, so much influence on the organism, 
as to destroy a natural immunity ; and this would again 
speak for the probability, that the apparently slight change, 
produced by the mere addition of Common-Salt to the system, 
can have significant beneficial effects on the organism in 
developing a natural immunity. 



Before making an appeal for an acknowledgment of the 
great probability in favour of Common-Salt as a Prophylactic 
for the prevention of plague, it will perhaps be expedient to 
answer one or two objections, that may be raised ; and to 



38 

point out the circumstance, in which Common-Salt can 
account for the natural immunity, acknowledged to exist 
among Europeans and the richer portion of the people in 
India. 

The principal objection or doubt, which may be advanced 
against the above exposition is, that : Common-Salt is 
already present in every human being — even when the use of 
it is neglected ; so that, did it possess the beneficial power, 
claimed for it — it could exercise this power and prevent an 
attack, without any further addition of it to the system. 

Whenever the presence of Sodium-chloride in the human 
body is the subject of inquiry or controversy — several facts 
are invariably overlooked or neglected ; the first is : that the 
absolute quantity — not only in the blood, but more especially 
throughout the tissues of the whole body — fluctuates to a 
considerable extent. In the blood it reaches a proportion of 
o'6o per cent, as a maximum; and it can be reduced to 0*25 
(in disease sometimes to 0*20) per cent, as a minimum. It 
never exceeds the higher density, as the kidneys excrete any 
amount above the 0.60 per cent. 

With regard to the minimum density : if salt be withheld, 
the amount expelled by the kidneys gradually lessens and 
soon ceases altogether; but the blood has retained 0*25 per 
cent., with which it does not part, and which appears to be 
necessary for the protection and the life of the red corpuscles. 
At the same time there is every indication, by estimating the 
quantity of salt eliminated, that the rest of the system has 
lost its sodium-chloride almost entirely ; and it must be quite 
reasonable to assume, that this absence or diminution must 
interfere with the function of the various organs, on the 
action of which common-salt has a direct or indirect influence 
and must disturb the health of the whole organism. 

Says Prof Beneke : " What a series ot physiological 
*' processes, most significant for the maintenance of our life. 



39 

f'are connected in a more or less high degree, with the 
presence of common-salt, which substance is mostly held in 
a low estimation." 

It is, however, not only a question of the fluctuation in 
the amount of salt, contained in the organism at any moment 
)f time — but also of the loss and the supply within a certain 
)eriod. And here enters a factor, which also seems to be 
leglected ; and that is : the quantity of liquid taken within 
such period. All liquid, which leaves^^^the system by way of 
the kidneys — and to a less extent by the skin as perspiration — 
leprives the body of common-salt ; and unless a corresponding 
imount is taken to replace the loss, it must follow : that 
much imbibing tends to deprive the organism of this mineral 
food, and thus leads to susceptibility for disease. It 
endangers the life of the blood [See " Common-Salt,"] 
and tends to the destruction of the red corpuscles with 
corresponding heart-weakness and the various more or less 
mortal symptons in its train. This will explain the fact that 
in tropical climates or during a continued high temperature 
in the temperate zone, such diseases as : diarrhoea, cholera, 
malaria, so-called sunstroke, etc. (in which the destruction 
of the blood-corpuscles forms one of the symptoms — if not 
the principal one) are so prevalent. 

The high temperature causes evaporation from the skin, 
resulting in thirst and consequent copious water-drinking. 
But even, when not any thirst exists — owing to the air being 
charged with moisture and evaporation being prevented — 
iced liquid is often imbibed with the object of cooling the 
body, thus flooding the system ; and the great amount of 
water, in its passage through the blood to the kidneys and 
the skin for its elimination, will — if the proportion of salt is 
at a minimum — destroy a part — more or less great — of the 
blood, unless common-salt in commensurate proportion is 
furnished to the system. 

The import nt and dangerous feature in this insidious 
process of depriving the body of common-salt is the fact, 



40 

that the symptoms are not directly discernible ; and the 
morbid results develop so slowly, that anything else, but 
not the want of salt in the system is accused of being the 
cause of what may appear as only a slight temporary indis- 
position ; and often not even this — whilst yet the organism 
is on the brink of an attack from one or the other of the 
above diseases. 

It is necessary to touch upon another aspect of the 
relation of common-salt to plague (or any other form of 
disease) ; although it applies to the state of mind of the 
professional, or more perhaps to the un-professional reader 
of, what may be called a bygone age : — that is the view 
which assumes, that sodium-chloride is put forward as a 
" specific " against the plague. A mind which is still in the 
bondage of the idea, that disease — instead of being a 
deviation from the healthy state (Galen) — is an entity, which 
enters our body like a "diabolus minor," which requires a 
"specific" — an anti-diaholus , to drive him out again— may 
with suspicion and credulity look upon the advice of adminis- 
tering common-salt as a medicine. It would be an unprofitable 
task to correct such a frame of mind ; but it is necessary to 
point out, that salt can perform its various functions in the 
human organism only, when it is present in sufficient quantity; 
in other words : that the salt, which is contained in the 
blood-serum to protect the red corpuscles, cannot act in the 
liver, or protect the lymph, or furnish the chlorine for the 
gastric juice ; that it cannot act like a magical specific of 
which one dose will perform the wonder; — but that it requires 
to be administered as a daily food, to permeate the system 
with it. 



If now the problem arises of bringing common-salt in 
connection with the Immunity, possessed by Europeans and 
the richer portion of the people of India, it is but to mention 
the salt-tax. Although assurances are given, that the tax 
does not weigh so heavily upon the poorest Indian, as to 



41 

prevent him from providing himself with this life-pre\ 
food — still, he knows, that it is heavily taxed, and h\ 
more of it than he can help. He probably (it would n\ 
assuming too much to say, absolutely) does not know, how 
necessary it is for his health, but looks upon it as a luxury, 
and only uses it as a condiment. The Europeans (ignorant 
perhaps, as they may still be about the great importance of 
it for their health), as also the better-placed Indians, never 
give the salt-tax one moment's consideration — not in relation 
to the wrong committed upon the poor (See " Common-Salt," 
pp. 287-293) but to the effect it has on the cost of salt, which 
affects them only infinitesimally ; and they use the mineral in 
sufficient quantity to prevent their system from becoming 
a prey to the heat and moisture, which attack the human 
organism in India, as in many other tropical climates. And 
as there are Europeans, who live according to strict hygienic 
rules, but are neglectful in the use of salt, and thus, in 
ignorance, allow their system to be exposed to the attack of 
one or the other tropical diseases — so we may conclude, that 
when these hygienic persons are attacked, it was not dirt or 
filth or unsanitary habits, which caused the infection and the 
disease — but a want of that ingredient in their system, which 
want gave them a susceptibility for the plague. 



If it were asked, what inducement and^ justification there 
is for an experiment to establish the prophylactic powers of 
common-salt against the plague — it cannot be difficult to give 
most weighty reasons in the affirmative. 

First: It is a question, in the immediate future, of 
saving human lives — in India, at a rough 
estimate, of another 100,000 in the next year or 
two; and ultimately in other countries in the 
tropics — not from plague alone, but also from 
cholera. In fact the ultimate far-reaching 
benefit, which is at stake, it would be bold to 



42 

define. But not only the saving of lives — it 
affects also the prevention of all the concomitant 
evils and calamities, connected with the out- 
break and persistence of epidemics of infectious 
diseases, in our social and commercial life, which 
involvethe loss of national energy, to be estimated 
by millions of pounds sterling. 

Second : The inefficiency, if not absolute failure of the 
means, hitherto employed to conquer the present 
epidemic, should instigate an attempt at dis- 
covering more effectual agents and remedies for 
preventing the individual attack and thus the 
spread of the malady ; the more so, since it is 
evident, that either sanitation or protective 
serum-injection — even if they proved adequate 
to the task — are impossible, owing to the 
enormous expenses involved in their application. 

Third : The simplicity, easy application (to which 
reference will be made immediately), the certainty 
of absence of opposition on the part of the 
populace, and above all — the great promise, 
which is held out by the several physiological 
and pathological reasons for the development of 
a natural immunity, as given above — all these 
more than justify — nay, they demand such an 
experiment on an extensive scale ; especially, 
when such experiment can be carried out by 
charitable means, should the Government be 
advised not to undertake it. This latter might 
be the result of medical opposition, since, no 
doubt, the political authorities would refer the 
decision of such a question to their medical 
advisers. But it is scarcely conceivable, that, 
and upon what grounds any opposition can be 
raised. 



43 

It certainly should not be difficult to obtain the support 
of medical men of authoritative standing in their profession, 
to lend their name and voice in favour of such an experiment ; 
to have the courage of stepping outside the contempt, which 
is so universally evinced for so common a substance as 
common-salt ; and to admit, that so insignificant a thing can 
have most vital and far-reaching influence on the life and 
well-being of the human body. 

It deserves to be repeated, that common-salt by its 
presence in the human body in sufficient quantity : — 

Furnishes the chlorine for a powerful antiseptic gastric 
juice, which gives organic stability to the 
products of digestion and thus to the cells, 
which ultimately are formed from them. And 
the presence of this acid in the gastric secretion 
kills the pathogenic poison, which may have 
entered the stomach. 

It gives a disease-resisting power to the tissues by 
withdrawing water from the system. 

It protects the lymph and the white blood-corpuscles 
by its anti-fermentative and anti-putrefactive 
qualities. 

It protects the red corpuscles from destruction, and 
keeps them in a condition favourable for the 
performance of their function, viz. : the supply 
of oxygen to the nerve-centres of the heart 
and to the nervous system generally, and thus 
prevents heart failure — the immediate cause of 
dedth in the majority of cases. 

Furthermore : it promises, to act as a curative agent, 
when injected as a simple saline-solution, without an admix- 
ture of any organic poison — as it has proved in the case of 
cholera. In Hamburg, in 1892, during the cholera-epidemic, 
it was found " that, after all other attempts to beneficially 
" influence the course of the disease have failed, the remedy 



44 

" left is : common-salt in solution, injected subcutaneously or 
" intraveinously, as the only reliable means for combating the 
" disease and saving the sufferer's life." 

And Dr. A. Gottstein (cited above) advises, respecting 
the serum-injection in the treatment of diphtheria : " The 
"result does not justify the enthusiasm, which is shown 
" everywhere ; but it should incite to further sober therapeutic 
** experiments, especially in the direction of injecting indifferent 
" common-salt solutions, which have hitherto not been used, 
** and the action of which would not be interfered with by the 
" addition of albuminoid substances — the anti-toxins." 

It must above all be remembered, that every serum, to 
be injected into the human body, must of necessity contain at 
least o*75 per cent, of sodium-chloride, as otherwise the so- 
called " serum " (however prepared, and however named) 
will be harmful to the system. And most significant of all : 
Prof. H. Buchner (according to Prof. Dr. Emmerich and 
Dr. Tsuboi, Die Natur der Schutz- und Heil-substance des 
Blutes, Wiesbaden, 1892, p. 10) has shown, that anti-toxin- 
serum, without common -salt loses its bacterium - killing 
effect. 

The fact, that the injection of serum is required to be in 
comparatively considerable quantity, would make it appear 
that the effective part of the serum is not the organic 
but rather the inorganic ingredient; in other words: the effect 
produced — if any — is not so much owing to the anti-toxin, of 
which the smallest germ would suflB.ce (as for example in the 
case of vaccinia) — as to the mineral constituent, which 
requires to be administered in quantity, to alter the blood- 
serum in its physico-physiological properties. 

Dr . Yersin (Sur la peste bubonique. — Ann. de ITnst, 
Pasteur, 1897 No. i) states, that the quantity of serum 
injected during the early stages of an attack amounted to 
20 or 30 c.c.m., and in cases of later application to 60 up to 
90 c.c.m. 



45 

In relation to the cure of diseases by the administration 
of common-salt it deserves to be recorded, what Prof. Beneke 
(Grundlinien einer Pathologie des Stoffwechsels, p. 320) 
advises ; " The generality of practitioners w^ork with the 
" most powerful agents in the form of medicine ; with iodine, 
"arsenic, mercury, quinine, and a host of others ; but ih^ fate 
** of the organism so far as it depends upon its integrating 
' • inorgaftic constituents, i s left to kind nature, without the 
" least reflection, that with all its benevolence, nature is limited 
" in its action by one or the other condition ; and that the 
"most rational method of curing disease is employed by 
" removing these conditions : in our case dy restoring the 
^^ inorganic ingredients to their normal proportions." 



The nature and modus operandi of such an experiment 
as suggested above, is easily stated. A community of 
perhaps 20,000 inhabitants is selected. To supply these with 
half an ounce of common-salt per day for one month (the 
period of the experiment) will require i lb. per head, that is 
altogether 20,000 lbs., or roughly 10 tons of salt. This should 
be dealt out in proportionate quantities of 3|- oz. per head per 
week, in the first instance accompanied by printed instruc- 
tions, stating the benefit and the necessity of salt for their 
health, and describing the manner of taking it ; that is : a 
part with food (even all farinaceous food should be cooked in 
slightly salted water), and the greater portion in solution — 
with a warning : never to drink water unless it has some salt 
dissolved in it. [This, if so mixed, that the salt is not tasted 
is very pleasant. See : " Common-Salt."] 

The cost of the salt would be under £^12 per ton {£,^ the 
salt, and £% or £() the tax) ; hence the total cost ot salt 
jQi2o. The printing of the instruction — say 10,000 hand-bills 
and perhaps 100 wall-bills, may possibly come to jQ^ or jQ^. 
There remains the cost of distribution and the supervision of 
the proper use during one month. The number of officials 



46 

required for this purpose may be assumed as 30 or 40, at a 
rough cost of ;^35o; so that the total expense would amount 
to ;^5oo- 

Would this be impossible to obtain from a nation which 
can spend ;^ 100,000 on a technical institution at Khartoum ? 

When a few prominent Medical Men of acknowledged 
scientific high standing, have given their support to such a 
trial on the strength of the promising nature of the experi- 
ment — surely there would be a long list of benevolent people 
anxious to assist towards the establishment of a prophylactic 
means against the scourges, from which mankind is now 
suffering. 



47 

AN APPEAL 

TO THE GENERAL PUBLIC. 



?His treatise, as far as presented in the preceding pages, was 
lubmitted to several Professors of Physiology and Hygiene 
at various European Universities, with a request for their 
support and their recommendation for a practical trial, as 
suggested. Of the replies received, it is only necessary to 
reproduce one ; viz. that of Professor Dr. Hans Buchner of 
Munich, who is acknowledged to be one of the highest 
authorities on bacteriological questions ; and whose researches 
referred to in his letter, entitle him to give an indisputable 
opinion on the question at issue. His reply is as follows : 

" 28th January, 1899. 

" I duly received your esteemed letter of the 24th inst. 
and hasten to inform you, that you could not have 
applied to any one, who is more convinced of the 
correctness of your views, than I am ; as I have 
ever since 1890, brought forward evidence of the fact, 
that the natural power of resistance of the organism 
against bacteria, depends directly upon the amount of its 
mineral constituents."" 

** The first proof of this I published in the ' Archiv fur 
* Hygiene' — vol. x, 1890 — in an article, entitled * In- 
'vestigation on the bacteria-destroying effects of the 
' blood and blood-serum ' ; and have already at that 
date shown, that the bacteria-killing faculty of the 
normal blood serum — upon which the natural protective 
powers of the organism against bacteria chiefly depend 
— is lowered and ultimately destroyed in proportion as 
the mineral constituents, especially Sodium-chloride, 
are abstracted from the serum." 

" Later on, in 1893, I continued these researches on 
the important office of the neutral Salts in relation 
to the bacterium-destroying protective substances of 



4« 

the serum, to which latter I gave (in 1891) the name of 
* Alexins ' ; and added the second proof, that : the 
bacterium-killing qualities of blood-serum — after having 
been made in-effective through the abstraction of 
Common- Salt — could be restored again by the restitution 
of the lost minerals, especially Common-Salt." 

" By same post I send you a copy of the dissertation 
of 1893, in which I have marked passages on pp. 138, 
139, 142, 174-6, to attract your attention." 

" These inquiries established the fact, that the presence 
of mineral salts in the organism is of great importance 
for the natural resisting powers against infection ; and 
that it would be dangerous to decrease their amount." 

" The influence of this diminution appears to become 
evident in the increased destructive action of water on 
the cells and on the protective serum (Schiitzstoffe) , 
which action is in itself always harmful. An organism, 
deficient of Salt, may be compared to one, which 
contains an abnormal quantity of water, and possesses, 
like this latter, a diminished resisting power against 
infection." (See "Common-Salt," pp. 43 and 125-9.) 

" It was naturally suggestive, to apply these scientific 
results for practical purposes. But when considering 
these possibilities, I was always induced to think, that 
the low price of Common-Salt in our countries, gave 
every one the opportunity of supplying himself with 
the quantity he needed ; and that any amount, beyond 
the body's necessity is, as you correctly state, excreted 
by the kidneys." 

"You are quite right in stating, that this does not apply 
to India, where, with the high salt-tax and among a 
people, who — partly through poverty, partly through 
habit '(ignorance?)' — do not use it, the human body 
does not receive sufficient of that mineral substance, 
which imparts the power of resisting infectious diseases. 



49 

And this applies in a special degree to vegetarians, as 
Prof. Bunge (Lehrbuch der physiologischen Chemie) 
has shown." 

" That such a deficiency of Common-Salt — when it 
exists — can be very harmful and must essentially 
increase the pre-disposition for infection, I consider — 
in accordance with my experiments, as certain. And ' 
the possibility of such deficiency of Common-Salt, 
which I did not think probable for Europeans, I must 
admit as possible for the inhabitants of India." 

" I must however add, that according to my inquiries, 
Sodium-chloride is by no means the only salt capable 
of performing the important office assigned to the 
Alkali-salts in the human body, but that other mineral 
salts are equally effective. I do not mean to say, that 
for example, experiments should be made with Sodium- 
sulphate, since I am convinced, that Sodium-chloride 
is the most suitable for the human organism. I only 
wish to point this out, in order to indicate, that Sodium- 
chloride must not be looked upon as a ^Specific' against 
the plague.'' (See ante p. 40; as also "Common-Salt" 

P- I5-) 

" In conclusion, dear Sir, I do not hesitate, to give 
my full support to the practical experiment, as sug- 
gested by you. I consider it to have a strong scientific 
basis ; and that it is for this very reason, urgently 
demanded — being besides perfectly harmless. I should 
hence feel highly gratified, were the British or Indian 
Government to decide, to accede to your request and 
institute an experiment of distributing Common-Salt 
among the members of a community, in which Plague 
has broken out." 

(Signed:) « Dr. HANS BUCHNER, 
Professor at, 
and President of the Hygienic Institute of, 
the University of Munich." 



50 

Accompanied by a transcript of this letter, a copy of the 
pamphlet was sent (Feb. 6th) to the Right Honorable Lord 
George Hamilton, Principal Secretary of State for India, with 
an Appeal : that his Lordship would take cognizance of the 
contents of the letter and of the pamphlet, with the view of 
instructing either the present Royal Commission in India, or 
any other special delegates, to institute an experiment, as 
suggested in the pamphlet. The receipt of the letter and 
pamphlet has been duly acknowledged (Feb. 8th) . 

Will the request be granted ? — Will the Government 
order such an experiment to be made ? 

The decision of this question will rest, no doubt, with the 
Medical Staff; but it may not be out of place here, to inquire 
into the objections that can possibly be raised against. the 
proposed experiment — to ascertain, whether — and how far — 
they justify a refusal of the appeal. 

The opposition to the trial may be based upon either 
politico-economical — or upon scientific grounds. The former 
resolves itself into a question of expense, and of ultimate 
influence upon the Indian finances — i.e. the Income derived 
from the Salt-tax. 

As to the cost — were this even to amount to, say, ^ looo, or 
more — to establish the prophylactic efiicacy of Common-Salt, it 
would be an insignificant sum, as compared with the expense 
incurred in fighting the plague, as done at the present time ; 
and it would be infinitesimal, when the ultimate great boon is 
considered, which would be achieved by so trifling an outlay. 
Should however the appeal be refused upon the mere con- 
sideration of expense — in that case there cannot exist the 
least doubt, that private means would be forthcoming, to bear 
the cost; and only the mere sanction of the Government would 
be required. Such a sanction would, in the eyes of the 
natives, give a moral support to the experiment ; and the 
withholding of it would be dictated by motives, which could 
not bear public exposure. 



51 

The objection based upon the disturbing influence on the 
Salt-tax, may be looked upon as of a more valid nature; but this 
is apparent only. Let the bulk of the inhabitants of India once 
learn the great benefit, which can be derived from a liberal 
use of Common-Salt, the Indian finances would not suffer, 
were the Government to reduce for example the Salt-tax to 
one half of its present rate (if incapable of rescinding it 
altogether) — since the reduction in the tax would be fully 
balanced by the increased consumption. 

This question presents however an additional aspect. The 
probable reduction in the Salt-tax would be compensated for 
by an improved state of public health and a consequent 
increase in the industrial energies of the community, and thus 
indirectly in the general finances of the country. In fact, this 
side of the question alone will well deserve the full attention 
of the Indian Government. 

So far the question at issue refers to the decision of the 
statesman ; what now can be the objection of the physician 
and scientist ? To declare, that the present means are fully 
adequate to meet the exigencies of the epidemic, would be in 
direct contradiction of all attested facts. The epidemic is 
dying out in some — and taking root in other districts ; and it 
does this admittedly without being influenced by the prophy- 
lactic and curative agencies employed. What apparently has 
been achieved by the serum-injection among the numerically 
few, as compared with the thousand times greater number of 
the non- inoculated, can be accounted for by a natural 
immunity and by the application of other means ; and this is 
after all most insignificant, as compared with the mass of the 
population untouched by it. The abatement is unquestionably 
due to a natural decline of the epidemic, either on the whole 
or in definite localities. The question remains as much an 
un-solved problem, as it has been hitherto ; and still awaits a 
satisfactory solution. 

Besides this assertion of non-expediency, there is the 
objection, that the suggested prophylactic remedy is far too 

D 2 



52 

simple, to produce so complicated a state of the system as an 
immunity against infectious diseases. This is not only 
expressed in half-veiled language or by inference, but also 
plainly asserted. Surely, such a pretext should not come 
from a highly-educated scientist ; it would be more in character 
with an ignorant layman, who is dominated by the idea, that 
great, far-reaching effects can only be achieved by causes 
and agencies of an uncommon nature — whereas the man of 
science should readily admit, that trifling causes can have 
important consequences. And it is not becoming of gentle- 
men in the position as teachers of the laity, to treat such 
questions with silence. They should remember, that the 
simple substance — Common-Salt, lies at the basis of human 
existence ; that by abstracting and absolutely withholding it 
from the system — illness and ultimately death is the result. 

That simple physiological means can prove effective 
against a malady usually considered fatal, which has its origin 
in pathogenic microbes, is illustrated by the acknowledged 
cure of tuberculosis. Here is a dangerous affliction— the 
result of an organic poison, for which bacteriological thera- 
peutics considers anti-toxins or internal anti-septics absolutely 
necessary; yet — it is found, that : instead of being cured by 
bacterium -killing medicines of any kiri^i^this dire disease 
will yield to fresh air, ample food and j^i^cious exercise. 
And not any medical man, however high hife position in the 
profession, is entitled — either through ignorance of its effect 
(see Prof. Buchner's letter), or of its importance for the 
existence or the health of the human organism — to oppose 
the employment of Sodium-chloride as a prophylactic before 
an outbreak ; or even as a curative agent, when injected in- 
traveinously or subcutaneously during an attack. (See : 
Results of Salt-injections during the Hamburg epidemic in 
1892, in "Natural Immunity against Cholera," pp. 78-9.) 
Such opposition deserves the severest opprobrium and should 
be met by charges of unworthy motives. 



53 

Surely, it cannot be derogatory to the nimbus of their 
science to admit, that Sodium-chloride can be instrumental in 
imparting to the human body the power of preservation and 
of protection against pathogenic influences. Certainly : to 
err is human ; and no doubt, it might appear to damage 
professional prestige, were so common a substance as Common- 
Salt to achieve, what the whole therapeutic armory has not 
been able to effect. Everyone will understand this wounded 
pride ; but every sensible person must admit, that such a 
sentiment should not stand in the way, when human lives, to 
be counted by thousands, are in question. 

Besides the above pretext, which may have its origin in 
the " amour-propre " of a highly-strung scientific mind, there 
is no valid and truly logical reason, that can be advanced in 
opposition to the suggested trial, which — besides a scientific 
basis, has everything in its favour : simplicity in its appli- 
cation ; comparative inexpensiveness ; and — what deserves 
weighty consideration — ready acceptance and active assistance 
on the part of the inhabitants of India. But above all : the 
promising prospect of conquering one of the scourges— with 
most probably other ailments — which afilict mankind. 

Should the Government nevertheless not accede to the 
request and either refuse to institute the experiment, or simply 
shelve the matter, — in that case it will be expedient and 
necessary, to make an appeal to the general public for an 
agitation in favour of the suggested experiment, and awaken 
an interest in a subject, which is of universal and far-reaching 
importance. 



That this appeal will meet with a ready and extensive 
response, cannot be doubted, since the publication of the 
treatise on "Common-Salt" has called forth, unsolicited 
(among many others), several communications on the subject 
of the prevention of disease in tropical climates by the liberal 
use of this mineral food. 



54 

Among these, the following extract from a letter of a 
gentleman, resident in the Riviera, deserves a place here, as 
its contents have a direct bearing on the subject of this 
treatise and on the question of the health of Europeans in the 
tropics. He writes : 

"27th Dec. 1898. 

" I have read your work ' Common-Salt ' with great 
pleasure and interest, having, for the most part of my 
career in India, been a great advocate for its use ; and 
I attribute my immunity from all serious illness, whilst 
in that country (some 35 years) to being a regular salt- 
eater. My duties at times took me into parts of the 
country, where malarial fevers and cholera were very 
rife ; and it is alone to this preventive, that I consider, 
I enjoyed good health and suffered no ill consequences 
. . . . and, as I mentioned before, I have had no 
serious illness during my life — not even tooth-ache — 
thanks to Salt." 

Another gentleman, for many years resident in India and 
Egypt, gives his experience in these countries, among other 
statements, as follows : 

" In 1873 I was in charge of a Government stud in 
Bengal, where cholera prevailed in the villages all 
round. I read in ' Braithwaite's Retrospect of Medicine' 
about a doctor in the West-Indies, treating the last 1 7 
cases of cholera there, with iced sea-water, and they all 
recovered. So I wrote to an English Chemist in Benares 
to prepare for me a large jar-full of sea-salt, giving him 
the proportions of the various ingredients. (I think, he 
sent me about 10 or 12 lbs.) There was no English 
doctor within 20 miles ; so I gave a quantity of the salt 
to a native doctor, who had obtained a diploma in the 
Government Medical College at Calcutta. I distributed 
the remainder among some villagers, who were suffering 
badly, — telling them, to dissolve it in water and let the 



55 

patients drink frequently, at the same time rolling 
them in blankets, to cause perpiration. The native 
doctor told me, that he gave the salt in 13 cases of 
cholera, and that 1 1 recovered. Some weeks after- 
wards several villagers came to my bungalow, and 
thanked me for giving them the medicine. They said, 
that 25 people were attacked and all recovered after 
taking it." 

" I always took a fair amount of salt, and have been in 
eight places, where there were outbreaks of cholera — 
some of them very virulent — and I never had a sign of 
the disease. I am strongly in favour of an ample 
supply of salt as advantageous to the health of all, 
except carnivorous animals — especially in hot climates. 
When in Egypt in 1882, I persuaded the officials to 
allow a daily ration of salt for all the Government 
horses and mules, although the military authorities 
were opposed to the expense, on the ground, that it 
was not given in England." 

" The natives of India are full believers in its being 
good for health ; but the heavy tax laid upon it by the 
Government, prevents the poorer classes from buying 
enough. If this were abolished or even reduced to one 
quarter of what it is now, I believe that the lives of 
thousands of cattle, as well as of natives, would be 
saved annually. The cattle cannot receive much now 
on account of the expense being too great. If the tax 
were one-fourth of what it is, I believe that the Govern- 
ment-revenue would not decrease, because the natives 
would buy the Salt in far greater quantities." 

" For the Government stallions under my charge in 
the Punjab I made a practice of greatly increasing the 
ration of salt, whenever anthrax or Loodiana fever was 
in the neighbourhood, giving two chittacks, or about 



56 

four ounces daily to each, I did this in hopes that it 
might render them less liable than they would other- 
wise have been to the attacks of the disease ; and 
certainly, I was fortunate enough, never to have had a 
case amongst them, even when the fever was very pre- 
valent and fatal in the artillery and cavalry at the 
same station." 

There can be scarcely any room for doubt, that — upon 
the publication of this treatise — a considerable number of 
reports of a similar nature in relation to India alone, will be 
forthcoming, to give support to the contention for a practical 
trial, which should lead to active steps towards its consum- 
mation, should the Government fail to undertake the same. 



At the moment of completing this treatise comes the 
news of a wonderful — " a romantic " — success of Haffkine's 
serum-injection as applied in a small community of 600 
people ''after'' 381 attacks, of which 378 proved fatal. 
Within four days of the appearance of Dr. Lieven (so it is 
reported), at the Central- Asian village of Anzop with 
"Bombay serum," the epidemic is stamped out. What a 
mockery upon the investigations, the researches, the trials 
and the efforts of the medical staff, engaged in combating 
the disease in India, and* upon the various commissions, 
delegated to gather knowledge about the nature and efficacy 
of the serum-treatment. The story, as given by the " Times 
of India." was brought to Bombay by a Russian nobleman. 
But it naturally raises the question : Why was this treatment 
not equally effective in India ? The answer will probably 
be found in the record itself, which says : Inoculation took 
place ''after" 378 deaths had occurred. Not any epidemic 
has ever completely annihilated a whole community ; there 
are always human beings, who escaped the attack, and most 
outbreaks have ceased without any prophylactic or curative 



57 

means being employed — entirely of their own accord. And 
the survivors, who escaped after the epidemic had raged 
out, were probably protected through a natural immunity ; 
for, they had ample time to be infected and to develop the 
disease during the illness of the 381 sufferers, before Dr. 
Lieven appeared on the scene. 

Why agitate the public mind with such a sensational 
story, which on the face of it bears the stamp of improbability 
and of being dictated by a kind of " jingoistic " bias. It can 
only lead to disappointment and to a mistrust in all scientific 
efforts, even when these have the best foundation for success. 
Editors of the public papers should fulfil their trust towards 
their readers with better knowledge and greater conscien- 
tiousness. That such stories are offered for our acceptance 
is an indication of the low estimate, in which the public 
intellect is held. 

Nothing is so detrimental to a healthy corporate life in 
our social fabric as that easy-going indifference, which can 
only be moved, when fate and our personal misfortunes shake 
us out of our selfishness or out of our ignorance. How many 
national calamities could have been prevented, had but the 
educated public taken more interest in special questions 
relating to our general welfare ; and shown less satisfaction 
— by a passive acquiescence — with the dicta of those, who by 
appointment or by general consent have been delegated to 
decide such matters. This does not apply only to our 
political, social and municipal organisations, but also to the 
employment of scientific principles, when these bear upon 
our mental and social wellbeing. The general indifference, 
shown in such cases, is the more reprehensible, when the 
educated public is declared to be incapable of understanding 
and of judging these questions, and is thus — one might say — 
persuaded into respectful submission and silence. 



58 

In conclusion : The object is, to prevent illness and save 
human lives by the employment ot a simple physiological 
agent, which either on scientific— or on financial grounds, 
offers no reason for objections — on the contrary is most 
favourably supported. 

And should the efficacy of this prophylactic means be 
ultimately established — for which there is every reason to 
hope — what a remorse, what a feeling of guilt, bordering on 
that of manslaughter, must take possession of those, who in 
their conceit and pseudo-wisdom have vetoed its employ- 
ment ! 

But there is no legal court, before which they can be 
arraigned, except popular opinion and their own conscience. 



Received in time, to be offered as evidence in favour of 
the contention of this treatise is a letter from : 

Professor Dr. Max von Pettenkofer, 

Past President of the Hygienic Institute 
of the University of Munich. 

" Munich, 24th February, 1899. 



'* Your ' Plague in India ' I have read with interest, 
and I support your suggestion, that the experiment 
with Salt should be made there. Your work on 
* Common-Salt ' I obtained from London, and I am 
lending it to my friends to read. It contains many 
original ideas." 

A copy of this letter has been forwarded to the Secretary 
of State for India, as Prof, von Pettenkofer's name stands 



59 

foremost in the medical world. It is difficult to conceive, 
upon what grounds the Government can possibly disregard 
the opinions of such high authorities as Prof, von Pettenkofer 
and Prof. Buchner — in the face of the bewildering evidence 
offered to the Royal Commission, and the absence of all valid 
reasons for refusing the suggested experiment. 



LATEST NEWS FROM INDIA. 

The " Times' " correspondent under date February 21st, 
reports the evidence before the Royal Commission as 
follows : 

" The monotony of the evidence was varied by the 
production of a native inspector in the Bombay 
Customs Lepartment, who had been twice attacked by 
the plague and had recovered, and also of one 
Narayan Muljee, a patient of Dr. Godinho, who had 
been attacked three times and had recovered." 

Nature's " inoculation " — as which the first attack must 
be considered — failed to protect against a second, and two 
even against a third attack ; what a mockery on all artificial 
attempts of protecting the system by serum-injection ! /F 
serum-injection is effective as a prophylactic, surely : the 
above examples prove, that the protection cannot be due 10 
the organic constituents of the serum, but must be ascribed to 
the action of the mineral ingredients — Common-Salt — which 
every serum, whatever its origin and composition, must 
contain, and without which it would be injurious to the 
organism. These two sufferers showed exceptional suscepti- 
bility for the disease ; but they recovered in virtue of a strong 
vitality of their blood and of their nervous system. 



6o 

And on the 23rd, ("Times " — 25th.) he states : 

" According to this report (of the Poona and Kirki 
cantonments), inoculation is but a makeshift. It is 
useful perhaps^ in time of trouble ; but it cannot take 
its place among the great sanitary laws, which secure 
health to, and govern the health-legislation of the 
civilized world." 

This may be taken as a just estimate of " Serum- 
therapeutics." 



The whole subject of the Plague, its prevention and cure 
illustrates, what a medical writer said a hundred years ago : 

" There is a tendency of observing too much and of 
thinking too little." 



" Troutbeck," 
Elm Road, Beckenham, 
Kent. 



6i 
JUST PUBLISHED. PRICE FIVE SHILLINGS. 



COMMON SALT. 



ITS USE AND NECESSITY 

FOR THE MAINTENANCE OF HEALTH AND 

THE PREVENTION OF DISEASE. 

BY 

C. GODFREY GUMPEL. 

FELLOW OF THE PHYSICAL SOCIETY ; ASSOCIATE OF THE INSTITUTION OF CIVIL 

ENGINEERS ; ASSOCIATE OF THE INSTITUTION OF ELECTRICAL ENGINEERS ; 

MEMBER OF THE BRITISH ASTRONOMICAL ASSOCIATION ; ETC. 



Criminal is the ignorance which causes Disease and Death. 



London: Swan Sonnenschein & Co., Ltd., Paternoster Square. 

1898. 



CONTENTS. 

To the reader, by way of preface — What is the use of it? — Inducement to 
study the subject — What is common salt? — The physical properties of salt 
— Salt in history — Salt in civilization — Distribution of salt — Salt in the 
human body — The blood — Salt in the blood — Quantity of salt in the blood 
— Want of salt in the blood — Potash salt in the blood — Potash salt and the 
heart — Oxygen in the blood — Deficiency of oxygen in the blood — Sudden 
death — Heart disease — Salt and the liver — Salt and digestion — Salt and 
the kidneys — Salt versus Water — Thirst — Scurvy — Cancer — Salt and the 



62 

nervous system — Other objections against the use of salt — How much salt? 
— How to take the salt ? — Sea-water and mineral waters — Sea- and salt- 
water bathing — Disease — Salt and disease — Merely a cold — Rheumatism 
and gout — Dropsy — Ansemia and chlorosis — Individual immunity — Cholera 
— Typhoid and other fevers — The Plague — Serum treatment — Diphtheria- 
Influenza — Small-pox — Salt and life in the tropics — The salt tax in India — 
Salt and infants — Salt and vegetarians — Practical experience — Salt no 
panacea — What should be done ? — Salt and the doctors — Concluding 
remarks. 

Appendix : Illness of H.R.H. the Prince of Wales — List of some cases 
of sudden death — Glossary of terms — Index. 



OPINIONS OF THE PRESS. 



Many medical men will be inclined to look with suspicion on a book 
dealing with the functions of salt in the human economy, written by one 
who is not himself a member of the profession ; but the greater number 
will read from cover to cover with interest, attd agree in the m.ain with 
the author's conclusions. Apart from the medical profession, a careful 
study of the book by laymen will well repay the time spent in doing so, 
on account of the nature and variety of the information it contains. — 
{Glasgow Herald.) 

Mr. Giimpel has produced a most fascinating volum-e. It is as 
interesting as a novel, and it is so brightly written, that we should prefer 
it to many a novel it has been our sad lot to peruse . . . What that treat- 
ment is we must leave our readers to find out for themselves from this 
most entertaining and instructive volume. — {London Review). 



The book has much to say for itself, and that is of an interesting and 
suggestive kind. It deserves to be read and weighed-up by the medical 
profession ; and a lay-reader could scarcely study it without deriving from 
it much good instruction in the principles of health. — {Scotsman.) 



It is a full inquiry into a whole set of questions, and it furnishes 
answers with respect to all. They deserve reading. — {Echo.) 



63 

We cannot too strongly recommend a perusal of this common-sense 
work as a valuable guide to the maintenance of health. — [Chester 
Courant.) 

The book deserves something more, than the curt dismissal which the 
professional man is too apt to give to works of the kind, which emanate 
from anybody but a medical man. — {Publishers' Circular.) 



The physiological reasons, upon which Mr. Giimpel's theories are 
based are clearly stated. — {Nottingham Guardian.) 



These and many kindred facts, Mr. Giimpel sets out with knowledge, 
clearness and vivacity. — [Saturday Review.) 

The book is one of great general interest to the educated reader and 
is not without -pregnant suggestion to the statesmen of India. — [Times 
0/ India.) 

It certainly puts the case for Salt very forcibly and very fully ... It 
covers a much wider field than the use or non-use of Common -Salt . . . 
Those, who wish to know, why we take Salt with our food or why we 
should get it into our bodies, should read his very interesting book. — 
[English Mechanic.) 

He has given the thoughtful reader a really fascinating treatise, 
full of startling asseverations, and striking at the very root of many of the 
supposed fundamentals of medical and other sciences. There is something 
in the book for the mother, for, in the chapter " Salt and Infants," the 
author becomes delightfully satirical as he deals with the notions and ways 
of the modern nursery. Its " Sugar " for everything, but of " Salt " there 
is never a word. The book is worth reading, and if it succeeds in a 
small degree in its aim and object, it will not have been written in 
vain. — [Food and Health. Supplement to the Sanitary Record.) 



Of so-called "high-class" criticism the following will serve as 
examples. 

The "Saturday Review'^ states, among other questionable asser- 
tions, that : " The author implores every one in health or out of health, to 
put a pinch of salt into every cup of tea, and to put a pinch of salt into 
every cup of coffee." And the "Christian World'' follows suit in an 
un-Christian like spirit, when declaring : "If you have a cup of tea in bed, 
Mr. Giimpel entreats you to pop a little salt into it, and you will live 
long." 



64 

Now, what does the book actually say ? 

The reader will find on page 323 the advice given : to avoid the early 
cup of tea on an etnfty stomach, as destructive to the powers of digestion ; 
and should the stidden denial of this bad habit ;prove too great a task, 
then to gradually reduce the strength of the tea and increase the pinch 
of salt — in order to arrive by easy stages at the desired morning dose of 
salt-solution ; and on page 147 the assertion : that salt-eaters cannot enjoy 
anything, unless it has a decided salty taste — is answered by calling 
attention to the old habit (older than the author or the "critic") of 
bringing out the flavour of the coffee by putting some salt — oithe size of a 
hempseed into the cup, which it would be absurd to declare was done in 
order to produce a taste of salt. 

The above barefaced mis-representations can have evidently no other 
object, than to hide the critic's inability of finding the author at fault, by 
exposing him to ridicule. Such tricks must bring the blush of shame 
into the face of the " honest " critic ; and a reviewer, who has the effrontery 
to offer to his readers such a distorted account, can certainly not claim 
public confidence. 

Of a similar character are other statements, which are put forward as 
scientific refutations of the contentions of the book — sweeping assertions, 
unsupported by either proofs or by citations from the book ; — demands for 
a great body of empirical, evidence for his "drug" as a "specific" (a 
" drug " and a " specific " — why, the man has never read the book); — " a 
bemuddled criticism of serum-therapeutics ' ' (a mere empty assertion, which 
must be accepted in evidence, either of the critic's confused understanding, 
or of his professional chagrin at the public exposition of the plain truth) ; 
— they all evince an animus, an obliquity of acumen, which is not very 
complimentary to the respective writers of the " Saturday Review," the 
"Westminster Review" and the "Sanitary Record." The scathing 
answer, which they deserve, cannot find a place here and must be left for 
a future occasion. 

On the whole, the critics have never given a specific case of doubtful 
physiological facts, or of incorrect inferences from them ; they have failed 
to show, that false conclusions have been deduced from wrong principles ; 
they have ignored such diseases as Diphtheria and Cholera, in which 
practical proof has been given of the action of Common-Salt as a curative 
agent, which is even more than the treatise desires to prove. And such 
evasion places either the understanding or the honesty of the reviewer in a 
questionable light. 



65 

Such "critics" deserve the answer, which Mephistopheles gave to 
Faust : 

Du bist am Ende — was du bist. 

Setz' dir Perriicken auf von Millionen Locken, 

Setz' deinen Fusz auf ellenhohe Socken, 

Du bleibst doch immer was du bist . . viz. . ? 



AN INDICTMENT FOR A SIN OF OMISSION. 



The editor of a public paper or journal is charged with a trust. This 
trust may be self-imposed ; but it nevertheless constitutes a charge, viz. : 
of rendering a true and undistorted account of whatever tends to promote 
human health and public welfare. 

Nor is he justified to withhold such information for the same reason, 
which may induce him to do so in matters and questions, appertaining to 
works of pure literature or art, without laying himself open to public 
censure. 

The information, contained in the treatise on " Common-Salt," 
will tend to the prevention of sudden deaths from internal causes, 
usually assigned to Heart-failure, Syncope or Apoplexy ; and in face of 
the scientific reasons in support of that contention, it would be bold and 
risky, to deny " a priori " the correctness of such reasons— unless from 
bias, prejudice or wilfulness. And as the dissemination of such knowledge 
may save human lives ; in the same degree will the withholding of the 
information deserve a serious reproach for neglect — if not worse. 

How far have the London daily and some of the weekly papers and 
journals acted-up to the demand for making the public acquainted with 
the cause and the means of preventing such untimely loss of life, witnessed 
in such striking cases, as the sudden deaths of the late Dr. Berry, Lord 
Justice Chitty and President Faure ? A copy of the work was sent for 
review to most of the journals ; but after nearly five months no notice has 
been taken of the book — although room could be spared for every other — 
sometimes trivial subject. When these papers indict the "peculiar 
people " for manslaughter on account of neglecting to call-in medical aid 
without any certainty, that such aid would have saved the life of the 
sufferer — with the same right, and on the same grounds can such an 



66 

indictment be laid against these same papers — for neglecting to dis- 
seminate the knowledge, which may serve in the prevention of these 
sudden deaths ; and the simple unfounded assertion, that Common-Salt 
can have no such power — cannot be accepted against the scientific reasons 
advanced in its favour. 

The above remarks apply in a still higher degree to the prevention of 
Diphtheria, considering the practical proofs of the successful application 
of Sodium -chloride in the cure of that disorder. 

The public "Press" prevents a free expression of opinions on such 
questions for apparently no other reason, than prejudice in favour of the 
infallible (?) tenets of Medical Science. 

The same spirit, which in a petty way denies publicity to new ideas 
as not in harmony with the generally-accepted doctrines — burnt John Huss 
and Giordano Bruno ; opposed Harvey's discovery of the blood-circulation ; 
ordered witches to the stake, etc., etc. 

Truly, we are living in a free and enlightened age ! 




7>0