Bacteria in Daily Life

That, however, some risk attends the placing of too implicit a reliance on this method of diagnosis alone is evident from the fact that a negative reaction, or in other words, absence of all agglutinising phenomena, is sometimes associated with blood throughout what is beyond all question a well-defined case of typhoid fever, whilst in the first week of this disease the test is frequently negative in character. Rouget, who has made a very careful inquiry into the value to be attached to the sero-diagnosis of typhoid fever, states that he has found in a large number of examinations of blood derived from undoubted typhoid patients the agglutination phenomena fail altogether; it is, therefore, not surprising that the sero-diagnosis of this disease is still the subject of much discussion and investigation.

An interesting example of how particular serums may be employed for the detection of particular poisons has been furnished by Dr. Calmette. In some districts of India the natives have an ugly custom of wreaking their vengeance on their enemies by poisoning their cattle, and to effect this both expeditiously and secretly they employ subtle poisons which they know can only be detected with great difficulty. Serpent venom is a favourite substance, whilst abrine, a highly toxic vegetable poison, is another. The method adopted for the application of this abrine is highly original, and consists in taking small bits of wood shaped like miniature clubs, so diminutive in size that they can be concealed in the hand. In the head of the club small holes are bored, and tiny pointed rodlets of a hard greyish substance are fitted into them. Armed with these crude instruments, the natives scratch the cattle in several places, and, although but little external sign of injury is to be seen, the rod-points penetrate the skin and are broken off, and the poison is left to work its lethal way through the animals' system. Mr. Hankin forwarded some of these broken-off rod-points to Dr. Calmette for the identification of their composition, and he diagnosed the material employed as abrine in the following original manner. He first introduced some of this rod material into animals, and found that their symptoms were suggestive of abrine poisoning. To confirm his suspicions, however, he took some more of this rod material, and, before inoculating it into animals, he mixed it with serum derived from animals which had been artificially rendered immune to abrine poison. Instead of the animals into which this mixture of serum and "rod material" had been introduced dying like the previous ones, they remained alive. Had the "rod material" consisted of some poison other than abrine, the abrine serum would not, according to Dr. Calmette, have negatived its action, and it has thus been indicated how protective serums may be successfully employed for the detection of poisons.

Foremost, however, among the beneficent reforms which have followed in the wake of bacteriology must be placed the antiseptic treatment of wounds, or Listerism, as it is now universally designated in recognition of its renowned champion, the former President of the Royal Society. "Lister comprend," in the words of Dr. Roux, "que les complications des plaies sont dues aux germes microbiens venus du dehors et il imagine les pansements antiseptiques. Avec l'antiseptie commencent les temps nouveaux de la chirurgie." It only remains to add that, with the modesty characteristic of a great man, its brilliant author delights in repeating how any good which he may have been permitted to do he owes entirely to the inspiration which he received from the labours of Louis Pasteur.

But if the Victorian era has been productive of so many important applications of bacteriology to commerce and medicine, this period has been also fraught with results of the highest moment in the progress of hygiene.

The terms of intimacy, so to speak, which we have been now able to establish with bacteria has enabled us to discover details of their life and habits which before were shrouded in mystery. Their distribution in air has led to renewed endeavours on the part of sanitary authorities to procure efficient ventilation in our hospitals and public institutions; dust has acquired a fresh horror since it has been shown how disease germs may be disseminated by its means; whilst the important part which flies and lice may play in the spread of epidemics has opened up a new field for research, and made us conscious of a fresh source of danger in our daily life.

The general public, however, is hardly yet fully alive to the capacity for mischief possessed and exercised by the common house-fly. True, it is universally execrated and regarded as a tiresome attendant upon the summer months, but it is not usually considered in any more serious light. That however, the comparative indulgence with which this homely insect pest has been treated is decidedly misplaced and fraught with danger to health, the researches of numerous scientists have now conclusively proved.

As long ago as the year 1888 Professor Celli showed that the germs of consumption, anthrax, and typhoid fever could pass through the digestive organs of flies and reappear in the excreta of the latter not only alive but in full possession of their disease-producing powers. Dr. Sawtschenko made similar experiments with cholera germs. Healthy flies were placed under glass shades and fed with broth in which these micro-organisms were growing, and the latter were not only subsequently recovered from the digestive organs of the flies but also from their excreta in a living and virulent condition.

This is, however, not the only means whereby these insects can distribute deadly and other microbes, for it has been shown that in crawling over substances containing bacteria these may become attached to the feet of flies, and are in this manner transferred to other materials upon which they may alight, just as Pasteur showed many years earlier silkworms can communicate the fatal plague of pébrine by crawling over each other's bodies, carrying in their disease-laden feet the infection from one worm to another. During the recent outbreak of bubonic plague in the East the part played by flies in disseminating the virus has been repeatedly emphasised. Yersin was the first who called attention to the presence in large numbers of virulent plague bacilli within the bodies of flies which he collected in the vicinity of plague-stricken persons, and it was found that flies which had fed on plague-infected material and were then isolated lived for several days afterwards, during which time virulent plague bacilli were present in their bodies in immense numbers; thus were these insects converted into winged messengers of evil of the most repulsive type.

I am not aware whether any experiments on the vitality and transmissibility of diphtheria and consumption germs by means of flies have been made; but in view of the overwhelming evidence of the culpability of these insects in spreading plague, it is not unreasonable to presume a responsibility on their behalf in regard to other diseases; indeed, in the report issued by the Army Medical Commissioners of the Spanish-American War, it is emphatically stated that flies played an important part in the dissemination of typhoid fever.

There is no question as to the capability of certain micro-organisms to reside for considerable periods of time within the bodies of flies, and during this sojourn to abate no jot of their virulence. Indeed, it has been shown that the bodies of these insects may constitute incubators of a most successful type, for some varieties of bacteria grow luxuriantly and multiply abundantly within them.

In the hot days of summer, when flies abound, it would be well to banish these insects, as far as lies in our power, not only from our sick-rooms in particular, but from our general surroundings. The catholic taste of flies for garbage of all kinds is too well known to require entering into, but the consequences which may follow from their visits to dustbins and centres of disease, and then alighting upon our food or persons, has received too little attention in the past.

In regard to the subject of insects as disease disseminators, it may be mentioned that Mr. Hankin, when studying plague conditions in India, expressed his belief that ants in Bombay also assisted in spreading the scourge, for he found that when he inoculated mice with the excreta of ants, such insects having previously fed on plague-stricken rats, the mice succumbed to plague in a few hours. Fleas have also been conclusively proved to be carriers of plague germs.

There is no doubt that the revelations of hygienic science have aroused the vigilance and zeal of public authorities in various new directions to try and cope with the spread of zymotic disease.

In no direction, perhaps, is the fruit of this energy so apparent as in the increasing supervision which it has incited over two of the greatest menaces to public health which hang over society —i. e. our water and dairy supplies. Now that it has been proven beyond doubt that the germs of consumption, typhoid fever, and cholera can be and are distributed through the consumption of contaminated milk or water, not to mention other diseases such as diphtheria and scarlet fever, an ever-increasing demand is being made that these all-important articles of diet shall be protected from pollution, and that public authorities shall be made responsible for their distribution in a pure and wholesome condition.

It is, however, undoubtedly in the matter of water that the greatest service has been rendered by bacteriology to sanitary science, and for the important advance in this department we are indebted to the beautifully simple and ingenious methods devised by Robert Koch.

Not yet twenty years have passed since the new bacterial examination of water was introduced and systematically employed, and the use which has been made of the opportunities thus opened up of investigating water problems on an entirely new basis is shown by the voluminous dimensions which the literature on this one branch of bacteriology alone has reached. Considerably upwards of two hundred different water bacteria have been isolated, studied, and their distinctive characters chronicled. The behaviour of typhoid, cholera, and other disease-producing microbes in waters of various kinds has been made the subject of exhaustive experiments; the purification power of time-honoured processes in operation at waterworks and elsewhere has been for the first time accurately estimated. Water engineers have through these bacteriological researches been provided with a code of conduct drawn up by the light of erudite scientific inquiries, which has now rendered possible the removal of the process of water purification from the rule of empiricism guided by tradition, and to raise it to the level of an intelligent and scientific undertaking.

The above short sketch may serve to convey some idea of the rise and phenomenal development of bacteriology during the past sixty years. To record, even in outline, the individual triumphs of the various branches of this science would require volumes, whilst the astounding mass of work already accumulated by its devotees is but the earnest, the guarantee of yet greater achievements in the future.

The progress which has been made in this brief period of time must not necessarily be expected to continue at this rapid rate; it may be that generations to come have yet the hardest and the longest tasks to accomplish; for in science, as in other walks of life, it is, as a rule, the easiest problems, which are first disposed of, and the farther we advance the more complicated, the more intricate become the questions to be attacked, the difficulties to be overcome.

The late Queen's reign has bestowed a splendid legacy of bacteriological discoveries upon those who, in the future as in the present, must inevitably follow in the footsteps of those great and brilliant leaders of bacteriological science belonging to this auspicious era, Louis Pasteur and Robert Koch.

WHAT WE BREATHE

Few people realise that, with the advent of autumn, the great majority of the swarms of bacteria which have been circulating in the air during the hot summer months take their leave of us and disappear.

Practically, however, we are all conscious of this fact, for we know what greater difficulties attend the keeping of food sweet and wholesome in the summer than are met with in the winter; bacteria, not unlike some other armies of occupation, securing a footing rather by their numbers at this season of the year, than by virtue of the superior strategy or, in other words, special attributes of their units. Bacterial operations are, however, distinctly favoured by the accident of temperature, the warmth of the summer encouraging their vitality and multiplication.

When Pasteur first announced his conviction that the familiar phenomena of putrefaction and decay were due to minute living particles present in our surroundings, his sceptical critics sought to ridicule his conclusions by declaring that, were this the case, the air must of necessity be so heavily laden with living forms that we should be surrounded by a thick fog – "dense comme du fer." We do not now, forty years later, require to recite the exquisitely simple experiments which, whilst sufficiently establishing his theories, served to effectually suppress those of his opponents.

Since Pasteur's pioneering work was carried out, a vast number of investigations have been made in all parts of the world by scientists of almost every nationality on the subject of the distribution of bacteria in air, and not only on their distribution, but on their functions or the place they occupy in the economy of nature. With our increased knowledge concerning their distribution has come our ability to differentiate between individuals, and to adequately assess the value and importance of their work from various points of view.

In the bacterial treatment of sewage we have not only one of the latest, but perhaps also one of the most successful examples of that system of division of labour, or specialisation of energy, which forms such a characteristic feature of work of all kinds at the present time. Other familiar instances of the applications of individual and special bacterial labourers to the solution of industrial problems are to be found in the conduct of commercial undertakings of such national magnitude and importance as brewing and agriculture. But it is not with these beneficent or great industrial classes of bacteria that we are now more immediately concerned, but rather with the malevolent varieties, or the so-called "submerged tenth," for which no labour colony has at present been created to direct their energies into useful and profitable channels.

We know that as regards mere numbers the bacteria in air may vary from 0 to millions in a couple of gallons, these extremes being dependent upon the surrounding conditions or relative purity of the atmosphere.

Out at sea, beyond the reach of land breezes, it is no uncommon thing to find none whatever; on mountains and even hills of humble elevation the paucity of bacteria is very marked if there are no abnormal or untoward circumstances contributing to their distribution. In illustration of this the recent investigations of the air on the summit of Mont Blanc by M. Jean Binot are of especial interest, inasmuch as the altitude at which they were carried out is the highest at which the search after bacteria has so far been pursued. This intrepid investigator spent no less than five days in the observatory, which is situated on the top of the mountain. As was to be anticipated, frequently no bacteria at all were found, and it was only when such comparatively large volumes of air as one thousand litres (about 200 gallons) were explored that microbes in numbers varying from four to eleven were discovered. The air of the country is far freer from microbial life than that of cities; whilst open spaces, such as those afforded by the London parks, are paradises of purity compared with the streets with their attendant bacterial slums.

That it is no exaggeration to describe streets from the bacterial point of view as slums is to be gathered from the fact that much less than a thimbleful of that dust which is associated with the blustering days of March and the scorching pavements of summer may contain from nine hundred to one hundred and sixty millions of bacteria. But investigators have not been content to merely quantitatively examine street dust; in addition to estimating the numerical strength of these bacterial dust-battalions, the individual characteristics of their units have been exhaustively studied, and the capacity for work, beneficent or otherwise, possessed by them has been carefully recorded. The qualitative discrimination of the bacteria present in dust has resulted in the discovery of, amongst other disease germs, the consumption bacillus, the lock-jaw or tetanus bacillus, bacteria associated with diphtheria, typhoid fever, pulmonary affections, and various septic processes. Such is the appetising menu which dust furnishes for our delectation.

There can be no doubt, therefore, that dust forms a very important distributing agent for micro-organisms, dust particles, aided by the wind, being to bacteria what the modern motor-car, with its benzine or electric current, is to the ambitious itinerant of the present day. Attached to dust, bacteria get transmitted with the greatest facility from place to place, and hence the significance of their presence in dust.

Mention has been made of the fact that the germs of typhoid fever have been discovered in dust, and the belief in the possibility of this disease being spread by dust is gaining ground.

An interesting case in point is afforded by an outbreak of typhoid fever which occurred in Athens a few years ago, and in which the starting-point or nucleus was discovered to be a group of labourers who were engaged upon excavating the soil in a street through which a sewer had once been taken. The epidemic subsequently spread to those districts of the city swept by the prevailing wind, which passed over the place where the soil had been turned up and exposed. M. Bambas, who brought his observations before the International Congress of Hygiene at Buda-Pesth, was convinced from the inquiries he made that this outbreak of typhoid was due to the disturbance of the soil and the dissemination by means of the wind of typhoid-dust-particles to certain parts of the city.

That this hypothesis is by no means without experimental justification is shown by the properties possessed by the typhoid bacillus in regard to its vitality in soil which have been discovered. Thus numerous investigators have studied the important question of the behaviour of this micro-organism in soil, and have found that it can exist over periods extending from three to twelve or more months in the ground. This property of the typhoid bacillus may possibly explain the appearance over and over again of typhoid fever in particular localities, suggesting that the bacteria had become indigenous in the soil.

Dr. Mewius, of Heligoland, describes an epidemic of typhoid fever in the island, concerning which he made a most searching and elaborate inquiry. It appears that a case of typhoid occurred and was concealed from the medical authorities, so that no steps for disinfection could be taken in the first instance; and, following the primitive custom which prevails on the island, the dejecta was thrown over and upon the cliffs, this being the usual method of disposing of sewage. Ample opportunity was thus given for its desiccation and subsequent distribution as dust. That this typhoidal matter did subsequently become pulverised and spread the infection Dr. Mewius has no doubt, the germs having been conveyed to the open rain-water cisterns which constitute the water-supply of the majority of the inhabitants. His theory is again supported by the coincidence between the prevailing direction of the wind and the quarter where the outbreak occurred.

That diphtheria germs can remain for a long time in a living and, what is more, virulent condition in dust has been clearly demonstrated by Germano, amongst other investigators, this organism being specially endowed with the capacity for resisting the, to other microbes, lethal effect of getting dried up.

Bacteria, however, survive this desiccation process much better when they are herded together in large numbers than when they have to face such untoward conditions as isolated individuals. This has been well illustrated in the case of diphtheria bacilli, and the difference in their powers of endurance under these respective conditions is very striking. Thus when a few only were exposed to a very dry atmosphere on silken threads they disappeared after eight days; but when somewhat larger numbers were taken they contrived to exist for eighteen days, whilst when great multitudes of them were herded together even one hundred and forty days' starvation in these desert-like surroundings could not entirely stamp out their vitality.

This dangerous property possessed by the germs of diphtheria should, if possible, increase the vigilance with which the outbreaks of this disease are watched and dealt with. Abel cites an instance in which a wooden toy in the sickroom of a child suffering from diphtheria was found six months later to have virulent diphtheria bacilli upon it.

This reminds me of a case in which tetanus or lock-jaw ensued from the use of some old cobwebs in stopping the bleeding of a cut. The wound was a perfectly clean one, and nothing need have resulted from this obedience to a superstitious prejudice had not the cobwebs unfortunately arrested some tetanus germs, and these getting access to the wound set up the typical symptoms of lock-jaw. That this implication of the cobweb was no idle accusation was subsequently proved by portions of the same web, on being inoculated into animals, inducing in the latter well-defined symptoms of tetanus.

That cobwebs readily catch dust is familiar to everyone who has the mortification of seeing them adorn ceilings and corners; that they also arrest bacteria follows as a natural consequence of the presence of dust, and hence these delicate filaments may become veritable bacterial storehouses, more especially as it is usually in the dark and remote corners that they best succeed in eluding the vigilance of the domestic eye, and are thus also out of reach of the lethal action of sunbeams; and hence their unwelcome lodgers may manage to maintain a very comfortable existence over long periods of time.

That the bacillus of consumption should have been very frequently found in dust by different investigators is hardly surprising when it is realised that the sputum of phthisical persons may contain the tubercle germ in large numbers, and that until recently no efforts have been made in this country to suppress that highly objectionable and most reprehensible practice of indiscriminate expectoration. Considering that the certified deaths from phthisis in 1901, in England and Wales only, reached the enormous total of 42,408, and bearing in mind the hardy character of the bacillus tuberculosis when present in sputum, it having been found alive in the latter even when kept in a dry condition after ten months, it is not too much to demand that vigorous measures should be taken by the legislature to cope with what is now regarded as one of the most fruitful means of spreading consumption. We know that in some of the states of America public opinion has permitted the enactment of laws penalising this practice. Local rules to the same effect exist in our Australian colonies. On the Continent the trend of public opinion is evident by the prohibition found in the railway carriages and the notices to that effect conspicuously posted in public places. In this country public opinion moves so slowly that we are not yet ripe for any such strong step, and so far one of the few attempts at official activity in this respect is to be found in a circular issued by the Local Government Board of Ireland to the various local authorities stating that "tuberculous sputum is the main agent for the conveyance of the virus of tuberculosis from man to man, and that indiscriminate spitting should therefore be suppressed." The public exhibition of notices calling attention to the danger accruing from expectoration in public resorts is, as already pointed out, one means of educating the people, and it has been stated that such a notice is posted in every beerhouse in Manchester. The question has also been raised of the inspection of beerhouses and the suggestion made that licences should be withdrawn in the case of those holders who did not wash the floors of their public rooms and keep them in a sanitary state. At the present time, in this country, it is perhaps more to the private conscience of the individual and the pressure of public opinion than to penal enactments that we must look for effective reform in this direction, for the objection of the English to official sanitary control is deeply rooted. It is to be hoped, however, that with the spread and popularisation of the knowledge acquired through the arduous labours of so many scientific authorities, it may come to be regarded as a matter for both public and private morality that every step should be taken which lies in the power of each member of society to minimise the opportunities for the spread of a disease which by its very familiarity we have until the last few years accepted as incurable and the ravages of which as inevitable.¹

Now that we are considering the status of street dust in bacterial circles, it will not perhaps be out of place to inquire into the character of another waste product of streets, i. e. the discarded ends of cigars and cigarettes. That what is carelessly tossed away on the one hand may be as carefully collected on the other is well known, as is also the fact that such material may subsequently be raised once more to the dignity of a marketable commodity. Under these circumstances, it is of hygienic interest and importance to ascertain whether disease germs, should they have obtained access to this tobacco refuse, are in a virulent or quiescent condition.

Some experiments to decide this question in connection with the tubercle bacillus have been recently carried out in Padua by Dr. Peserico, who, whilst extending our knowledge on the subject of bacteria and tobacco, has also confirmed the earlier results obtained by Kerez.

Portions of cigar-stumps smoked by phthisical persons in whose saliva the tubercle bacillus was known to be abundantly present were inoculated into guinea-pigs, with the result that fifty per cent. of the animals thus treated succumbed to tuberculosis. Thus neither the fumes nor juice of the tobacco had destroyed the consumption bacillus. In these experiments the cigar ends were used directly they were discarded, in another series of investigations they were collected and kept in a dry place for from fifteen to twenty days before being tested; but even storage for this length of time did not prevent the animals inoculated with them from contracting tuberculosis. In another series of experiments Dr. Peserico kept the infected cigar-ends in damp surroundings, and it was satisfactory to find that under these conditions the tubercle bacillus at the end of ten days was entirely deprived of its virulence. Encouraged by these results, inoculations were made with cigar-ends which had been left in the open and exposed to normal atmospheric conditions, which included falls of rain and snow, and in this case also no symptoms of tuberculosis followed their introduction into the guinea-pigs. These experiments show that the tubercle bacillus is prejudicially affected by contact with tobacco when the latter is kept in a moist condition, but that in a dry condition the properties in tobacco inimical to its vitality are not liberated and the bacillus can retain its virulent properties for a period of over twenty days.

In view of the importance of this discovery on the destruction of the toxic character of the tubercle bacillus by contact with moist tobacco, further experiments were made in which emulsions of tobacco were infected with tuberculous sputum. It was found that the bacilli steadily declined in virulence as the length of time they were kept in the emulsion was prolonged. Thus whereas after a few hours they were still armed with all their virulent properties, after three days, out of the four animals inoculated with the emulsion three succumbed to tuberculosis, after five days two out of four succumbed, whilst after eight days only one animal out of the four was infected, and after a period of ten days' immersion in the tobacco emulsion the tubercle bacillus failed to kill a single animal.

Cigar- and cigarette-ends were collected from the streets and cafés of Padua by Peserico, but in spite of consumption being stated to be very prevalent in this city, in no single case could the presence of the tubercle bacillus be discovered, although, as in the other investigations, the surest method for its detection, i. e. animal inoculations, was employed.

Brief reference may be made also to the experiments conducted to ascertain if cigars and cigarettes, as sold, contain the tubercle bacillus. The more interest attaches to this investigation because it is well known that the operators employed in tobacco factories are, as a rule, an unhealthy class, diseases of the respiratory organs, and especially tuberculosis, being very prevalent amongst them. A German official report on this subject states that the average duration of life of such factory hands only reaches thirty-eight years. Doubtless the lightness of the occupation encourages many to seek employment in these factories whose state of health would debar them from obtaining work under more trying circumstances. Some of the conditions under which cigars and cigarettes are made, such as the workers using their saliva to facilitate the rolling of them and fixing of the leaves, and the testing of the "drawing" properties of a cigar by placing it in the mouth, with the facilities offered for the dissemination of dried tuberculous sputum as dust, contribute to make it highly probable that tobacco as it leaves the factory may contain the germs of consumption.