Volume 2

First report of the Commissioners appointed to inquire whether any and what special means may be requisite for the improvement of the health of the metropolis, with minutes of evidence.

  • Great Britain. Metropolitan Sanitary Commission.
Date:
1848
Catalogue details

Licence: Public Domain Mark

Credit: First report of the Commissioners appointed to inquire whether any and what special means may be requisite for the improvement of the health of the metropolis, with minutes of evidence. Source: Wellcome Collection.

Provider: This material has been provided by London School of Hygiene & Tropical Medicine Library & Archives Service. The original may be consulted at London School of Hygiene & Tropical Medicine Library & Archives Service.

    109/160 (page 97)
    Are not the opinions which you have stated to prevail, mere hypotheses, No. 8. without any experience or proof?—My opinion is, that at present no J^D. Grai one is in a position to affirm what is the real and efficient cause of f!ii.s.' typhus fever. I have mentioned Professor Chomel as an example of the prevailing opinions. He says that there are two opinions, one, that the noxious agent acts upon the nervous system, and another, that it acts by poisoning the blood. Now it is quite possible, though I do not myself believe this to be the cause of the disease, that some electric state or subtle change of the atmosphere may be induced, and that this is the efficient cause of disease, and not the production of poisonous gases. I believe, that at the present day, science does not afford sufficient data for an answer to the question, as to what is the real and efficient cause under which typhus fever will arise. You mean that the aggregation of causes, supposing that aggre- gation always to occur, has always the same result, but that the present state of knowledge does not enable you to pick out of that aggregation the exact agent which produces disease?—Certainly. We know that a certain aggregation of circumstances will cause typhus fever, and that the prevention of that aggregation of circumstances will prevent its occurring; but we do not know which is the efficient agent among those numerous causes. I may also observe, that in the works of nature gene- rally, the most obvious phenomenon to human observation, that which most commonly strikes a person amongst a number or series of phenomena, is not generally the real arid efficient cause of what results —that is generally concealed, a circumstance increasing the difficulty in the present case. Is it not sufficient that we know the force of the aggregation of causes, without pretending to know the efficient cause. For example, we know that by the combination of sulphur, and carbon, and nitre, in certain proportions, and an application of heat, we get the explosive force of gunpowder. Why should practical applications be stayed, by specula- tive hypotheses,—without trial—as to what is the efficient cause of the explosive force of gunpowder, the nitre, the carbon, the sulphur or the heat ?—I would not stay any practical application. It is with aggregates we have to deal ; and, fortunately, we know practically, to some extent, how to deal with them. Because, in the present state of our knowledge, we cannot single out from the aggregate the immediate disease-producing agent, that is no reason why we should not do all we can to act upon the disease-producing aggregate. To illustrate my meaning, I should choose the example of the composition of the atmo- sphere rather than that of gunpowder. It has always been known, that atmospheric air sustains combustion and life ; but until the several principles which enter into the composition of the atmosphere were dis- covered, and obtained in a separate form, the particular principle which sustains combustion and life could not be known. Now we know, that among the aggregate principles contained in atmospheric air, the life- sustaining principle is oxygen. What the disease-producing principle, which is to typhus-fever and other maladies what oxygen is to healthy existence, we do not yet know; and I think it is wrong to speak as if we did know. But when true disinfectants are talked of as contradis- tinguished from deodorizers, the possession of this knowledge is assumed ; and this, I think, the present state of science does not warrant. Does not that amount to an express statement that this particular