do often perish of their first attack; as, for instance, of tubercular meningitis, or of acute phthisis (galloping consumption); but the very general prevalence of more resistant individuals, who as regards their powers of defence against the bacilli correspond to a far later stage in the phylogeny, justifies Laennec's dictum.
"In a very large number of cases also, Laennec's first proposition is true, and we may extend it by saying, that not only do they not die of the first attack, but not a few recover from it and have no more seizures. Unfortunately this occurrence is not so common among the patients of our consumptive hospitals as it is among the rich or amongst those who can take the necessary precautions against further attacks."[1]
It is clear, then, that the men of our race are very generally so resistant to tuberculosis, that even after infection their phagocytes, under slightly improved conditions, are able to wage successful war against the microbes. It is clear also that no immunity can be acquired against the disease, since those who are recovered, under fit conditions, take it again and again. Their only safety lies in the absence of the pathogenic micro-organisms. On this account I have always thought it unwise, in the interests of the patients, to gather them into special hospitals. However excellent the arrangements may be in such establishments, they can hardly be made so perfect as to exclude the possibility of those who have recovered, in so far that their phagocytes have destroyed the microorganisms within them, receiving fresh infection from inmates who are yet diseased. Doubtless such establishments discharge many persons cured of their complaint, but these fortunate cases, I apprehend, are usually those
- ↑ Dr. Arthur Ransom, British Medical Journal, July 23, 1892.