Report on the etiology and prevention of yellow fever / by George M. Sternberg.

  • Sternberg, George Miller, 1838-1915.
Date:
24 cm
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Licence: Public Domain Mark

Credit: Report on the etiology and prevention of yellow fever / by George M. Sternberg. 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.

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    The same material is often massed in tlio urinary tubules in tbo form of plugs, which are deeply staiued by the aniline dyes. Again, fragmentation of nuclei of cells still in position may give the impression of a cell containing cocci, and the karyokinotic iiguros found in the colls, especially in the liver, often resemble bacilli so closely that it is diihcult to convince any one not familiar with them that they are not microorganisms. The plasma cells of Ehrlich, also, seem to have as their chief function the role of deluding amateur microscopists into the idea that they have made a discovery. They are often very abundant in the liver and in the kidney of yellow fever cases, and so closely resemble zooglcea masses of micrococci that experienced pathologists have been deceived by them. In addition to these objects which resemble microorganisms there are dangers from the post-mortem invasion of the tissues when the autopsy has been delayed be- yond an hour or two, in the warm climates where yellow fever prevails, or even in the preserving medium or during the process of staining. My experiments made in 1883 showed that exposure to 9.5 per cent, alcohol for 48 hours did not kill the bacteria in broken-down beef tea (old stock), and pathologists are familiar with the picture presented by the post-mortem invasion of tissues which have been left in alcohol which was not strong enough to preserve them. Finally, inasmuch as my culture experiments with material collected soon after death from the liver and kidney gave a positive result in a certain proportion of the cases, it is evident that the microorganism most frequently found by this method— my bacillus a—should occasionally be encountered in staiued preparations. The possibility rem.Tins that by some method of staining not hitherto employed, the specific infectious agent may yet be demonstrated iu the tissues; but the fact that my culture experiments with material from the liver and kidney of ten cases failed to demonstrate any such specific microbe is opposed to this view. We may, of course, suppose that the yellow fever germ not only requires special methods yet un- discovered for its demonstration in the tissues, but that it will not grow in the culture media which I have employed in my researches. I would say in rei)ly to this hypothesis that all known pathogenic microorganisms, may be demonstrated by the staining methods employed, and that inasmuch as the yellow fever germ appears to find a favorable nidus in filth beds external to the body, I have been inclined to be- lieve that; like the bacillus of typhoid fever and cholera, it is not especially nice as to the character of the medium in which it may develop. However, this may be a mis- taken idea, and I propose in my future researches to make use of various culture media not yet employed, and especially to make cultures from the tissues and the excreta in an atmosphere from which oxygen has been excluded; for it may be that like the bacillus of malignant oedema and the bacillus of tetanus the yellow fever microbe is auterobic. Inasmuch as some of the readers of this report may not have at hand the volume in which the report of my investigations in Brazil and in Mexico is contained, I introduce here a paper read before the College of Physicians of Philadelphia in April, 1888, and published in the Medical News of April 28, 1888, iu which a summary of the results of these investigations is given: Gentlemen : You are aware that I have been engaged during the past year in an nvestigation of the methods of inoculation practiced in Brazil and in Mexico, by whichlt is claimed that protection against yellow fever is afforded. The subject is one of such <rroat interest to the medical profession everywhere, and of such impor- tance with reference to the sanitary interests of that portion of tho United States subject to invasion by tho disease in ,,uestion, that Congress provided lor an luves- ti.ration of the methods of inoculation practiced in Braz/il and in Mexico, lu the act