Mr. John Spear's report to the Local Government Board upon the so-called "woolsorters' disease" as observed at Bradford and in neighbouring districts in the West Riding of Yorkshire.

  • Spear, John.
Date:
1881
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Licence: Public Domain Mark

Credit: Mr. John Spear's report to the Local Government Board upon the so-called "woolsorters' disease" as observed at Bradford and in neighbouring districts in the West Riding of Yorkshire. Source: Wellcome Collection.

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    anatomy of anthrax without supposing some acute nutritive disturbance of the walls of blood vessels and of surrounding tissues, with coexistent favouring conditions of blood and of blood circulation—conditions that there are other pathological and clinical reasons for believing to be present in this disease. The bronchial glands are very usually swollen, soft, and, infiltrated with blood, of a purple or blackish colour. The bronchial mucous membrane may or may not be reddened, small haemorrhagic extravasations are frequently to be seen beneath its substance, and in the bronchi blood-stained mucus is sometimes found. The mucous membrane of the pharynx and trachea is commonly hyperasmic. In the abdominal organs, also, signs of congestion, with various haemorrhages, are usually met with. The spleen is usually, although not constantly, enlarged, its substance soft and even diffluent; the liver is less frequently hyperaemic, may indeed appear anaemic; the kidneys are usually much congested, and show signs of cloudy swelling. The mucous membrane of the intestinal tract occasionally exhibits signs of acute catarrh, and the mesenteric glands will probably then be congested and swollen; but this condition is far from constant, nor have I been able to find anthrax car¬ buncles, such as are spoken of by some authors, in any part of the digestive tract. The bladder in two of the five autopsies conducted by myself was quite empty, in two the urine contained albumen. The brain may exhibit no conspicuous lesion, or there may be extensive haemorrhages into its substance or in the membranes. Perhaps the most constant and striking lesions are the serous, or sero-hsemorrhagic jelly-like infiltrations in various connective tissues. They abound sometimes in all the loose connective tissues of the body; especially in those of the neck, in the mediastinum, in the sub-pleural cellular tissue, and in the loose connective tissue around the kidneys. They give the organs and vessels in the neck the appearance of being embedded in and surrounded by a jelly-like plasma, and the lungs of having jelly-like masses appended to them; they may be of a yellow or straw colour, or of various blood tints ; or the blood sometimes appears to have been extravasated over an already gelatinised effusion. Lastly, the specific contagium of the disease, the bacillus anthracis, will usually, in my small experience always, be found, although in widely varying quantity and unequally distributed, in the blood and extra-vascular fluids. It will be seen that many points have arisen in the foregoing pages that call for discussion. The pronounced symptomatology of anthrax would, one would think, in the light of its known parasitic nature, and its observed anatomy, render possible an interpretation of the pathological conditions which constitute the disease. A theory of disease, if only approximately true, is still of practical utility to the practitioner, and, when true, is of high scientific value. The question as to the channels by which the poison reaches the system is obviously one of moment. The apparent latency at times of the disease germs ; the ill-health of indefinite features and duration from which those who are exposed to infection often suffer, and which sometimes ushers in the fully developed disease; the .sudden onset of the latter under such circumstances, and its then specific course, are all observations that, if we could rightly interpret their significance, might prove of vast importance, not only in their bearing upon the disease immediately in question, but on infective processes in general. But in their considera¬ tion one must necessarily tread upon speculative ground ; the views that can at present be advanced can only be tentative, and consequently one is in a sense debarred from the discussion in an official report. I propose, however, to consider certain of these questions in an appended note. Meanwhile, I will say this much only, and I would beg that opinion upon the hypothesis be reserved until I have had an opportunity of developing the evidence and arguments which support it, namely, that there are certain curious circumstances and coincidences associated with attacks of this anthrax disease in man that would seem to suggest that the food supply of the sufferers may be in some sense related to certain of the phenomena I have remarked upon—would seem to suggest that such influence may determine in some degree the onset of the stage of full development of the disease, the sudden appearance, and in some cases the recurrence, of the violent symptoms. It is conceivable that alimentary substances may bring about in the body such chemical or morphological change as will render its fluids a richer field for the proliferation of disease germs. Q 2890. B