Licence: Public Domain Mark
Credit: On lupus / by J.L. Milton. Source: Wellcome Collection.
Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.
5/20 (page 5)
![6 with stringy muscles, badly shaped, and bearing upon them the impress of coming disease, may at once be admitted; but, on the other hand, some of them are healthy looking, and reporting them- selves healthy, ruddy, and well-made people, and I have myself become as sceptical as to this affection being connected with any particular kind of bodily frame as to its being dependent on any diathesis or temperament. Such arguing as that which ascribes lupus to the ravages of a micro-organism would not be allowed a hearing in any branch of science, and I am at a loss to understand why it should pass cur- rent in this case. The bacillus cannot always be detected in the tissues, and therefore to maintain that the disease is always due to it would be to maintain that there may sometimes be an effect without a cause; and if lupus can in some cases spring up inde- pendently of the organism, then in strict reasoning it may do so in every instance. Unfortunately there is with respect to many points but little strict reasoning in medicine, and here even a smaller amount than usual. The dependence of the disease on the bacillus and the 0])erations of the latter are spoken of as confidently as if every position concerning them had been proven, though there is neither proof nor probability in their favour. The long venerated doctrine of blood poisons, the offspring of Sydenham's cherished creed, which was to flourish after his death, me, mid functo, once so authoritatively taught, which required men to believe that two- and-twenty such poisons existed, though not one of them could be either seen or felt; that the entrance of every one of these into the blood, its multiplication there by zymosis, and its final elimination, were as effectually demonstrated as the discoveries of Harvey and Jenner; the doctrine so promptly abandoned, without even one word of regret, at the bidding of Pasteur and Koch, is really re- vived here, and indeed applied to other diseases, under a new name and in a new shape, and with all its inherent defects. There never yet was a doctrine of blood-poison that would bear looking into, and the bacillus theory of lupus stands investigation almost as badly. It breaks down at the first stage, because it is certain that in remote country places patients contract lupus who have never seen a person with this disease. The second stage must share the same fate, for it is equally certain that in many instances the bacillus cannot be found in the most developed phases of the complaint, which again constantly gets well under treatment with- out anything special being done to starve, poison, or expel the invader, thus effectually disposing of the third stage. Face to face with clinical experience, the theory fades into a figment without begitming, middle, or end, and for anything it explains the bacillus might have for ever remained undetected by the microscope. A patient with lupus frequently enough lives long years in a family without communicating the disease to a single person. The bacillus, which traverses miles of open country to reach some lonely](https://iiif.wellcomecollection.org/image/b22320015_0005.jp2/full/800%2C/0/default.jpg)
