The San Francisco Call. Newspaper, September 4, 1898, Page 21

THE SAN FRANCISCO CALL, SUNDAY, SEPTEMBER 4, 1898. 21 . REMARKABLE DISCOVERY OF DR. MANSON JUST GIVEN TO S THE MOSQUITOES » EGGS HATCHING . AND YOUNG g MOSQUITOES ESCAPING THE MOSQUITO ) i GETTING TWO BREATHY: THROUGH ITS FREE AT LAST. EGG.RAFT. i N i ‘ = HORN LIKE TUBES.- - USING HER CAST OF! SKIN AS A BODXT. TO SKIM OVER THE SWAMPS AND GET OFF TO BUSINESS. & STAGES OF DEVELOPMENT OF THE MOSQUITO FROM THE EGG TO THE FULL-FLEDGED PEST. CO00CO000C00000000000000000C00000000QL200000000000000000 “I believe that medical college or the practice of medicine unsexes & woman. woman. By that statement I mean There are thase, the exceptions, who physically and the average mentally differ so from the rest of their sex that they can suc- cessfully pursue the study and practice of medicine. But these exceptional women are likewise the exception in medical college. The majority of the women who enter medical college are in nowise different from their sisters who cannot handle the knife. them. The process they go through I believe unsexes I have reached this conclusion after many years of teaching both sexes—in fact, I am the oldest medica: instruct- or in America. But since women do elect to study medicine and since the privilege has been granted them I do all in my power to help them both in college and out regardicss of my convictions. I am the friend of womankind, even if she in- sists on going to medical college—but I believe that it un- sexes her.”—Dr. R. Peverly Cole, Professor at Toland Medical College, in a recent interview. e a woman should medicine? O you bel stud Friends, relative. and ac- uaintances put the question to t all inconceivable and in- 1t times and places. Perhaps yne with pure malice afore- it, but to “‘de over deadly lulls the conversadon. To mv certain wledge 1 ne been allowed the in knc to answer the question. Some one al- ways rushes in with a convincing af- firmative. Then ‘he wiiling or unwill- in~ listener is inundated with a torrent of anecdotes showing that since in- fancy 1 displayeu a remarkable tend- ency toward r:edicine. m. before I entered mec that the work claired nt to b. a doctor all your hours for its own. Buj I did not know -vhat the first week at medical college means. No matter how you have discussed dis- secting theoretically It 15 a severe sl )ck when you come face to face with the actuall No matter how long you have been cultivating and exercising will power, no matter how zealously you have been nursing the delusion that you have “no merves” you feel vour. courage oozing from you in the firet visit to the dissecting room. When once I began to dissect I for- got all else and soon began to look for- ward with pleasure to the work. 1 do believe a woman should .go to medical colleges, but with an amend- ment, providing she is fitted for the work. I do not believe a medical col- legé nor the practice of medicine un- rexes a woman. ‘I believe that medical coliege is the al college. I knew | place for the women who are fitted to become doctors. To say that it un- sexes them has a strong medieval fla- vor that echoes oddly with the rush of modern times. G. B.,, M. D. FRIENDLY LIFTS IN THE OPERATING-ROOM. Perhaps the hot, moist air of the operating room made him a little nerv- ous; certainly his hand trembled as he | touched the instruments in the pan of sterilized water. They were all right, everything he could possibly need was there, even to the latest shaped bis- toury; there seemed no reason why his first venture in major surgery should not be a great success. The patient on the table was taking the ether well, for the interne giving the anesthetic was a capable woman who knew her husiness. The other in- terne, who stood by him ready to hand the sponges, had been disinfecting her hands for the last thirty minutes, and she had moreover kept an eye on the nurses to see that they, too, should be germless. The visiting surgeons stood at a safe distance; to be sure, one of them, an old man, after a mere dab of his hands in a basin of bichloride, had ap- proached the table, but the glint in the young surgeon’s eye had made him re- treat, saying laughingly, with a good humored ignoring of his own successful | 300 cases of a similar sort, “All right, Gummison, all right, I won’t put any of my bugs in your ple.” . “She’s under,-” the anesthetizer sald at last, raising the patient's arm and letting it fall limply on the table, then lifting the flaccid eyelld and touching the apparently insensate eyeball. The surgeon took up his knife. ‘‘Stop rubbing the cornea,” he said irritably. The interne’s mouth twitched. She bent over her task with an air of elab- orate attention, but managed to Incline her head toward the sponger with a movement which sald, ‘“‘Scared stiff, isn’t he?” As the knife made its first wavering stroke the sponger did a rude thing which a woman doctor should have blushed at doing. She changed her position, standing so that it was im- possible for the guests to see the oper- atifon. The surgeon did not correct her, in fact he let her raise her arms so that the stiffly starched linen sleeves of her big apron made the cutting entirely his own affair. In a moment, however, she realized her rudeness and stood back with an apologetic lifting of her eyebrows, far enough back for the old doctors to see the firm, clean strokes. “Do it up in twenty minutes, Gummi- son,” the big surgeon said. ‘“With my first laparotomy I was ready to sew up in twenty minutes.” Things went well; the surgeon’s nat- ural courtesy returned to him, and toward the end of the twenty minutes he even thanks the sponger for tying a ligature neatly, and nodded cordially at the anesthetizer, as he sald: “You've kept her under well, let up a ! bit now, for there are only the stitches to put in.” A nurse handed him the threaded needles on a carbolized towel. The sponger, who had an instant free, leaned forward to wipe the perspira- tion from his forehead with another disinfected towel. As she did it she noted a green line quivering around the surgeon’s mouth. She dropped her hands to his hands—saw that one of them was shaking, that the fingers were not able to close on the needle- holder. “Dr. Gummison,” she said impulsive- 1y, in her girlish, appealing tones, “I know I shouldn’t ask it, but—won’t you let me sew up? I have dreamed for so long of putting in the stitches myself— indeed I'll do it right, doctor.” She took up the needle at once, the old doctor laughed. “Times have changed,” the big sur- geon said; ‘“we didn’t have such chances while AN he mosquito and you will banish malaria! That is, you will banish ma- laria as far as its infection of human beings is concerned, for the mosquito is 1ow declared by some authorities to be the villain who is re- sponsible for all our trouble. Physiclans all over the country are discussing this lmportant subject at present on account of the amount of fevers contracted by our troops. Some physicians go 0 far as to say that ma- laria cannot be contracted except throu~h the bite of the mosquito. No mosquitoes, no malaria. Whether this can be borne out by facts or not is still a question. The point has not yet been thoroughly in- vestigated, but indications seem to point to there being considerable truth in it. The attention of the medical world was called to this important subject by a paper read by Dr. Patrick Manson before the sixty-sixth annual meeting of the British Medical Soclety held in Edinburgh, Scotland, during the latter part of last July. The printed reports of this meeting have just reached this country. Dr. Mans.n has been working on the subject for years. In 1894 he had per- fected his theory in regard to the trans- mission of malarial poisons by mos- quitoes. He had a general idea of its workings, but other business prevented his continuance of the experiments, so he turned all his matter over to Dr. Ronald Ross of the British army in In- dia. Dr. Ross gave all his attention to it for three years, and a few weeks ago turned over his reports, which were read before the British Medical So- clety. Many eminent physiclans have de- clared that Ross’ discovery places geience on the threshold of one of the most important discoveries in the etiol- ogy of this or any other age. Malaria in one form or another is the most common of all the ailments of man. The diseases caused by the ml- crcbe range from the mild fevers of low countries to the deadly fevers of swamps. Every country of the world, except those in the far north, is sub- ject to some form of it. And malarial countries are all mosquito countries. Dr. Ross' work does not tear down all the old theories In regard to ma- laria nor suggest any better cure than quinine, but it does point to a way of preventing malaria. By experiments with birds he has completed the cycle of the transmisgsion of disease and shown conclusively that tnhalation of the “deadly marsh gases” is not the only way the disease {8 spread. In fact he doubts that it is spread at all in this way, but he is sure that it is spread by mosquito bites. A careful study of the paper read be- fore the British Medical Society makes several facts most apparent. The prin- cipal of these Is that man and the mos- quito are subject to malaria; the hae- matozoon, or malarial germs, will live in the blood of elther. They exist in the blood of the insect I‘?nd are communicated to man by the ite. The mosquito’s bill is provided with six fine blades, which make an incision in the skin; a delicate apparatus sucks the insect full of blood; she then in- Ject about an equal amoutnt of poison- ous matter into the blocd of her vie- tim. In this matter are contained the malarial germs when the Insect is In- fected with the disease. The matter injected by the mosquito Is poisonous. This is made apparent to even the laymen by the pain and swell- ing resulting from the bite. The min- ute abrasfon of the skin made by the bill would, alone, be barely noticeable, and that only at the time of the bite. Malarial disease develops twenty-one days after the bite. The old theory that malaria was con- tracted through water and marshy at- mosphere Is shown to be wrong, as has been proved by continuous tests by Itallan bacteriolosists, or by Dr. Koch, the famous German, who studied ma- laria and its cause minutely in South Africa. Malaria may be given to a healthy person by injecting the blood of a ma- larfal patient. This has been proven time and agaln; that the germs could be conveyed to the blood through, the stomach is generally disbelieved; the malarial germ is damp and heavy and cannot be wafted about in the air. The nose, throat and lungs they would have to be inhaled with the air we breathe. But the haematozoa do not in a dried state; they die as soon the blood containing them dries. To get into the air and be blown about they would have to exist as dust, but they are moist bodies, and even if they could live outside of the blood, would cling tight to the object to which they are attached. They are not provided with wings, and consequently cannot fly about. The air theory is not at all plausible. The skin affords an effective barrier to the entrance of the parasite, for heamatozoa can be rubbed on the skin without producing the slighte: = If, however, some blood of a larial fever patient, known to contain haema- tozoa, be injected beneath the skin of a healthy person that person will in- variably be given malarial fever of the type with which the malarial patient was affected, and the same kind of ¢ those experienced itology in_bird's v allowed a particular s quito (the gra; feed on birds with Prot blood, and soon di »d the mosqu his mosqui covered ce tain *o cular cc & By blood bteosoma par- sent_that those pigmented (7) From this Ross cor- t the plgmented body form of Proteo- had previously the analo- fdium—the flag- ase, after spherical, g them to be aveling pig- in virtue of k and mechanical power, DIAGRAM SHOWING HOW THE RED CORPUSCLES OF THE HUMAN BLOOD ARE AFFECTED BY THE BITE OF A MOSQUITO THAT INJECTS THE MALARIA FEVER POISON. THE DIFFERENT NUM- BERS ILLUSTRATE THE DEVELOPMENT CF THE GERM. only means of conveying the germ Is through inoculation, and the mosquito is th Inoculator. To bacteriologists the most interest- ing feature of the subject is the origi- nation of the plasmodium and how It gets into the mosquito’s blood. While we know absolutely nothing about the malarial germ outside of the body, it Is probable that in some form it lives and grows in the warm water of nmarshes and in rank vegetation, where so much disease life s generated. The mosquito deposits her eggs in the water, where they develop into a species of ‘“‘wiggletail.” The wiggle- tail quite likely feeds upon or becom: inoculated with the malarial germs, and when it is transformed into a mos- quito it contains the parasite for in- troduction into man. The parasite of pernicious malarial fever is smaller than the others and seems to accumulate in the Internal organs, developing apparently in grouns, In the irregular intermittent, two other forins of the parasite are found: the beautiful crescent is found within the red blood corpuscles, and the flagellate form outside of the blood corpuscles. In the flagellate form the pigment is in the center of the body and dances about verv rapidly. Sud- denly long threadlike processes extend out from the body of the parasite and whip about with great rapidity. Occa- sionally one or more of the processes break off and swim about independent- ly. The part played by the flagellate form in the production of malaria is unknown. The relation of these varieties of ma- larial parasites to one another is still under discussion. The consensus of opinion is that they are distinct va- rieties, not interchangable, but very closely related. The Interesting question in connec- tion with the malarial germ is: How do they get into the blood of patients sick with the disease? There are three possible ways: Through the mouth, stomach and testines. 2. Through the nose, throat and lungs. 3. Through the skin. There is a theory that water of ma- larial regions causes the disease. But the malarial haematozoa have never been found in water. Water of malar- ial regions has been freely drunk by a number of observers without the least results, and, further, blood of malarial patients known to contain haematozoa has been eaten by a number of observ- ers without contracting the disease. It seems, therefore, that the juices of the mucous membrane of the stomach and Intestines kill the parasite; hence it is impossible for it to get into the blood through these organs. To get into the 1 in- haematozoa will be found in the blood of both subjects. It would appear, then, that, try as we-may, the only way in which malarial fever can be given to a healthy man is by inject- ing the living haematozoa beneath his skin. Quite a number of lower animals have haematozoa in their blood. A notable example is that of cattle suffer- ing with Texas cattle fever. It has been found by a Texas scientist that the Texas tick conveys the disease to cattle, so that the dipping experiments now being carrifed on in Texas and other States, of which we read sc much in the newspapers, are for the purpose of killing the ticks on the cattle be- fore shipping them to other States, and thus prevent the spread of the fever to non-infected animals. -Usd JUBW 23} 2[OYM SUJ, "UO[ISanD [8d -IpaW B S 19A9) [BLIE[BW 240D 0} MOH ters about one drug, and that is qui- nine. As Sydenham said over 200 years ago, “it is an absolute specific for the disease.” Following are some selections from the paper read before the British Medi- cal Society, giving in technical lan- guage Dr. Ross' results in regard to the transmission of malarial poison by mosquitoes: / Seelng that certain phases of the para- site developed into a flagellated body in the microscopic field some twenty min- utes, more or le fter withdrawal from the body; seein Iso that these flagella broke away and sought to enter other cells, Dr. Manson recognized in this an indication, if indeed he did not establish the fact, of the commencement of the ex- tracorporeal life of the parasite. Beyond this, however, no clew was forthcoming as to how the narasite bred and continued its existence. It was at this stage that Manson propounded the mosquito theory and Intrusted its elucidation to Ross. The various stages of their work were arranged under several headings. (1) Ross found that the mosquito, in imbibing the human blood, ingested the parasite. (2) He saw the formation of the flagellated body in the blood in the mosquito’s stom- ach. (3) He observed the flagella break away from the parent cell and attain a separate existence. Ross thereby estab- lished the probable correctness of the conjecture that in the mosquito the para- site entered a new stage of existence. To work out the behavior and development of the parasite in the mosquito was now the problem. After partial success with the human malaria, and for several reasons, Ross elected to investigate the problem in birds. Birds, the speaker sald, suffered from intracorpuscular blood parasites like those In human malaria, and Labbe had shown that definite forms of para- sites were frequent in Europe. Two spe- cies in particular he described. They were known as Proteosoma and Halteridium; they were definite organ- ) Analogy suggested that a similar thing occurred in Proteosoma, and that the traveling pigmented Proteosoma ver- micule entered the tissue of the mos- quito's stomach and became Ross' pig- mented body, in the same w as Manson had shown took place in the case of the Filaria sanguinis hominis. (10) Arrived in the stomach wall of the mosquito, the Proteosoma increased rapidly in size un- til it projected beyond the stomach walls into the coelom, or body cavity, of the mosquito, as a rounded body, which he styled « the Proteosoma coccidla. (1) During its progress and growth various changes took place in size and in the arance of the contents of the coc- Pigment diminished and then dis- appeared, and as the parasite protruded into the coelom it was seen that the con- tents had a more or less granular ap- pearance. (12) The coccidia now burst, and what Ross called germinal vermi- cules, which had formed in its interfor, were set free in the body, blood and tissues of the mosquito. (13) The next step in the problem was one of great consequence—it was no other than the discovery of these vermicules in the venomo-salivary glands of the mos- quito. Ross during dissection of the mos- quito found a couple of head glands with a duct leading toward the proboscis of the animal, and traced the parasite vermi- cules into these glands. (14) The climax of the discovery now within_Ross grasp, and he elucldated it thus: He al- lowed mosquitoes to feed on birds in- fected with Proteosoma. After a few days he fed the mosquitoes on birds whose blood was void of any parasite in- fection. He found in due urse that the parasite-bearing mosquitoes had infected the healthy birds and that the blood of s charged with Proteosoma. vas the cycle completed, and the between bird and human infec- ad only to be proved to establish what was no doubt a great scientific truth, that the mosquito was a carrier of malaria and an infecter of man. Much had yet to be done, however, before the full mificance of the mosquito in malar- ia wi worked out. Malaria, it was known, muitiplied without the intermedi- ary of any vertebrate. Did it do so sole- 1y in mosquitoes? If so, we had yet to learn how it passed from mosquito to mosquito. Did it mllltiyly in other media? If so, what were they? Dr. Manson sajd that he had given merely the outline Bf Ross’ great work. Doubtiess Ross or oth- ers would soon take up the other prob- lems it suggested and show how to solve them. It was impossible in a short space to give in detall the multitudinous experi- ments and observations he had carried out. Suffice it to say that they had been done In a masterly way and with a_power of reasoning, of induction, and of tech- nical detail which marked Ross as one of the most eminent scientific workers of the day. The practical applications of the discovery were immeasurable, and the fact that as the bites of the snake or the rabid dog inoculated the blood of their victims, so might the mosquito convey malaria, opened up a new and hopeful phase in the prevention of disease in the tropics. ¢ ©00000CO00000000000000000000000000000C00C000000000C0000000C0000000C000000C0 DO MEDICAL STUDIES MAKE A GIRL UNWOMANLY? Dr. 00000000 €00000000000000000000000000CC0C000000000C00000000000000000000000000000000 glven us when we were 'prentices, did we, Robbins? But then,” he added, winking jovially, “‘neither did we have pink cheeks and light brown curls.” The sponger flushed and stiffened her slender neck, but the anesthetizer gig- gled. “Don’t limit it to curls, doctor,” she Beverly Cole Says They Do. sald pertly, giving a cross-eyed glance at a lock of her own straight, wispy, black hair, which had fallen across her face. And the old doctor, who liked pertness almost as well as he did sweet- ness, pulled up a stool by her and gave her no end of good advice about the AT WORK IN THE This Girl Student Says They Don’t. bringing of patients out of anesthe- sla. Later when they were washing their hands in the anteroom Dr. Gummison nervously took an end of the spon- ger's towel. ‘“You"—he began, but she interrupted him, DISSECTING ROOM. (] © © © [} © [} [} 8 “How good you were to let me,” she said gratefully. “Not many surgeons would have given an assistant such a chance. You don’t know how good it seems to have made a beginning, to think I have really put in some stitches all by myself.” KATHERINE BATES.