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An Address on the Fight against Tuberculosis in the Light of the Experience that has been Gained in the Successful Combat of other Infectious Diseases

1901; BMJ; Volume: 2; Issue: 2117 Linguagem: Inglês

10.1136/bmj.2.2117.189

0959-8138

Richard S Koch,

Zoonotic diseases and public health

THE task with which this Congress will have to busy itself is one of the most difficult, but it is also one in which labour is most sure of its reward.I need not point again to the innumerable victims tuber- .culosisannually claims in all countries, nor to the boundless misery it brings on the families it attacks.You all know that there is no disease which inflicts such deep wounds on mankind as this.All the greater, however, would be the general joy and satisfaction if the efforts that are being made to rid mankind of this enemy, which consumes its inmost marrow, were crowned with success.There are many, indeed, who doubt the possibility of suc- cessfully combating this disease, which has existed for thou- aadsd of years, and has spread all over the world.This is by -no means my opinion.This is a conflict into which we may 'enter with a surely founded prospect of success, and I will tell you the reasons on which I base this conviction.TUBERCULOSIS A PREVENTABLE DISEASE.Only a few decades ago the real nature of tuberculosis was 'unknown to us; it was regarded as a consequence, as the ex- pression, so to speak, of social misery, and, as this supposed cause could not be got rid of by simple means,.people relied ,on the probable gradual improvement of social conditions, aud did nothing.All this is altered now.We know that social misery does indeed go far to foster tuberculosis, but the real cause of the disease is a parasite-that is, a visible and palpable enemy, which we can pursue and annihilate, just as we can pursue and annihilate other parasitic enemies of man- 'kind.Strictly speaking, the fact that tuberculosis is a preventable ,disease ought to have become clear as soon as the tubercle tacillus was discovered, and the properties of this parasite and the manner of its transmission became known.I may add that I, for my part, was aware of the full significance of this discovery from the first, and so will everybody have been -who had convinced himself of the causal relation between tuberculosis and the tubercle bacillus.But the strength of a small number of medical men was inadequate to the conflict 'with a disease so deeply rooted in our habits and customs.Such a conflict requires the co-operation of many, if possible ,of all, medical men, shoulder to shoulder with the State and the whole population.But now themoment when such co-ope--ration is possible seems to have come.I suppose there is hardly any medical man now who denies the parasitic nature of tuberculosis, and among the non-medical public, too, the .knowledge of the nature of the disease has been widely propagated.Another favourable circumstance is that success has recently been achieved in combating several parasitic dis- eases, and that we have learned from these examples how the conflict with-pestilences is to be carried on. SPECIAL PREVENTIVE MEASURES NEEDED FOR VARIOUSDISEASES.-The most important lesson we have learned from the said 4