Tuberculosis : its cause, nature and treatment

Front matter

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Table Of Contents

CHAPTER PAGE

Preface . v

I. The Body in Health and Disease . . i

Chapter I

T 7 VER 10 NE should know something about his body and how it works. If this knowledge were more widespread there would be much less disease. It is especially important for the well per¬ son to understand his needs in order that he may remain well. But it is also very important for the sick person to have this information in order that he may find the road back to health. In finding the road, if he is wise, he will also have found the way to retain health when it has been secured. The sick person is under the additional necessity of know¬ ing something about the needs of the body when it has broken down from abuse. Hence he requires an even wider knowledge than the fortunate individ¬ ual in good health. There is no escaping this neces¬ sity for study. We cannot hire another to repair our bodies as we can to repair our houses and ma¬ chines; we must do the work ourselves. The only assistance we can hire is a teacher who will instruct us in our work. The sooner people realize that man’s greatest study is man the sooner will disease be eradicated.

The body is composed of cells and each cell is a little “life” in itself. Some cells may function im¬ perfectly without creating any noticeable effect upon the general health, but the effect is there just the same; and if any considerable number of cells is affected the individual will not long be left in doubt as to something being wrong.

Each cell is interested in the same functions in which the body as a whole is interested—that is, nutrition, elimination, and reproduction. The food we absorb ultimately becomes cells or is utilized by cells, and the waste products of the individual cells must ultimately be eliminated through some groups of cells known as organs, such as the kidneys, bowels, etc. Unless each cell reproduces as it should there will be degeneration and ultimate death, for the body is constantly changing and new cells must be constantly produced. The old and the new cells must be normal cells if health is to result. This continual tearing down and building up is known as metabolism.

It will readily be seen how important is food to metabolism and, hence, to the maintenance of health and the elimination of diseased conditions. But the importance of removing the waste products must not be lost sight of. Even with a perfect diet, if the elimination is not normally active a toxic condi¬ tion would result. This is the underlying cause of all disease. Looking at the body as a whole, there¬ fore, the digestive and eliminative organs are the important ones to consider in overcoming disease.

The mouth is the first part of the digestive tract, 2 and as everybody is familiar with its appearance it will not be necessary to describe it. But two very important phases of digestion are accomplished in the mouth. These are mastication, which reduces the food to a pulp so that the digestive juices can reach all the elements, and the mixture of the food with saliva which serves the double purpose of mois¬ tening it and of changing much of the starch to sugar and the complex sugars to simpler forms. The latter function is produced by an enzyme in the sa¬ liva known as ptyalin. If this has little opportunity to act, owing to rapid eating and insufficient masti¬ cation, it will mean more work for the intestines and, hence, more cause for them to become weakened and susceptible to tuberculosis, and tuberculosis in the intestines is no picnic. The tube connecting the mouth with the stomach is known as the esophagus. It serves simply as a passageway for food and is seldom affected with tuberculosis.

The next organ is the stomach. This is a pouch¬ like receptacle for the food, located approximately in the center of the body just below the breast bone. The stomach is lined with mucous membrane, in which are the glands which secrete the gastric juice which contains two enzymes, pepsin and rennin, and the highly important hydrochloric acid which makes pepsin an efficient enzyme. The walls of the stom¬ ach are composed of muscles whose function it is to contract the organ with rhythmic motions so that the food is well mixed with the gastric juice. The function of the pepsin is to digest protein foods.

Contrary to the popular idea, there is not much digestion taking place in the stomach, the protein being the only element which is affected to any ex¬ tent. The stomach is really more for storing the food, mixing it thoroughly, and getting it ready for the main work of digestion which takes place in the intestines. As the mouth prepares for the stomach, so the stomach prepares for the intestines. Never¬ theless, the work of each is important, and if neg¬ lected or imperfectly performed it means trouble later on in the digestive tract—and in life, as well. The rennin, which is the other enzyme in the gastric juice, curdles milk. This is its sole function, but the curdling must be done before the milk can be digested. The persistence of the rennin throughout life is one proof that milk is a natural food for the adult and not a poison, as some misguided theorists claim. After the food has been thoroughly mixed by the stomach, partly digested and rendered acid in reaction by the gastric juice, it is ready to be passed on into the intestines. At this stage it is called chyme (from a Greek work for juice).

The normal chemical condition of the mouth fluid is alkaline, and the food should be alkaline when it reaches the stomach, as this stimulates the flow of the acid gastric juice. The normal state of the stomach secretions being acid, as soon as an alkali is injected there is a tendency for the stomach to secrete more acid in order to maintain the normal acidity. The acidity of the stomach contents, on passing into the intestines, stimulates the flow of 4 the intestinal digestive juices, since these latter are alkaline and the normal chemical condition of the intestines is alkaline. It will be seen from this that the use of chemical alkalies to overcome hyperacid¬ ity of the stomach only results in making the condi¬ tion worse as the alkali stimulates the production

of more acid.

If the food is properly prepared in the mouth there will be little tend¬ ency toward

ach even if the diet is not all that it might be.

The intes¬ tines are the most compli¬ cated part of the di¬ gestive tract and as they are often affected with tuberculosis we will consider them in somewhat more detail. The intestine is a muscular tube about thirty feet in length, twenty-five feet of that length being the small intestine, so-called because it is only about an inch in diameter. The remaining five feet hyperacidity of the stom-

BLADDER'

CESSER. SAC

PANCREAS

DUODENUM

TRANSVERSE

COLON

MESENTERY

A cross-section of the female abdomen and pelvis. Any of the organs shown may be affected with tuberculosis but the intestine is most frequently attacked.

make up the large intestine, which is not a digestive organ but an eliminative organ, and a very impor¬ tant one at that. The intestines are built like the stomach in that they have muscular walls and are lined with mucous membrane which (in the small intestines) contains glands. The muscles in the walls of the small intestines are chiefly arranged cir¬ cularly and contract with a wave-like motion so that the food is gradually forced along the tract. In the large intestine there are more developed longi¬ tudinal muscles, which by contracting help to hold back the food so that it will not move along so rapidly and will have time to dry out to some ex¬ tent, thereby producing a semisolid material for evacuation. All these muscles must be in good work¬ ing order if we are to avoid constipation with its long train of ills. Constipation is a strong predis¬ posing factor to tuberculosis, as it is to all other diseases.

As most of the digestion has to take place in the intestines three digestive juices are found there, the bile, pancreatic juice, and the intestinal juice. The bile has other functions also, the most important of which are to keep the food from decomposing in the warm, moist intestine, and to stimulate the wave-like motions of the intestine, known as peri¬ stalsis. The pancreatic juice is secreted by the pan¬ creas. This secretion has to do the most work of all. It contains three enzymes, trypsin, amylopsin, and steapsin, which digest proteins, starches, and fats respectively. The digestion of the starches starts in the mouth and is finished in the intestines. The digestion of the proteins starts in the stom¬ ach and is finished by the pancreatic juice, assisted by the intestinal juice (succus entericus). The lat¬ ter juice is secreted by glands in the walls of the intestines, and has its action mostly on the less com¬ plex protein material.

It will be noted that nothing has been said about the digestion of the mineral salts and vitamins which are receiving so much attention at present and which are without doubt even more important than the proteins, fats, and carbohydrates (starches and sugars). This is because as far as we know now they require no digestion but are directly absorbed the same as water—an extremely wise provision of Nature. These are absorbed partly from the stom¬ ach but mostly from the intestines. The other food elements are all absorbed from the intestines.

After the food elements have been removed by absorption, the residue is passed on into the large intestine where some more of the water is absorbed and the remaining solid material ejected during defecation. If this refuse is not promptly and regu¬ larly removed it soon undergoes fermentation and putrefaction, with the production of injurious gases and other toxins which will be absorbed into the blood stream and cause trouble of some kind, greater or less according to several factors.

Let us now proceed to a consideration of the elim¬ inative organs. We have seen how food gets into the body, what happens to it and how the residue is eliminated by one of the depurating organs—the bowels. But we also take water and air into the body and some of this must be eliminated. Then, too, there are other forms of waste material pro¬ duced by muscular and organic action which must be disposed of, not to mention the many foreign

articles we are contin¬ ually putting into the body, such as dust, dirt, bacteria, drugs and medicines of all kinds, tea, coffee, spices, tobacco, alco¬ hol, synthetic soft drinks, etc. All these must be thrown out of the body by the skin, kidneys, bowels, and lungs. All too often they have a tremen¬ dous amount of work to do, and while they can stand much abuse they will break down sooner or later if not given a rest. When they do break down they may become tuberculous.

The skin has other functions to perform besides that of elimination. It is the protecting surface of the body, being composed of several layers of cells, the outer ones quite tough and resistant, yet elastic. The outer layer of the skin, whose chief function

A greatly magnified cross-section of the skin, showing its marvel¬ ous and complicated structure.

is protective, is called the epidermis. The next layer, which contains the tiny muscles which move the skin, the blood vessels which feed it and the nerve endings of the sense of touch, as well as the oil glands, is called the derma or true skin. Under¬ neath this is the subcutaneous layer, which is com¬ posed of connective tissue for joining the skin to the underlying tissues. It also contains fat cells and the sweat glands. The ducts of the sweat glands pass up through the derma and open onto the free surface of the epidermis. The sebaceous or oil glands also open onto the surface of the epidermis. These latter secrete an oil which serves to keep the skin soft and pliable and also acts as an additional protective agent the same as oil minimizes wear in an engine by taking up friction. The primary func¬ tion of the sweat glands is to regulate the tempera¬ ture of the body by producing perspiration when the body or external temperature becomes too hot. The evaporation of this perspiration causes cooling of the body. Certain waste products are eliminated in the sweat, also, and when the body is very toxic, considerable amounts of these impurities may thus be thrown off. This is why a sweat bath or the sweat resulting from exercise helps to cleanse the body. In addition to these duties the skin also breathes to a certain extent, thus assisting the lungs in their function, which will be explained later.

The skin may be affected with tuberculosis, but only if it is under the necessity of eliminating a lot of toxins so that there is plenty of food material for the germs. Of course, if the skin is not kept clean it will be more susceptible to tuberculosis.

Closely associated with the skin in the work of elimination are the kidneys. These are two bean-shaped organs located slightly above the so-called “small of the back.” The right kidney is

somewhat lower than the left, but the lower edge of each teiffcV is approximately two inches above the upper edges of the hip bones. The kid¬ neys are con¬ nected by tubes called ureters with the blad¬ der, located in the lower front of the pelvis.

The bladder is connected with the outside of the body by another tube called the urethra. The kidneys themselves are composed of many tiny tubes or tubules surrounded by blood-vessels. All these tubes converge to empty into the ureters.

As probably everyone knows, the function of the kidneys is to secrete urine. Urine is composed largely of water, but there are also considerable 10

PYRAMID

A cross-section of the kidney show¬ ing its various parts. This organ may be affected with tuberculosis, producing serious complications.

amounts of solid waste materials, most of which come from the end-products of protein digestion or from the destruction of tissue cells occasioned by the activities of the body. These waste materials are brought by the blood to the kidneys, and here they are collected in the little tubules of the kidneys through a process somewhat resembling filtration. This collection, in dilution, flows into the bladder through the ureters as rapidly as formed. It is then stored in the bladder until this is fairly full, when there will be a call to urinate and pass it out of the body. The normal amount of urine is about three pints per day, but this varies considerably with the quantity of liquids taken in the diet and the amount of perspiration.

The functions of the skin and kidneys are closely related, as the process of secreting sweat does not vary greatly in its fundamentals from that of the secretion of urine. When we perspire freely there will be less urine, but when we perspire very little there will be more urine. This is a normal relation¬ ship between kidneys and skin and their excretions. It is even more pronounced in abnormal conditions. In other words, if the skin is not normally active the kidneys will have more work to do, and vice versa. In fact, all the eliminative organs are thus connected. If one fails to any extent more work is thrown on the rest.

Through overwork occasioned by improper diet and the resulting necessity for eliminating an excess of solid materials, the kidneys may become irritated or actually inflamed. When in this condition they furnish soil for the tubercle bacillus and many an unlucky patient has had his kidney removed because it was tuberculous. Not that there is any necessity for doing this, but such usually is the medical pro¬ cedure. It is possible to live with only one kidney,

PROSTATE

^EJACULATORY DUCT -PROSTATE

LONGITUDINAL

FIBRES

CIRCULAR

FIBRES

ORIFICE OF

TRANSVERSE FIBRES OF TRIGONE

LONGITUDINAL FIBRES OF TRIGONE

A magnified cross-section of the bladder, showing the openings for both the urethra, which goes to the kidney, and the urethra, which connects the bladder with the surface of the body. The prostate gland is also shown.

but much care will be necessary to avoid overwork and destruction of the one organ. We should keep both our kidneys as long as possible, and if given proper care they will last indefinitely.

We now come to a consideration of the lungs, 12 those unfortunate organs which are so often afflicted with tuberculosis. We will not consider the reason for this here but will discuss it later. For the pres¬ ent let us look at their structure and function, a knowledge of which will be necessary for a proper understanding of the various matters to be taken up later in this book. Every one should know about the lungs anyway, for they are vitally important, this being demonstrated by the fact that there are few things which will bring about death sooner than fail¬ ure of the lungs to act. If you doubt it, try having

A magnified view of a globule of the lung and of a group of air-cells (alveoli) and their connecting ducts and bronchioles. A lobule is made up of a great number of alveoli.

someone choke you or see how long you can hold your head under water. The average person will become unconscious in about two minutes if his air supply is cut off.

The air enters the lungs through the nose, mouth, • larynx and trachea, or windpipe. In a single day the lungs handle on an average of 105 barrels of air. All are familiar with the mouth and nose, but most people know little about the larynx. This is really the voice-box, as it is here that the vocal cords are located and it is through the contraction

TRUE

A view of the larynx, looking down upon its top so that the vocal cords are seen. Any of the parts shown may be affected with tuberculosis, producing a very painful and serious condition.

and relaxation of these cords that sounds are pro¬ duced. The larynx is a box-like structure composed chiefly of cartilage, though it has both extrinsic and intrinsic muscles attached for moving it and the vocal cords. The front cartilage is the chief one and is called the thyroid cartilage. It is the familiar “Adam’s apple.” Below and behind this is the cricoid cartilage. Above the back of the cricoid and forming the back of the larynx are the two arytenoid cartilages. The top of the larynx is closed with another cartilage called the epiglottis. This is hinged and moves up and down so as to open the larynx when breathing and close it when swallowing food, as the food has to pass over the larynx on its way to the stomach. When the larynx is affected with tuberculosis it often becomes ulcerated and swollen, especially about the epiglottis and arytenoid cartilages; and this interferes greatly with swallow¬ ing and breathing, often leading to serious results. The vocal cords also may be affected, producing hoarseness or loss of voice. These cords are in two sets. The upper set is known as the false cords and the lower as the true cords. They are small liga¬ mentous bands passing from the front to the back of the larynx with an opening between. By con¬ tracting or relaxing the cords this opening may be enlarged or closed. When closed, either naturally or because of swelling, no air can pass.

The trachea or windpipe is a tube composed of cartilage, muscle, and mucous membrane which leads from the larynx down through the chest to where it divides into two branches called the bronchi. One bronchus goes to the right lung, the other to the left lung. Each bronchus divides and subdivides, much like the branches of a tree (only inverted), so that a very large number of small tubes are formed, 15 called bronchioles. On the end of each bronchiole there is a membranous sac, the air-cell. It is these bronchial tubes and air-cells, together with blood vessels, nerves, and connective tissue, which make up the substance of the lungs.

The lungs are pyramidal in shape, being held in this form by the chest cavity and by a fibrous cov¬ ering called the pleura. The chest cavity is lined with a similar membrane and the very small space between these two layers of pleura is filled with lubricating fluid so that the movements of the lungs will not cause friction. Each lung is partly divided into sections called lobes, the right lung having three lobes, the left lung only two lobes in order to make room for the heart, which lies between the lungs.

During breathing the lungs expand as the air en¬ ters, and contract, because of their elasticity, as the air leaves. Inspiration is a muscular effort which raises the ribs and lowers the diaphragm (the muscle forming the base of the. chest cavity) so that the size of the chest cavity is increased and the air rushes in because of the difference in the inside and outside air pressures. Expiration, during quiet breathing, is simply a relaxing of the muscles so that the ribs are allowed to descend and the dia¬ phragm to ascend, thus decreasing the size of the chest cavity and forcing the air out. It is because of these different movements that pain and various other symptoms are produced when the lungs or pleura become affected with tuberculosis, and when adhesions form as a result of this trouble.

The purpose of breathing is to bring the fresh air containing a good supply of oxygen into approxima¬ tion with the blood so that it can absorb oxygen and throw off carbon dioxide, which is then breathed out during exhalation. This interchange

RIGHT pulmonary

ARTERY Z, VEIN

HEART

'INFERIOR. LOBE

A view of the lungs showing the circulation to and from the heart. All the blood must pass from the heart to the lungs to be purified before it is returned to the heart to be distributed to

the rest of the body

of gases takes place in the air-cells above men¬ tioned. These cells are surrounded by many fine blood-vessels, and the membranes forming the walls in each case are so thin that the gases can pass through, but solids and liquids are held back. Thus the blood is prevented from escaping into the lungs, and the air as a whole is prevented from entering the blood-vessels, also any foreign material which may be contained in the air. Such foreign matter may remain in the air cells or bronchial tubes, how¬ ever, and cause much trouble.

A plentiful supply of oxygen is extremely neces¬ sary at all times, for it is used to support metabo¬ lism, which I shall explain presently. Oxygen also enters into all the tissues so that the body would almost evaporate without it. The body is threefourths water and water is one-third oxygen. An ample supply of oxygen at all times, not only in the lungs but in the tissues, is one of the best pre¬ ventives of tuberculosis.

Now what is metabolism? It is the breaking down and building up of tissue. As the body is used, certain of the older cells in all parts wear out, die, and must be replaced. The cells use oxygen in their functions and when they die they must either be consumed (burned) by oxygen or eliminated from the body in some other manner. If they are allowed to remain they interfere with normal func¬ tions. In building up new cells, oxygen is necessary for combining with food materials to form the cells and to furnish food material for the cells. Thus you see further the importance of oxygen and why tuberculosis, through interfering with the function of the lungs, brings about such serious general symp¬ toms as it does.

This breaking down and building up of tissues must be balanced if we are to have health. If more cells die than are replaced we will naturally deterio¬ rate. If more cells are produced than are used up we will grow in some way. During childhood it is very important that more cells be built in order to produce growth. Metabolism is therefore more 18 rapid in the child than in the adult. The child be¬ comes sick more quickly if the environment is bad, but it also gets well more quickly under the proper treatment. When a person has not been living rightly this normal interchange of tissue may be perverted in many ways and this is responsible for the many varying symptoms which we call disease, but which in reality are merely different manifesta¬ tions from the same causes.

If toxins of any kind are allowed to accumulate in the body, whether their source be from the outside or from the inside, the effect is to place obstacles* in the way of this building up of tissue and to pro¬ duce a greater breaking down of tissue. The body could not long exist under these circumstances, and must do something about it. What we call disease, therefore, is only Nature’s effort at removing these obstacles or toxins. The eliminative func¬ tions of the body are greatly accelerated and this gives rise to many symptoms such as fever or the dis¬ charge of mucus, etc., which are called abnormal. As a matter of fact, however, they are normal under the circumstances. They are abnormal only because the conditions are abnormal.

What we ordinarily call disease—and this in¬ cludes tuberculosis—is therefore only a physiolog¬ ical process which is produced by the guiding intel¬ ligence within the body for the best interests of the body in order to clean out the excess of toxins and to warn us to discontinue the wrong habits of living which are producing the toxins. Therefore 19 we should look upon so-called disease as a friend. By so doing we will lose our fear of disease and thus be in a better position to profit by a correction of the habits of living. For even perfect habits will not produce perfect health if fear is allowed to in¬ hibit and alter all the functions of the body. Of course, fear is itself a bad habit.

From the description here given you should be able to visualize fairly well the normal functioning of the organs most often affected by tuberculosis. If you will visualize all the organs functioning nor¬ mally as here described, and especially any which may be diseased, it will help much to accelerate your progress toward health. More of this hereinafter. For the present, try to remember what I have told you of the different parts of the body and how they work, for it will help you much in understanding and utilizing the suggestions that will be given in the subsequent pages.

Chapter II

TfVER since the bacillus tuberculosis was discov¬ ered by Koch in 1882 the medical doctors have claimed that this was the cause of the disease and that the nature of the symptoms was determined entirely by the type of germ and its activities. They maintain that the prevalence and destructiveness of the disease are due to the numbers and virulence of the germs. They have long laid great stress upon hunting out and exterminating the bacillus. People were so impressed with the fear of the “bugs,” as they were familiarly called, that they were afraid to go within a mile of any one having tuberculosis. Often the patient’s own family would desert him.

The truth of the matter is that tuberculosis is essentially a filth disease—that is, internal filth. The germs are necessary as scavengers; and if tuberculo¬ sis did not develop, something else would develop, because the body could not continue to exist when overloaded with toxins. Of course, external filth is also a factor, because it does to some extent inter¬ fere with internal cleanliness.

The disease is most prevalent among the poorer classes, especially in the cities, where the living con¬ ditions are the worst and the struggle for existence the most severe. Denatured, partly decomposed, 21 and artificially preserved foods are used because of their cheapness; but they produce many toxins in the body, and lower vitality through failing to fully nourish. Ventilation is very poor and sometimes wholly absent in the dwellings of these poor people, and elimination is checked.

However, rich people also are affected by tuber¬ culosis. They may suffer just as much from malnu¬ trition as the poor, because they are inclined to buy the fancy foods which appeal to the taste and sight but which have had the life principle removed by manufacturing processes. On the other hand, they may be overfed, and this, too, leads to toxemia. Many times they suffer nearly as much from lack of fresh air as do the poor, not because they cannot get it but because they are too lazy to go out and get it, or coddle themselves in overheated rooms or shut their windows and draw the curtains to pro¬ tect their valuable furnishings from the dust and sunlight. The rich are almost always enervated from overindulgence in all the pleasures of sense. Thus they may become as lacking in vitality as may the poor. Nevertheless, though many cases occur among the rich, they are not so frequently affected as are the poor. They do have better opportuni¬ ties for keeping themselves in good condition, and in the main they take advantage of them.