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110
Hippocrates, a celebrated Greek physician about B.C. 400, gave a very good clinical picture
of consumption and its treatment; whilst Galen, A.D. 130, recognised that it was an infectious
complaint—an opinion which was also held by the Arabian, Avicenna, A.D. 1037.
The early treatment of consumption, judged by the writings of these old-time doctors,
appeared to have been conducted on sound lines, and in some fundamental principals viz., fresh
air, rest, sunshine, adequate and good dietary (milk and fats), was much the same as is carried out
nowadays in Sanatoria: whilst the drug Creosote was used in those days, as it is now.
Although the cause of tuberculosis during the middle ages was in a large degree considered
to be due either to " curses or visitations evil eye, witchcraft, or to " miasma from the East
one finds that a definite view as to its infectivity was constant in foreign countries: whilst in
England it was regarded rather as " hereditary " than infectious—a belief which held sway until
within comparatively recent times. It was not until numerous experiments, carried out by
Klencke, Villemin, I3urdon-Sanderson, Chaveau and Klebs, Cohnheim and others had shown its
infectious nature that this erroneous theory fell into disrepute: and the crowning discovery of the
causative micro-organism by Robert Koch in 1832 set the seal on all the extensive experimental
work which had been done during the previous fifty years.
Just as Laennec's teachings in Paris at the beginning of the 19th century laid the foundations
of modern methods of clinical examination (particularly the use of the stethoscope), so did Koch's
discovery of the tubercle bacillus revolutionize our treatment of the disease and methods of
prevention.
The outlook in the early part of the 19th century was extremely pessimistic, and the
writings of such well-known novelists as Charles Dickens, Samuel Warren and Charlotte Bronte
give us a clear indication how dread the disease was in popular estimation, and how slight was
the chance of recovery considered to be in those times.
Control and prevention of tuberculosis.
Hospitals for consumption existed as far back as 1814, but rather focussed attention on
clinical aspects of the disease and symptomatic treatment, than on preventive measures such as
segregation.
In 1840, George Bodington stressed the benefits of open-air treatment accompanied by
proper feeding and graduated exercises; but his teaching and theories were disregarded in this
country. Abroad, however, they were accepted and promptly acted upon with the result that
Sanatoria and treatment on similar lines were established in Germany, Switzerland and America.
The excellent results of sanatorium treatment thus conducted no doubt influenced public attention
in this country; and after Koch's epoch-making discovery, more energetic measures were
instituted. To Sir Robert Philip is due the honour for the foundation in Edinburgh of the first
tuberculosis dispensary system in the British Isles in 1887.
In England, charitable enterprise was responsible for the inauguration of the Paddington
Dispensary for the Prevention of Consumption in 1909; followed in 1910 by the St. Marylebone
Dispensary and in 1911 by the Fulham Dispensary. By 1911 fourteen Sanitary Authorities had
provided Dispensaries in their areas; and in fifty other districts voluntary establishments had
been founded.
It will be seen that the theory of hereditary tuberculosis has now given place to one of
direct infectivity: and Public Health Regulations. 1912, set the official seal on the evidence of