THE MYSTERY MALADY

Dominion, Volume 11, Issue 154, 19 March 1918, Page 6

THE MYSTERY MALADY

X AND Iis'VICTIMS

IOOKING FOR THE MICROBE

Tile Health' Department likes nothing better than a mystery disease (says tho Sydney "Sun," apropos of the baffling diseitse~ which recent telegrams have described- as' "X"), The appearance of :some 1 unfamiliar- enemy to human health .'throws the pathologists and micro-biologists, into a 'condition of joyful iand" expectant'activity. They plunge "into the search after tho secret that Nature strives to withhold, and the chase after the elusive, microbe, whose habits and methods : must be understood before the disease cau be successfully treated, is relentlessly maintained. • )

It is not often that medical scientists are afforded such' an opportunity for investigation and research as has been presented by the occurrence of the disease - which has been designated by the algebraic symbol X. It is the unknown quantity in medical science for the time being. 1

There are .plenty of other unknown quantities—such, for-instance, as cancer and-infantile paralysis—but Xis the most mysterious of them all, because it is the newest.

The last great opportunity for original research was when bubonic plague came to Sydney from the . East. Though the scourge had ravaged older countries for centuries, claiming' its hundreds of thousands of victims, it ■was not understood by the medical .profession. The New South Wales Board of Health, of which Dr. Asliburton' Thompson was then president, .took the investigation in hand, and in a short period it was established beyond doubt that the rat was the host of the dreaded disease, and that the flea. was the vehicle of infection between the affected rat and the healthy man. , .There is no reason- why the brilliant success achieved on that occasion should not be repeated in tracing the X microbe to - his lair.

Ignorance of tho Disease, The ignorance of the medical profession concerning X is profound. It is not evcn,known how long it has been here, when, it c^ie, ; how .many cases have occurred, what is its favourite locality, what its mortality percentage, what its congenial conditions, or whether it is due to the eating of unwashed ■ grapes or to. the inhaling of .poison fumes from the silver-lead works. The first cases were reported quite recently. It is considered possible, however, that other..cases occurred and were-not identified, and there,is reason to suspect that a. number of patients suffering from the disease in a more or less mild form are still being treated for something else. While it is true that most of the cases repforted have occurred at Broken Hill, there is no conclusive evidence that their origin was due to eating grapes, and the idea that they may have been caused by, lead fumes is discounted by the vfact that similar sicknesses have occurred in-localities where such influences do not exist. In thp absence of precise pathological and micro-biological conclusions, however, it is impossible to say-that the case at Wagga, for instance, was identical with the cases that have occurred elsewhere. ' / . Up to the'present very little indeed has been accomplished in the way of identifying the disease or deciding as to its cause. Oases of sickness, accompanied by all the apparent symptoms and effects of X have been reported over a wide area'in the west, especially in the north-west,' extending as far south as Wagga. and as far north as Narrabri. But in the condition.of uncertainty which prevails it is impossiblo to say positively that the eases are similar, or that if ,X, '.represents the Barrier cases it also" represents the cases that have occurred 200' miles away. ' . Although one of the Barrier, doctors has expressed the opinion that there is some connection between. X and \inwashed grapes, the health authorities in. Sydney do not accept the theory. Tho fact that- several, patients had ■,eaten grapes before they became ill is not regarded as any more conclusive evidence than that they drank tea or made a meal of bread and bntter. _' The circumstances of cases occurring in the Far West, away from the Barrier, are easily suggestive of the probability that the patients there had no opportunity of eating grapes. In the absence pf. any more convincing proof it is considered quite probable that there is 110 relationship of cause and effect between grapes and X. •The idea of scaring people against e.njoying good, wholesome fruit is also deprecated. Fruit .that is unripe, or. is not good, or is .dirty may cause a multitude of troubles, but these are conditions that ordinarily careful pspplq guard against as a matter of course.

High Rate of Mortality. X is .terribly fatal. Just; how much ao has not yet been 'decided. But probably 50 per cent, of the patients die. Perhaps more, because it-is not. at all certain that alPeases have been identified. The high mortality is 'lue mainly to' ignorance of the pathology of the disease. Diphtheria used to be the most dreaded infantile disease known. 1 To-day it is understood, and is so amenable to modtern treatment that it is scarcely more fatal.than measles or whooping-cough. There is every reason to hope that X will be as completely mastered in the near future. ■ ITlie pathological effects of X are largely those of infantile paralysis. They take the form of an acute attack upon the nervous system, with all the distressing effects of infantile paralysis. The outstanding features of the symptoms appear to bo high fever, convulsions, and sudden collapse. In. fatal cases the patieiit usually dies of exhaustion, though the information available is not sufficient to enable the medical profession to say that death is always due to exhaustion. Doctors in the Wost have been asked to forward to the Board of Health the histories of eases that comp under their notice, and in due course the profession will be able to identify X immediately it appears. There is one feature quite distinct from infantile paralysis, however, so far as is known. In cases of recovery from X there is 110 resulting paralysis so often present in the other disease. About 30 cases have been reported this year, and the deaths to date number about 12. "Whether the diseaso is contagious oi: infectious has not yet been established, but the comparatively few victims seems to suggest that it is neither. No sufficient opportunity has yet been afforded of accurately defining the course of the disease. There appears no medical reason why it should not thrive in the coastal area 3, hut in the cautious ivorcls of "'an official of the Health Department, "So far the disease, as far as this department is aware, has been confined to the west and north-west districts.'' The Board of Health is engaged in an attempt to isolate the micro-organ-ism and to discover how it obtains access to the human system. The eluci-

elation of the former problem is a necessary precedent to the determination of th© other. Doctors have been sent to Brolcon Hill to inquire respecting local conditions, and specimens from each case aro sent- to Sydney for investigation and research by tlio Hoard of Health. The laboratory is deeply interested in the problem, but the best report the authorities can make' to date is: "Wo have not yet reached finality. Until we have, no opinion can be expressed."