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Abortus Fever: Some notes from Southern Rhodesia
JUBILEE NUMBER.
,1HORTUS FEVER: SOME NOTES FROM SOUTHERN RHODESIA
TREATMENT OF A HUMAN CASE WITH PROSEPTICINE. By 1.1. E. W. BEVAN, M.R.C.V.S., The Trypanosomiasis Bureau, Salisbury, Southern Rhodesia. BOVINE infectious abortion is said to have existed in Southern Rhodesia even before the advent of the white man in 1892, but the evidence advanced is based upon the statements of natives whose powers of diagnosis cannot be relied upon. It was not until 191~~ that the writer, by the application of the agglutination test, proved the presence of specific abortion in two herds, one of which had recently arrived from Northern Rhodesia. The strains of organism used in the tests were derived from Sir John M'Fadyean at the Pathological Laboratory of the Royal Veterinary College, London; from the Nairobi Laboratory, British East Africa; and from the Onderstepoort Laboratory, Union of South Africa. The reactions with the different strains corresponded, indicating tlJat the specific contagious abortion of these countries, namely Great Britain, Kenya, the Union of South Africa, Northern and Southern Rhodesia, were closely related. Samples of the bloods were sent to Sir John M'Fadyean, who was able to confirm the diagnosis. These facts were recorded in this journal of June 30th, 1915. In those days tran~port in Southern Rhodesia was primitive and extremely slow, and it often happened that blood sent to the laboratory in Salisbury for the agglutination test arrived decomposed and putrid. The writer therefore devised a pipette, resembling the Wright capsule, containing a special solution which preserved the blood without interfering with its agglutinating titre. This rendered it possible for the stockman or farmer at a distance to send samples of blood to the laboratory for the test. The method was described in this journal and is used by the Veterinary Research Department of the Colony even to-day. Incidentally it proved of considerable value to the Veterinary Department in that owners of infected cattle by forwarding samples thereby revealed the fact. A modification of this method known as the " Abortoscope" was introduced, by means of which the owners themselves could test their cattle with accuracy. This was useful where regular monthly tests of dairy cattle were recommended, or dairymen desired to " buy in " cows for their herds. It mav be mentioned that the disease was at one time included in the Schedule of Infectious Diseases and the attempt was made to control it. This was extremely difficult in view of the fact that owners failed to report, fearing quarantine and knowing that no specific remedy was available. The detection of the disease was one thing but its effective control under the conditions obtaining in this country,
ABORTUS FEVER.
339
another. Eventually, in despair, the disease was removed from the list of Scheduled Diseases, but it remained as a disease under the Public Health Act and its control was relegated to the Medical Department but was seldom if ever attempted. This appeared to the writer to be a retrograde step and an admission of ignorance on the part of the veterinary profession. To obviate this difficulty-a difficulty which is not peculiar to Southern Rhodesia-the writer experimented with various dead vaccines, the live vaccine being too dangerous to apply under local conditions. He found that several of the co-called " dead" vaccines gave rise to agglutinins in the inoculated animal: but, apparently, agglutinins are not synonymous with immunity although often an indication of it. Finally he introduced a vaccine prepared from massive cultures of Br. abortus attenuated by exposure to chloroform. This was applied in over one hundred outbreaks and in some instances with most favourable results, but in others the results were not so satisfactory. Whether the good results were due to the vaccine or to a natural" wearing out" process is uncertain, but it is remarkable that the cessation of abortions so frequently followed the application of the vaccine. Of course, the vaccine could not restore life to a dead fcetus and the abortion of a dead calf after the application of it was often unfairly attributed to it. Another possible reason for its failure was a concomitant infection with infectious vaginitis which was very prevalent throughout the country. Also, it would now appear, sufficient care was not taken to ensure that the cultures from which the vaccines were prepared were " rough" or" smooth," a factor upon which their antigenic properties are said to depend. In 1916, Dr. Alice C. Evans drew attention to the resemblance between the organisms of contagious abortion of cattle and undulant or Malta fever of man. The importance of this observation was immediately recognised in this country where mysterious cases of undulant fever were occurring although no possible association with goats could be traced. The writer was struck by the fact that many of these cases were from farms where bovine abortion existed, and on November 12th, 1921, he presented a paper to a combined meeting of the Southern Rhodesia Veterinary Association and the British Medical Association, in Salisbury, entitled " Infectious Abortion of Cattle and its possible relation to human health," in which he suggested that these cases of so-called undulant fever were suffering from an infection caused by Br. abortus of cattle. This subsequently proved to be correct. He also said in his paper, " If infectious abortion of cattle is essentially a bovine disease, a grave responsibility attaches to the Veterinary Department: and if this disease is communicable to man, a hearty co-operation between the medical and veterinary profession is necessary in dealing with it "-a practical application of comparative pathology. In a table of 35 cases of this nature compiled by the Medical Department during the period 1921-25, 15 of them were known to
MO
JUBILEE NUMBER.
the writer to have come from areas where infectious abortion of cattle existed, or to have consumed dairy products from infected herds. During the following years as many as 200 such cases were recorded -the actual number must have been .far greater-but recently the number has markedly declined and at present cases are rare. Possibly the population is becoming immune, for abortion of cattle is as prevalent as hitherto. The publication of the above paper in the Transactions of the Royal Society of Tropical Medicine and Hygiene, January 19th, 1922, and of another paper read before the Sections of Tropical Medicine and Comparative Medicine of the Royal Society of Medicine, March 12th, 1925, gave rise to considerable criticism, but it has since been found that Brucella abortus of cattle does, in circumstances which are not even yet precisely understood, occasionally infect man in most parts of the world. But in view of the prevalence of abortus infection of cattle and swine it is remarkable that human cases are so rare. For example, in Great Britain where probably one-third of the cows are infected with the disease, and the milk is frequently contaminated, cases are rarely detected. It is admitted that in man the clinical symptoms are so little characteristic that the disease may be wrongly diagnosed as influenza, tuberculosis, enteric fever, rheumatism, malaria or some other condition. The disease has, however, been detected in Denmark, the United States of America, Canada, Sweden, Poland, Switzerland, Holland and many other countries where infectious abortion occurs. It is commoner in males than females, and most often attacks those between the ages of 15 and 45. It is very uncommon in children under 5 years of age. To account for this very curious incidence of the disease the writer, when attending the N ational Veterinary Medical Association Conference at Folkestone in 1932, hazarded the suggestion that children, by frequently imbibing infected milk might contract the disease in a sub-acute form and thereby derive some degree of resistance. Later, at a meeting of the London Medical Society, he repeated this suggestion and drew attention to the fact that Sven Wall had reported to the Fifth Scandinavian Pathological Congress at Lund, 1932, that in the herds where the calves lived together with the infected cows and were fed upon their milk, the disease in the course of years became less severe in the young animals than in those herds with special stalls containing the infected cows, and" where the calves were fed on sterilised milk. In view of the writer's long association with this problem, it is a somewhat remarkable coincidence that he is now able to record in some detail a case of abortus fever in a child of 5t years, his own daughter, who recently contracted the disease, and it is hoped, is now recovering from a severe infection, the course of which has been carefully observed. The subject, Catherine Mary, was born at Chertsey, in Surrey, on July 9th, 1932, and remained in England until March, 1934. During that period, she received no cow's milk, it being impossible to obtain milk
ABORTUS FEVER.
841
free from the suspicion of tuberculosis and contagious abortion. She was, therefore, brought up on " Cow and Gate" and grew into a fine, welldeveloped baby. On her return to Rhodesia, she was given unboiled milk from a dairy where every possible care was taken to ensure the cleanliness of the milk. Some fi months ago, however, this dairy was removed into the country and milk had to be obtained from another source. In August last, the child contracted measles somewhat severely, and during that period received unboiled milk from the new dairy. Her elder sister contracted measles from her and also received the milk throughout. During the illness of the sister, Catherine, who was recovering, could not be given wholetime attention, but it was soon realised that she did not improve as rapidly as was expected. She was weak and easily tired, and complained of a pain in the left groin. Later, this pain disappeared from the groin, but developed behind the knee, ankles and elbow, and the child became lame and unable to run. Her lassitude increased and at last she became so weak that she had to be kept in bed. Here she suffered from severe sweats, especially in the afternoons, but these were at first attributed to the extremely hot weather. From time to time she complained of a slight sore throat. From day to day she became weaker and rapidly" faded away." Her complexion, previously that of a healthy English child, became putty-coloured, although her lips and conjunctiva: did not indicate ana:mia. Throughout, she was obstinately constipated and her urine was thick with phosphates. Dr. P - - was called in and was at a loss to diagnose the cause of the complaint. He suspected B. coli infection of the kidneys but on examination of the urine by the Public Health Laboratory, no bacteria, albumen, sugar or acetone could be found: indeed, a report of " normal" was returned. In desperation, the writer, on November 27th, when the child appeared in danger of passing away, tested her blood by means of the Abortoscope and almost immediately obtained a positive reaction. Control bloods from himself and her sister were negative, and the latter has remained in excellent health throughout. Apparently she had not become infected from the milk, or by constant attention on her sister. There being no recognised specific treatment for this disease, it, was decided to try the effects of prosepticine which, according to recent literature, is as effective against ha:molytic streptococci as prontosil, but less toxic. As the administration of this drug was left to the writer, he could only summon up courage to apply it at first in small doses ofk gramme, three times a day, but as no ill-effects were noticed, and the patient showed marked improvement, he became bolder and gradually increased the dose to i gramme three times a day. The dosage and quantity administered are shown in the chart. From the second day, when the child had received only It grammes of prosepticine, an improvement was noticed in her clinical condition, and from day to day the improvement increased. The afternoon elevation of temperature and weakening sweats gradually became less and after the 4th day the latter only occasionally occurred. Appetite returned, the patient became cheerful, the temperature, although still slightly irregular, showed no marked elevations. But for a persistent constipation which did not yield to the mild purgatives which only could 'be administered, the patient appeared to be on the road to recovery. Some comments on the above case may be permitted. The history is given in some detail to indicate that no opportunity had occurred for the child to derive immunity by the previous imbibing of infected milk. It is believed that the infection took place during I
342
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343
or after the measles when her natural resistance was lowered. The elder sister was a stronger child and her recovery from measles was more rapid. The characteristic features of the sickness were the afternoon elevations of temperature and severe sweating, the resulting constipation, fleeting pains in the joints, the putty-coloured complexion, extreme weakness and rapid emaciation. The selection of prosepticine'*' was not entirely a " shot in the dark." It was based upon the known specificity of the drug for the streptococci and the fact that the Brucellre were at one time regarded as micrococci. The rapid recovery of one case cannot be attributed with certainty to the drug: it may have been due to naturaL causes : but previous cases observed in this country have persisted for many months and in most cases recovery has only occurred following a change of climate. In this case recovery appeared to synchronise with the administration of the drug. With regard to the source of infection. On enquiry, the dairyman admitted that shortly after he commenced to supply the milk a series of abortions occurred in his herd, and that on testing twelve selected cows the Veterinary Research Department had detected ten to be infected. These observations appear to afford an explanation of some of the mysteries associated with abortus fever, referred to earlier in this article. In presenting these notes the writer desires most gratefully to acknowledge the influence of his great master, Sir John M'Fadyean, whose teaching inspired these investigations and whose encouragement Il}aintained them. And this being the Jubilee issue of his journal, he would wish to record the valuable assistance always obtained from its so carefully edited columns. In an inaugural address to the students of the Royal Veterinary College, Sir John once urged them to endeavour to leave their heritage richer than they found it. He might well have invited them to strive to follow his noble example. REFERENCES.
Report of the Department';l Committee appointed by the Board of Agriculture and Fisheries to enquire into Epizootic Abortion. (1905.) Part 1. M'Fadyean, J., and Stockman, S. (1909). Epizootic Abortion in Cattle. Appendix to Part I of above Report. Bevan, LI. E. W. (1915). Contagious Abortion in Cattle in Rhodesia. J. Compo Path. &J Ther., 28, 9/. (1915). A simple method of obtaining serum for the agglutination test from cattle suspected to be suffering from Contagious Abortion. Ibid. 277. '"After the despatch to us from S. Rhodesia, on December 11th, 1937, of Mr. Bevan's paper, our attention has been drawn [Lancet, 2 (Dec. 11) 1385, Annotation] to the report of another successful treatment of a human patient with compounds of the sulphanilamide group [Bethoux, L., Gourdon. E., and Rochedix, J., Bull Soc. 111M. Hop. Paris, Nov. L3th, 1937, p. 1297. Several cases of recovery after similar treatment have subsequently been recorded.]-Ed.
344
JUBILEE NUMBER.
Bevan, Ll. E. W. (1925). The Abortoscope. A simple apparatus for the detection of Infectious Abortion of Cattle. Vet. J., 81, 476. Ross, G. R. (1927-28). The Agglutination Test in Undulant Fever due to Brucella abortus. A Preliminary Note on the value of the" Abortoscope." Trans. Roy. Soc. Trop. Med. &! Hyg., 57. Evans, Alice C. (1918). Further studies on Bacterium abortus and related bacteria. II. A comparison of Bacterium abortus with Bacterium bronchisepticus and with the organism which causes Malta Fever. J. Infect. Dis., 22, 580. Bevan, LI. E. W. (1921-22). Infectious Abortion of Cattle and its possible Revelation to Human Health. Trans. Roy. Soc. Trop. Med. &! Hyg., 15, 215. (1931). The Correlation between Infectious Abortion of Cattle and Undulant Fever of Man. Vet. Rec., 18, 547. Smith, A. (1937). Chemotherapy of Streptococcal Infections. Lancet, 2, 1064. In a letter dated 5th January, 1928, Mr. Bevan gives further notes on the above case. On 24th December, the patient suffered a relapse and was administered 4 grammes of the drug, but this seemed to affect her heart and breathing, and so the treatment was not pressed further. The patient became" bloodless" and appeared to "fade away."
,1HORTUS FEVER: SOME NOTES FROM SOUTHERN RHODESIA
TREATMENT OF A HUMAN CASE WITH PROSEPTICINE. By 1.1. E. W. BEVAN, M.R.C.V.S., The Trypanosomiasis Bureau, Salisbury, Southern Rhodesia. BOVINE infectious abortion is said to have existed in Southern Rhodesia even before the advent of the white man in 1892, but the evidence advanced is based upon the statements of natives whose powers of diagnosis cannot be relied upon. It was not until 191~~ that the writer, by the application of the agglutination test, proved the presence of specific abortion in two herds, one of which had recently arrived from Northern Rhodesia. The strains of organism used in the tests were derived from Sir John M'Fadyean at the Pathological Laboratory of the Royal Veterinary College, London; from the Nairobi Laboratory, British East Africa; and from the Onderstepoort Laboratory, Union of South Africa. The reactions with the different strains corresponded, indicating tlJat the specific contagious abortion of these countries, namely Great Britain, Kenya, the Union of South Africa, Northern and Southern Rhodesia, were closely related. Samples of the bloods were sent to Sir John M'Fadyean, who was able to confirm the diagnosis. These facts were recorded in this journal of June 30th, 1915. In those days tran~port in Southern Rhodesia was primitive and extremely slow, and it often happened that blood sent to the laboratory in Salisbury for the agglutination test arrived decomposed and putrid. The writer therefore devised a pipette, resembling the Wright capsule, containing a special solution which preserved the blood without interfering with its agglutinating titre. This rendered it possible for the stockman or farmer at a distance to send samples of blood to the laboratory for the test. The method was described in this journal and is used by the Veterinary Research Department of the Colony even to-day. Incidentally it proved of considerable value to the Veterinary Department in that owners of infected cattle by forwarding samples thereby revealed the fact. A modification of this method known as the " Abortoscope" was introduced, by means of which the owners themselves could test their cattle with accuracy. This was useful where regular monthly tests of dairy cattle were recommended, or dairymen desired to " buy in " cows for their herds. It mav be mentioned that the disease was at one time included in the Schedule of Infectious Diseases and the attempt was made to control it. This was extremely difficult in view of the fact that owners failed to report, fearing quarantine and knowing that no specific remedy was available. The detection of the disease was one thing but its effective control under the conditions obtaining in this country,
ABORTUS FEVER.
339
another. Eventually, in despair, the disease was removed from the list of Scheduled Diseases, but it remained as a disease under the Public Health Act and its control was relegated to the Medical Department but was seldom if ever attempted. This appeared to the writer to be a retrograde step and an admission of ignorance on the part of the veterinary profession. To obviate this difficulty-a difficulty which is not peculiar to Southern Rhodesia-the writer experimented with various dead vaccines, the live vaccine being too dangerous to apply under local conditions. He found that several of the co-called " dead" vaccines gave rise to agglutinins in the inoculated animal: but, apparently, agglutinins are not synonymous with immunity although often an indication of it. Finally he introduced a vaccine prepared from massive cultures of Br. abortus attenuated by exposure to chloroform. This was applied in over one hundred outbreaks and in some instances with most favourable results, but in others the results were not so satisfactory. Whether the good results were due to the vaccine or to a natural" wearing out" process is uncertain, but it is remarkable that the cessation of abortions so frequently followed the application of the vaccine. Of course, the vaccine could not restore life to a dead fcetus and the abortion of a dead calf after the application of it was often unfairly attributed to it. Another possible reason for its failure was a concomitant infection with infectious vaginitis which was very prevalent throughout the country. Also, it would now appear, sufficient care was not taken to ensure that the cultures from which the vaccines were prepared were " rough" or" smooth," a factor upon which their antigenic properties are said to depend. In 1916, Dr. Alice C. Evans drew attention to the resemblance between the organisms of contagious abortion of cattle and undulant or Malta fever of man. The importance of this observation was immediately recognised in this country where mysterious cases of undulant fever were occurring although no possible association with goats could be traced. The writer was struck by the fact that many of these cases were from farms where bovine abortion existed, and on November 12th, 1921, he presented a paper to a combined meeting of the Southern Rhodesia Veterinary Association and the British Medical Association, in Salisbury, entitled " Infectious Abortion of Cattle and its possible relation to human health," in which he suggested that these cases of so-called undulant fever were suffering from an infection caused by Br. abortus of cattle. This subsequently proved to be correct. He also said in his paper, " If infectious abortion of cattle is essentially a bovine disease, a grave responsibility attaches to the Veterinary Department: and if this disease is communicable to man, a hearty co-operation between the medical and veterinary profession is necessary in dealing with it "-a practical application of comparative pathology. In a table of 35 cases of this nature compiled by the Medical Department during the period 1921-25, 15 of them were known to
MO
JUBILEE NUMBER.
the writer to have come from areas where infectious abortion of cattle existed, or to have consumed dairy products from infected herds. During the following years as many as 200 such cases were recorded -the actual number must have been .far greater-but recently the number has markedly declined and at present cases are rare. Possibly the population is becoming immune, for abortion of cattle is as prevalent as hitherto. The publication of the above paper in the Transactions of the Royal Society of Tropical Medicine and Hygiene, January 19th, 1922, and of another paper read before the Sections of Tropical Medicine and Comparative Medicine of the Royal Society of Medicine, March 12th, 1925, gave rise to considerable criticism, but it has since been found that Brucella abortus of cattle does, in circumstances which are not even yet precisely understood, occasionally infect man in most parts of the world. But in view of the prevalence of abortus infection of cattle and swine it is remarkable that human cases are so rare. For example, in Great Britain where probably one-third of the cows are infected with the disease, and the milk is frequently contaminated, cases are rarely detected. It is admitted that in man the clinical symptoms are so little characteristic that the disease may be wrongly diagnosed as influenza, tuberculosis, enteric fever, rheumatism, malaria or some other condition. The disease has, however, been detected in Denmark, the United States of America, Canada, Sweden, Poland, Switzerland, Holland and many other countries where infectious abortion occurs. It is commoner in males than females, and most often attacks those between the ages of 15 and 45. It is very uncommon in children under 5 years of age. To account for this very curious incidence of the disease the writer, when attending the N ational Veterinary Medical Association Conference at Folkestone in 1932, hazarded the suggestion that children, by frequently imbibing infected milk might contract the disease in a sub-acute form and thereby derive some degree of resistance. Later, at a meeting of the London Medical Society, he repeated this suggestion and drew attention to the fact that Sven Wall had reported to the Fifth Scandinavian Pathological Congress at Lund, 1932, that in the herds where the calves lived together with the infected cows and were fed upon their milk, the disease in the course of years became less severe in the young animals than in those herds with special stalls containing the infected cows, and" where the calves were fed on sterilised milk. In view of the writer's long association with this problem, it is a somewhat remarkable coincidence that he is now able to record in some detail a case of abortus fever in a child of 5t years, his own daughter, who recently contracted the disease, and it is hoped, is now recovering from a severe infection, the course of which has been carefully observed. The subject, Catherine Mary, was born at Chertsey, in Surrey, on July 9th, 1932, and remained in England until March, 1934. During that period, she received no cow's milk, it being impossible to obtain milk
ABORTUS FEVER.
841
free from the suspicion of tuberculosis and contagious abortion. She was, therefore, brought up on " Cow and Gate" and grew into a fine, welldeveloped baby. On her return to Rhodesia, she was given unboiled milk from a dairy where every possible care was taken to ensure the cleanliness of the milk. Some fi months ago, however, this dairy was removed into the country and milk had to be obtained from another source. In August last, the child contracted measles somewhat severely, and during that period received unboiled milk from the new dairy. Her elder sister contracted measles from her and also received the milk throughout. During the illness of the sister, Catherine, who was recovering, could not be given wholetime attention, but it was soon realised that she did not improve as rapidly as was expected. She was weak and easily tired, and complained of a pain in the left groin. Later, this pain disappeared from the groin, but developed behind the knee, ankles and elbow, and the child became lame and unable to run. Her lassitude increased and at last she became so weak that she had to be kept in bed. Here she suffered from severe sweats, especially in the afternoons, but these were at first attributed to the extremely hot weather. From time to time she complained of a slight sore throat. From day to day she became weaker and rapidly" faded away." Her complexion, previously that of a healthy English child, became putty-coloured, although her lips and conjunctiva: did not indicate ana:mia. Throughout, she was obstinately constipated and her urine was thick with phosphates. Dr. P - - was called in and was at a loss to diagnose the cause of the complaint. He suspected B. coli infection of the kidneys but on examination of the urine by the Public Health Laboratory, no bacteria, albumen, sugar or acetone could be found: indeed, a report of " normal" was returned. In desperation, the writer, on November 27th, when the child appeared in danger of passing away, tested her blood by means of the Abortoscope and almost immediately obtained a positive reaction. Control bloods from himself and her sister were negative, and the latter has remained in excellent health throughout. Apparently she had not become infected from the milk, or by constant attention on her sister. There being no recognised specific treatment for this disease, it, was decided to try the effects of prosepticine which, according to recent literature, is as effective against ha:molytic streptococci as prontosil, but less toxic. As the administration of this drug was left to the writer, he could only summon up courage to apply it at first in small doses ofk gramme, three times a day, but as no ill-effects were noticed, and the patient showed marked improvement, he became bolder and gradually increased the dose to i gramme three times a day. The dosage and quantity administered are shown in the chart. From the second day, when the child had received only It grammes of prosepticine, an improvement was noticed in her clinical condition, and from day to day the improvement increased. The afternoon elevation of temperature and weakening sweats gradually became less and after the 4th day the latter only occasionally occurred. Appetite returned, the patient became cheerful, the temperature, although still slightly irregular, showed no marked elevations. But for a persistent constipation which did not yield to the mild purgatives which only could 'be administered, the patient appeared to be on the road to recovery. Some comments on the above case may be permitted. The history is given in some detail to indicate that no opportunity had occurred for the child to derive immunity by the previous imbibing of infected milk. It is believed that the infection took place during I
342
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343
or after the measles when her natural resistance was lowered. The elder sister was a stronger child and her recovery from measles was more rapid. The characteristic features of the sickness were the afternoon elevations of temperature and severe sweating, the resulting constipation, fleeting pains in the joints, the putty-coloured complexion, extreme weakness and rapid emaciation. The selection of prosepticine'*' was not entirely a " shot in the dark." It was based upon the known specificity of the drug for the streptococci and the fact that the Brucellre were at one time regarded as micrococci. The rapid recovery of one case cannot be attributed with certainty to the drug: it may have been due to naturaL causes : but previous cases observed in this country have persisted for many months and in most cases recovery has only occurred following a change of climate. In this case recovery appeared to synchronise with the administration of the drug. With regard to the source of infection. On enquiry, the dairyman admitted that shortly after he commenced to supply the milk a series of abortions occurred in his herd, and that on testing twelve selected cows the Veterinary Research Department had detected ten to be infected. These observations appear to afford an explanation of some of the mysteries associated with abortus fever, referred to earlier in this article. In presenting these notes the writer desires most gratefully to acknowledge the influence of his great master, Sir John M'Fadyean, whose teaching inspired these investigations and whose encouragement Il}aintained them. And this being the Jubilee issue of his journal, he would wish to record the valuable assistance always obtained from its so carefully edited columns. In an inaugural address to the students of the Royal Veterinary College, Sir John once urged them to endeavour to leave their heritage richer than they found it. He might well have invited them to strive to follow his noble example. REFERENCES.
Report of the Department';l Committee appointed by the Board of Agriculture and Fisheries to enquire into Epizootic Abortion. (1905.) Part 1. M'Fadyean, J., and Stockman, S. (1909). Epizootic Abortion in Cattle. Appendix to Part I of above Report. Bevan, LI. E. W. (1915). Contagious Abortion in Cattle in Rhodesia. J. Compo Path. &J Ther., 28, 9/. (1915). A simple method of obtaining serum for the agglutination test from cattle suspected to be suffering from Contagious Abortion. Ibid. 277. '"After the despatch to us from S. Rhodesia, on December 11th, 1937, of Mr. Bevan's paper, our attention has been drawn [Lancet, 2 (Dec. 11) 1385, Annotation] to the report of another successful treatment of a human patient with compounds of the sulphanilamide group [Bethoux, L., Gourdon. E., and Rochedix, J., Bull Soc. 111M. Hop. Paris, Nov. L3th, 1937, p. 1297. Several cases of recovery after similar treatment have subsequently been recorded.]-Ed.
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Bevan, Ll. E. W. (1925). The Abortoscope. A simple apparatus for the detection of Infectious Abortion of Cattle. Vet. J., 81, 476. Ross, G. R. (1927-28). The Agglutination Test in Undulant Fever due to Brucella abortus. A Preliminary Note on the value of the" Abortoscope." Trans. Roy. Soc. Trop. Med. &! Hyg., 57. Evans, Alice C. (1918). Further studies on Bacterium abortus and related bacteria. II. A comparison of Bacterium abortus with Bacterium bronchisepticus and with the organism which causes Malta Fever. J. Infect. Dis., 22, 580. Bevan, LI. E. W. (1921-22). Infectious Abortion of Cattle and its possible Revelation to Human Health. Trans. Roy. Soc. Trop. Med. &! Hyg., 15, 215. (1931). The Correlation between Infectious Abortion of Cattle and Undulant Fever of Man. Vet. Rec., 18, 547. Smith, A. (1937). Chemotherapy of Streptococcal Infections. Lancet, 2, 1064. In a letter dated 5th January, 1928, Mr. Bevan gives further notes on the above case. On 24th December, the patient suffered a relapse and was administered 4 grammes of the drug, but this seemed to affect her heart and breathing, and so the treatment was not pressed further. The patient became" bloodless" and appeared to "fade away."