CASE-TO-CASE INFECTION IN PNEUMONIA.
next aneesthetised, then submitted to operation, and finally passed on into a series of cubicles forming practically a little hospital. Other institutes, including that at University College, London, have been based on this model. Under these conditions the success of a gastric or intestinal fistula became as certain as that of a simple aseptic operation in man. By means of the gastric fistula Pavlov demonstrated the secretion of gastric juice before food actually reached the animal’s mouth, and the absence of such secretion unless the animal regarded his food with relish. Starting from these observations he gradually built up the whole modern teaching of the sequence of the digestive processes. Pavlov’s second and equally important work on conditioned reflexes has been less widely recognised, for it is as yet only accessible in original Russian and partly in German translation. He was the first to investigate the functions of the higher centres of the brain by strictly physiological method and to show how extremely modifiable by concurrent circumstances are the reflexes obtained from the higher centres. The building of a new laboratory with thick walls and small windows, in order to shut out disturbing external stimuli, became a necessity for this research. A growing insight into the mechanism of inhibition has been the result of this work, some clue to the essential nature of sleep, and a means of estimating the sensibility of the various sense The lecturer did not suggest it, but it organs. seems likely that Pavlov’s work may throw light on the omnipresent factor of inhibition shown by sufferers from shell shock, and that a knowledge of his work on inhibition may prove to be an indispensable preliminary to the proper understanding of the psycho-analytic method. The lecture was attended on behalf of the Russian Ambassador by Baron Heyking, who gracefully acknowledged the growing recognition in this country of the achievements of Russian science. Over and above the originality of his work, amounting to real genius, Pavlov’s generosity to his co-workers and pupils has made him the subject of a devoted affection and has formed a link in the chain of the Anglo-Russian scientific entente which is becoming realised. CASE-TO-CASE
INFECTION
IN
PNEUMONIA.
RECENT authorities agree that while
pneumonia
communicable disease, it is not from transmitted readily person to person. Limited of have been described, for pneumonia epidemics the most part before the discovery of the pneumois
unquestionably
a
had made the diagnosis a matter of precision. Even in epidemics where this organism has been proved to be the infective agent it must be remembered that the pneumococcus is such a frequent inmate of the fauces and naso-pharynx in health as to make it difficult to prove direct transference from person to person. When in two cases successively occurring in a household the same organism is isolated, the seed may have been lying dormant in each case and some common preparation of the soil have determined the incidence of the disease. The matter is still further complicated by the probability " of the existence of healthy carriers" of this as of the meningococcus. If the pneumococcus were not a single well-defined entity but included differing strains capable of precise identification, transference might more easily be demonstrated. In a brief paper in the June issue of the Medical Journal of South Africa, Mr. F. S. Lister contends that this is the case, and he cites, as an instance, coccus
687
the successive illnesses of a married couple where the husband had acted as nurse to his wife and fell a victim to a precisely similar attack of pneumonia after an interval of 11 days. From the sputum of the second case Mr. Lister isolated, by passage through a mouse, a pneumococcus of a strain " G," which he identified through its agglutination by a stock anti-serum as belonging to a strain occurring but rarely in Europeans in South Africa, and this pneumococcus " G " gave the serological reaction in both the husband’s and the wife’s case, while no other strain which he tried did so. Recent researches by Dochez, Gillespie, and Avery in America confirm this view of the pneumococcus as a generic rather than a specific organism, and a further application of serological methods of identification may settle the vexed question of the origin of pneumonia epidemics. ALCOHOL AND THE DEVELOPMENT OF THE FŒTUS.
I
THE present times have brought about at least desirable condition of things-the serious problem and the serious man are more likely to receive serious attention than has been the vogue for many years past. More than this, the consideration of the serious problem and the serious man is far less likely to be upset by the pratings of the crank than was the case in times of peace. Into the workings of the legislature and into the workings of the laboratory alike has come a feeling that simple issues must be dealt with upon simple and effective lines, and that the eccentric and the mental gymnast must not be heard too far on questions into the solution of which much common sense and much accumulated human experience enter. For some years past it has been the fashion to pay an undue degree of homage to work which produced results contrary to common sense and accumulated experience. There is no need to single out examples of this type of research, for time and again we have been told that by some method-statistical, bacteriological, or chemical it may be-it had been determined beyond dispute that some custom we all supposed to be healthful was in reality bad, or some habit we all supposed to be noxious in reality did no harm to us nor to our descendants. With the accumulation of very much more of this type of work we might have looked for a day when the visitation of the sins of the fathers upon the children would have been regarded as an archaic formula. Of all questions which touch upon the present and future welfare of mankind, none has been exposed so much to the labours of the eccentric as has that of the influence of parental alcoholism the upon offspring. Common sense prompted the belief that the taking of any toxin into the system of the parent would probably affect the health of the germ cell, and so tend to be a harmful influence upon the well-being of the next generation. Accumulated experience confirmed this belief, and the average man confidently looked to see the children of alcoholic parents suffer in some degree from their parentage. In times of peace, when the breeding of the race up to its maximum of physical and mental effectiveness was not felt to be of the urgent moment that it is to-day, this was a subject in which any startling finding merely made a pleasing mental diversion. To be told that all our ideas upon the subject were wrong was a stimulus to academic argument, and provocative of but little else. But now if common sense and accumulated one
I
I