"MICROBE HUNTERS."

729 ’destruction of centres which have been demonstrated literature ; that they are clearly derived almost only to have important efferent paths which are afferent from his own imagination or from spurious prompting to the red nucleus or of the red nucleus itself have by others ; and that his knowledge of the subjects been shown to be constantly present in encephalitis with which we have been concerned is obviously lethargica. There is thus evidence that in encephalitis incomplete. Wehave been legally advised that some of his the loss of the righting reflexes is determined by impairment of the function of the red nucleus. assertions regarding ourselves are libellous according Rademaker points out that the rubro-spinal tract is to British laws, but in America we haveno means of probably the efferent path from the red nuclei. protection except a public denial of the truth of his During the last year and a half I have had an allegations, and we therefore trust that you will allow opportunity of examining something over 70 cases us to publish such a denial, as emphatically as we may, exhibiting the post-encephalitic state, and I have found in your columns. Dr. Cuthbert Christy’s signature does not appear on that in all of them the righting reflexes are either this letter as he is in Africa ; before sailing, however, impaired or absent. With regard to *Led by these considerations I have endeavoured by he left us the following statement : special exercises to restore the impaired righting Chapter IX. of Paul de Kruif’s book,Microbe reflexes in these cases, and was astonished to find that Hunters,’ I beg to emphatically state that it contains with such training the righting reflexes reappeared, statements which are totally erroneous, misleading, and I think that I may go as far as to say that the and some of them libellous. As an example I will post-encephalitic improved both subjectively and quote paragraph 2, page 264, which reads : ’The third objectively in proportion to the degree of reappearance member (viz., myself) became disgusted with the of his righting reflexes. The only explanation that ignorance and failures of his two colleagues and went This paragraph is has occurred to me is that alternative paths can off prospecting for rubber...’ by re-education be brought to function in relation absolutely untrue and libellous. I never abandoned to the red nucleus. The post-encephalitic forms the my colleagues, and, as a matter of fact, I did not get most interesting study of neck reflexes in man that I interested in rubber until 1906, which was three years have encountered, but altered righting reflexes are after the labours of the First Sleeping Sickness Comalso found in cases of labyrinthine disturbances and mission were completed." in other conditions. A cinematograph film of the We are. Sir. vours faithfullv. exercises for retraining the righting reflexes in postALDO CASTELLANI. encephalitics has been prepared. GEORGE C. LOW. Finally I wish to make it clear that any observations that I have been able to make are entirely dependent upon the data which, as a result of his researches, Prof. Magnus has brought forward in his addresses, and I HELIOTHERAPY IN PULMONARY am indebted to Dr. P. C. P. Cloake and Dr. G. Eden, TUBERCULOSIS. of the Nerve Hospital, Birmingham, for much valuable assistance in dealing with the neurological problems To the Editor of THE LANCET. "

DAVID NABAR O.

RONALD ROS .

I am,

.involved.

Sir,

yours faithfully, A. LOWNDES YATES. --

STRETCHING THE INTUSSUSCIPIENS. To the Editor of THE LANCET. SiR,-In the encouraging article on intussusception by Mr. Hamilton Bailey in your last issue I note that he obtains help by Daw’s method of stretching the intussuscipiens by forceps. There can be little doubt that reduction is often facilitated and resection In dealing with avoided by some such method. friable and oedematous tissues, however, the finger is a very safe and convenient instrument. By inserting the little finger between the entering and returning layers of the intussusceptum the surfaces can be separated and the cedematous fluid expressed out of the returning and ensheathing layers. I think if this method were used resection would be less often needed. I described and illustrated this method in the British Jozc7.rzal of Surgery, Yo!. IX., p. ;);’)8. I am, Sir. yours faithfully, ZACHARY COPE.

"MICR OB E

H U NT E R S."

A PUBLIC DENIAL.

To the Editor’

of THE LANCET.

Sm.-Our attention has been drawn to a book called Microbe Hunters," recently published by Harcourt, Bruce and Company, New York, and alleged to have been written by one Paul de Kruifa gentleman whose name is quite unknown to us. The work evidently aims at being a kind of popular history or rather romance regarding medical discovery, and mentions us among others. We should like an "

opportunity

to say, for the information of your readers, that the author’s statements about ourselves and our researches are almost entirely apocryphal ; that they are not supported by reference to the original

SiR,-Dr. Chandler’s letter in your issue of Sept. I 1 th (p. 574) advances a reasoned plea in favour of an extended trial of heliotherapy in pulmonary tuberculosis. In the light department of the Royal Free Hospital we have been giving ultra-violet light treatment to cases of quiescent pulmonary tuberculosis not only without harm, but with considerable benefit to the majority. These favourable results have not been secured without " buying our experience." For instance, in one case, a patient who had had a persistent backache following an injury, was freed from this pain by one strong erythema dose only to fall a victim to a serious flare up of an old (and unsuspected) pulmonary lesion. As far as our present experience goes ultra-violet light can be safely given to cases of pulmonary tuberculosis if the following rules be observed. 1. That the initial dose should he one-quarter of the dose that will give the patient an erythema at 20 in., as tested by the " spot " method on the forearm. 2. That this quarter dose be secured by the appropriate increase of distance and not by a diminution of time. 3. That the skin first exposed be the legs and that a gradually increasing area of skin be added day by day. This being the only increase in dosage until the whole body is receiving this quarter erythema dose. 4. That subsequent increase in dosage be obtained by increasing the time of exposure with little or no diminution of the distance.

An accurate record of the weight and morning and evening temperature of these cases should, of course, be kept. In some way which I do not, as yet, understand, certain cases respond better to doses of ultra-violet light from a distance (and among these are cases of pulmonary tuberculosis) than to precisely the same dose, calculated on the inverse square law, when given close to the patient. I should be glad to

know whether any of your readers have formed the opinion from their clinical experience as regards this physical law not being strictly applicable to I am. Sir, yours faithfully, patients. same

C. B. HEALD.