TROPICAL DISEASES.

1898. Hindu writer gave instructions to his fellowto what steps to take in the event of an outbreak of plague and laid stress upon the point that whenever a mortality amongst rats was observed they were to leave the locality. The rat infection was therefore very old as even in Biblical history we found the same animals or rather mice named as sources of infection. In remarkable confirmation of the behaviour of plague in Hong-Kong was the evidence given by Fryer, who stated that the great city of Surat in India was visited by plague in 1684 and that the disease continued for six years. HongKong was now in the fourth year of its infection and there seemed no certaintv that the visitation was over. Dr. Simpson was of that the Levantine plague, although allied to the Indo-China plague, was a species that was dying out and different in the acuteness of its powers of infection and destruction from the deadly disease now raging now understood by gout. in India and China. He was of opinion that the pandemic form in India might invade countries where the more atGeneral Revort. tenuated form of the disease now existed, and that as plague This first meeting in connexion with the Association on the was a slow traveller it behoved Western Asia and Eastern subject of Medicine in relation to Life Assurance was, on the Europe to keep a careful watch on the spread of the disease. whole, exceedingly successful. This was due largely to the Dr. Simpson discussed the prevalence of fever with fact that the meetings took place at a centre of life glandular enlargements which occurred in the Shropshire It is the first occasion on which actuaries have assurance. regiment, which went from Hong-Kong to Calcutta, after met medical officers in debate by formal invitation and the being engaged in cleansing duties in Hong-Kong during the experiment has proved very satisfactory. The attendance 1894 epidemic there. In January, 1895, the regiment went was good at all the meetings, though slow to collect on to Calcutta and this disease was first diagnosed as syphilis, the first day; during the last two days exceptionally so. then as malarial fever with bubo, and finally the cause was The papers were all short, giving ample time for discussion. declared to be unknown. In June, 1896, one of the medical There was a total absence in the papers and discussion of officers to the regiment was attacked with fever and the tedious references to medical points of common knowledge glands of the neck, axilla, and groin were all enlarged. A sometimes introduced into such debates ; all that was goodly number of similar cases were met with in the town ; said had a direct bearing on life assurance. The figures moreover, the rats became sick and the grain stores swarmed submitted were object lessons of statistical science. The with diseased and dead rats. In spite of opposite evidence conference arranged between the Section of Laryngology it was well-nigh certain that plague in a sporadic form had and Otology and the above Section by Dr. McBride, in been in Calcutta since 1895 or 1896. Even in the spring of reference to the question of middle ear disease, was a happy 1898, when plague was in evidence, it was held by some thought and proved most successful and instructive. The that it was "only malarial fever accompanied by buboes." only flaw in the arrangements-and this was a serious one- Dr. Simpson advocated a proper sanitary service for India and was that the meetings took place at the same time as those gave in detail the essentials of such a service. He continued:-. of Medicine and Surgery. Several members expressed 11 I divide the medical part of a sanitary service into three their regret at not being able to be present as they were branches-(l) the administrative, (2) the investigative, and obliged to be at other sections. Life assurance is not (3) the scientific-which should be in close connexion with in the ordinary sense a specialty but a special applica- one another and in large towns should form parts of one tion of medicine carried out by general physicians and large department. Broadly, in England the administrative surgeons, and meetings to discuss the subject should be is represented by the local health officers and their suborarranged so as not to clash with the meetings on general dinates, the investigative by the medical inspectors of the subjects. This might be done by holding the meetings in Local Government Board, and the scientific by the laborathe afternoon, the other sections being held in the morning. tory researches made into the causes of disease in conIt is scarcely likely that when the Association meets at nexion with special investigations of either the medical places not the headquarters of life assurance this section will inspector or local health officer. The Government of hold so important a position as in the present instance, India has always been imbued with the great importance of nor could a like attendance of actuaries be obtainable. One establishing laboratories in India, but the state of finances or two papers, therefore, read in the afternoon on questions has invariably blocked the way. This difficulty, however, of special importance would probably meet the circumstances, in a most charming and unexpected manner disappeared if, indeed, it would not be better to omit this subject from in 1897, when a number of the Princes in India expressed the programme except when the meetings are at insurance their desire to commemorate the sixtieth year of Her centres. The predominant note through all the meetings Gracious Majesty’s reign by establishing a Health Institute was a desire to get more accurate knowledge of the value of for India, which should have M. Haffkine as its first aberrations from the normal by means of a joint inquiry by director. The spontaneity of the offer and the generosity medical officers and actuaries through the records of life with which it was made were enhanced by the peculiar offices. appropriateness of this Royal memorial to our beloved Empress Queen, whose reign has been so distinguished for TROPICAL DISEASES. the advances made in scientific and preventive medicine. The Princes were anxious that the site should be chosen and FRIDAY, JULY 29TH. the foundation of the Health Institute laid on the day of the Dr. AKDREW DAVIDSOX. LL.D. (Edinburgh), Vice-Pre- Jubilee. Owing to delays over which possibly the Governsident, in the chair. ment of India had not full control, in consequence of its The attendance at this section was very gratifying to the plague and famine work, the auspicious day was allowed organisers, for up to the very end of the meeting, at to pass and no foundation-stone was laid. Everyone 1.30 P.M., on Friday a large number still took an active acquainted with India will know the importance of an part in the proceedings. The whole meeting on July 29th auspicious day. It is the symbol of success and good was given up to a discussion on Plague. fortune." Dr. W. J. SmsPSOw, late medical officer of health of Professor W. M. HAFFKINE, C.I.E., and Surgeon-Major Calcutta, read a paper on I.M.S., communicated a paper on BANNERMAN, Plague in India. The of Xcz,’kinze’s Plagite Prophylactio in PlagueTesting Dr. Simpson paid a graceful tribute to the excellent work ’, str’ieken Con-77iqtnities in India, and the heroism displayed in India by medical men, nurses, civil and military officers, missionaries, and native assistants. which was read by the HONORARY SECRETARY. A series In India plague was not an endemic disease but an exotic with of experiments upon animals was recorded and the imlong intervals of mostly over one hundred years. In 542 A.D. munity conveyed and the powers of recovery of protected accounts of plague v.’ere met with in Indian annals. Some 800 persons by inoculation with plague serum were stated. It

extra rates charge<1 had covered only about half the real extra risk. The PRESIDENT urged the necessity of offices combining to make a uniform extra rate for gout. Dr. SPRAGUE (actuary) advocated independent action in the matter, remarking that in the long run it would be better not to interfere with the action of offices willing to take unfair risks. Dr. BALFOUR GRAHAM (Leven) thought the extra risk due to gout had been reduced of late years on account of the discovery of medicinal solvents of the gouty products. Mr. CHATHAM pointed out the fallacy of rating up endowment policies in the same way as all life policies. Mr. Low raised the question as to the value of the figures, relating as they did to old experience ; he thought the condition then designated gout might be different from what is

____

years ago

a

countrymen

as

opinion

451 would appear from undeniable testimony that the protection afforded was most pronounced and that the possibility of recovery of inoculated persons when attacked

PHYSIOLOGY.

WEDNESDAY, JULY 27TH.

As examples of protection the was highly satisfactory. Professor ‘’ILLZ.3DS RUTHERFORD (Edinburgh), the Prefollowing statements were given: 1. Half the inmates sident of the Section, delivered an address on of the Byculla House of Correction were inoculated Tone 5eimation 7vitk Reference to the Fllndion of From with Haffkine’s serum on Jan. 30th, 1897. the Cochlea. and uninoculated this date the inoculated lived together address is This published in another part of our present under exactly similar circumstances during the time issue. Of 173 12 were unprotected persons plague prevailed. Dr. AUGUSTUS D. WALLER (London) read a paper on attacked by plague and 6 died ; and of 148 protected persons 2 were attacked and none died. 2. During 1897 8200 The Action of Anaesthetics on Tegetable and Animal persons were inoculated in Bombay, of whom 18 (all natives) Protoplasm. were attacked and only 2 died, and these two developed This was an extension of previous work on the action of plague symptoms within twenty-four hours after inoculation. anaesthetic gases on living matter in which nerve and muscle 3. In Lanowlie, a small hill station near Poona, with a popu- were used as examples. In the present lation under 2000, a recrudescence of plague occurred. The research other representative such as spinal cord and tissues, protoplasmic officers of the Research Laboratory took charge of two wards and vegetable protoplasm in the form of cells of retina, of the town most severely attacked and made a house-tovallisneria, Elodea Canadensis (the Canadian duckweed), house visitation, carefully noting the effects of previous inocu- and nitella were investigated. Dr. Waller then gave a brief lation. Of 323 protected inhabitants 14 were attacked and of his method of experiment by a series of explanation ’7 died ; whilst of 377 unprotected persons 78 were attacked lantern slides, showing the arrangement of the nerve upon the and 58 died-a reduction in mortality by inoculation of or "questioning" electrodes and the electrodes stimulating 85’7 per cent. 4. Of a section of the Mussulman community connected with the or "answering " electrodes. of Bombay 5184 were inoculated and 8146 remained unpro- He then described galvanometer an apparatus by which the effects of a tected. Amongst the former 7 deaths and amongst the stream of an anaesthetic gas could be studied on a vegetable latter (the unprotected) 177 deaths occurred from all causes. cell of elodea) and a frog’s nerve simultaneously, the (e.g., Altogether inoculation lessened the mortality by 86 per stream of gas passing through a moist cell in which the cent.-a result which was sufficient to establish inoculation vegetable cell was examined by a microscope and then through as a preventive and remedial agent in plague of high value. a moist chamber in which the frog’s nerve was arranged in the Brigade-Surgeon-Lieutenant-Colonel DIMMOCK, I.M.S., usual way. The effect on the vegetable cell was studied by

gave a brief outline of The 1I1eas1lres Adopted for Dispelling Plague in Bombay. It would appear that the city was carefully watched, inspected and disinfected by well-organised bands of workers from almost the very commencement of the epidemic, and endeavours were made to induce the native accede to the requirements of sanitation. An abstract of Surgeon-Captain L. F. CHILDE’S report to the Plague Research Committee in Bombay on the

that

unceasing

population to

read

Pathology of Plag1le by Brigade-Surgeon-Lieutenant-Colonel

ARNOTT. is met with in three varieties. First, the bubonic form. In this variety the main glandular lesion was met with at the seat of the primary bubo and but slight signs of disease were found in other glands. Associated with this engorgements and petechiaa or haemorrhages were found in nearly all viscera. Second, the septicasmic form. Glandular enlargement in this phase of the disease was general in all parts except in the mesenteric glands. Here evidences of change were less distinct and the necropsies showed that the plague bacillus had not reached the stomach or intestines by the food. Third, the pneumonic form of plague. Whilst the lymphatic glands and other organs were scarcely affected the lungs were engorged with pneumonic patches here and there, or occasionally half the lower lung was found in this state. The bronchial glands were either swollen or oedematous or quite normal. Surgeon-Major BAKER, I.M.S., referred to the great danger to which workers at house-cleaning in plague were subjected when infected materials were handled or moved by them before disinfectants were applied. Mr. CANTLIE (London) referred to the excellent work done by Yersin, but wished to discredit the notion that Yersin’s name should be associated with Kitasato’s in the discovery of the plague bacillus. Kitasato was demonstrating plague bacilli a week before Yersin had his preparations ready. Mr. Cantlie stated that he believed India was only commencing her plague troubles and that the urgency for a sanitary service for India as suggested by Dr. Simpson was imperative. After the business of the meeting was over Dr. ANDREW DAVIDSON, the chairman, proposed that the section should send a message of congratulation to Surgeon-Major Ronald Ross at Calcutta upon the brilliant work he has done in connexion with the extra-corporeal life of the plasmodium malarise and that a vote of thanks be accorded to Dr. Patrick Manson for his exposition of and share in Surgeon-Major ZD Ross’s work. The proposition was unanimously carried, as was also a vote of thanks to the honorary secretaries. was

Plague, according

to

Surgeon-Captain Childe,

watching the rotation movements of the protoplasm and counting the number of chlorophyll bodies which passed a given spot per minute ; the effect on the nerve was studied in the usual way by the galvanometric response. The results

follows : nitrous oxide had little or no action on nerve, and the same result was obtained with vegetable protoplasm. Carbon dioxide caused a diminution of the electromobility of the nerve and an arrest in the movements of the plant protoplasm, followed in each case by a return to and beyond the normal as the effect passed off. Ether caused a diminution or arrest of these functions followed by a return to the normal both in the case of the nerve and of the plant. Chloroform caused complete and permanent abolition in both cases. Dr. Waller had also studied the effect of anaesthetics on the electrotonic currents obtained in a long cell of nitellae.g., carbon dioxide caused a temporary abolition of these currents which returned as the carbon dioxide passed off. He had also studied the effect of anaesthetics on the retinal currents obtained by illuminating the eyeball of a frog with standard amounts of light at regular intervals and found the same difference between the action of ether and chloroIn conform as he had previously found for nerve. firmation of these results he had also investigated the effect of ether and chloroform on the reflex excitability of the frog’s spinal cord. A slight dose of strychnine was given and the frog arranged in a bell jar and a slight touch applied to its hind limb at a definite rate, say once a minute, yielding a reflex jerk. He found that ether abolished this reflex response, but only temporarily ; chloroform, on the other hand, abolished it completely and permanently. It was of interest to note that these effects occurred with weaker strength of ether and chloroform than was the case with nerve or the heart. On the whole, however, nerve was by far the best living tissue to use in these investigations.-In the discussion which followed Professor WAYMOUTH REID objected that since the frog was suspended in a bell jarthe air of which was impregnated with the vapour-a possible fallacy existed in that the results might have been primarily due to the action of the anaesthetic on the endings of the nerves in the skin. Dr. CORSAR STURROCK (Edinburgh) then read a paper on the Selective P07ver of Tissu.es, as illustrated in the mammary gland, in which he especially first briefly discussed the process of selection in general and then pointed out that no tissue possessed this power in so striking a degree as the mammary gland, since it produced a material, not for the nutrition of its own cells or of the organism of which it is a part, but of an entirely different organism. It selected from the blood a food, milk, resemfreely-chosen bling in the proportions of its constituents thediffered in the diet of an adult, from which it, however, were as