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LYNN THOMAS AND SKYRME FUND.
REVIEWS AND NOTICES OF BOOKF.-LYNN THOMAS & SKYRME FUND.
1424
the blood pressure. 4. A Note on the Distribution of the Salts in Haemolysis, by Dr. Albert Woelfel, from the Hull
Physiological Laboratory, Chicago. The Scottish Medical and Surgical Jocrnal.-In the April issue is published the first instalment of an article by Dr. A. H. F. Barbour on the Frozen Sections made by Bumm and Blumreich and by Zangemeister and the question as to whether there is
a
lower uterine
segment. Mr. David M.
Greig records a case of Henoch’s purpura which simulated intussusception ; there were pain, vomiting, and diarrhoea, with passage of blood frcm the bowel and the presence of a in the right iliac fossa. At the laparotomy this last was found to be due to" great congestion of the lower end of the ileum which projected as a distinct collar into the caseum." Dr. J. Wallace Milne gives notes of a case of chronic intussusception in a girl, aged ten years, who recovered after resection of a portion of the bowel ; and Dr. Norman Walker discusses the use of chrysarobin in psoriasis in a paper which is illustrated by a very good coloured picture of the untreated disease, as well as by some others showing the results of treatment.
palpable lump
The West London Medical Journal.-The April number of this quarterly journal contains an article by Dr. Andrew Wylie on the causes, pathology, and treatment of foul breath. Mr. W. H. Bowen writes on pneumococcal otitis media, and among other causes blames the too familiar I I infant’s comforter"for some instances of infection. An abstract of two lectures by Dr. Harold Pritchard on specific inoculation does not add much to our knowledge on this
subject. The Medical Chronicle.-Only one original article appears in the April number of this magazine. In it Mr. H. W. Bruce and Mr. H. H. Rayner record two cases of acute glanders. The second case was remarkable in that no connexion of the patient with horses could be traced. In both diagnosis was difficult, as the characteristic pustular eruption did not appear till late in the course of the malady. Q2cy’s Hospital Gazette.-In the issue for April 4th the most interesting article is one entitled, "Notes of a Roving Guy’s Man," which deals with the writer’s experiences in Berlin and gives an account of the methods there adopted for medical study and of some of the cases demonstrated by Professor Pels-Leusden. A dental clinical lecture by Mr. J. Lewin Payne deals with the treatment and filling of root. canals. In the following number (April 18th) is an account by Dr. Hertz of the hospitals of Paris, which is to be continued in the next issue. A clinical lecture by Mr. Ormond deals with cataract extraction and gives a tabular statement of the results of 50 consecutive cases. St. Bartholomew’s Hospital Gazette.-In the April number is published a lecture by Dr. H. Morley Fletcher on whooping-cough. By way of treatment he speaks favourably of creasote and cresolene for inhalation and of belladonna as the main drug for internal use. Antipyrin, bromoform, butyl, chloral, and liquid extract of grindelia are also useful. An abstract of a lecture on art and medicine, by Dr. Leonard P. Mark, contains some interesting reading and is illustrated by some reproductions of celebrated paintings. St. Thomas’s Hospital Gazette.-In the March number of this periodical is an interesting paper by Mr. Edred M. Corner on the modern treatment of fractures by means of direct internal splintage-that is to say, by wiring and so forth. It is illustrated by skiagrams showing the apparatus in situ. The London Hospital Gazette.- In the March issue appears a clinical lecture signed " F. J. S." on the subject of medical haemorrhage, with special reference to bsematemesis and gastric ulcer. The indications for surgical interference are considered. May we suggest that members of a learned
profession should not write per oreitt for by the mouth? Two unusual cases of injury to joints are recorded on another page-one of separation of the capitellum of the humerus and the other of dislocation forwards of the whole foot at the ankle-joint. St. George’s Hospital azette.-The March number opens with a further instalment of the paper on ancient medicine, which contains much that is of interest. A note on medical practice at sea, by Mr. Hamilton S. Faber, is also worthy of the attention of those who meditate " going down to the sea in shipsin the capacity of medical officers ; it gives a by no means unattractive picture of the life and duties. LYNN THOMAS AND SKYRME FUND. THE following subscriptions have been received between May 2nd and May 8th by Mr. William Sheen, M.S. Lond., F.R.C.S. Eng. (2, St. Andrew’s-crescent, Cardiff), honorary secretary to the fund. Subscriber of Five Pounds. L. A. R. Wallace, London. Subscribers of Tltree Pounds Five Shillings. Glossop and District Medical Society Members, per Arthur Walker. Subscriber of Two Pounds Ten Shillings. Victoria Central Hospital Staff, per D. Malcolm Smith, Liscard. Subscriber of Two Gnineas. Lieutenant Owen Berkeley Hill, I.M.S., Bangalore, India. Subscribers of One Guinea. Beaumont and Trevor, London. G. Wright Hutchison, Chipping Arthur Burton. Cromer. Norton, Oxon. Ernest Carter, Cheltenham. Keighley and District MedicoErnest H. Cartwright, Ticehurst, Chirurgical Society, per Alfred Sussex. G. Hebblethwaite. G. Lloyd Jones. Cambridge. Henry W. Drew, East Croydon. Theodore Duka, Bournemouth. G. A. Leon, Sidmouth. W. E. Nickolls Dunn, London. Ernest C. Maguire, Brighton. George Fuller England, Win- Gervase G. Newby, East Croydon. cheater. W. G. Scott, Newton Abbott. Thomas Evans Flitcroft, Bolton. J. H. Sequeira, London. William T. Gardner, Bourne- J. 0. Skevington, Windsor. mouth. R. Percy Smith, London. Thomas Fred Higgs, Dudley. Charles Steele, Bristol. J. 0. Hollick, Knowle, near J. Connall Wilson, Haworth, near
Birmingham.
Keighley.
Subscriber of One Pound. Logan D. H. Russell, Bristol. Subscribers of Half a-Guinea. M. D. French, Buralem. J. W. Meek. London. M. Iles, Bhopal, India. Gay WittonMiller,North Thomas John, Swansea. Thoresby, S.O.. Lincs. Walter J. Jolliffe, Shorewell, Isle of William P. Morgan, Seaford, Sussex.
Wight.
Joseph O’Connor, St. Anne’s-on-
A. Hill Joseph, Bexhill-on-Sea. Launcelot E. Jowers, St. Leonards-
the-Sea. T. Richards, Cardiff. T. W. E. Ross, Cardiff.
by-the-Sea.
W. Lockwood, Worthing. A. Angus Martin, North Shields.
Cary
Coombs,
Somerset. T. Muir Murdock,
Subscribers of Ten Shillings. Castle Cary, Elizabeth L. Bristol.
Edinburgh.
Walker
Dunbar.
I
Subscriber of Seven Shillings. S. G. Champion, Bournemouth. Subscribers of Five Shillings. Thomas M. Callender, Sidcup. Lincoln Hatch, Pinner. J. S. Sewell, Horwich, Lanes.
Taynton, London. J. M. Whyte, Dundee.
William
Subscriber of Half-a-Crown. T. H. J. E. Hughes, Meathop, Westmoreland.
DONATIONS AND BEQUESTS.-Under the will of the late Mr. Thomas Webb of Cardiff, University College, London, will receive 5000 to be used and applied, so far as is practicable, for the purposes of physical research ; University College of South Wales and Monmouthshire £5000 for a similar purpose ; and £500 are bequeathed to the Cardiff General Infirmary and 500 to the General Hospital, Tunbridge Wells.-By his will Mr. Caleb Ashworth Tate of West Dulwich has bequeathed .&5000 each to the National Hospital for the Paralysed and Epileptic and the National Society for the Employment of the Epileptic.-The late Mr. R. H. Wood of Sidmouth has bequeathed £1000 to. the funds of the West of England Eye Infirmary, Exeter.
THE ADMINISTRATION OF BACTERIAL VACCINES BY THE MOUTH.
1425
Dr. LATHAM’S paper contaiias records of a number cf cases, 25 in all, of various infections, chiefly tuberculous,
THE LANCET. LONDON: SATURDAY, MAY 16, 1908.
staphylococcal and pneumococcal, in which he administerEd appropriate vaccines by the mouth and sometimes by the rectum, together with normal saline solution or horse serum, and then studied the effects upon the clinical course of the cases, upon the temperature curve, and also upon the opsonic. index. In the course of his observations many hundreds
of opsonic index determinations were made by Dr. SPITTA. and by Dr. INMAN, so that the laborious nature of the The Administration of Bacterial work is obvious, and Dr. LATHAM pays a well-deserved the Mouth. Vaccines tribute to the assistance which he has received in this respect THE interesting and suggestive wOIk of Sir ALMROTH E. from his collaborators. We may briefly review some of WRIGHT and his co-workers has led to a greatly extended use the chief results claimed to have been obtained. In regard of bacterial products or vaccines in the treatment of morbid to the use of tuberculin only one form has been employed conditions due to bacterial invasion and has established this in this research-viz., tuberculin T.R. When given by the form of treatment on a more assured and scientific basis than n even in so small a dose as 1/20000 th of a milligramme, mouth, it had previously enjoyed. Whatever the exact and absolute ttogether with normal saline solution or some other agent practical value of the opsonic index may prove to be as a tto facilitate absorption, it produces a definite effect upon the guide and control in administering vaccines for diagnosis and c opsonic content of the blood. The negative phase produced treatment, the impetus which it has afforded to their use con- after oral administration appears in general to be shorter a stitutes a noteworthy achievement in rational and scientific and less marked than that after hypodermic administraa medicine. At the same time it must be admitted that the ttion, and the positive phase is also shorter, rarely lasting frequent determinations of the opsonic index necessitated by more x than five days, often to be followed by a further short a prolonged course of vaccine treatment involve an ex. negative phase and a more prolonged positive phase. penditure of time on the part of a skilled observer and Ooincidently with these changes there is an improvean expenditure of money on the part of the patient x ment in the clinical features of the cases if the doses of which tend to hinder the wider employment of the ituberculin are suitably administered so as to avoid overtreatment. Dr. ARTHUR LATHAM, in an interesting dosage or too frequent repetition. The temperature falls, communication read before the Medical Section of the Royal the cough becomes less troublesome, expectoration is Society of Medicine1 on March 24th recording a series of c diminished, and the patient has a sense of well-being. A observations made in conjunction with Dr. H. R. D. further noteworthy point is that in three cases with the and Dr. A. C. INMAN, maintains that the use of tuberculin iinverse type of pyrexia the administration of tuberculin and of other vaccines has not been adopted sufficiently, and brought about a return to the ordinary type. Dr. LATHAM suggests that this is due to the necessity for employing the recommends that tuberculin should always be given on an hypodermic method of administration and for the frequent i and best in the stomach morning when the resistance empty estimations of the opsonic index to which reference has is highest. In regard to dosage, he states that the inveatialready been made. Dr. LATHAM’S objects in his research gations have not progressed to a sufficient extent to enable were to overcome these difficulties and to simplify the definite rules to be formulated but the condition of the technique of treatment by vaccines. Undeterred by the patient and the temperature chart afford important indicastatement made by KocH some years ago that tuberculin tions. If the dose chosen dc es good the patient feels administered by the mouth would not confer immunity, he better and the temperature falls, while the other symptoms proceeded to administer it and other vaccines in this manner, improve. If the dose is too large the patient quickly comarguing that they would probably be absorbed if given plains of headache, his appetite fails, and he becomes on an empty stomach together with some substance which listless, though there may be but little iise of temperature. would facilitate absorption, such as normal saline solution If the dose be much beyond what is needed there may be in or horse serum. Dr. LATHAM further argued that, since addition a definite rise of temperature. The smallest dose there is now very strong evidence that some cases of given in these cases was 1/20000 th of a milligramme and the pulmonary tuberculosis are brought about by the absorplargest was 1/200 th. In some cases doses of1/2000 th of a tion of living bacilli from the alimentary canal, it was milligramme or 1/1000 th have been given on two or three reasonable to suppose that the absorption of dead bacilli or successive days with good results. In febrile cases it is of their products would likewise occur and that they would necessary to proceed with greater caution both in regard to, excite the protective mechanisms of the body. This the dose and to the frequency of administration than in assumption received important experimental confirmation localised or afebrile cases. It is of special importance to in a paper by CALMETTE, GUERIN, and BRETON, published avoid any attempt to hurry on the treatment in thee some two months after Dr. LATHAM commenced his own matters, since overdosage has in the past been responsible clinical observations, in which it was shown that the for the discredit which overtook the vaccine treatment administration of specially prepared emulsions of dead In regard tuberculin after its first introduction. tubercle bacilli conferred immunity on guinea-pigs, provided by to the administration of staphylococcal and streptothat the emulsion was not given together with food. coccal vaccines by the mouth it is claimed that the 1 suits are obtained as on hypodermic iniection same of the of No. 6., p. 195. Royal Society Medicine, vol. i., Proceedings
by
SPiTTA j
.
1424
the blood pressure. 4. A Note on the Distribution of the Salts in Haemolysis, by Dr. Albert Woelfel, from the Hull
Physiological Laboratory, Chicago. The Scottish Medical and Surgical Jocrnal.-In the April issue is published the first instalment of an article by Dr. A. H. F. Barbour on the Frozen Sections made by Bumm and Blumreich and by Zangemeister and the question as to whether there is
a
lower uterine
segment. Mr. David M.
Greig records a case of Henoch’s purpura which simulated intussusception ; there were pain, vomiting, and diarrhoea, with passage of blood frcm the bowel and the presence of a in the right iliac fossa. At the laparotomy this last was found to be due to" great congestion of the lower end of the ileum which projected as a distinct collar into the caseum." Dr. J. Wallace Milne gives notes of a case of chronic intussusception in a girl, aged ten years, who recovered after resection of a portion of the bowel ; and Dr. Norman Walker discusses the use of chrysarobin in psoriasis in a paper which is illustrated by a very good coloured picture of the untreated disease, as well as by some others showing the results of treatment.
palpable lump
The West London Medical Journal.-The April number of this quarterly journal contains an article by Dr. Andrew Wylie on the causes, pathology, and treatment of foul breath. Mr. W. H. Bowen writes on pneumococcal otitis media, and among other causes blames the too familiar I I infant’s comforter"for some instances of infection. An abstract of two lectures by Dr. Harold Pritchard on specific inoculation does not add much to our knowledge on this
subject. The Medical Chronicle.-Only one original article appears in the April number of this magazine. In it Mr. H. W. Bruce and Mr. H. H. Rayner record two cases of acute glanders. The second case was remarkable in that no connexion of the patient with horses could be traced. In both diagnosis was difficult, as the characteristic pustular eruption did not appear till late in the course of the malady. Q2cy’s Hospital Gazette.-In the issue for April 4th the most interesting article is one entitled, "Notes of a Roving Guy’s Man," which deals with the writer’s experiences in Berlin and gives an account of the methods there adopted for medical study and of some of the cases demonstrated by Professor Pels-Leusden. A dental clinical lecture by Mr. J. Lewin Payne deals with the treatment and filling of root. canals. In the following number (April 18th) is an account by Dr. Hertz of the hospitals of Paris, which is to be continued in the next issue. A clinical lecture by Mr. Ormond deals with cataract extraction and gives a tabular statement of the results of 50 consecutive cases. St. Bartholomew’s Hospital Gazette.-In the April number is published a lecture by Dr. H. Morley Fletcher on whooping-cough. By way of treatment he speaks favourably of creasote and cresolene for inhalation and of belladonna as the main drug for internal use. Antipyrin, bromoform, butyl, chloral, and liquid extract of grindelia are also useful. An abstract of a lecture on art and medicine, by Dr. Leonard P. Mark, contains some interesting reading and is illustrated by some reproductions of celebrated paintings. St. Thomas’s Hospital Gazette.-In the March number of this periodical is an interesting paper by Mr. Edred M. Corner on the modern treatment of fractures by means of direct internal splintage-that is to say, by wiring and so forth. It is illustrated by skiagrams showing the apparatus in situ. The London Hospital Gazette.- In the March issue appears a clinical lecture signed " F. J. S." on the subject of medical haemorrhage, with special reference to bsematemesis and gastric ulcer. The indications for surgical interference are considered. May we suggest that members of a learned
profession should not write per oreitt for by the mouth? Two unusual cases of injury to joints are recorded on another page-one of separation of the capitellum of the humerus and the other of dislocation forwards of the whole foot at the ankle-joint. St. George’s Hospital azette.-The March number opens with a further instalment of the paper on ancient medicine, which contains much that is of interest. A note on medical practice at sea, by Mr. Hamilton S. Faber, is also worthy of the attention of those who meditate " going down to the sea in shipsin the capacity of medical officers ; it gives a by no means unattractive picture of the life and duties. LYNN THOMAS AND SKYRME FUND. THE following subscriptions have been received between May 2nd and May 8th by Mr. William Sheen, M.S. Lond., F.R.C.S. Eng. (2, St. Andrew’s-crescent, Cardiff), honorary secretary to the fund. Subscriber of Five Pounds. L. A. R. Wallace, London. Subscribers of Tltree Pounds Five Shillings. Glossop and District Medical Society Members, per Arthur Walker. Subscriber of Two Pounds Ten Shillings. Victoria Central Hospital Staff, per D. Malcolm Smith, Liscard. Subscriber of Two Gnineas. Lieutenant Owen Berkeley Hill, I.M.S., Bangalore, India. Subscribers of One Guinea. Beaumont and Trevor, London. G. Wright Hutchison, Chipping Arthur Burton. Cromer. Norton, Oxon. Ernest Carter, Cheltenham. Keighley and District MedicoErnest H. Cartwright, Ticehurst, Chirurgical Society, per Alfred Sussex. G. Hebblethwaite. G. Lloyd Jones. Cambridge. Henry W. Drew, East Croydon. Theodore Duka, Bournemouth. G. A. Leon, Sidmouth. W. E. Nickolls Dunn, London. Ernest C. Maguire, Brighton. George Fuller England, Win- Gervase G. Newby, East Croydon. cheater. W. G. Scott, Newton Abbott. Thomas Evans Flitcroft, Bolton. J. H. Sequeira, London. William T. Gardner, Bourne- J. 0. Skevington, Windsor. mouth. R. Percy Smith, London. Thomas Fred Higgs, Dudley. Charles Steele, Bristol. J. 0. Hollick, Knowle, near J. Connall Wilson, Haworth, near
Birmingham.
Keighley.
Subscriber of One Pound. Logan D. H. Russell, Bristol. Subscribers of Half a-Guinea. M. D. French, Buralem. J. W. Meek. London. M. Iles, Bhopal, India. Gay WittonMiller,North Thomas John, Swansea. Thoresby, S.O.. Lincs. Walter J. Jolliffe, Shorewell, Isle of William P. Morgan, Seaford, Sussex.
Wight.
Joseph O’Connor, St. Anne’s-on-
A. Hill Joseph, Bexhill-on-Sea. Launcelot E. Jowers, St. Leonards-
the-Sea. T. Richards, Cardiff. T. W. E. Ross, Cardiff.
by-the-Sea.
W. Lockwood, Worthing. A. Angus Martin, North Shields.
Cary
Coombs,
Somerset. T. Muir Murdock,
Subscribers of Ten Shillings. Castle Cary, Elizabeth L. Bristol.
Edinburgh.
Walker
Dunbar.
I
Subscriber of Seven Shillings. S. G. Champion, Bournemouth. Subscribers of Five Shillings. Thomas M. Callender, Sidcup. Lincoln Hatch, Pinner. J. S. Sewell, Horwich, Lanes.
Taynton, London. J. M. Whyte, Dundee.
William
Subscriber of Half-a-Crown. T. H. J. E. Hughes, Meathop, Westmoreland.
DONATIONS AND BEQUESTS.-Under the will of the late Mr. Thomas Webb of Cardiff, University College, London, will receive 5000 to be used and applied, so far as is practicable, for the purposes of physical research ; University College of South Wales and Monmouthshire £5000 for a similar purpose ; and £500 are bequeathed to the Cardiff General Infirmary and 500 to the General Hospital, Tunbridge Wells.-By his will Mr. Caleb Ashworth Tate of West Dulwich has bequeathed .&5000 each to the National Hospital for the Paralysed and Epileptic and the National Society for the Employment of the Epileptic.-The late Mr. R. H. Wood of Sidmouth has bequeathed £1000 to. the funds of the West of England Eye Infirmary, Exeter.
THE ADMINISTRATION OF BACTERIAL VACCINES BY THE MOUTH.
1425
Dr. LATHAM’S paper contaiias records of a number cf cases, 25 in all, of various infections, chiefly tuberculous,
THE LANCET. LONDON: SATURDAY, MAY 16, 1908.
staphylococcal and pneumococcal, in which he administerEd appropriate vaccines by the mouth and sometimes by the rectum, together with normal saline solution or horse serum, and then studied the effects upon the clinical course of the cases, upon the temperature curve, and also upon the opsonic. index. In the course of his observations many hundreds
of opsonic index determinations were made by Dr. SPITTA. and by Dr. INMAN, so that the laborious nature of the The Administration of Bacterial work is obvious, and Dr. LATHAM pays a well-deserved the Mouth. Vaccines tribute to the assistance which he has received in this respect THE interesting and suggestive wOIk of Sir ALMROTH E. from his collaborators. We may briefly review some of WRIGHT and his co-workers has led to a greatly extended use the chief results claimed to have been obtained. In regard of bacterial products or vaccines in the treatment of morbid to the use of tuberculin only one form has been employed conditions due to bacterial invasion and has established this in this research-viz., tuberculin T.R. When given by the form of treatment on a more assured and scientific basis than n even in so small a dose as 1/20000 th of a milligramme, mouth, it had previously enjoyed. Whatever the exact and absolute ttogether with normal saline solution or some other agent practical value of the opsonic index may prove to be as a tto facilitate absorption, it produces a definite effect upon the guide and control in administering vaccines for diagnosis and c opsonic content of the blood. The negative phase produced treatment, the impetus which it has afforded to their use con- after oral administration appears in general to be shorter a stitutes a noteworthy achievement in rational and scientific and less marked than that after hypodermic administraa medicine. At the same time it must be admitted that the ttion, and the positive phase is also shorter, rarely lasting frequent determinations of the opsonic index necessitated by more x than five days, often to be followed by a further short a prolonged course of vaccine treatment involve an ex. negative phase and a more prolonged positive phase. penditure of time on the part of a skilled observer and Ooincidently with these changes there is an improvean expenditure of money on the part of the patient x ment in the clinical features of the cases if the doses of which tend to hinder the wider employment of the ituberculin are suitably administered so as to avoid overtreatment. Dr. ARTHUR LATHAM, in an interesting dosage or too frequent repetition. The temperature falls, communication read before the Medical Section of the Royal the cough becomes less troublesome, expectoration is Society of Medicine1 on March 24th recording a series of c diminished, and the patient has a sense of well-being. A observations made in conjunction with Dr. H. R. D. further noteworthy point is that in three cases with the and Dr. A. C. INMAN, maintains that the use of tuberculin iinverse type of pyrexia the administration of tuberculin and of other vaccines has not been adopted sufficiently, and brought about a return to the ordinary type. Dr. LATHAM suggests that this is due to the necessity for employing the recommends that tuberculin should always be given on an hypodermic method of administration and for the frequent i and best in the stomach morning when the resistance empty estimations of the opsonic index to which reference has is highest. In regard to dosage, he states that the inveatialready been made. Dr. LATHAM’S objects in his research gations have not progressed to a sufficient extent to enable were to overcome these difficulties and to simplify the definite rules to be formulated but the condition of the technique of treatment by vaccines. Undeterred by the patient and the temperature chart afford important indicastatement made by KocH some years ago that tuberculin tions. If the dose chosen dc es good the patient feels administered by the mouth would not confer immunity, he better and the temperature falls, while the other symptoms proceeded to administer it and other vaccines in this manner, improve. If the dose is too large the patient quickly comarguing that they would probably be absorbed if given plains of headache, his appetite fails, and he becomes on an empty stomach together with some substance which listless, though there may be but little iise of temperature. would facilitate absorption, such as normal saline solution If the dose be much beyond what is needed there may be in or horse serum. Dr. LATHAM further argued that, since addition a definite rise of temperature. The smallest dose there is now very strong evidence that some cases of given in these cases was 1/20000 th of a milligramme and the pulmonary tuberculosis are brought about by the absorplargest was 1/200 th. In some cases doses of1/2000 th of a tion of living bacilli from the alimentary canal, it was milligramme or 1/1000 th have been given on two or three reasonable to suppose that the absorption of dead bacilli or successive days with good results. In febrile cases it is of their products would likewise occur and that they would necessary to proceed with greater caution both in regard to, excite the protective mechanisms of the body. This the dose and to the frequency of administration than in assumption received important experimental confirmation localised or afebrile cases. It is of special importance to in a paper by CALMETTE, GUERIN, and BRETON, published avoid any attempt to hurry on the treatment in thee some two months after Dr. LATHAM commenced his own matters, since overdosage has in the past been responsible clinical observations, in which it was shown that the for the discredit which overtook the vaccine treatment administration of specially prepared emulsions of dead In regard tuberculin after its first introduction. tubercle bacilli conferred immunity on guinea-pigs, provided by to the administration of staphylococcal and streptothat the emulsion was not given together with food. coccal vaccines by the mouth it is claimed that the 1 suits are obtained as on hypodermic iniection same of the of No. 6., p. 195. Royal Society Medicine, vol. i., Proceedings
by
SPiTTA j
.