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NEW ZEALAND
420
Dr. A. Q. WELLS described briefly the characteristic features of the vole bacillus, which because of its natural habitat he prefers to call the murine strain of tubercle bacillus. It was established experimentally that a live vole-bacillus vaccine produces a non-progressive lesion in various animal species-guineapig, rabbit, cattleand that in the guineapig the resistance induced to subsequent infection is equal to or greater than that induced by B.C.G. vaccine. Dr. Wells described his personal experience with the inoculation of this vaccine in man by subcutaneous, intradermal, and multiplepuncture methods. Subcutaneous inoculation in 48 people of varying ages produced local reactions in all, with in most cases ulcerative lesions up to 3 cm. in diameter, and although all were tuberculin-positive within four weeks and were still positive after a year, the severity of the local reaction precluded this method for large-scale trials. Intradermal inoculation was tried in only a few people, but 79 older boys and young adults were chosen at random from a large number of tuberculin-negative reactors in an institution for inoculation by multiple
puncture.
The
technique
is to
place
a
disc of
filter-paper
soaked in 1-5 mg. of the vaccine on the upper arm, place the perforated plate of the multiple-puncture instrument firmly on top, and then, by releasing a spring, puncture with many needles through the filter-paper into the skin. Little or no pain is felt. The reaction takes the form of small red papules which persist for one to three months, leaving behind some shotty thickening of the skin but no ulceration and no regional adenitis. In this group 73 of the inoculated were tuberculinpositive at nine weeks ; all were positive at thirteen weeks and -remained so for an observation period of thirty-two months ; while 36% of a control group became tuberculin-positive in that time. Dr. Wells was convinced of the safety of the volebacillus vaccine in man, and felt that it has this advantage over B.C.G.: that since its virulence for the natural host can be maintained at a steady level, the vaccine is likely to be a more stable antigen than B.c.G., which cannot be accepted as a " virus fixe." CONTROL OF
TUBERCULOSIS
IN
CATTLE
The value of B.c.G. vaccination in the control of tuberculosis in cattle was discussed by Prof. T. DALLING. The vaccine produces in calves a non-progressive infection and raises their resistance to virulent experimental infection introduced either intravenously or by mouth. Intravenous injections of the vaccine are more satisfactory than subcutaneous or intradermal inoculations which often result in abscess formation. A positive tuberculin reaction can best be maintained by intravenous injections at six-monthly intervals of 50 mg. of a wet culture from the surface of solid egg-containing media. Of two field trials, the first and smaller was completed. 47 calves were placed on four farms where the incidence of natural infection was quite high. Calves were given 100 mg. of vaccine intravenously before going on the farms and then 50 mg. six-monthly. Only 23 of the vaccinated animals were available for study at the end of the trial, and 6 of them had non-progressive tuberculosis whereas 61 of 116 control " contacts were infected and of these 19 had progressive tuberculosis. The second trial was much more extensive and run on different lines. Calves born on farms with a high incidence of natural tuberculosis were tuberculin tested and if negative were given inoculations of 50 mg. B.C.G. intravenously at six-monthly intervals. There were a number of deaths and delayed reactions with loss of weight following the injections, occurring after the first or any of the subsequent inoculations. The calves were not wittingly exposed to infection until they reached maturity, when they gradually replaced tuberculin reactors in the herd. There were no control unvaccinated animals. Of 73 herds, involving some 5000 cattle, 27 have
Here,
the trial-that is, all the animals have been vaccinated and have lost their sensitivity to tuberculin, so that the farm now has a registered T.T. herd. A further 19 herds have completed the trial and await the final tuberculin test before registration.
completed
TIIE VOLE BACILLUS
It seems,
therefore, that this method may be useful in
eradicating bovine tuberculosis from herds of cattle over a period of time. The experiment bears a resemblance to the method adopted with considerable success for the control of tuberculosis among the inhabitants of the island of Bornholm, and may suggest another mode of attack in the successful fight which man is waging
against tuberculosis. NEW ZEALAND FROM OUR OWN CORRESPONDENT
Dr. R. S. Aitken, who has been appointed vicechancellor elect of Otago University, Dunedin, expects to leave his present post of regius professor of medicine at Aberdeen in August. All the four university colleges in New Zealand are appointing full-time principals (or vice-chancellor in Otago). Sir Thomas Hunter is the principal in Wellington, and Dr. Hulme has been appointed to Canterbury College, Christchurch. The appointment in Auckland has not yet been made. Last January the senate adopted a report on medical education which recommended the continuance of the present limit of admission of 120 students per annum, with a quota system for the various centres. The General Medical Council’s recommendation of 5 terms for anatomy and physiology, with a subsequent term introductory to clinical work, was also adopted. The present distribution of final-year students to the four centres, without substantial development of teaching facilities in any one of the other centres, was confirmed. A hospital year after graduation and before full registration was to be sought from the Medical Council. Postgraduate education was left very much in its present elementary state. These decisions were not uncontested. Some thought it wrong to deny to properly prepared students the right to study medicine ; some wanted the final-year students-some half the students in each clinical year-massed in one centre away from Dunedin under professorial teaching units ; and some wanted a major development of postgraduate effort and clinical research also under university units ’in another centre. All these things, however, were denied, and the committee on medical education was dissolved. POLIOMYELITIS EPIDEMIC
During the past -three months there have been about 160 cases of poliomyelitis, including 120 in the Auckland district. There has been an unusually large proportion of cases with encephalitis and also with muscle spasm, but a low proportion with serious paralysis. There have been 7 deaths. On Dec. 1 the Health Department closed the schools and swimming-baths, and banned gatherings of children and swimming on city beaches. In spite of a blazing summer, these precautions have been well observed. Whether respect for authority or fear of the disease counted most is hard to say. ’ Schools may possibly reopen in the South Island early in March. Since the end of December cases have been less severe, suggesting a decline in virulence. Since early in January Kenny technicians have been working in the Auckland Hospital alongside the regular physiotherapists, sharing the patients. All cases have made good progress. The outstanding feature in treatment has been the success of hot packs in relieving muscle spasm and pain in the early stages. OVERSEAS TRAVELLERS
Mr. W. S. Robertson, orthopaedic surgeon of Wellington, was sent to the United States in December by the government to look into matters connected with poliomyelitis. Mr. Douglas Robb, thoracic surgeon of Auckland, is also visiting the States and Britain at the government’s request, to study cardiac surgery with particular reference to Blalock’s operation for pulmonary stenosis. A clinic for congenital heart diseases is to be set up in Green Lane Hospital, Auckland, to receive cases from all parts of New Zealand.
Dr. A. Q. WELLS described briefly the characteristic features of the vole bacillus, which because of its natural habitat he prefers to call the murine strain of tubercle bacillus. It was established experimentally that a live vole-bacillus vaccine produces a non-progressive lesion in various animal species-guineapig, rabbit, cattleand that in the guineapig the resistance induced to subsequent infection is equal to or greater than that induced by B.C.G. vaccine. Dr. Wells described his personal experience with the inoculation of this vaccine in man by subcutaneous, intradermal, and multiplepuncture methods. Subcutaneous inoculation in 48 people of varying ages produced local reactions in all, with in most cases ulcerative lesions up to 3 cm. in diameter, and although all were tuberculin-positive within four weeks and were still positive after a year, the severity of the local reaction precluded this method for large-scale trials. Intradermal inoculation was tried in only a few people, but 79 older boys and young adults were chosen at random from a large number of tuberculin-negative reactors in an institution for inoculation by multiple
puncture.
The
technique
is to
place
a
disc of
filter-paper
soaked in 1-5 mg. of the vaccine on the upper arm, place the perforated plate of the multiple-puncture instrument firmly on top, and then, by releasing a spring, puncture with many needles through the filter-paper into the skin. Little or no pain is felt. The reaction takes the form of small red papules which persist for one to three months, leaving behind some shotty thickening of the skin but no ulceration and no regional adenitis. In this group 73 of the inoculated were tuberculinpositive at nine weeks ; all were positive at thirteen weeks and -remained so for an observation period of thirty-two months ; while 36% of a control group became tuberculin-positive in that time. Dr. Wells was convinced of the safety of the volebacillus vaccine in man, and felt that it has this advantage over B.C.G.: that since its virulence for the natural host can be maintained at a steady level, the vaccine is likely to be a more stable antigen than B.c.G., which cannot be accepted as a " virus fixe." CONTROL OF
TUBERCULOSIS
IN
CATTLE
The value of B.c.G. vaccination in the control of tuberculosis in cattle was discussed by Prof. T. DALLING. The vaccine produces in calves a non-progressive infection and raises their resistance to virulent experimental infection introduced either intravenously or by mouth. Intravenous injections of the vaccine are more satisfactory than subcutaneous or intradermal inoculations which often result in abscess formation. A positive tuberculin reaction can best be maintained by intravenous injections at six-monthly intervals of 50 mg. of a wet culture from the surface of solid egg-containing media. Of two field trials, the first and smaller was completed. 47 calves were placed on four farms where the incidence of natural infection was quite high. Calves were given 100 mg. of vaccine intravenously before going on the farms and then 50 mg. six-monthly. Only 23 of the vaccinated animals were available for study at the end of the trial, and 6 of them had non-progressive tuberculosis whereas 61 of 116 control " contacts were infected and of these 19 had progressive tuberculosis. The second trial was much more extensive and run on different lines. Calves born on farms with a high incidence of natural tuberculosis were tuberculin tested and if negative were given inoculations of 50 mg. B.C.G. intravenously at six-monthly intervals. There were a number of deaths and delayed reactions with loss of weight following the injections, occurring after the first or any of the subsequent inoculations. The calves were not wittingly exposed to infection until they reached maturity, when they gradually replaced tuberculin reactors in the herd. There were no control unvaccinated animals. Of 73 herds, involving some 5000 cattle, 27 have
Here,
the trial-that is, all the animals have been vaccinated and have lost their sensitivity to tuberculin, so that the farm now has a registered T.T. herd. A further 19 herds have completed the trial and await the final tuberculin test before registration.
completed
TIIE VOLE BACILLUS
It seems,
therefore, that this method may be useful in
eradicating bovine tuberculosis from herds of cattle over a period of time. The experiment bears a resemblance to the method adopted with considerable success for the control of tuberculosis among the inhabitants of the island of Bornholm, and may suggest another mode of attack in the successful fight which man is waging
against tuberculosis. NEW ZEALAND FROM OUR OWN CORRESPONDENT
Dr. R. S. Aitken, who has been appointed vicechancellor elect of Otago University, Dunedin, expects to leave his present post of regius professor of medicine at Aberdeen in August. All the four university colleges in New Zealand are appointing full-time principals (or vice-chancellor in Otago). Sir Thomas Hunter is the principal in Wellington, and Dr. Hulme has been appointed to Canterbury College, Christchurch. The appointment in Auckland has not yet been made. Last January the senate adopted a report on medical education which recommended the continuance of the present limit of admission of 120 students per annum, with a quota system for the various centres. The General Medical Council’s recommendation of 5 terms for anatomy and physiology, with a subsequent term introductory to clinical work, was also adopted. The present distribution of final-year students to the four centres, without substantial development of teaching facilities in any one of the other centres, was confirmed. A hospital year after graduation and before full registration was to be sought from the Medical Council. Postgraduate education was left very much in its present elementary state. These decisions were not uncontested. Some thought it wrong to deny to properly prepared students the right to study medicine ; some wanted the final-year students-some half the students in each clinical year-massed in one centre away from Dunedin under professorial teaching units ; and some wanted a major development of postgraduate effort and clinical research also under university units ’in another centre. All these things, however, were denied, and the committee on medical education was dissolved. POLIOMYELITIS EPIDEMIC
During the past -three months there have been about 160 cases of poliomyelitis, including 120 in the Auckland district. There has been an unusually large proportion of cases with encephalitis and also with muscle spasm, but a low proportion with serious paralysis. There have been 7 deaths. On Dec. 1 the Health Department closed the schools and swimming-baths, and banned gatherings of children and swimming on city beaches. In spite of a blazing summer, these precautions have been well observed. Whether respect for authority or fear of the disease counted most is hard to say. ’ Schools may possibly reopen in the South Island early in March. Since the end of December cases have been less severe, suggesting a decline in virulence. Since early in January Kenny technicians have been working in the Auckland Hospital alongside the regular physiotherapists, sharing the patients. All cases have made good progress. The outstanding feature in treatment has been the success of hot packs in relieving muscle spasm and pain in the early stages. OVERSEAS TRAVELLERS
Mr. W. S. Robertson, orthopaedic surgeon of Wellington, was sent to the United States in December by the government to look into matters connected with poliomyelitis. Mr. Douglas Robb, thoracic surgeon of Auckland, is also visiting the States and Britain at the government’s request, to study cardiac surgery with particular reference to Blalock’s operation for pulmonary stenosis. A clinic for congenital heart diseases is to be set up in Green Lane Hospital, Auckland, to receive cases from all parts of New Zealand.