,transcriber's note3 ,minor spelling and punctuation inconsistencies been harmonized4 ,obvious printer errors have been repaired4 ,italic text has been marked with underscores4 ,please see the end of this book for further notes4 ,,experiments ,,on ,,animals ,illustration3 ,,brain ,,of ,,an ,,anthropoid ,,ape1 ,,showing ,,the ,,position ,,of ,,the ,,motor ,,centres4 7,from a paper by ,sir ,victor ,horsley and ,dr4 ,beevor4 ,phil4 ,trans4 ,roy4 ,soc41 #ahib47 ,,experiments ,,on ,,animals ,,by ,,stephen ,,paget ,,with ,,an ,,introduction ,,by ,,lord ,,lister ,,third ,,and ,,revised ,,edition ,perhaps it is wrong to compare sin with sin1 but ,i declare to you1 the more ,i think of it1 the more intimately does this ,prejudice seem to me to corrupt the soul1 even beyond those sins which are commonly called more deadly4--,,cardinal ,,newman4 ,,new ,,york ,,william ,,wood ,,and ,,company ,,mdccccvii ,,to ,,charles ,,alfred ,,ballance ,m4,s41 ,f4,r4,c4,s4 ,,and ,,william ,,hunter ,m4,d41 ,f4,r4,c4,p4 ,,preface ,the first edition of this book was published in #aijj4 ,for twelve years it had been my business1 as ,secretary to the ,association for the ,advancement of ,medicine by ,research1 to know something about experiments on animals1 and to follow the working of the ,act of #ahgf2 and to give facts and references to a very large number of applicants4 ,believing that an account of these experiments1 and of the conditions imposed on them by the ,act1 might serve a useful purpose1 ,i proposed to the ,council of the ,association that ,i should write a book on the subject4 ,the ,council accepted this proposal2 and decided that the book should be written for general reading1 that it should not be anonymous1 and that it should be published without reserve4 ,it was1 of course1 a doubtful and embarrassing task4 ,but1 from twelve years' experience of the things said by the chief opponents of all experiments on animals1 ,i knew that there was only one way of doing it--to give the original authorities1 the plain facts1 the very words1 chapter and verse for everything4 ,among those who kindly revised the proofs were ,prof4 ,rose ,bradford and ,prof4 ,starling1 who revised ,part ,i42 ,mr4 ,shattock1 who revised ,part ,,ii42 and ,prof4 ,schfer4 ,valuable help was given by ,mr4 ,r4 ,h4 ,clarke1 ,sir ,victor ,horsley1 ,dr4 ,beevor1 ,prof4 ,ronald ,ross1 and the late ,dr4 ,washbourn2 and ,i was allowed to make free use of ,mr4 ,george ,pernet's careful researches into the history of the subject4 ,lord ,lister himself did me the honour to read and correct1 with the utmost patience1 ,parts ,i4 and ,,ii4 ,in the second edition 7#aijd7 some mistakes were corrected1 and some facts were added4 ,the present edition has been thoroughly revised2 and ,i have included in it a reprint1 with some changes and omissions1 of a pamphlet1 ,the ,case against ,anti-vivisection1 which ,i wrote in #aijd4 #aijf4 ,,introduction ,,to ,,the ,,first ,,edition ,this work by ,mr4 ,paget is entirely a labour of love4 ,not being himself engaged in researches involving experiments upon the lower animals1 he is not directly interested in the subject4 ,but1 in his official capacity as ,secretary 7#ahhg-ahii7 to the ,association for the ,advancement of ,medicine by ,research1 he has become widely conversant with such investigations1 and has been deeply impressed with the greatness of the benefits which they have conferred upon mankind1 and the grievous mistake that is made by those who desire to suppress them4 ,the action of these well-meaning persons is based upon ignorance4 ,they allow that man is permitted to inflict pain upon the lower animals when some substantial advantage is to be gained2 but they deny that any good has ever resulted from the researches which they condemn4 ,how far such statements are from the truth will be evident to those who peruse this book4 ,its earlier pages deal with ,physiology1 the main basis of all sound medicine and surgery4 ,the examples given in this department are not numerous2 they are1 however1 sufficiently striking1 as indications that1 from the discovery of the circulation of the blood onwards1 our knowledge of healthy animal function has been mainly derived from experiments on animals4 ,the chief bulk of the work is devoted to the class of investigations which are most frequent at the present day2 and it shows what a flood of light has been already thrown by ,bacteriology upon the nature of human disease and the means of combating it4 ,the chapter on the ,action of ,drugs will be to many a startling disclosure of the gross ignorance that prevailed among physicians even in the earlier part of last century4 ,the great revolution that has since taken place is no doubt largely due to advances in sciences other than ,biology1 especially ,chemistry4 ,but it could not have attained its present proportions without the ever-increasing knowledge of ,physiology1 based on experiments on animals2 and ,mr4 ,paget shows how large a share these have had in the direct investigation of articles of the ,materia ,medica4 ,the concluding part of the volume discusses the restrictions which have been placed by the legislature in this country on those engaged in these researches1 with the view of obviating possible abuse4 ,whether the ,act in question has been really useful1 whether it has not done more harm than good1 by hampering and sometimes entirely preventing legitimate and beneficent investigation1 ,i will not now discuss4 ,meanwhile ,i commend ,mr4 ,paget's book to the careful consideration of the reader4 ,,lister4 ,,contents ,,part ,i ,,experiments ,,in ,,physiology ,,page ,i4 ,,the ,,blood #c ,,ii4 ,,the ,,lacteals #ai ,,iii4 ,,the ,,gastric ,,juice #bd ,,iv4 ,,glycogen #cj ,v4 ,,the ,,pancreas #cf ,,vi4 ,,the ,,growth ,,of ,,bone #dj ,,vii4 ,,the ,,nervous ,,system #dd ,,part ,,ii ,,experiments ,,in ,,pathology1 ,,materia ,,medica1 ,,and ,,therapeutics ,i4 ,,inflammation1 ,,suppuration1 ,,and ,,blood-,,poisoning #ge ,,ii4 ,,anthrax #hg ,,iii4 ,,tubercle #if ,,iv4 ,,diphtheria #ajb ,v4 ,,tetanus #abh ,,vi4 ,,rabies #acg ,,vii4 ,,cholera #aeb ,,viii4 ,,plague #afh ,,ix4 ,,typhoid ,,fever2 ,,malta ,,fever #aif ,x4 ,,the ,,mosquito3 ,,malaria1 ,,yellow ,,fever1 ,,filariasis #bad ,,xi4 ,,parasitic ,,diseases #bdc ,,xii4 ,,myxoedema #bdg ,,xiii4 ,,the ,,action ,,of ,,drugs #bea ,,xiv4 ,,snake-,,venom #bei ,,part ,,iii ,,the ,,act ,,relating ,,to ,,experiments ,,on ,,animals ,,in ,,great ,,britain ,,and ,,ireland ,i4 ,,text ,,of ,,the ,,act #bga ,,ii4 ,,an,,sthetics ,,under ,,the ,,act #bha ,,iii4 ,,inspectors' ,,report1 #aije #bhc ,,part ,,iv ,,the ,,case ,,against ,,anti-,,vivisection ,i4 ,,anti-,,vivisection ,,societies #big ,,ii4 ,,literature #cac ,,iii4 ,,arguments #cbe ,,iv4 ,,our ,,cause ,,in ,,parliament #cfg ,v4 ,a ,,historical ,,parallel #cga ,,index #cgg ,,part ,i ,,experiments ,,in ,,physiology ,,experiments ,,on ,,animals ,i ,,the ,,blood ,i4--,,before ,,harvey ,galen1 born at ,pergamos1 #aca ,a4,d41 proved by experiments on animals that the brain is as warm as the heart1 against the ,aristotelian doctrine that the office of the brain is to keep the heart cool4 ,he also proved that the arteries during life contain blood1 not ,greek3 pneuma1 or the breath of life3-- ,ourselves1 having tied the exposed arteries above and below1 opened them between the ligatures1 and showed that they were indeed full of blood4 ,though all vessels bleed when they are wounded1 yet this experiment was necessary to refute the fanciful teaching of ,erasistratus and his followers1 of whom ,galen says3-- ,erasistratus is pleased to believe that an artery is a vessel containing the breath of life1 and a vein is a vessel containing blood2 and that the vessels1 dividing again and again1 come at last to be so small that they can close their ultimate pores1 and keep the blood controlled within them2 yea1 though the pores of the vein and of the artery lie side by side1 yet the blood remains within its proper bounds1 nowhere passing into the vessels of the breath of life4 ,but when the blood is driven with violence from the veins into the arteries1 forthwith there is disease2 and the blood is poured the wrong way into the arteries1 and there withstands and dashes itself against the breath of life coming from the heart1 and turns the course of it--and this forsooth is fever4 ,for many centuries after ,galen1 men were content to worship his name and his doctrines1 and forsook his method4 ,they did not follow the way of experiment1 and invented theories that were no help either in science or in practice4 ,here1 in ,galen's observation of living arteries1 was a great opportunity for physiology2 but the example that he set to those who came after him was forgotten by them1 and1 from the time of ,galen to the time of the ,renaissance1 physiology remained almost where he had left it4 ,of the men of the ,renaissance1 ,servetus1 ,csalpinus1 ,ruinius1 and others1 ,harvey's near predecessors1 this much only need be said here1 that they did not discover the circulation of the blood2 and that the claim made a few years ago to this discovery1 on behalf of ,csalpinus1 by his countrymen1 was not successful4 ,but it is probable that ,realdus 7#aeaf-aeeg7 did understand the passage of blood through the lungs1 but not the general circulation4 ,he says3-- ,the blood is carried through the pulmonary artery to the lung1 and there is attenuated2 thence1 mixed with air1 it is carried through the pulmonary vein to the left ventricle of the heart3 which thing no man hitherto has noted or left on record1 though it is most worthy of the observation of all men4444 ,and this is as true as truth itself2 for if you will look1 not only in the dead body but also in the living animal1 you will always find this pulmonary vein full of blood1 which assuredly it would not be if it were designed only for air and vapours4444 ,verily1 ,i pray you1 ,o candid reader1 studious of authority1 but more studious of truth1 to make experiment on animals4 ,you will find the pulmonary vein full of blood1 not air or fuligo1 as these men call it1 ,god help them4 ,only there is no pulsation in the vein4 7,de ,re ,anatomic1 ,venice1 #aeei47 ,fabricius ab ,aquapendente1 ,harvey's master at ,padua1 published his work on the valves of the veins--,de ,venarum ,ostiolis--in #afjc4 ,he did not discover them4 ,sylvius speaks of them in his ,isagoge 7,venice1 #aeee71 and they were known to ,amatus 7#aeeb71 and even to ,theodoretus1 ,bishop of ,syria1 who lived1 as ,john ,hunter said of ,sennertus1 the ,lord knows how long ago4 ,but ,fabricius studied them most carefully2 and in anatomy he left nothing more to be said about them4 ,in physiology1 his work was of little value2 for he held that they were designed to retard the blood in some measure1 lest it should run pell-mell into the feet1 hands1 and fingers1 there to be impacted3 they were to prevent distension of the veins1 and to ensure the due nourishment of all parts of the body4 ,it is true that he compared them to the locks or weirs of a river1 but he understood neither the course nor the force of the blood3 as ,harvey said of him1 ,the man who discovered these valves did not understand their right use2 neither did they who came after him--,harum valvularum usum rectum inventor non est assecutus1 nec alii addiderunt2 non est enim ne pondere deorsum sanguis in inferiora totus ruat2 sunt namque in jugularibus deorsum spectantes1 et sanguinem sursum ferri prohibentes4 ,men had no idea of the rapidity and volume of the circulation2 they thought of a sort of ,stygian tide1 oozing this way or that way in the vessels--,csalpinus was of opinion that it went one way in the daytime and another at night--nor did they see that the pulmonary circulation and the general circulation are one system1 the same blood covering the whole course4 ,the work that they did in anatomy was magnificent2 ,vesalius1 and the other great anatomists of his time1 are unsurpassed4 ,but physiology had been hindered for ages by fantastic imaginings1 and the facts of the circulation of the blood were almost as far from their interpretation in the sixteenth century as they had been in the time of ,galen4 ,,ii4--,,harvey 7#aegh-afeg7 ,the ,de ,motu ,cordis et ,sanguinis in ,animalibus was published at ,frankfurt in #afbh4 ,and it begins with these words3 ,cum multis vivorum dissectionibus1 uti ad manum dabantur3-- ,when by many dissections of living animals1 as they came to hand1 ,i first gave myself to observing how ,i might discover with my own eyes1 and not from books and the writings of other men1 the use and purpose of the movement of the heart in animals1 forthwith ,i found the matter hard indeed1 and full of difficulty3 so that ,i began to think1 with ,frascatorius1 that the movement of the heart was known to ,god alone4 ,for ,i could not distinguish aright either the nature of its systole and diastole1 or when or where dilatation and contraction took place2 and this because of the swiftness of the movement1 which in many animals in the twinkling of an eye1 like a flash of lightning1 revealed itself to sight and then was gone2 so that ,i came to believe that ,i saw systole and diastole now this way now the other1 and movements now apart and now together4 ,wherefore my mind wavered2 ,i had nothing assured to me1 whether decided by me or taken from other men3 and ,i did not wonder that ,andreas ,laurentius had written that the movement of the heart was what the ebb and flow of the ,euripus had been to ,aristotle4 ,at last1 having daily used greater disquisition and diligence1 by frequent examination of many and various living animals--multa frequenter et varia animalia viva introspiciendo--and many observations put together1 ,i came to believe that ,i had succeeded1 and had escaped and got out of this labyrinth1 and therewith had discovered what ,i desired1 the movement and use of the heart and the arteries4 ,and from that time1 not only to my friends1 but also in public in my anatomical lectures1 after the manner of the ,academy1 ,i did not fear to set forth my opinion in this matter4 ,it is plain1 from ,harvey's own words1 that he gives to experiments on animals a foremost place among his methods of work4 ,take only the headings of his first four chapters3-- i4 ,caus1 quibus ad scribendum auctor permotus fuerit4 ii4 ,ex vivorum dissectione1 qualis fit cordis motus4 iii4 ,arteriarum motus qualis1 ex vivorum dissectione4 iv4 ,motus cordis et auricularum qualis1 ex vivorum dissectione4 ,he thrusts it on us1 he puts it in the foreground4 ,read the end of his ,preface3-- ,therefore1 from these and many more things of the kind1 it is plain 7since what has been said by men before me1 of the movement and use of the heart and arteries1 appears inconsistent or obscure or impossible when one carefully considers it7 that we shall do well to look deeper into the matter2 to observe the movements of the arteries and the heart1 not only in man1 but in all animals that have hearts2 and by frequent dissection of living animals1 and much use of our own eyes1 to discern and investigate the truth--vivorum dissectione frequenti1 multque autopsi1 veritatem discernere et investigare4 ,finally1 take the famous passage in the eighth chapter1 ,de copi sanguinis transeuntis per cor e venis in arterias1 et de circulari motu sanguinis3-- ,and now1 as for the great quantity and forward movement of this blood on its way1 when ,i shall have said what things remain to be said--though they are well worth considering1 yet they are so new and strange that ,i not only fear harm from the envy of certain men1 but am afraid lest ,i make all men my enemies2 so does custom1 or a doctrine once imbibed and fixed down by deep roots1 like second nature1 hold good among all men1 and reverence for antiquity constrains them4 ,be that as it may1 the die is cast now3 my hope is in the love of truth1 and the candour of learned minds4 ,i bethought me how great was the quantity of this blood4 ,both from the dissection of living animals for the sake of experiment1 with opening of the arteries1 with observations manifold2 and from the symmetry of the size of the ventricles1 and of the vessels entering and leaving the heart--because ,nature1 doing nothing in vain1 cannot in vain have given such size to these vessels above the rest--and from the harmonious and happy device of the valves and fibres1 and all other fabric of the heart2 and from many other things--when ,i had again and again carefully considered it all1 and had turned it over in my mind many times--,i mean the great quantity of the blood passing through1 and the swiftness of its passage--and ,i did not see how the juices of the food in the stomach could help the veins from being emptied and drained dry1 and the arteries contrariwise from being ruptured by the excessive flow of blood into them1 unless blood were always getting round from the arteries into the veins1 and so back to the right ventricle--,i began to think to myself whether the blood had a certain movement1 as in a circle--coepi egomet mecum cogitare1 an motionem quandam quasi in circulo haberet--which afterward ,i found was true4 ,this vehement passage1 which goes with a rush like that of the blood itself1 is a good example of the width and depth of ,harvey's work--how he used all methods that were open to him4 ,he lived to fourscore years2 an old man1 he says1 far advanced in years1 and occupied with other cares3 and1 near the end of his life1 he told the ,hon4 ,robert ,boyle that the arrangement of the valves of the veins had given him his first idea of the circulation of the blood3-- ,i remember that when ,i asked our famous ,harvey1 in the only discourse ,i had with him1 which was but a while before he died1 what were the things which induced him to think of the circulation of the blood1 he answered me that when he took notice that the valves in the veins of so many parts of the body were so placed that they gave free passage of the blood towards the heart1 but opposed the passage of the venal blood the contrary way1 he was invited to imagine that so provident a cause as ,nature had not so placed so many valves without design2 and no design seemed more probable than that1 since the blood could not well1 because of the interposing valves1 be sent by the veins to the limbs1 it should be sent by the arteries1 and return through the veins1 whose valves did not oppose its course that way4 ,but between this observation1 which invited him to imagine a theory1 and his final proofs of the circulation1 lay a host of difficulties2 and it is certain1 from his own account of his work1 that experiments on animals were of the utmost help to him in leading him out of the labyrinth4 ,,iii4--,,after ,,harvey #a4 ,the ,capillaries ,the capillary vessels were not known in ,harvey's time3 the capillamenta of ,csalpinus were not the capillaries1 but the ,greek3 neura of ,aristotle4 ,it was believed that the blood1 between the smallest arteries and the smallest veins1 made its way through blind porosities in the tissues1 as water percolates through earth or through a sponge4 ,the first account of the capillaries is in two letters 7,de ,pulmonibus1 #affa7 from ,malpighi1 professor of medicine at ,bologna1 to ,borelli1 professor of mathematics at ,pisa4 ,in his first letter1 ,malpighi writes that he has tried in vain1 by injecting the dead body1 to discover how the blood passes from the arteries into the veins3-- ,this enigma hitherto distracts my mind1 though for its solution ,i have made many and many attempts1 all in vain1 with air and various coloured fluids4 ,having injected ink with a syringe into the pulmonary artery1 ,i have again and again seen it escape 7become extravasated into the tissues7 at several points4 ,the same thing happens with an injection of mercury4 ,these experiments do not give us the natural pathway of the blood4 ,but1 in his second letter1 he describes how he has examined1 with a microscope of two lenses1 the lung and the mesentery of a frog1 and has seen the capillaries1 and the blood in them3-- ,such is the divarication of these little vessels1 coming off from the vein and the artery1 that the order in which the vessel ramifies is no longer preserved1 but it looks like a network woven from the offshoots of both vessels4 ,he was able1 in a dead frog1 to see the capillaries2 and then1 in a living frog1 to see the blood moving in them4 ,but1 in spite of this work1 it took nearly half a century before ,harvey's teaching was believed by all men--,tantum consuetudo apud omnes valet4 #b4 ,the ,blood-pressure ,harvey had seen the facts of blood-pressure--the great quantity of blood passing through1 and the swiftness of its passage--but he had not measured it4 ,keill's experiments on the blood-pressure 7#agah7 were inexact1 and of no value2 and the first exact measurements were made by ,stephen ,hales1 who was rector of ,farringdon1 ,hampshire1 and minister of ,teddington1 ,middlesex2 a ,doctor of ,divinity1 and a ,fellow of the ,royal ,society4 ,his experiments1 in their width and diversity1 were not surpassed even by those of ,john ,hunter1 and were extended far over physiology1 vegetable physiology1 organic and inorganic chemistry1 and physics2 they ranged from the invention of a sea-gauge to the study of solvents for the stone1 and he seems to have experimented on every force in ,nature4 ,the titles of his two volumes of ,statical ,essays 7#agbf-agcc7 show the great extent of his non-clerical work3-- ,volume ,i4 ,statical ,essays1 containing ,vegetable ,statics1 or an ,account of some ,statical ,experiments on the ,sap in ,vegetables1 being an ,essay towards a ,natural ,history of ,vegetation2 also1 a ,specimen of an ,attempt to ,analyse the ,air1 by a great ,variety of ,chymio-,statical ,experiments4 ,volume ,,ii4 ,statical ,essays1 containing ,hmostatics1 or an ,account of some ,hydraulic and ,hydrostatical ,experiments made on the ,blood and ,blood-vessels of ,animals2 also1 an ,account of some ,experiments on ,stones in the ,kidneys and ,bladder1 with an ,enquiry into the ,nature of those anomalous ,concretions4 ,we can never want matter for new experiments1 he says in his preface4 ,we are as yet got little further than to the surface of things3 we must be content1 in this our infant state of knowledge1 while we know in part only1 to imitate children1 who1 for want of better skill and abilities1 and of more proper materials1 amuse themselves with slight buildings4 ,the farther advances we make in the knowledge of ,nature1 the more probable and the nearer to truth will our conjectures approach3 so that succeeding generations1 who shall have the benefit and advantage both of their own observations and those of preceding generations1 may then make considerable advances1 when many shall run to and fro1 and knowledge shall be increased4 ,his account of his plan of measuring the blood-pressure1 and of one of many experiments that he made on it1 is as follows3-- ,finding but little satisfaction in what had been attempted on this subject by ,borellus and others1 ,i endeavoured1 about twenty-five years since1 by proper experiments1 to find what was the real force of the blood in the crural arteries of dogs1 and about six years afterwards ,i repeated the like experiments on two horses1 and a fallow doe2 but did not then pursue the matter any further1 being discouraged by the disagreeableness of anatomical dissections4 ,but having of late years found by experience the advantage of making use of the statical way of investigation1 not only in our researches into the nature of vegetables1 but also in the chymical analysis of the air1 ,i was induced to hope for some success1 if the same method of enquiry were applied to animal bodies4444 ,having laid open the left crural artery 7of a mare71 ,i inserted into it a brass pipe whose bore was #a_/f of an inch in diameter2 and to that1 by means of another brass pipe which was fitly adapted to it1 ,i fixed a glass tube of nearly the same diameter1 which was #i feet in length2 then1 untying the ligature on the artery1 the blood rose in the tube #h feet #c inches perpendicular above the level of the left ventricle of the heart1 but it did not attain to its full height at once3 it rushed up gradually at each pulse #ab1 #h1 #f1 #d1 #b1 and sometimes #a inch4 ,when it was at its full height1 it would rise and fall at and after each pulse #b1 #c1 or #d inches1 and sometimes it would fall #ab or #ad inches1 and have there for a time the same vibrations up and down1 at and after each pulse1 as it had when it was at its full height1 to which it would rise again1 after forty or fifty pulses4 #c4 ,the ,collateral ,circulation ,after ,hales1 came ,john ,hunter1 who was five years old when the ,statical ,essays were published4 ,his experiments on the blood were mostly concerned with its properties1 not with its course2 but one great experiment must be noted here that puts him in line with ,harvey1 ,malpighi1 and ,hales4 ,he got from it his knowledge of the collateral circulation2 he learned how the obstruction of an artery is followed by enlargement of the vessels in its neighbourhood1 so that the parts beyond the obstruction do not suffer from want of blood3 and the facts of collateral circulation were fresh in his mind when1 a few months later1 he conceived and performed his operation for aneurysm 7,december #aghe74 ,the old operation gave him no help here2 and ,anel's operation was but a single instance1 and no sure guide for ,hunter1 because ,anel's patient had a different sort of aneurysm4 ,hunter knew that the collateral circulation could be trusted to nourish the limb1 if the femoral artery were ligatured in ,hunter's canal for the cure of popliteal aneurysm2 and he got this knowledge from the experiment that he had made on one of the deer in ,richmond ,park1 to see the influence of ligature of the carotid artery on the growth of the antler4 ,the following account of this experiment was given by ,sir ,richard ,owen1 who had it from ,mr4 ,clift1 ,hunter's devoted pupil and friend3-- ,in the month of ,july1 when the bucks' antlers were half-grown1 he caused one of them to be caught and thrown2 and1 knowing the arterial supply to the hot 'velvet1' as the keepers call it1 ,hunter cut down upon and tied the external carotid2 upon which1 laying his hand upon the antler1 he found that the pulsations of the arterial channels stopped1 and the surface soon grew cold4 ,the buck was released1 and ,hunter speculated on the result--whether the antler1 arrested at mid-growth1 would be shed like the full-grown one1 or be longer retained4 ,a week or so afterward he drove down again to the park1 and caused the buck to be caught and thrown4 ,the wound was healed about the ligature2 but on laying his hand on the antler1 he found to his surprise that the warmth had returned1 and the channels of supply to the velvety formative covering were again pulsating4 ,his first impression was that his operation had been defective4 ,to test this1 he had the buck killed and sent to ,leicester ,square4 ,the arterial system was injected4 ,hunter found that the external carotid had been duly tied4 ,but certain small branches1 coming off on the proximal or heart's side of the ligature1 had enlarged2 and1 tracing-on these1 he found that they had anastomosed with other small branches from the distal continuation of the carotid1 and these new channels had restored the supply to the growing antler4444 ,here was a consequence of his experiment he had not at all foreseen or expected4 ,a new property of the living arteries was unfolded to him4 ,all the anatomists had overlooked this physiological change in the living body1 brought about by disease4 ,and the surgeons1 since anatomy could not help them1 had been driven by the mortality of the old operation to the practice of amputation4 #d4 ,the ,mercurial ,manometer ,hale's experiments on the blood-pressure were admirable in their time2 but neither he nor his successors could take into account all the physiological and mathematical facts of the case4 ,but a great advance was made in #ahbh1 when ,poiseuille published his thesis1 ,sur la ,force du ,coeur ,aortique1 with a description of the mercurial manometer4 ,poiseuille had begun with the received idea that the blood-pressure in the arteries would vary according to the distance from the heart1 but he found by experiment that this doctrine was wrong3-- ,at my first experiments1 wishing to make sure whether the opinions1 given priori1 were true1 ,i observed to my great astonishment that two tubes1 applied at the same time to two arteries at different distances from the heart1 gave columns of exactly the same height1 and not1 as ,i had expected1 of different heights4 ,this made the work very much simpler1 because1 to whatever artery ,i applied the instrument1 ,i obtained the same results that ,i should have got by placing it on the ascending aorta itself4 ,he found also1 by experiments1 that the coagulation of the blood in the tube could be prevented by filling one part of the tube with a saturated solution of sodium carbonate4 ,the tube1 thus prepared1 was connected with the artery by a fine cannula1 exactly fitting the artery4 ,with this instrument1 ,poiseuille was able to obtain results far more accurate than those of ,hales1 and to observe the diverse influences of the respiratory movements on the blood-pressure4 ,he sums up his results in these words3-- ,i come to this irrevocable conclusion1 that the force with which a molecule of blood moves1 whether in the carotid1 or in the aorta1 etc41 is exactly equal to the force which moves a molecule in the smallest arterial branch2 or1 in other words1 that a molecule of blood moves with the same force over the whole course of the arterial system--which1 priori1 with all the physiologists1 ,i was far from thinking4 ,and he adds1 in a footnote3-- ,when ,i say that this force is the same over the whole course of the arterial system1 ,i do not mean to deny that it must needs be modified at certain points of this system1 which present a special arrangement1 such as the anastomosing arches of the mesentery1 the arterial circle of ,willis1 etc4 ,later1 in #ahce1 he published a very valuable memoir on the movement of the blood in the capillaries under different conditions of heat1 cold1 and atmospheric pressure4 #e4 ,the ,registration of the ,blood-pressure ,poiseuille's work1 in its turn1 was left behind as physiology went forward3 especially1 the discovery of the vaso-motor nerves compelled physiologists to reconsider the whole subject of the blood-pressure4 ,if ,poiseuille's thesis 7#ahbh7 be compared with ,marey's book 7#ahfc71 ,physiologie ,mdicale de la ,circulation du ,sang1 it will be evident at once how much wider and deeper the problem had become4 ,poiseuille's thesis is chiefly concerned with mathematics and hydrostatics2 it suggests no method of immediate permanent registration of the pulse1 and is of no great value to practical medicine3 ,marey's book1 by its very title1 shows what a long advance had been made between #ahbh and #ahfc--,physiologie ,mdicale de la ,circulation du ,sang1 base sur l'tude graphique des mouvements du coeur et du pouls artriel1 avec application aux maladies de l'appareil circulatoire4 ,though the contrast is great between ,hales' may-pole and ,poiseuille's manometer1 there is even a greater contrast between ,poiseuille's mathematical calculations and ,marey's practical use of the sphygmograph for the study of the blood-pressure in health and disease4 ,marey had the happiness of seeing medicine1 physiology1 and physics1 all three of them working to one end3-- ,la circulation du sang est un des sujets pour lesquels la mdecine a le plus besoin de s'clairer de la physiologie1 et o celle-ci son tour tire le plus de lumire des sciences physiques4 ,ces dernires annes sont marques par deux grands progrs qui ouvrent aux recherches venir des horizons nouveaux3 en ,allemagne1 l'introduction des procds graphiques dans l'tude du mouvement du sang2 en ,france1 la dmonstration de l'influence du systme nerveux sur la circulation priphrique4 ,cette dernire dcouverte1 que nous devons ,m4 ,cl4 ,bernard1 et qui depuis dix ans a donn tant d'impulsion la science1 montre mieux que toute autre combien la physiologie est indispensable la mdecine1 tandis que les travaux allemands ont bien fait ressortir l'importance des connaissances physiques dans les tudes mdicales4 ,marey's sphygmograph was not the first instrument of its kind4 ,there had been1 before it1 ,hrisson's sphygmometer1 ,ludwig's kymographion1 and the sphygmographs of ,volckmann1 ,king1 and ,vierordt4 ,but1 if one compares a ,vierordt tracing with a ,marey tracing1 it will be plain that ,marey's results were far advanced beyond the useless oscillations isochrones recorded by ,vierordt's instrument4 ,beside this improved sphygmograph1 ,chauveau and ,marey also invented the cardiograph1 for the observation of the blood-pressure within the cavities of the heart4 ,their cardiograph was a set of very delicate elastic tambours1 resting on the heart1 or passed through fine tubes into the cavities of the heart1#a and communicating impulses to levers with writing-points4 ,these writing-points1 touching a revolving cylinder1 recorded the variations of the endocardial pressure1 and the duration of the auricular and ventricular contractions4 #a ,on peut s'assurer de l'innocuit de ce premier temps de l'exprience en examinant l'animal1 qui n'est nullement troubl1 qui marche et mange comme de coutume4 ,en comptant le chiffre du pouls1 on trouve quelquefois une lgre accleration1 surtout dans les premiers instants2 mais les mouvements du coeur sont toujours rguliers1 et donnent1 l'auscultation1 des bruits d'un caractre normal4 7,marey1 loc4 cit4 p4 #fc47 99 99 99 99 99 ,it is impossible here to describe the subsequent study of those more abstruse problems that the older physiologists had not so much as thought of3 the minutest variations of the blood-pressure1 the multiple influences of the nervous system on the heart and blood-vessels1 the relations between blood-pressure and secretion1 the automatism of the heart-beat1 the influence of gravitation1 and other finer and more complex issues of physiology4 ,but1 even if one stops at ,marey's book1 now more than forty years old1 there is an abundant record of good work1 from the discovery of the circulation to the invention of the sphygmograph4 ,,ii ,,the ,,lacteals ,asellius1 in his account of his discovery of the lacteal vessels 7#afbb71 is of opinion that certain of the ancients had seen these vessels1 but had not recognised them4 ,he has a great reverence for authority3 ,hippocrates1 ,plato1 ,aristotle1 the ,stoics1 ,herophilus1 ,galen1 ,pollux1 ,rhases1 and a host of other names1 he quotes them all1 and all with profound respect2 and comes to this conclusion3 ,it did not escape the ancients1 that certain vessels must needs be concerned with containing and carrying the chyle1 and certain other vessels with the blood3 but the true and very vessels of the chyle1 that is1 my 'veins1' though they were seen by some of the ancients1 yet they were recognised by none of them4 ,he can forgive them all1 except ,galen1 qui videtur nosse omnino debuisse--but1 as for ,galen1 ,i know not at all what ,i am to think4 ,for he1 who made more than six hundred sections of living animals1 as he boasts himself1 and so often opened many animals when they were lately fed1 are we to think it possible that these veins never showed themselves to him1 that he never had them under his eyes1 that he never investigated them--he to whom ,erasistratus had given so great cause for searching out the whole matter8 ,probably1 the milk-white threads had been taken for nerves by those who had seen them3 and those who had never seen them1 but believed in their existence1 rested their belief on a general idea that the chyle must1 somehow1 have vessels of its own apart from the blood-vessels4 ,what ,galen and ,erasistratus must have seen1 ,asellius and ,pecquet discovered3 and ,harvey gives a careful review of the discovery in his letters to ,nardi 7,may #afeb7 and to ,morison 7,november #afec74 ,he does not accept it2 but the point is that he recognises it as a new thing altogether4 ,a year or two after he had made the discovery1 ,asellius died2 and his work was published in #afbg by two ,milanese physicians1 and was dedicated by them to the senate of the ,academy of ,milan1 where ,asellius had been professor of anatomy4 ,the full title of his book is1 ,de ,lactibus sive ,lacteis ,venis1 quarto ,vasorum ,mesaraicorum genere novo invento1 ,gasparis ,asellii ,cremonensis1 ,anatomici ,ticinensis1 ,dissertatio4 ,qu sententi anatomic mult vel perperam recept convelluntur vel partim percept illustrantur4 ,he gives the following account of the discovery1 in the chapter entitled ,historia prim vasorum istorum inventionis cum fide narrata4 ,on #bcrd ,july #afbb1 demonstrating the movement of the diaphragm in a dog1 he observed suddenly1 as it were1 many threads1 very thin and very white1 dispersed through the whole mesentery and through the intestines1 with ramifications almost endless--plurimos1 eosque tenuissimos candido-sissimosque ceu funiculos per omne mesenterium et per intestina infinitis propemodum propaginibus dispersos3-- ,thinking at first sight that they were nerves1 ,i did not greatly heed them4 ,but soon ,i saw that ,i was wrong1 for ,i bethought me that the nerves1 which belong to the intestines1 are distinct from these threads1 and very different from them1 and have a separate course4 ,wherefore1 struck by the newness of the matter1 ,i stopped for a time silent1 while one way and another there came to my mind the controversies that occupy anatomists1 as to the mesenteric veins and their use2 which controversies are as full of quarrels as of words4 ,when ,i had pulled myself together1 to make experiment1 taking a very sharp scalpel1 ,i pierce one of the larger threads4 ,scarcely had ,i hit it off1 when ,i see a white fluid running out1 like milk or cream4 ,at which sight1 when ,i could not hold my joy1 turning to those who were there1 first to ,alexander ,tadinus and ,senator ,septalius1 both of them members of the most honourable ,college of ,physicians1 and1 at the time of this writing1 officers of the public health1 ',i have found it1' ,i say like ,archimedes2 and therewith invite them to the so pleasant sight of a thing so unwonted2 they being agitated1 like myself1 by the newness of it4 ,he then describes the collapse and disappearance of the vessels at death1 and the many experiments which he made for further study of them2 and the failure1 when he tried to find them in animals not lately fed4 ,he did not trace them beyond the mesentery1 and believed that they emptied themselves into the liver4 ,the discovery of their connection with the receptaculum chyli and the thoracic duct was made by ,jehan ,pecquet of ,dieppe1 ,madame de ,svign's doctor1 her good little ,pecquet4 ,the full title of his book 7#bnd ed41 #afed7 is1 ,exprimenta ,nova ,anatomica1 quibus incognitum hactenus ,receptaculum1 et ab eo per ,thoracem in ramos usque subclavios ,vasa ,lactea deteguntur4 ,he has not the academical learning of ,asellius1 nor his obsequious regard for the ancients2 and the discovery of the thoracic duct came1 as it were by chance1 out of an experiment that was of itself wholly useless4 ,he had killed an animal by removing its heart1 and then saw a small quantity of milky fluid coming from the cut end of the vena cava--,albicantem subinde ,lactei liquoris1 nec certe parum fluidi scaturiginem1 intra ,ven ,cav fistulam1 circa dextri sedem ,ventriculi1 miror effluere--and found that this fluid was identical with the chyle in the lacteals4 ,in another experiment1 he succeeded in finding the thoracic duct--,at last1 by careful examination deep down along the sides of the dorsal vertebr1 a sort of whiteness1 as of a lacteal vessel1 catches my eyes4 ,it lay in a sinuous course1 close up against the spine4 ,i was in doubt1 for all my scrutiny1 whether ,i had to do with a nerve or with a vessel4 ,therefore1 ,i put a ligature a little below the clavicular veins2 and then the flaccidity above the ligature1 and the swelling of the distended duct below the ligature1 broke down my doubt--,ergo subducto paulo infra ,claviculas vinculo1 cum a ligatur sursum flaccesceret1 superstite deorsum turgentis alveoli tumore1 dubium meum penitus enervavit4444 ,laxatis vinculis1 lacteus utrinque rivulus in ,cavam affatim ,chylum profudit4 ,it is to be noted that ,asellius and ,pecquet1 both of them1 made their discoveries as it were by chance4 ,unless digestion were going on1 the lacteals would be empty and invisible2 and1 on the dead body1 lacteals1 receptaculum1 and thoracic duct would all be empty4 ,for these reasons1 it cost a vast number of experiments to prove the existence1 and to discover the course1 of these vessels4 ,once found in living animals1 they could be injected and dissected in the dead body2 but they had been overlooked by ,vesalius and the men of his time4 ,from the discovery of the lacteals came the discovery of the whole lymphatic system4 ,daremberg1 in his ,histoire des ,sciences ,mdicales 7,paris1 #ahgj71 after an account of ,pecquet's work1 says3-- ,up to this point1 we have seen ,english1 ,italians1 and ,french working together1 with more or less success and genius1 to trace the true ways of blood and chyle3 there is yet one field of work to open up1 the lymphatics of the body4 ,the chief honour here belongs1 without doubt1 to the ,swede ,rudbeck1 though the ,dane ,bartholin has disputed it with him1 with equal acrimony and injustice4 ,rudbeck's work 7#afea-ed7 coincides exactly1 in point of time1 with the first and second editions1 #afea and #afed1 of ,pecquet's ,de ,lactibus4 ,it may be said1 therefore1 that the whole doctrine of the lymphatic system was roughed out half-way through the seventeenth century4 ,,iii ,,the ,,gastric ,,juice ,from many causes1 the experimental study of the digestive processes came later than the study of the circulation4 ,as an object of speculative thought1 digestion was a lower phase of life1 the work of crass spirits1 less noble than the blood2 from the point of view of science1 it could not be studied ahead of organic chemistry1 and got no help from any other sort of knowledge2 and1 from the medical point of view1 it was the final result of many unknown internal forces that could not be observed or estimated either in life or after death4 ,it did not1 like the circulation1 centre itself round one problem2 it could not be focussed by the work of one man4 ,for these reasons1 and especially because of its absolute dependence on chemistry for the interpretation of its facts1 it had to bide its time2 and ,raumur's experiments are separated from the publication of ,harvey's ,de ,motu ,cordis et ,sanguinis by a hundred and thirty years4 ,the following account of the first experiments on digestion is taken from ,claude ,bernard's ,physiologie ,opratoire1 #ahgi3-- ,the true experimental study of digestion is of comparatively recent date2 the ancients were content to find comparisons1 more or less happy1 with common facts4 ,thus1 for ,hippocrates1 digestion was a 'coction'3 for ,galen1 a 'fermentation1' as of wine in a vat4 ,in later times1 van ,helmont started this comparison again3 for him1 digestion was a fermentation like that of bread3 as the baker1 having kneaded the bread1 keeps a little of the dough to leaven the next lot kneaded1 so1 said van ,helmont1 the intestinal canal never completely empties itself1 and the residue that it keeps after each digestion becomes the leaven that shall serve for the next digestion4 ,the first experimental studies on the digestion date from the end of the seventeenth century1 when the ,academy of ,florence was the scene of a famous and long controversy between ,borelli and ,valisnieri4 ,the former saw nothing more in digestion than a purely mechanical act1 a work of attrition whereby the ingesta were finely divided and as it were pulverised3 and in support of this opinion ,borelli invoked the facts that he had observed relating to the gizzard of birds4 ,we know that this sac1 with its very thick muscular walls1 can exercise on its contents pressure enough to break the hardest bodies4 ,identifying the human stomach with the bird's gizzard1 ,borelli was led to attribute to the walls of the stomach an enormous force1 estimated at more than a thousand pounds2 whose action1 he said1 was the very essence of digestion4 ,valisnieri1 on the contrary1 having had occasion to open the stomach of an ostrich1 had found there a fluid which seemed to act on bodies immersed in it2 this fluid1 he said1 was the active agent of digestion1 a kind of aqua fortis that dissolved food4 ,these two opposed views1 resulting rather from observations than from regularly instituted experiments1 were the starting-point of the experimental researches undertaken by ,raumur in #ageb4 ,to resolve the problem set by ,borelli and ,valisnieri1 ,raumur made birds swallow food enclosed in fenestrated tubes1 so that the food1 protected from the mechanical action of the walls of the stomach1 was yet exposed to the action of the gastric fluid4 ,the first tubes used 7glass1 tin1 etc47 were crushed1 bent1 or flattened by the action of the walls of the gizzard2 and ,raumur failed to oppose to this force a sufficient resistance1 till he employed leaden tubes thick enough not to be flattened by a pressure of #dhd pounds3 which was1 in fact1 the force exercised by the contractile walls of the gizzard in turkeys1 ducks1 and fowls under observation4 ,these leaden tubes--filled with ordinary grain1 and closed only by a netting that let pass the gastric juices--these tubes1 after a long stay in the stomach1 still enclosed grain wholly intact1 unless it had been crushed before the experiment4 ,when they were filled with meat1 it was found changed1 but not digested4 ,raumur was thus led at first to consider digestion1 in the gallinace1 as pure and simple trituration4 ,but1 repeating these experiments on birds of prey1 he observed that digestion in them consists essentially in dissolution1 without any especial mechanical action1 and that it is the same with the digestion of meat in all animals with membranous stomachs4 ,to procure this dissolving fluid1 ,raumur made the birds swallow sponges with threads attached3 withdrawing these sponges after a definite period1 he squeezed the fluid into a glass1 and tested its action on meat4 ,that was the first attempt at artificial digestion in vitro4 ,he did not carry these last investigations very far1 and did not obtain very decisive results2 nevertheless he must be considered as the discoverer of artificial digestion4 ,after ,raumur1 the ,abb ,spallanzani 7#aghc7 made similar observations on many other animals1 including carnivora4 ,he showed that even in the gallinace there was dissolution of food1 not mere trituration3 and observed how after death the gastric fluid may under certain conditions act on the walls of the stomach itself4 ,henceforth the experimental method had cut the knot of the question raised by the theories of ,borelli and ,valisnieri3 digestion could no longer be accounted anything but a dissolution of food by the fluid of the stomach1 the gastric juice4 ,but men had still to understand this gastric juice1 and to determine its nature and mode of action4 ,nothing could be more contradictory than the views on this matter4 ,chaussier and ,dumas1 of ,montpellier1 regarded the gastric juice as of very variable composition1 one time alkaline1 another acid1 according to the food ingested4 ,side by side with these wholly theoretical opinions1 certain results of experiments had led to ideas just as erroneous1 for want of rigorous criticism of methods2 it was thus that ,montgre denied the existence of the gastric juice as a special fluid2 what men took for gastric juice1 he said1 was nothing but the saliva turned acid in the stomach4 ,to prove his point1 he made the following experiment3--,he masticated a bit of bread1 then put it out on a plate2 it was at first alkaline1 then at the end of some time it became acid4 ,in those days 7#ahac7 this experiment was a real embarrassment to the men who believed in the existence of a special gastric juice3 we have now no need to refute it4 ,these few instances suffice to show how the physiologists were unsettled as to the nature and properties of the gastric juice4 ,then 7#ahbc7 the ,academy had the happy idea of proposing digestion as a subject for a prize4 ,tiedemann and ,gmelin in ,germany1 ,leuret and ,lassaigne in ,france1 submitted works of equal merit1 and the ,academy divided the prize between them4 ,the work of ,tiedemann and ,gmelin is of especial interest to us on account of the great number of their experiments1 from which came not only the absolute proof of the existence of the gastric juice1 but also the study of the transformation of starch into glucose4 ,thus the theory of digestion entered a new phase3 it was finally recognised1 at least for certain substances1 that digestion is not simply dissolution1 but a true chemical transformation4 7,cl4 ,bernard1 loc4 cit47 ,in #ahbe ,dr4 ,william ,beaumont1 a surgeon in the ,united ,states ,army1 began his famous experiments on ,alexis ,st4 ,martin1 a young ,canadian travelling for the ,american ,fur ,company1 who was shot in the abdomen on #fth ,june #ahbb1 and recovered1 but was left with a permanent opening in his stomach4 ,since the surgery of those days did not favour an operation to close this fistula1 ,dr4 ,beaumont took ,st4 ,martin into his service1 and between #ahbe and #ahcc made a vast number of experiments on him4 ,these he published1#b and they were of great value4 ,but it is to be noted that the ground had been cleared already1 fifty years before1 by ,raumur and ,spallanzani3-- ,i make no claim to originality in my opinions1 as it respects the existence and operation of the gastric juice4 ,my experiments confirm the doctrines 7with some modifications7 taught by ,spallanzani1 and many of the most enlightened physiological writers4 7,preface to ,dr4 ,beaumont's book47 #b ,experiments and ,observations on the ,gastric ,juice1 and the ,physiology of ,digestion1 by ,william ,beaumont1 ,m4,d42 ,edinburgh1 #ahch4 ,further1 it is to be noted that ,alexis ,st4 ,martin's case proves that a gastric fistula is not painful4 ,scores of experiments were made on him1 off and on1 for nine years3-- ,during the whole of these periods1 from the spring of #ahbd to the present time 7#ahcc71 he has enjoyed general good health1 and perhaps suffered much less predisposition to disease than is common to men of his age and circumstances in life4 ,he has been active1 athletic1 and vigorous2 exercising1 eating1 and drinking like other healthy and active people4 ,for the last four months he has been unusually plethoric and robust1 though constantly subjected to a continuous series of experiments on the interior of the stomach2 allowing to be introduced or taken out at the aperture different kinds of food1 drinks1 elastic catheters1 thermometer tubes1 gastric juice1 chyme1 etc41 almost daily1 and sometimes hourly4 ,such have been this man's condition and circumstances for several years past2 and he now enjoys the most perfect health and constitutional soundness1 with every function of the system in full force and vigour4 7,dr4 ,beaumont1 loc4 cit4 p4 #bj47 ,in #ahcd ,eberl published a series of observations on the extraction of gastric juice from the mucous membrane of the stomach after death2 in #ahdb ,blondlot of ,nancy studied the gastric juice of animals by the method of a fistula1 such as ,alexis ,st4 ,martin had offered for ,dr4 ,beaumont's observation4 ,after ,blondlot1 came experiments on the movements of the stomach1 and on the manifold influences of the nervous system on digestion4 ,it has been said1 times past number1 that an animal with a fistula is in pain4 ,it is not true4 ,the case of ,st4 ,martin is but one out of a multitude of these cases3 an artificial orifice of this kind is not painful4 ,,iv ,,glycogen ,claude ,bernard's discovery of glycogen in the liver had a profound influence both on physiology and on pathology4 ,take first its influence on pathology4 ,diabetes was known to ,celsus1 ,aretus1 and ,galen2 ,willis1 in #afgd1 and ,morton1 in #afge1 noted the distinctive sweetness of the urine2 and their successors proved the presence of sugar in it4 ,rollo1 in #aghg1 observed that vegetable food was bad for diabetic patients1 and introduced the strict use of a meat diet4 ,but ,galen had believed that diabetes was a disease of the kidneys1 and most men still followed him3 nor did ,rollo greatly advance pathology by following not ,galen1 but ,aretus4 ,later1 with the development of organic chemistry1 came the work of ,chevreuil 7#ahae71 ,tiedemann and ,gmelin 7#ahbc71 and other illustrious chemists3 and the pathology of diabetes grew more and more difficult3-- ,these observations gave rise to two theories3 the one1 that sugar is formed with abnormal rapidity in the intestine1 absorbed into the blood1 and excreted in the urine2 the other1 that diabetes is due to imperfect destruction of the sugar1 either in the intestine or in the blood4 ,some held that it underwent conversion into lactic acid as it was passing through the intestinal walls1 while others believed it to be destroyed in the blood by means of the alkali therein contained4#c #c ,reynolds' ,system of ,medicine1 vol4 v41 art4 ,diabetes ,mellitus4 ,thus1 before ,claude ,bernard 7#ahac-ahgh71 the pathology of diabetes was almost worthless4 ,and1 in physiology1 his work was hardly less important than the work of ,harvey4 ,a full account of it1 in all its bearings1 is given in ,sir ,michael ,foster's ,life of ,claude ,bernard 7,fisher ,unwin1 #ahii74 ,in ,bernard's ,leons sur le ,diabte et la ,glycogense ,animale 7,paris1 #ahgg71 there is a sentence that has been misquoted many times3-- ,sans doute1 nos mains sont vides aujourd'hui1 mais notre bouche peut tre pleine de lgitimes promesses pour l'avenir4 ,this sentence has been worked so hard that some of the words have got rubbed off it3 and the statement generally made is of this kind3-- ,claude ,bernard himself confessed that his hands were empty1 but his mouth was full of promises4 ,of course1 he did not mean that he was wrong in his facts4 ,but1 in this particular lecture1 he is speaking of the want of more science in practice1 looking forward to a time when treatment should be based on science1 not on tradition4 ,medicine1 he says1 is neither science nor art4 ,not science--,trouverait-on aujourd'hui un seul mdecin raisonnable et instruit osant dire qu'il prvoit d'une manire certaine la marche et l'issue d'une maladie ou l'effet d'une remde8 ,not art1 because art has always something to show for its trouble3 a statue1 a picture1 a poem--,le mdecin artiste ne cre rien1 et ne laisse aucune oeuvre d'art1 moins d'appliquer ce titre la gurison du malade4 ,mais quand le malade meurt1 est-ce galement son oeuvre8 ,et quand il gurit1 peut-il distinguer sa part de celle de la nature8 ,to ,claude ,bernard1 experiments on animals for the direct advancement of medicine seemed a new thing3 new1 at all events1 in comparison with the methods of some men of his time4 ,he was only saying what ,sir ,john ,burdon ,sanderson said in #ahge to the ,royal ,commission3-- ,it is my profound conviction that a future will come1 it may be a somewhat distant future1 in which the treatment of disease will be really guided by science4 ,just as completely as mechanical science has come to be the guide of the mechanical arts1 do ,i believe1 and ,i feel confident1 that physiological science will eventually come to be the guide of medicine and surgery4 ,anyhow1 lecturing a quarter of a century ago on diabetes1 his special subject1 ,claude ,bernard spoke out his longing to compel men into the ways of science1 to give them some immediate sign which they could not refuse to see3-- ,at this present time1 medicine is passing from one period to another4 ,the old traditions are losing ground1 and scientific medicine 7la mdecine exprimentale7 has got hold of all our younger men3 every day it gains ground1 and will establish itself against all its critics1 and in spite of the excesses of those who are over-zealous for its honour4444 ,and when men ask us what are the results of scientific medicine1 we are driven to answer that it is scarcely born1 that it is still in the making4 ,those who care for nothing but an immediate practical application must remember ,franklin's words1 ,what is the use of a new-born child1 but to become a man8 ,if you deliberately reject scientific medicine1 you fail to see the natural development of man's mind in all the sciences4 ,without doubt1 our hands are empty to-day1 but our mouth may well be filled with legitimate promises for the future4 ,he died in #ahgh4 ,the following account of the discovery of glycogen is taken from his ,nouvelle ,fonction du ,foie 7,paris1 #ahec73-- ,my first researches into the assimilation and destruction of sugar in the living organism were made in #ahdc3 and in my inaugural thesis 7,dec4 #ahdc7 ,i published my first experiments on the subject4 ,i succeeded in demonstrating a fact hitherto unknown1 that cane-sugar cannot be directly destroyed in the blood4 ,if you inject even a very small quantity of cane-sugar1 dissolved in water1 into the blood or under the skin of a rabbit1 you find it again in the urine unchanged1 with all its chemical properties the same4444 ,i had soon to give up my first point of view1 because this question of the existence of a sugar-producing organ1 that ,i had thought such a hard problem of physiology1 was really the first thing revealed to me1 as it were of itself1 at once4 ,he kept two dogs on different diets1 one with sugar1 the other without it2 then killed them during digestion1 and tested the blood in the hepatic veins3-- ,what was my surprise1 when ,i found a considerable quantity of sugar in the hepatic veins of the dog that had been fed on meat only1 and had been kept for eight days without sugar3 just as ,i found it in the other dog that had been fed for the same time on food rich in sugar4444 ,finally1 after many attempts--aprs beaucoup d'essais et plusieurs illusions que je fus oblig de rectifier par des ttonnements--,i succeeded in showing1 that in dogs fed on meat the blood passing through the portal vein does not contain sugar before it reaches the liver2 but when it leaves the liver1 and comes by the hepatic veins into the inferior vena cava1 this same blood contains a considerable quantity of a sugary substance 7glucose74 ,his further discovery1 that this formation of sugar is increased by puncture of the floor of the fourth ventricle1 was published in #ahdi4 ,it is impossible to exaggerate the importance of ,claude ,bernard's single-handed work in this field of physiology and pathology3-- ,as a mere contribution to the history of sugar within the animal body1 as a link in the chain of special problems connected with digestion and nutrition1 its value was very great4 ,even greater1 perhaps1 was its effect as a contribution to general views4 ,the view that the animal body1 in contrast to the plant1 could not construct1 could only destroy1 was1 as we have seen1 already being shaken4 ,but evidence1 however strong1 offered in the form of numerical comparisons between income and output1 failed to produce anything like the conviction which was brought home to every one by the demonstration that a substance was actually formed within the animal body1 and by the exhibition of the substance so formed4 ,no less revolutionary was the demonstration that the liver had other things to do in the animal economy besides secreting bile4 ,this1 at one blow1 destroyed the then dominant conception that the animal body was to be regarded as a bundle of organs1 each with its appropriate function1 a conception which did much to narrow inquiry1 since when a suitable function had once been assigned to an organ there seemed no need for further investigations4444 ,no less pregnant of future discoveries was the idea suggested by this newly-found-out action of the hepatic tissue1 the idea happily formulated by ,bernard as 'internal secretion4' ,no part of physiology is at the present day being more fruitfully studied than that which deals with the changes which the blood undergoes as it sweeps through the several tissues1 changes by the careful adaptation of which what we call the health of the body is secured1 changes the failure or discordance of which entails disease4 ,the study of these internal secretions constitutes a path of inquiry which has already been trod with conspicuous success1 and which promises to lead to untold discoveries of the greatest moment2 the gate to this path was opened by ,bernard's work4 7,sir ,m4 ,foster1 loc4 cit47 ,but the work to be done1 before all the clinical facts of the disease can be stated in terms of physiology1 is not yet finished4 ,in ,england1 especial honour is due to ,dr4 ,pavy for his life-long study of this most complex problem4 ,v ,,the ,,pancreas ,here again ,claude ,bernard's name must be put first4 ,before him1 the diverse actions of the pancreatic juice had hardly been studied4 ,vesalius1 greatest of all anatomists1 makes no mention of the duct of the pancreas1 and speaks of the gland itself as though its purpose were just to support the parts in its neighbourhood--ut ventriculo instar substerniculi ac pulvinaris subjiciatur4 ,the duct was discovered by ,wirsung1 in #afdb3 but anatomy could not see the things that belong to physiology4 ,lindanus 7#afec7 said1 ,i cannot doubt that the pancreas expurgates1 in the ordinary course of ,nature1 those impurities of the blood that are too crass and inept to be tamed by the spleen3 and1 in the extraordinary course1 all black bile1 begotten of disease or intemperate living4 ,wharton 7#afef7 said1 ,it ministers to the nerves1 taking up certain of their superfluities1 and remitting them through its duct into the intestines4 ,and ,tommaso ,bartholini 7#afff7 called it the biliary vesicle of the spleen4 ,this chaos of ideas was brought into some sort of order by ,regnier de ,graaf1 pupil of ,franois de ,bois 7,sylvius74 ,de ,bois had guessed that the pancreas must be considered not according to its position in the body1 but according to its structure3 that it was analogous to the salivary glands4 ,he urged his pupil to make experiments on it3 and de ,graaf says3-- ,i put my hand to the work3 and though many times ,i despaired of success1 yet at last1 by the blessing of ,god on my work and prayers1 in the year #affj ,i discovered a way of collecting the pancreatic juice4 ,and1 by further experiment1 he refuted ,bartholini's theory that the pancreas was dependent on the spleen4 ,sylvius had supposed that the pancreatic juice was slightly acid1 and de ,graaf failed to note this mistake2 but it was corrected by ,bohn's experiments in #agaj4 ,nearly two hundred years come between ,regnier de ,graaf and ,claude ,bernard3 it is no wonder that ,sir ,michael ,foster says that de ,graaf's work was very imperfect and fruitless4 ,so late as #ahdj1 there was yet no clear understanding of the action of the pancreas4 ,physiology could not advance without organic chemistry2 de ,graaf could no more discover the amylolytic action of the pancreatic juice than ,galvani could invent wireless telegraphy4 ,the physiologists had to wait till chemistry was ready to help them3-- ,of course1 while physical and chemical laws were still lost in a chaos of undetermined facts1 it was impossible that men should analyse the phenomena of life3 first1 because these phenomena go back to the laws of chemistry and physics2 and next1 because they cannot be studied without the apparatus1 instruments1 and all other methods of analysis that we owe to the laboratories of the chemists and the physicists4 7,cl4 ,bernard1 ,phys4 ,opr41 p4 #fa47 ,therefore de ,graaf failed1 because he got no help from other sciences4 ,but it cannot be called failure2 he must be contrasted with the men of his time1 ,lindanus and ,bartholini1 facts against theories1 not with men of this century4 ,and ,claude ,bernard went back to de ,graaf's method of the fistula1 having to guide him the facts of chemistry observed by ,valentin1 ,tiedemann and ,gmelin1 and ,eberl4 ,his work began in #ahdf1 and the ,acadmie des ,sciences awarded a prize to it in #ahej3-- ,let this vague conception 7the account of the pancreas given in ,johannes ,mller's ,text-book of ,physiology7 be compared with the knowledge which we at present have of the several distinct actions of the pancreatic juice1 and of the predominant importance of this fluid not only in intestinal digestion but in digestion as a whole1 and it will be at once seen what a great advance has taken place in this matter since the early forties4 ,that advance we owe in the main to ,bernard4 ,valentin1 it is true1 had in #ahdd not only inferred that the pancreatic juice had an action on starch1 but confirmed his view by actual experiment with the juice expressed from the gland2 and ,eberl had suggested that the juice had some action on fat2 but ,bernard at one stroke made clear its threefold action4 ,he showed that it on the one hand emulsified1 and on the other hand split up1 into fatty acids and glycerine1 the neutral fats2 he clearly proved that it had a powerful action on starch1 converting it into sugar2 and lastly1 he laid bare its remarkable action on proteid matters4 7,sir ,michael ,foster1 loc4 cit47 ,finally came the discovery that the pancreas--apart from its influences on digestion--contributes its share1 like the ductless glands1 to the general chemistry of the body3-- ,it was discovered1 a few years ago1 by von ,mering and ,minkowski1 that if1 instead of merely diverting its secretion1 the pancreas is bodily removed1 the metabolic processes of the organism1 and especially the metabolism of carbo-hydrates1 are entirely deranged1 the result being the production of permanent diabetes4 ,but if even a very small part of the gland is left within the body1 the carbo-hydrate metabolism remains unaltered1 and there is no diabetes4 ,the small portion of the organ which has been allowed to remain 7and which need not even be left in its proper place1 but may be transplanted under the skin or elsewhere7 is sufficient1 by the exchanges which go on between it and the blood generally1 to prevent those serious consequences to the composition of the blood1 and the general constitution of the body1 which result from the complete removal of this organ4 7,prof4 ,schfer1 #ahid47 ,here1 in this present study of pancreatic diabetes1 by ,dr4 ,vaughan ,harley and others1 are facts as important as any that ,bernard made out3 in no way contradicting his work1 but adding to it4 ,the pancreas is no longer taken to be only a sort of salivary gland out of place3 over and above the secretion that it pours into the intestines1 it has an internal secretion1 a constituent of the blood3 it belongs not only to the digestive system1 but also1 like the thyroid gland and the suprarenal capsules1 to the whole chemistry of the blood and the tissues4 ,so far has physiology come1 unaided by anatomy1 from the fantastic notions of ,lindanus and the men of his time3 and has come every inch of the way by the help of experiments on animals4 ,professor ,starling's observations1 on the chemical influence of the duodenal mucous membrane on the flow of pancreatic fluid1 have advanced the subject still further4 ,,vi ,,the ,,growth ,,of ,,bone ,the work of du ,hamel proved that the periosteum is one chief agent in the growth of bone4 ,before him1 this great fact of physiology was unknown2 for the experiments made by ,anthony de ,heide 7#afhd71 who studied the production of callus in the bones of frogs1 were wholly useless1 and serve only to show that men in his time had no clear understanding of the natural growth of bone4 ,de ,heide says of his experiments3-- ,from these experiments it appears--forsan probatur--that callus is generated by extravasated blood1 whose fluid particles being slowly exhaled1 the residue takes the form of the bone3 which process may be further advanced by deciduous halitus from the ends of the broken bone4 ,and ,clopton ,havers1 in his ,osteologia ,nova 7,london1 #afia71 goes so far the wrong way that he attributes to the periosteum not the production of bone1 but the prevention of over-production2 the periosteum1 he says1 is put round the shaft of a bone to compress it1 lest it grow too large4 ,du ,hamel's discovery 7#agci-agdc7 came out of a chance observation1 made by ,john ,belchier1#d that the bones of animals fed near dye-works were stained with the dye4 ,belchier therefore put a bird on food mixed with madder1 and found that its bones had taken up the stain4 ,then du ,hamel studied the whole subject by a series of experiments4 ,to estimate the advance that he gave to physiology1 contrast de ,heide's fanciful language with the title of one of du ,hamel's papers--,quatrime ,mmoire sur les ,os1 dans lequel on se propose de rapporter de nouvelles preuves qui tablissent que les os croissent en grosseur par l'addition de couches osseuses qui tirent leur origine du prioste1 comme le corps ligneux des ,arbres augmente en grosseur par l'addition de couches ligneuses qui se forment dans l'corce4 ,or take an example of du ,hamel's method3-- ,three pigs were destined to clear up my doubts4 ,the first1 six weeks old1 was fed for a month on ordinary food1 with an ounce daily of madder-juice--garence grappe--put in it4 ,at the end of the month1 we stopped the juice1 and fed the pig in the ordinary way for six weeks1 and then killed it4 ,the marrow of the bones was surrounded by a fairly thick layer of white bone3 this was the formation of bone during the first six weeks of life1 without madder4 ,this ring of white bone was surrounded by another zone of red bone3 this was the formation of bone during the administration of the madder4 ,finally1 this red zone was covered with a fairly thick layer of white bone3 this was the layer formed after the madder had been left off4444 ,we shall have no further difficulty in understanding whence transudes the osseous juice that was thought necessary for the formation of callus and the filling-up of the wounds of the bones1 now we see that it is the periosteum that fills up the wounds1 or is made thick round the fractures1 and afterward becomes of the consistence of cartilage1 and at last acquires the hardness of bones4 #d ,an ,account of the ,bones of ,animals being changed to a ,red ,colour by ,aliment only1 by ,john ,belchier1 ,f4,r4,s41 ,phil4 ,trans4 ,roy4 ,soc41 #agce-cf4 ,there is a letter from ,sir ,hans ,sloane1 then ,president of the ,royal ,society1 to ,m4 ,geoffroy1 member of the ,french ,academy3--,m4 ,belchier1 chirurgien1 membre de cette ,socit1 dnant un jour chez un ,teinturier qui travaille en ,toiles peintes1 remarqua que dans un ,porc frais qu'on avoit servi sur table1 et dont la chair toit de bon got1 les os toient rouges4 ,il demanda la cause d'un effet si singulier1 et on lui dit que ces sortes de ,teinturiers se servoient de la racine de ,rubia ,tinctorum1 ou garence1 pour fixer les couleurs dj imprimes sur les ,toiles de coton1 qu'on appelle en ,angleterre callicoes4 ,this passage of dye into the bones of animals had been noted so far back as #aegc1 by ,antoine ,mizald1 a doctor in ,paris--,erythrodanum1 vulgo rubia tinctorum1 ossa pecudum rubenti et sandycino colore imbuit4 ,these results1 confirmed by ,bazan 7#agdf7 and ,boehmer 7#agea71 were far beyond anything that had yet been known about the periosteum4 ,but the growth of bone is a very complex process3 the naked eye sees only the grosser changes that come with it2 and du ,hamel's ingenious comparison between the periosteum and the bark of trees was too simple to be exact4 ,therefore his work was opposed by ,haller1 and by ,dethleef1 ,haller's pupil3 and the great authority of ,haller's name1 and the difficulties lying beyond du ,hamel's plain facts1 brought about a long period of uncertainty4 ,bordenave 7#agef7 found reasons for supporting ,haller2 and ,fougeroux 7#agfj7 supported du ,hamel4 ,thus men came to study the whole subject with more accuracy--the growth in length1 as well as the growth in thickness2 the medullary cavity1 the development of bone1 the nutrition and absorption of bone4 ,among those who took up the work were ,bichat1 ,hunter1 ,troja1 and ,cruveilhier2 and they recognised the surgical aspect of these researches in physiology4 ,after them1 the periosteal growth of bone became1 as it were1 a part of the principles of surgery4 ,from this point of view of practice1 issued the experiments made by ,syme 7#ahcg7 and ,stanley 7#ahdi73 which proved the importance of the epiphysial cartilages for the growth of the bones in length1 and the risk of interfering with these cartilages in operations on the joints of children4 ,finally1 with the rise of ansthetics and of the antiseptic method1 came the work of ,ollier1 of ,lyon1 whose good influence on the treatment of these cases can hardly be over-estimated4 ,,vii ,,the ,,nervous ,,system ,as with the circulatory system1 so with the nervous system1 the work of ,galen was centuries ahead of its time4 ,before him1 ,aristotle1 who twice refers to experiments on animals1 had observed the brain during life3 for he says1 ,in no animal has the blood any feeling when it is touched1 any more than the excretions2 nor has the brain1 or the marrow1 any feeling1 when it is touched3 but there is reason for believing that he neither recognised the purpose of the brain1 nor understood the distribution of the nerves4 ,galen1 by the help of the experimental method1 founded the physiology of the nervous system3-- ,galen's method of procedure was totally different to that of an anatomist alone4 ,he first reviewed the anatomical position1 and by dissection showed the continuity of the nervous system1 both central and peripheral1 and also that some bundles of nerve fibres were distributed to the skin1 others to the muscles4 ,later1 by process of the physiological experiment of dividing such bundles of fibres1 he showed that the former were sensory fibres and the latter motor fibres4 ,he further traced the nerves to their origins in the spinal cord1 and their terminations as aforesaid4 ,from these observations and experiments he was able to deduce the all-important fact that different nerve-roots supplied different groups of muscles and different areas of the skin4444 ,an excellent illustration of his method1 and of the fact that we ought not to treat symptoms1 but the causes of symptoms1 is shown very clearly in one of the cases which ,galen records as having come under his care4 ,he tells us that he was consulted by a certain sophist called ,pausanias1 who had a severe degree of ansthesia of the little and ring fingers4 ,for this loss of sensation1 etc41 the medical men who attended him applied ointments of various kinds to the affected fingers2 but ,galen1 considering that that was a wrong principle1 inquired into the history1 and found that while the patient was driving in his chariot he had accidentally fallen out and struck his spine at the junction of the cervical and dorsal regions4 ,galen recognised that he had to do with a traumatism affecting the eighth cervical and first dorsal nerve2 therefore1 he says1 he ordered that the ointments should be taken off the hand and placed over the spinal column1 so as to treat the really affected part1 and not apply remedies to merely the referred seat of pain4#e #e ,from an address on ,galen1 given by ,sir ,victor ,horsley before the ,medical ,society of the ,middlesex ,hospital4 ,see ,middlesex ,hospital ,journal1 ,may #ahii4 ,galen1 by this sort of work1 laid the foundations of physiology2 but the men who came after him let his facts be overwhelmed by fantastic doctrines3 all through the ages1 from ,galen to the ,renaissance1 no great advance was made toward the interpretation of the nervous system4 ,long after the ,renaissance1 his authority still held good2 his ghost was not laid even by ,paracelsus and ,vesalius1 it haunted the medical profession so late as the middle of the seventeenth century2 but the men who worshipped his name missed the whole meaning of his work4 ,this long neglect of the experimental method left such a gap in the history of physiology1 that ,sir ,charles ,bell seems to take up the experimental study of the nervous system at the point where ,galen had stopped short2 we go from the time of ,commodus to the time of ,george the ,third1 and there is ,bell1 as it were1 putting the finishing touch to ,galen's facts4 ,it is true that experiments had been made on the nervous system by many men2 but a dead weight of theories kept down the whole subject4 ,for a good instance1 how imagination hindered science1 there is the following list1 made by ,dr4 ,risien ,russell1 of theories about the cerebellum3-- ,galen was of opinion that the cerebellum must be the originator of a large amount of vital force4 ,after him1 and up to the time of ,willis1 the prevalent idea seems to have been that it was the seat of memory2 while ,bourillon considered it the seat of instinct and intelligence4 ,willis supposed that it presided over involuntary movements and organic functions2 and this view1 though refuted by ,haller1 continued in the ascendency for some time4 ,some believed strongly in its influence on the functions of organic life2 and according to some1 diseases of the cerebellum appeared to tell on the movements of the heart4444 ,haller believed it to be the seat of sensations1 as well as the source of voluntary power2 and there were many supporters of the theory that the cerebellum was the seat of the sensory centres4 ,renzi considered this organ the nervous centre by which we perceive the reality of the external world1 and direct and fix our senses on the things round us4 ,gall1 and later ,broussais1 and others1 held that this organ presided over the instinct of reproduction1 or the propensity to love2 while ,carus regarded it as the seat of the will also4 ,rolando looked on it as the source of origin of all movements4 ,jessen adduced arguments in favour of its being the central organ of feeling1 or of the soul1 and the principal seat of the sensations4 ,it is plain1 from this list1 that physiology had become obscured by fanciful notions of no practical value4 ,if a better understanding of the nervous system could have been got without experiments on animals1 why had men to wait so long for it8 ,the ,italian anatomists had long ago given them all the anatomy that was needed to make a beginning2 the hospitals1 and practice1 had given them many hundred years of clinical facts2 nervous diseases and head injuries were common enough in the ,middle ,ages2 and by the time of ,ambroise ,par1 if not before1 post-mortem examinations were allowed4 ,the one thing wanted was the experimental method2 and1 for want of it1 the science of the nervous system stood still4 ,experiments had been made2 but the steady1 general1 unbiassed use of this method had been lost sight of1 and men were more occupied with logic and with philosophy4 ,then1 in #ahaa1 came ,sir ,charles ,bell's work4 ,if any one would see how great was the need of experiments on animals for the interpretation of the nervous system1 let him contrast the physiology of the eighteenth century with that one experiment by ,bell which enabled him to say1 ,i now saw the meaning of the double connection of the nerves with the spinal marrow4 ,it is true that this method is but a part of the science of medicine2 that experiment and experience ought to go together like the convexity and the concavity of a curve4 ,but it is true also that men owe their deliverance from ignorance about the nervous system more to experiments on animals than to any other method of observing facts4 #a4 ,sir ,charles ,bell 7#aggh-ahdb7 ,the great authority of ,sir ,charles ,bell has been quoted a thousand times against all experiments on animals3-- ,experiments have never been the means of discovery2 and a survey of what has been attempted of late years in physiology1 will prove that the opening of living animals has done more to perpetuate error than to confirm the just views taken from the study of anatomy and natural motions4 ,he wrote1 of course1 in the days before bacteriology1 before ansthetics2 he had in his mind neither inoculations1 nor any observations made under chloroform or ether1 but just the opening of living animals4 ,he had also in his mind1 and always in it1 a great dislike against the school of ,magendie4 ,let all that pass2 our only concern here is to know whether these words are true of his own work4 ,they occur in a paper1 ,on the ,motions of the ,eye1 in ,illustration of the ,uses of the ,muscles and ,nerves of the ,orbit2 communicated by ,sir ,humphry ,davy to the ,royal ,society1 and read ,march #bj1 #ahbc4f ,this essay was one of a series of papers on the nervous system1 presented to the ,royal ,society during the years #ahba-ahbi4 ,in #ahcj1 having already published four of these papers under the title1 ,the ,exposition of the ,nervous ,system1 ,bell published all six of them1 under the title1 ,the ,nervous ,system of the ,human ,body4 #f ,this paper includes an ,experimental ,enquiry into the ,action of these ,muscles1 giving an account of an experiment on the eye4 ,in his ,preface to this book 7#ahcj7 he quotes the earliest of all his printed writings on the nervous system1 a pamphlet1 printed in #ahaa1 under the title1 ,an ,idea of a ,new ,anatomy of the ,brain1 ,submitted for the ,observation of the ,authors ,friends4 ,we have therefore two statements of his work1 one in #ahaa1 the other in #ahbc and #ahcj4 ,the first of them was written when his work was still new before his eyes4 ,those who say that experiments did not help ,bell in his great discovery--the difference between the anterior and the posterior nerve-roots--appeal to certain passages in the #ahcj volume3-- ,in a foreign review of my former papers1 the results have been considered as a further proof in favour of experiments4 ,they are1 on the contrary1 deductions from anatomy2 and ,i have had recourse to experiments1 not to form my own opinions1 but to impress them upon others4 ,it must be my apology that my utmost efforts of persuasion were lost1 while ,i urged my statements on the grounds of anatomy alone4 ,i have made few experiments2 they have been simple and easily performed1 and ,i hope are decisive4444 ,my conceptions of this matter arose by inference from the anatomical structure2 so that the few experiments which have been made were directed only to the verification of the fundamental principles on which the system is established4 ,if it were not for the #ahaa pamphlet1 the opponents of all experiments on animals might claim ,sir ,charles ,bell on their side4 ,but while his work was still a new thing1 he spoke in another way of it3-- ,i found that injury done to the anterior portion of the spinal marrow convulsed the animal more certainly than injury to the posterior portion2 but ,i found it difficult to make the experiment without injuring both portions4 ,next1 considering that the spinal nerves have a double root1 and being of opinion that the properties of the nerves are derived from their connections with the parts of the brain1 ,i thought that ,i had an opportunity of putting my opinion to the test of experiment1 and of proving at the same time that nerves of different endowments were in the same cord 7nerve-trunk7 and held together by the same sheath4 ,on laying bare the roots of the spinal nerves1 ,i found that ,i could cut across the posterior fasciculus of nerves1 which took its origin from the posterior portion of the spinal marrow1 without convulsing the muscles of the back2 but that on touching the anterior fasciculus with the point of the knife1 the muscles of the back were immediately convulsed4 ,such were my reasons for concluding that the cerebrum and cerebellum were parts distinct in function1 and that every nerve possessing a double function obtained that by having a double root4 ,i now saw the meaning of the double connection of the nerves with the spinal marrow2 and also the cause of that seeming intricacy in the connections of nerves throughout their course1 which were not double at their origins4 ,it is impossible to reconcile the #ahcj sentences with this vivid personal account of himself2 ,i had an opportunity of putting my opinion to the test of experiment 444 an opportunity of proving 444 ,such were my reasons for concluding 444 ,i now saw4444 ,it is just what all men of science say of their experiments3 the very phrase of ,archimedes1 and ,asellius1 and de ,graaf4 ,if ,sir ,charles ,bell had been working at the facts of chemistry or of botany1 who would have doubted the meaning of these words8 ,this same inconsistency of sentences occurs elsewhere in his ,nervous ,system of the ,human ,body4 ,in one place he says that he has made few experiments3 ,they have been simple1 and easily performed1 and ,i hope are decisive4 ,in another he says3 ,after making several experiments on the cerebrum and cerebellum1 ,i laid the question of their functions entirely aside1 and confined myself to the investigation of the spinal marrow and the nerves2 a subject which ,i found more within my power1 and which forms the substance of the present volume4 ,next1 take his account of the cranial nerves3-- ,it was necessary to know1 in the first place1 whether the phenomena exhibited on injuring the separate roots corresponded with what was suggested by their anatomy4444 ,here a difficulty arose4 ,an opinion prevailed that ganglions were intended to cut off sensation2 and every one of these nerves1 which ,i supposed were the instruments of sensation1 have ganglions on their roots4 ,some very decided experiment was necessary to overturn this dogma4 7,account of the experiment47 ,by pursuing the inquiry1 it was found that a ganglionic nerve is the sole organ of sensation in the head and face3 ganglions were therefore no hindrance to sensation2 and thus my opinion was confirmed4444 ,it now became obvious why the third1 sixth1 and ninth nerves of the encephalon were single nerves in their roots4444 ,observing that there was a portion of the fifth nerve which did not enter the ganglion of that nerve1 and being assured of the fact by the concurring testimony of anatomists1 ,i conceived that the fifth nerve was in fact the uppermost nerve of the spine4444 ,this opinion was confirmed by experiment4444 7,account of an experiment on the dead body47 ,on dividing the root of the nerve in a living animal1 the jaw fell relaxed4 ,thus its functions are no longer matter of doubt3 it is at once a muscular nerve and a nerve of sensibility4 ,and thus the opinion is confirmed1 that the fifth nerve is to the head what the spinal nerves are to the other parts of the body1 in respect to sensation and volition4 ,the value of the experimental method could hardly be stated in more emphatic words4 ,he supposed something1 conceived it1 had an opinion about it4 ,anatomy had suggested something to him4 ,he put his opinion to the test of phenomena1 that is to say1 to the test of visible facts2 and then his opinion was confirmed4 ,as with the spinal nerve-roots1 so with the fifth cranial nerve--his work was successful1 because he followed the way of experiment4 ,he was by nature of a most complex and sensitive temperament1 full of contrary forces--one man in #ahaa1 another in #ahcj4 ,in #ahaa he wrote1 ,i now saw the meaning of the double connection of the nerves2 in #ahcj he had come to hate the stupid sterile materialism of the ,french school3 he beheld anatomy falling behind physiology1 and his ,windmill ,street school perishing to make way for the ,hospital schools and for the ,university of ,london4 ,he was before everything else a great anatomist3 he stood up for the honour of anatomy against the new physiology1 and for the honour of the ,monroes and the ,hunters against ,magendie3 he hated the notion that any man should proceed to experiments on function till the very last secrets had been got out of structure4 ,he died a few years afterward4 ,the #ahcj writings are his last stand for the defence of his country1 his school1 and his beloved anatomy1 against the methods of ,magendie2 who said of himself1 ,i am a mere street scavenger1 chiffonier1 of science4 ,with my hook in my hand and my basket on my back1 ,i go about the streets of science1 collecting what ,i find4 ,this open conflict between ,bell's first and last thoughts is a part of his character3 he was brilliant1 impulsive1 changeable1 inconsistent2 and1 what is more important1 his honour kept him from trying to evade this trumpery charge of inconsistency2 and he reprinted the #ahaa ,preface in the book that he published in #ahcj4 ,doubtless he would have picked his words more carefully if he had foreseen that one of the #ahcj sentences would be wrested out of its place in his life's work1 and used as false evidence against the very method that he followed4 ,his observations on the cranial nerves brought about an immediate change in the practice of surgery3-- ,up to the time that ,sir ,charles ,bell made his experiments on the nerves of the face1 it was the common custom of surgeons to divide the facial nerve for the relief of neuralgia1 tic douleureux2 whereas it exercises1 and was proved by ,sir ,charles ,bell to exercise1 no influence over sensation1 and its division consequently for the relief of pain was a useless operation4 7,sir ,j4 ,erichsen47 ,the relation of ,magendie's work on the nerve-roots to ,bell's work need not be considered here4 ,the exact dates of ,bell's observations are given by one of his pupils in the ,preface to the #ahcj volume4 ,magendie finally proved the sensory nature of the posterior nerve-roots3 ,the exact and full proof which he brought forward of the truth which ,charles ,bell had divined rather than demonstrated1 that the anterior and posterior roots of spinal nerves have essentially different functions--a truth which is the very foundation of the physiology of the nervous system--is enough by itself to mark him as a great physiologist4 7,sir ,m4 ,foster1 loc4 cit47 #b4 ,marshall ,hall 7#agij-aheg7 ,reflex action had been studied long before the time of ,marshall ,hall4 ,the ,hon4 ,robert ,boyle 7#affc7 had observed the movements and actions of decapitated vipers1 flies1 silkworms1 and butterflies4 ,similar observations were made on frogs1 eels1 and other lower animals1 by ,redi1 ,woodward1 ,stuart1 ,le ,gallois1 and ,sir ,gilbert ,blane4 ,according to ,richet1 it was ,willis who first gave the name reflex to these movements4 ,it cannot be said that these first studies of reflex action did much for physiology4 ,but the following translation from ,prochaska 7#ahjj7 shows how they cleared the way for ,marshall ,hall's work1 by the proof that they gave of the liberation of nervous energy in the spinal cord3-- ,these movements of animals after decapitation must needs be by consent and commerce betwixt the spinal nerves4 ,for a decapitated frog1 if it be pricked1 not only draws away the part that is pricked1 but also creeps and jumps2 which cannot happen but by consent betwixt the sensory nerves and the motor nerves4 ,the seat of which consent must needs be in the spinal cord1 the only remaining portion of the sensorium4 ,and this reflexion of sensory impressions into motor impressions is not accomplished in obedience to physical laws alone--wherein the angle of reflexion is equal to the angle of incidence1 and reaction to action--but it follows special laws as it were written by ,nature on the spinal cord1 which we can know only by their effects1 but cannot fathom with the understanding4 ,but the general law1 whereby the sensorium reflects sensory impressions into motor impressions1 is the preservation of ourselves4 ,it was not possible1 in #ahjj1 to go further1 or to put the facts of reflex action more clearly3 but this fine sentence gives no hint of the truth that guided ,marshall ,hall--that the consent and commerce of reflex action are to be found at definite points or levels in the spinal cord2 that the cord no more works as a whole than the brain4 ,the greatness of ,marshall ,hall's work lies in his recognition of the divisional action of the cord3 he proved the existence of definite centres in it1 he discovered the facts of spinal localisation1 and thus foreshadowed the discovery of cerebral localisation4 ,in his earlier writings 7#ahbc-cc7 he showed how the movements of the trunk and of the limbs are only one sort of reflex action2 how the larynx1 the pharynx1 and the sphincter muscles1 all act by the consent and commerce of the spinal cord4 ,later1 in #ahcg1 he demonstrated the course of nerve-impulses along the cord from one level to another1 the results of direct stimulation of the cord1 and other facts of spinal localisation4 ,he noted the different effects of opium and of strychnine on reflex action2 and he extended the doctrines of reflex action beyond physiology to the convulsive movements of the body in certain diseases4 #c4 ,flourens 7#agid-ahfg7 ,beside his work on the nervous system1 ,flourens studied the periosteal growth of bone1 and the action of chloroform2#g but he is best known by his experiments on the respiratory centre and the cerebellum4 ,the men who interpreted the nervous system followed the anatomical course of that system3 first the nerve-roots1 then the cord1 then the medulla oblongata and the cerebellum1 and last the cerebral hemispheres2 a steady upward advance1 from the observation of decapitated insects to the localisation of centres in the human brain4 ,flourens1 by his work on the medulla oblongata1 localised the respiratory centre1 the nerve-cells for the reflex movements of respiration3-- ,m4 ,flourens a circonscrit ce centre avec une scrupuleuse prcision1 et lui a donn le nom de noeud vital 7,cl4 ,bernard47 #g ,when ,flourens died1 ,claude ,bernard was appointed to his place in the ,french ,academy2 and1 in the ,discours de ,reception 7,may #bg1 #ahfi71 said1 ,it is twenty-two years since the discovery of ansthesia by ether came to us from the ,new ,world1 and spread rapidly over ,europe4 ,m4 ,flourens was the first man who showed that chloroform is more active than ether4 ,afterward came the discovery of cardiac and other centres in the same portion of the nervous system4 ,flourens also showed that the cerebellum is concerned with the equilibration of the body1 and with the coordination of muscular movements2 that an animal1 a few days old1 deprived of sensation and consciousness by removal of the cerebral hemispheres1 was yet able to stand and move forward1 but1 when the cerebellum was removed1 its muscles lost all co-ordinate action4 7,recherches ,exprimentales1 ,paris1 #ahdb47 ,and from his work1 and the work of those who followed him1 on the semicircular canals of the internal ear1 came the evidence that these minute structures are the terminal organs of equilibration3 that as the special senses have their terminal apparatus and their central apparatus1 so the semicircular canals and the cerebellum are the terminal apparatus and the central apparatus of the sense of equilibrium4 #d4 ,claude ,bernard 7#ahac-ahgh7 ,the discovery of the vaso-motor nerves1 and of the control of the nervous system over the calibre of the arteries1 was made by ,claude ,bernard at the outset of his work on the influence of the nervous system on the temperature4#h ,the evidence of ,professor ,sharpey before the ,royal ,commission of #ahge shows how things had been misjudged1 before ,bernard's time1 in the light of views taken from the ,study of ,anatomy and ,natural ,motions3-- ,i remember that ,sir ,charles ,bell gave the increased size of the vessels in blushing1 and their fulness of blood1 as an example of the increased action of the arteries in driving on the blood4 ,it turns out to be just the reverse1 inasmuch as it is owing to a paralysis of the nerves governing the muscular coats of the arteries4 #h ,a full account of this discovery1 and of its relation to the experiments of ,brown ,squard1 ,waller1 and ,budge1 is given by ,sir ,michael ,foster in his life of ,claude ,bernard2 and the question of priority between ,bernard and ,brown ,squard need not be considered here1 for the experimental method was the only way open to either of them4 ,for an account of the work done1 before ,bernard1 in this field of physiology1 see ,prof4 ,stirling's admirable and learned monograph1 ,some ,apostles of ,physiology 7,waterlow ,sons1 ,london1 #aijb71 p4 #ajd4 ,claude ,bernard's first account of his work was communicated to the ,socit de ,biologie in ,december #ahea4 ,the following description is taken from his ,leons de ,physiologie ,opratoire3-- ,i will remind you how ,i was led to the discovery of the vaso-motor nerves4 ,starting from the clinical observation1 made long ago1 that in paralysed limbs you find at one time an increase of cold1 and at another an increase of heat1 ,i thought this contradiction might be explained by supposing that1 side by side with the general action of the nervous system1 the sympathetic nerve might have the function of presiding over the production of heat2 that is to say1 that in the case where the paralysed limb was chilled1 ,i supposed the sympathetic nerve to be paralysed1 as well as the motor nerves2 while in the paralysed limbs that were not chilled1 the sympathetic nerve had retained its function1 the systemic nerves alone having been attacked4 ,this was a theory1 that is to say1 an idea leading me to make experiments2 and for these experiments ,i must find a sympathetic nerve-trunk of sufficient size1 going to some organ that was easy to observe1 and must divide this trunk to see what would happen to the heat-supply of the organ4 ,you know that the rabbit's ear1 and the cervical sympathetic nerve of this animal1 offered us the required conditions4 ,so ,i divided the nerve2 and immediately my experiment gave the lie direct to my theory--,je coupai donc ce filet et aussitt l'exprience donna mon hypothse le plus clatant dmenti4 ,i had thought that the section of the nerve would suppress the function of nutrition1 of calorification1 over which the sympathetic system had been supposed to preside1 and would cause the hollow of the ear to become chilled2 and here was just the opposite1 a very warm ear1 with great dilatation of its vessels4 ,i need not remind you how ,i made haste to abandon my first theory1 and gave myself to the study of this new state of things4 ,and you know that here was the starting-point of all my researches into the vaso-motor and thermic system2 and the study of this subject is become one of the richest fields of experimental physiology4 ,waller1 in #ahec1 studied the vaso-motor centre in the spinal cord2 and ,schiff1 in #ahef1 found evidence of the existence of two kinds of vaso-motor nerves--those that constrict the vessels1 and those that dilate them4 ,this view was finally established in #aheh by ,claude ,bernard's experiments on the chorda tympani and the submaxillary gland4 ,the ,leons de ,physiologie ,opratoire were published in #ahgi4 ,twenty years later1 ,sir ,michael ,foster says of ,bernard's work3-- ,it is almost impossible to exaggerate the importance of these labours of ,bernard on the vaso-motor nerves1 since it is almost impossible to exaggerate the influence which our knowledge of the vaso-motor system1 springing as it does from ,bernard's researches as from its fount and origin1 has exerted1 is exerting1 and in widening measure will continue to exert1 on all our physiological and pathological conceptions1 on medical practice1 and on the conduct of human life4 ,there is hardly a physiological discussion of any width in which we do not sooner or later come on vaso-motor questions4 ,whatever part of physiology we touch1 be it the work done by a muscle1 be it the various kinds of secretive labour1 be it the insurance of the brain's well-being in the midst of the hydrostatic vicissitudes to which the changes of daily life subject it1 be it that maintenance of bodily temperature which is a condition of the body's activity2 in all these1 as in many other things1 we find vaso-motor factors intervening4 ,and if1 passing the insecure and wavering line which parts health from illness1 we find ourselves dealing with inflammation1 or with fever1 or with any of the disordered physiological processes which constitute disease1 we shall find1 whatever be the tissue specially affected by the morbid conditions1 that vaso-motor influences have to be taken into account4 ,the idea of vaso-motor action is woven as a dominant thread into all the physiological and pathological doctrines of to-day2 attempt to draw out that thread1 and all that would be left would appear as a tangled heap4 #e4 ,cerebral ,localisation ,finally1 moving upward along the anatomy of the nervous system1 physiology came to study the motor-centres and special sense-centres of the cerebral hemispheres4 ,the year #ahfa may fairly be said to mark the beginning of the discovery of these centres1 when ,broca1 at a meeting of the ,anthropological ,society of ,paris1 heard ,aubertin's paper on the connection between the frontal convolutions and the faculty of speech4 ,but1 of course1 some sort of belief in cerebral localisation had been in the air long before ,broca's time4 ,willis 7#afba-afge71 who was contemporary with ,sir ,isaac ,newton1 had written of the brain as though its convolutions1 or cranklings as he called them1 showed that its work was departmental3-- ,as the animal spirits for the various acts of imagination and memory ought to be moved within certain and distinct limits1 or bounded places1 and these motions to be often iterated or repeated through the same tracts or paths1 for that reason these manifold convolutions and infoldings of the brain are required for these divers manners of ordinations of the animal spirits--to wit1 that in these cells or storehouses1 severally placed1 might be kept the species of sensitive things1 and as occasion serves1 may be taken from thence4#i #i ,for an account of ,willis' work on the nervous system1 see ,sir ,victor ,horsley's ,fullerian ,lectures1 #ahia4 ,willis was the first1 or one of the first1 to recognise the fact that the cerebral ventricles are nothing more than lymph-cavities4 ,and ,gall1 a century after ,willis1 had collected and published1 in support of his system of phrenology1 many cases and post-mortem examinations showing the differentiation of the work of the brain4 ,gall is a warning for all time against the dangers of deduction2 he had but one idea1 and he drove it to death2 but the clinical and pathological facts which he amassed1 in the hope of establishing a set of doctrines out of all relation to facts1 are as true now as ever2 and1 if he had been content to go the way of induction1 and to set himself to the accumulation of facts1 he might have become a great physiologist4 ,in his knowledge of the anatomy of the brain1 and in the dissection of the brain1 he was far ahead of the men of his time2 but he followed his own imaginings1 and left nothing that could last1 except those cases and pathological instances that are buried in the ruins of his system4 ,but there they are1 and are still of value4 ,for example1 ,gall's case of loss of speech1 after an injury involving the speech-centres1 ought to have commanded the attention of all physiologists3 but it came to nothing1 because he used it to support his doctrine of organs and bumps1 and it shared the fate of that doctrine4 ,phrenology is gone past recall2 it died of that congenital disease1 the deductive fallacy2 but there was a time when it might have been turned to the service of science4 ,the excitement that ,gall aroused by the spread of his ideas shows that some belief in cerebral centres was waiting for development4 ,all men are by nature phrenologists2 the commonplace excuses that are offered for lapses of memory1 venial offences1 and inherited weaknesses1 all appeal to the comfortable notion that the offender is not wholly perverted1 and that some very small and strictly localised group of cells is at fault4 ,and it is probable that the physiology of the central nervous system1 with its present strong tendency toward psychology1 will some day be back1 at a far higher level1 above the point where phrenology went wrong4 ,as ,mme4 de ,stal said1 ,l'esprit humain fait progrs toujours1 mais c'est progrs en spirale4 ,but the question1 whether the general desire for a rational system of psychology will ever commend itself to physiology1 belongs to the future4 ,all that is of present concern is the steady1 continuous1 and successful advance1 by the way of induction1 and by the help of experiments on animals1 toward a clear and accurate statement of the departmental work of the brain4 ,it is one of many instances how science and practice work together1 that the modern study of these centres began not in experiment but in experience4 ,the first centres that were thus studied were the speech-centres2 and the observation of them arose out of the cases recorded by ,bouillard in #ahbe1 and ,dax in #ahcf4 ,clinical observation1 and post-mortem examination1 found the speech-centres2 physiological experiments had nothing to do with it2 and phrenology had1 as it were1 found them1 and then lost them4 ,but at once1 so soon as practice gave the word to science1 physiology set to work4 ,these clinical facts had been there all the time2 loss of speech had gone with disease or injury of ,broca's convolution ever since man had been on the earth1 and nobody had seen the significance of this sequence4 ,then1 after #ahfa1 everything was changed2 and in a few years physiology had mapped out a large part of the surface of the brain1 and had charted the motor-centres4 ,the story of ,broca's convolution is told in ,hamilton's ,text-,book of ,pathology3-- ,in #ahbe1 ,bouillard collected a series of cases to show that the faculty of speech resided in the frontal lobes4 ,in the year #ahcf ,m4 ,dax1 in a paper read to the ,medical ,congress of ,montpellier1 stated as a result of his researches that1 where speech was lost from cerebral causes1 he believed the lesion was invariably found in the left cerebral hemisphere1 and that the accompanying paralysis of the right side of the body is consequent upon this4 ,this paper for long lay buried in the annals of medical literature1 but was unearthed years afterwards by his son1 and presented to the ,french ,academy4 ,bouillard's views were also disinterred by ,aubertin1 and in the year #ahfa were brought by him before the notice of the ,anthropological ,society of ,paris4 ,broca1 who was present at the meeting1 had a patient under his care at the time who had been aphasic 7without power of speech7 for twenty-one years1 and who was in an almost moribund state4 ,the autopsy proved of great interest1 as it was found that the lesion was confined to the left side of the brain1 and to what we now call the third frontal convolution4 ,broca was struck with the coincidence2 and when a similar case came under his care afterwards1 unaware of what had been done by ,dax1 he postulated the conclusion that the integrity of the third frontal convolution1 and perhaps also part of the second1 is essential to speech4 ,in a subsequent series of fifteen typical cases examined1 it was found that the lesion had destroyed1 among other parts1 the posterior part of the third frontal in fourteen4 ,in the fifteenth case the destruction had taken place in the island of ,reil and the temporal lobe4 ,after #ahfa1 physiology took the lead1 and kept it4 ,but1 through all the work1 science and practice have been held together2 the facts of experimental physiology have been and are tested1 every inch of the way1 by the facts of medicine1 surgery1 and pathology4 ,the infinite minuteness and complexity of the investigation1 and its innumerable side-issues1 are past all telling4 ,they who are doing the work1 in science and in practice1 have always had in their thoughts the fear of fallacies in the interpretation of these highest forms of life4 ,sir ,william ,gowers1 fourteen years ago1 wrote as follows of the earlier workers3-- ,doubt was formerly entertained as to the existence of differentiation of function in different parts of the cortex1 but recent researches have established the existence of a differentiation which has almost revolutionised cerebral physiology1 and has vastly extended the range of cerebral diagnosis4 ,the first step of the new discovery was constituted by the clinical and pathological observations of ,hughlings ,jackson1 which suggested the existence1 on each side of the fissure of ,rolando1 of special centres for the movements of the leg1 arm1 and face4 ,these observations led to the experiments of ,ferner1 which resulted in the demonstration of the existence in the cortex of the lower animals of well-defined regions1 stimulation of which caused separate movements1 or evidence of special sense excitation1 while the destruction of the same parts caused indications of a loss of the corresponding function4 ,hence he came to the conclusion that these regions constitute actual motor and sensory centres4 ,ferrier had1 however1 been anticipated in many of these results by two ,german experimenters1 ,fritsch and ,hitzig1 whose results1 differing a little in detail1 correspond closely in their general significance4 ,many other investigations of the same character have since been made1 of which those of ,munk are especially important4 ,the original observations of ,hughlings ,jackson left little doubt that the general facts1 learned from experiments on animals1 are true of man2 and this conclusion has been to a large extent confirmed by pathological and clinical observations directed to the verification on man of the pathological results4 ,to this verification the labours of ,charcot and his coadjutors have largely contributed4 ,but the verification has already made it probable that some differences exist between the brain of man and that of higher animals 7even of monkeys71 and that the conclusions from the latter cannot be simply transferred to the former4 ,many and great difficulties1 beyond this danger of the fallacy of simple transference1 beset every step of the work3 it required the right use of the most delicate and susceptible instruments and tests1 and the right understanding of anatomy1 microscopic anatomy1 comparative anatomy1 organic chemistry1 electricity1 and physics3 every moment of advance must be guarded1 every word must be weighed4 ,among the earlier difficulties1 was the failure of almost all the physiologists1 before ,hitzig1 to produce muscular action by excitation of the cerebral cortex4 ,longet1 ,magendie1 ,flourens1 ,matteuci1 ,van ,deen1 ,weber1 ,budge1 and ,schiff1 had all failed4 ,hitzig 7,untersuchungen ber das ,gehirn1 ,berlin1 #ahgd7 had observed1 in man1 that it was easy to produce movements of the eyes by the passage of the constant current through the occipital region4#aj ,taking this fact for a starting-point1 he used a very low current1 and thereby succeeded in producing certain definite muscular movements by stimulation of the cortex in animals4 ,of ,hitzig's work1 ,sir ,victor ,horsley says3-- ,it was not till #ahgj that the next absolute proof 7after ,bell's work in #ahac7 was obtained of the localisation of function1 so far as the highest centres of the nervous system were concerned4 ,in that year ,fritsch and ,hitzig discovered that electrical excitation1 with minimal stimuli1 of various points of the cortex1 caused those storehouses1 of which ,willis spoke1 to discharge1 and to reveal their function by the precise limitation of the groups of muscles which they were able to throw into action4 ,these researches were abundantly confirmed and greatly extended by ,professor ,ferrier1 and thus has been constructed in the history of this subject the most recent great platform or stage of permanent advance4#aa #aj ,that the surface of the brain is not sensitive of such stimulation1 that it does not perceive its own substance1 was known to ,aristotle4 ,the fact is so familiar that there is no need to quote evidence of it1 beyond that of ,sir ,charles ,bell3 ,i have had my finger deep in the anterior lobes of the brain1 when the patient1 being at the time acutely sensible1 and capable of expressing himself1 complained only of the integument4 #aa ,horsley1 ,fullerian ,lectures1 #ahia1 loc4 cit4 ,the thirty years since ,hitzig's work cannot be put here1 for they would take a volume to themselves4 ,there have been differences of interpretation of this or that fact1 diversities of results1 and problems too hard to solve1 and other difficulties1 such as befall all the natural sciences2 but these imperfections amount to very little1 when the whole result comes to be reckoned4 ,the marvel is that the work is so nearly perfect1 seeing its immeasurable complexity4 ,let any man1 who has but touched the study of physiology1 consider what is involved in even the most superficial observation of the simplest facts of the nervous system3 for instance1 the ordinary nerve-muscle preparation that is taught to every medical student1 or the microscopic structure of the spinal cord1 or the ,wallerian method4 ,or let him consider how the physiology of the nervous system has been founded on the lower forms of life3 the work of ,romanes and others on the ,medusa and the ,echinodermata1 and ,huxley's work in biology1 and the endless chain of forces that are alike in man and in jelly-fishes4 ,then let him try to estimate the output of hard thinking1 for the advance from lower to higher structures1 and up to man2 the vigilant criticism of all theories and foregone conclusions1 the incessant self-judgment and wearisome doubts and disputes all the way1 elusiveness of facts1 and vagueness of words4 ,and the results thus wrung out of science had still to be stated in terms of practice1 and tested by the facts of medicine1 surgery1 and pathology1 and used in every hospital in the civilised world1 not only for the saving of life1 but also for the diagnosis and medical or surgical treatment of innumerable varieties of disease or injury of the brain1 the cord1 or the nerves4 ,sir ,michael ,foster1 in a short summary of the problems of physiology1 puts clearly these consummate difficulties of the physiology of the nervous system3-- ,in the first place there are what may be called general problems1 such as1 ,how the food1 after its preparation and elaboration into blood1 is built up into the living substance of the several tissues8 ,how the living substance breaks down into the dead waste8 ,how the building up and breaking down differ in the different tissues in such a way that energy is set free in different modes1 the muscular tissue contracting1 the nervous tissue thrilling with a nervous impulse1 the secreting tissue doing chemical work1 and the like8 ,to these general questions the answers which we can at present give can hardly be called answers at all4 ,in the second place there are what may be called special problems1 such as1 ,what are the various steps by which the blood is kept replenished with food and oxygen1 and kept free from an accumulation of water2 and how is the activity of the digestive1 respiratory1 and excretory organs1 which effect this1 regulated and adapted to the stress of circumstances8 ,what are the details of the vascular mechanism by which each and every tissue is for ever bathed with fresh blood1 and how is that working delicately adapted to all the varied changes of the body8 ,and1 compared with which all other problems are insignificant and preparatory only1 how do nervous impulses so flit to and fro within the nervous system as to issue in the movements which make up what we sometimes call the life of man8 ,the physiology of the nervous system is wrought to finer issues now than in the time of ,bell and ,magendie2 and this generation of students may live to see the present facts and methods of cerebral localisation as the mere rudiments or elements of science4 ,happily for mankind1 science has already so far elucidated them that they have done good service for the diagnosis and treatment of disease1 and for the saving of lives4 99 99 99 99 99 ,some examples have been given1 in the foregoing chapters1 of the value of physiological experiments on animals4 ,it would be easy to lengthen the list1 for there is no general subject in all physiology that does not owe something to this method3 as ,mr4 ,darwin said1 in his evidence before the ,royal ,commission of #ahge1 ,i am fully convinced that physiology can progress only by the aid of experiments on living animals4 ,i cannot think of any one step which has been made in physiology without that aid4 ,many examples have been left out altogether--the work of ,boyle1 ,hunter1 ,lavoisier1 ,haldane1 ,despretz1 and ,regnault1 on animal heat and on respiration2 of ,petit1 ,dupuy1 ,breschet1 and ,reid1 on the sympathetic system2 of ,galvani1 ,volta1 ,haller1 du ,bois-,reymond1 and ,pflger1 on muscular contractility3 nothing has been said of the work lately done on the suprarenal glands and adrenalin1 and on the blood-pressure in its relation to secretion4 ,for the most part1 only those examples have been taken that occur far back in the history of physiology3 more has been said about the past than about the present4 ,first1 because it was necessary to put an end to the false statements that are made1 by those who are opposed to all experiments on animals1 about the work done in the past4 ,next1 because the abstruse details of physiology1 in the present1 are not intelligible for general reading4 ,next1 because it is impossible now to isolate physiology1 or to say what belongs to physiology alone1 to have back the simpler problems of the past1 to discover the circulation of the blood twice4 ,but the experimental method1 alike in the past and in the present1 has been the chief way of advance4 ,and if a forecast may be made without offence1 it is certain that the work of physiology1 as in the past and the present1 so in the near future1 will exercise a profound influence for good on medical and surgical treatment4 ,among the subjects that especially occupy physiologists now are1 the more exact localisation and interpretation of the special sense-centres1 and the better knowledge of the internal secretions and chemical influences of the glands and tissues of the body4 ,it would be hard to find two fields of work more sure to favour the growth of the arbor vit side by side with the arbor scienti4 ,but the last word here must be said by a physiologist of the very highest authority1 ,professor ,starling4 ,he has kindly given me1 for this edition1 the following note3-- ,among the researches of the last thirty years1 those bearing on the ,circulation of the ,blood must take an important place1 both for their physiological interest and for the weighty influence they have exerted on our knowledge and treatment of disorders of the vascular system1 such as heart disease4 ,we have learned to measure accurately the work done by the great heart-pump2 and by studying the manner in which this work is affected by different conditions1 we are enabled to increase or diminish it1 according to the needs of the organ4 ,experiments in what is often regarded as the most transcendental department of physiology--i4e4 that which treats of muscle and nerve--have thrown light on the wonderful process of 'compensation1' by which a diseased heart is able to keep up a normal circulation4 ,vaso-motor ,system4--,largely by the labours of ,british physiologists1 the exquisite control exercised by the nervous system over every blood-vessel in the body has been brought to light1 the paths tracked out1 and the mechanisms elucidated1 by means of which the circulation through each part of the body is subordinated to the needs of the whole4 ,since the chief vaso-motor nerves take their course through the sympathetic system1 the researches on their distribution have led to the mapping out of the whole of this system1 and to an accurate knowledge of its functions4 ,we are now acquainted with the course1 to all parts of the body1 of the nerves which not only determine the changes in the calibre of the blood-vessels1 but affect also the secretion of sweat and the erection of the hairs4 ,incidentally1 the mapping out of these nerves1 in the hands of ,mackenzie1 ,head1 and others1 has led to more power of localising the seat of visceral disease4 ,digestion4--,our knowledge of the processes of digestion has of late years received a great accession by the work of ,professor ,pawlow1 of ,st4 ,petersburg4 ,his success is largely due to his recognition of the importance of keeping his experimental animals under the most normal conditions possible1 and of studying the different parts of the alimentary tract in animals which were not ansthetised1 but which were free from any pain or even discomfort1 either of which conditions materially interferes with the activity of the digestive glands4 ,he therefore established in dogs fistul in chosen portions of the alimentary canal1 analogous to the fistula which accident rendered so valuable in the case of ,alexis ,st4 ,martin4 ,not only has the knowledge thus gained enabled the physician to understand the sequel of events in disordered digestion1 but the success of the operative measures undertaken by physiologists for the elucidation of their science has emboldened surgeons to attack disease in the most various parts of the alimentary canal4 ,renewed study of the secretion of pancreatic juice evoked by the passage of the acid digestive products from the stomach into the small intestine1 which had been described by ,pawlow1 has resulted in the discovery of a new class of chemical agents1 which act as special messengers from one part of the body to another1 and exercise an important function in determining the action of all parts to one common end4 ,respiration4--,the investigation of the chemical properties of the colouring matter of blood1 and of its compound with carbon monoxide1 has resulted1 in the hands of ,dr4 ,haldane1 in the laying down of measures for the prevention of accidents from choke-damp or after-damp in mines4 ,the same investigation has resulted in the discovery of a method of determining the total amount of blood circulating in the body of a living man4 ,the application of this method has already added largely to our knowledge of the pathology of different forms of anmia1 as well as of the conditions obtaining in heart disease4 ,experiments by ,hill and others on the physiological effects of compressed air have shown the precautions which should be observed in all diving operations4 ,a proper appreciation of these results by diving-engineers would not only entirely obviate the cases of 'caisson disease1' but would enable diving to be carried on safely to a greater depth than has hitherto been attempted4 ,it is impossible1 however1 to enumerate all the physiological gains of the last twenty or thirty years1 or to point out their manifold applications in the cure and prevention of disease4 ,the full control of the processes of disease1 which is the goal of the physician and the surgeon1 can only be attained through an accurate knowledge of the conditions governing the functions of the healthy body4 ,the foundation of medicine and surgery is physiology3 and it is only on living animals that the processes of life can be investigated4 ,,part ,,ii ,,experiments ,,in ,,pathology1 ,,materia ,,medica1 ,,and ,,therapeutics ,i ,,inflammation1 ,,suppuration1 ,,and ,,blood-,,poisoning ,pathology1 the study of the causes and products of diseases1 is a younger science than physiology3 the use of the microscope was the beginning of pathology2 and the microscope1 even so late as sixty years ago1 was very different to the microscope now4 ,the great pathologists of that time had not the lenses1 microtomes1 and reagents that are now in daily employment2 they knew nothing of the present methods of section-cutting and differential staining4 ,but the publication in #ahci of ,schwann's cell-theory marks the rise of modern pathology4 ,in #ahdc1 ,darwin wrote his first draft of the doctrine of the origin of species2 and ,pasteur1 that year1 was in for his examination at the cole ,normale4 ,the work of ,schwann1 ,virchow1 and ,pasteur had such profound influences on science that the span of sixty years seems to cover the modern development of pathology3 and this span of years is marked1 half-way1 by the rise of bacteriology4 ,in #ahge1 when the ,royal ,commission on ,experiments on ,animals was held in ,london1 the evidence was concerned practically with physiology alone3 very little was said about pathology1 and of bacteriology hardly a word4 ,the witnesses say that they believe they are beginning to get an idea of the true nature of tubercle3 and the evidence as to the nature of anthrax1 given by ,sir ,john ,simon1 reads now like a very old prophecy3-- ,we are going through a progressive work that has many stages1 and are now getting more precise knowledge of the contagium4 ,by these experiments on sheep it has been made quite clear that the contagium of sheep-pox is something of which the habits can be studied3 as the habits of a fern or a moss can be studied3 and we look forward to opportunities of thus studying the contagium outside the body which it infects4 ,this is not a thing to be done in a day1 or perhaps in ten years1 but must extend over a long period of time4 ,dr4 ,klein's present paper represents one very important stage of a vast special study4 ,he gives the identification of the contagium as something which he has studied to the end in the infected body1 and which can now in a future stage be studied outside the body4 ,thirty years ago1 there was no bacteriology1 in the present sense of the word3 and now the habits of these contagia have been studied1 outside and inside the body1 with amazing accuracy4 ,it has been proved1 past all possibility of doubt1 that the pathogenic bacteria are the cause of infective diseases2 they have fulfilled ,koch's postulates--that they should be found in the diseased tissues1 be cultivated outside the body1 reproduce the same disease in animals1 and be found again in the tissues of those animals4 ,by an immeasurable amount of hard work crowded into a few years1 this ,new ,world of bacteriology has been subdued4 ,the ,royal ,commissioners of #ahge1 speaking of physiological experiments only1 said1 ,it would require a voluminous treatise to exhibit in a consecutive statement the benefits that medicine and surgery have derived from these discoveries4 ,if physiology in #ahge required a treatise1 bacteriology in #aijf requires a library3 and it is impossible here to give more than the faintest outline of some of the work that has been done4 ,but all pathology is not bacteriology2 and it would take a treatise of prodigious length to set forth the work of modern pathology in the years before anything was known of bacteria4 ,the microscopic structure of tumours and of all forms of malignant disease1 the nature of amyloid1 fatty1 and other degenerative changes1 and the chief facts of general pathology--hypertrophy and atrophy1 necrosis1 gangrene1 embolism1 and many more--all these subjects were studied to good purpose1 before bacteriology4 ,above all1 men were occupied in the study of inflammation under the microscope4 ,it was this use of the microscope that revolutionised pathology2 especially1 it made visible the whole process of inflammation1 the most minute changes in the affected tissues1 the slowing and arrest of the blood in the capillaries1 the choking-up of the stream1 and the escape of blood-cells out of the capillaries into the tissues4 ,everything had been made ready for the fuller interpretation that was coming from bacteriology3 the old naked-eye descriptions of inflammation were left behind2 men set aside the definition of ,celsus1 that it was rubor et tumor cum colore et dolore--words that sound like ,molire's jest about the vis dormitiva of opium--they watched inflammation under the microscope1 in such transparent structures as the frog's web and mesentery1 the bat's wing1 and the tadpole's tail4 ,it was thus that ,wharton ,jones discovered the rhythmical contraction of the veins in the bat's wing4 ,the discovery of the escape of the white blood-cells1 diapedesis1 through the walls of the capillaries1 was made by ,waller and ,cohnheim4 ,to those who are opposed to all experiments on animals1 it may seem a very small thing that a blood-cell should be on one side or the other of a microscopic film in a tadpole's tail2 but this diapedesis1 the first move of the blood in its fight against disease1 is now seen1 in the light of ,metschnikoff's work1 as a fact of very great importance4 ,the history of this transitional period1 from the study of inflammation in transparent living tissues to the use1 in surgery1 of the facts of bacteriology1 is told in ,lord ,lister's ,huxley ,lecture1 ,october #aijj4 ,he describes how the foundations were laid in surgical pathology1 by microscopical and experimental work on inflammation1 coagulation1 suppuration1 and pymia1 for bacteriology to build on3 how his own share of the work began when he was house-surgeon to ,sir ,john ,erichsen at ,university ,college ,hospital1 and afterward to ,mr4 ,syme in ,edinburgh1 and how it was continued through all his ,edinburgh and ,glasgow life3-- ,after being appointed to the ,chair of ,surgery in the ,university of ,glasgow1 ,i became one of the surgeons to the ,royal ,infirmary of that city4 ,here ,i had1 too1 ample opportunities for studying hospital diseases1 of which the most fearful was pymia4 ,about this time ,i saw the opinion expressed by a high authority in pathology that the pus in a pymic vein was probably a collection of leucocytes4 ,facts such as those which ,i mentioned as having aroused my interest in my student days in a case of pymia1 made such a view to me incredible2 and ,i determined to ascertain1 if possible1 the real state of things by experiment4444 ,while these investigations into the nature of pymia were proceeding1 ,i was doing my utmost against that deadly scourge4 ,professor ,polli1 of ,milan1 having recommended the internal administration of sulphite of potash on account of its antiputrescent properties1 ,i gave that drug a very full trial as a prophylactic4444 ,at the same time1 ,i did my best1 by local measures1 to diminish the risk of communicating contagion from one wound to another4 ,i freely employed antiseptic washes1 and ,i had on the tables of my wards piles of clean towels to be used for drying my hands and those of my assistants after washing them1 as ,i insisted should invariably be done in passing from one dressing to another4 ,but all my efforts proved abortive2 as ,i could hardly wonder when ,i believed1 with chemists generally1 that putrefaction was caused by the oxygen of the air4 ,it will thus be seen that ,i was prepared to welcome ,pasteur's demonstration that putrefaction1 like other true fermentations1 is caused by microbes growing in the putrescible substance4 ,thus was presented a new problem3 not to exclude oxygen from the wounds1 which was impossible1 but to protect them from the living causes of decomposition by means which should act with as little disturbance of the tissues as is consistent with the attainment of the essential object4444 ,to apply that principle1 so as to ensure the greatest safety with the least attendant disadvantage1 has been my chief life-work4#ab #ab ,see also the admirable ,life of ,pasteur1 by ,m4 ,vallry-,radot4 ,translation by ,mrs4 ,devonshire1 vol4 ii4 p4 #bj4 ,and1 of course1 the application of that principle is not limited to the performance of the major operations of surgery4 ,it is in daily use in every hospital1 and in every practice all the world over1 for the safe and quick healing of whole legions of injuries1 casualties1 and minor operations4 ,but what of ,semmelweis1 and his study of puerperal fever8 ,did he not1 before ,lord ,lister1 and without the help of experiments on animals1 discover antiseptic surgery8 ,his claim is urged by those who are opposed to all such experiments4 ,and the answer is1 that his work was lost just for want of experiments on animals4 ,if he could have demonstrated1 as ,pasteur did1 the living organism1 the thing itself1 there in the tissues of an infected rabbit1 and in a test-tube1 and under a microscope1 he might have stopped the mouths of his adversaries4 ,he could not4 ,he could only demonstrate to them the fact that their patients died1 and his patients lived3 and that some sort of direct infection was the cause of the deaths4 ,the tragedy of his life cannot be told too often1 and may be told again here4#ac ,for want of the final proof that bacteriology1 and the inoculation of animals1 alone could give1 he was unable to hold out against his enemies till ,pasteur could rescue him4 #ac ,this account of ,semmelweis1 reprinted by permission from the ,middlesex ,hospital ,journal1 is mostly taken from ,dr4 ,theodore ,duka's excellent paper on ,childbed ,fever4 7,lancet1 #ahhf47 ,in #ahdf1 when he was twenty-three years old1 ,ignaz ,semmelweis was appointed assistant-professor in the maternity department of the huge general hospital of ,vienna4 ,for many years1 the mortality in the lying-in wards had been about #a4be per cent41 and no more4 ,then1 under a new professor1 it had risen2 and1 for some years before ,semmelweis came on the scene1 it had been #e per cent41 or even #g per cent4 ,in ,october #ahda1 there had been an epidemic that had lasted till ,may #ahdc4 ,in these twenty months1 out of #eaci women delivered1 #hbi had died2 that is to say1 #af per cent4 ,there were two sets of wards in the maternity department4 ,the one set may be called ,clinique ,a1 and the other ,clinique ,b4 ,for many years1 the mortality had been the same in each4 ,in #ahda a change was made3 ,clinique ,a was assigned to the teaching of students1 and ,clinique ,b to the teaching of midwives3 and1 so soon as this change had been made1 the mortality in ,clinique ,b became less1 but the mortality in ,clinique ,a did not4 ,commissions of inquiry were held1 and in vain4 ,it was suggested that the foreign students were somehow to blame1 nobody knew why2 and many of them were sent away4 ,still the deaths went on4 ,women admitted to ,clinique ,a would go down on their knees and pray to be allowed to go home2 almost every day the bell was heard ringing in the wards1 for the administration of the ,sacrament to a dying woman4 ,people talked about atmospheric influences1 and overcrowding1 and the tainted air of old wards1 and the power of the mind over the body3 and ,semmelweis set to work4 ,he observed that cases of protracted labour in ,clinique ,a died1 almost all of them2 but not in ,clinique ,b4 ,he observed also that cases of premature labour1 nearly all of them1 did well1 whichever ,clinique they were in2 so did those women who were delivered before they came to the hospital1 and were admitted after delivery4 ,he observed also that a row of patients1 lying side by side1 would all be attacked at once in ,clinique ,a2 which never happened in ,clinique ,b4 ,he tried everything3 he altered the details of treatment2 he used various subterfuges to prevent one of the professors from examining serious cases2 he enforced this or that rule in ,clinique ,a1 because it was the custom in ,clinique ,b2 he slaved away at the notes of the cases--and at last the truth came to him1 by the death of one of his friends from a dissection-wound4 ,he says1 ,my friend's fatal symptoms unveiled to my mind an identity with those which ,i had so often noticed at the deathbeds of puerperal cases4 ,he saw now that the students1 coming straight from the dissecting-rooms1 had infected the patients during examination4 ,in ,may #ahdg he gave orders that every student1 before examining1 should thoroughly disinfect his hands4 ,but1 though he had reckoned with dissecting-room poisons1 he had forgotten to reckon with other sources of infection4 ,in ,october of that year1 a woman was admitted who had malignant disease2 of twelve women examined after her1 eleven got puerperal fever1 and died4 ,in ,november1 a woman was admitted who had a suppurating knee-joint1 with sinuses2 and eight women were infected from her1 and died4 ,therefore ,semmelweis said1 ,not only can the particles from dead bodies generate puerperal fever1 but any decomposed material from the living body can also generate it1 and so can air contaminated by such materials4 ,henceforth he isolated all infected cases1 he enforced the strict use of disinfectants3 and the mortality in ,clinique ,a1 which in ,may #ahdg had stood at #ab4bd per cent41 fell in ,december to #c4jd1 and in #ahdh was #a4bg4 ,his work was taken up with enthusiasm by ,hebra1 ,skoda1 and ,haller2 the news of it was sent to every capital in ,europe4 ,in ,february #ahdi ,haller read a paper on it before the ,medical ,society of ,vienna1 and said1 ,the importance of these observations is above all calculation1 both for the maternity department and for the hospitals in general1 but particularly for the surgical wards4 ,a committee was nominated to report on the whole matter2 but it was opposed by the professor in charge of ,clinique ,a1 and nothing came of it4 ,in ,may #ahej1 ,semmelweis opened a great debate on puerperal fever1 which occupied three sittings of the ,vienna ,medical ,society4 ,his opponents were there in full force1 all the ,scribes and ,pharisees of the profession4 ,they brought about a vague distrust of his figures and his facts2 they got people to believe that there must be something else in puerperal fever1 as well as the local infection4 ,semmelweis began to be discouraged4 ,the ,university authorities made a dead set against him--they refused to renew his appointment1 they got him out of the hospital1 and out of ,vienna4 ,he went to ,pesth1 and was ,professor of ,midwifery there2 but the same opposition and hostility were at ,pesth as at ,vienna4 ,slowly he began to lose his hold over himself1 went down hill1 became excitable and odd4 ,the end came in ,july #ahfe4 ,at a meeting of ,university professors1 he suddenly took a paper from his pocket and read aloud to them a solemn oath1 to be enforced on every midwife and every doctor4 ,his mind had given way3 he was moved to an asylum at ,vienna1 and died there a few weeks later4 ,he was only forty-two when he died--,what a wounded name1 ,things standing thus unknown1 shall live behind me4 ,the contrast between the work of ,semmelweis and the work of ,pasteur cuts like a knife here4 ,the failure of ,semmelweis' teaching may be estimated by the fact that it had all to be done over again4 ,the year of his success at ,vienna was #ahdh4 ,eight years later1 in the ,paris ,maternity ,hospital1 between #ast ,april and #ajth ,may #ahef1 came such an outbreak of puerperal fever that out of #cdg patients #fd died4 ,in #ahfd1 out of #acej cases1 #caj deaths4 ,in ,jan4-,feb4 #ahff1 out of #ajc cases1 #bh deaths3 ,women of the lower classes looked upon the ,maternit as the vestibule of death4 ,in #ahgg-gh1 came the use of carbolic acid and perchloride of mercury at the hospital1 thirty years after ,semmelweis' work3 and1 about the same time1 ,pasteur's discovery of the streptococcus in puerperal fever4#ad ,pasteur could demonstrate to his opponents the visible cause of the infection1 the thing itself4 ,roux tells the story3-- ,dans le pus des abcs chauds et dans celui des furoncles on constate un petit organisme arrondi1 dispos en amas1 qu'on cultive facilement dans le bouillon4 ,on le retrouve dans l'ostomylite infectieuse des enfants4 ,pasteur affirme que l'ostomylite et le furoncle sont deux formes d'une mme maladie1 et que l'ostomylite est le furoncle de l'os4 ,en #ahgh1 cette assertion a fait rire bien les chirurgiens4 ,dans les infections puerprales1 les caillots renferment un microbe grains arrondis se disposant en files4 ,cet aspect en chapelet est surtout manifest dans les cultures4 ,pasteur n'hsite pas dclarer que cet organisme microscopique est la cause la plus frquente des infections chez les femmes accouches4 ,un jour1 dans une discussion sur la fivre puerprale l',acadmie de ,mdicine1 un de ses collgues le plus couts dissertait loquemment sur les causes des pidmies dans les maternits4 ,pasteur l'interrompt de sa place3 ,ce qui cause l'pidmie1 ce n'est rien de tout cela3 c'est le mdecin et son personnel qui transportent le microbe d'une femme malade une femme saine4 ,et comme l'orateur rpondit qu'il craignait fort qu'on ne trouve jamais ce microbe1 ,pasteur s'lance vers le tableau noir1 dessine l'organisme en chapelet de grains1 en disant1 ,tenez1 voici sa figure4 7,roux1 ,l',o,euvre ,mdicale de ,pasteur4 ,agenda du ,chimiste1 #ahif1 p4 #ebh47 #ad ,see ,pasteur's ,life1 vol4 ii4 p4 #hi4 ,all suppuration1 and all forms of blood-poisoning--abscesses1 boils1 carbuncles1 erysipelas1 puerperal fever1 septicmia1 pymia--are due to minute organisms1 various kinds of micrococcus4 ,it has indeed been shown that suppuration may1 in exceptional conditions1 occur without micro-organisms3 but practically every case of suppuration is a case of infection either from without or from within the body4 ,there is no room here for any account of the work spent on these micrococci3 on their identification1 isolation1 culture1 and inoculation4 ,it is the same with all the pathogenic bacteria--each kind has its own habits1 phases and idiosyncrasies1 antagonisms and preferences3 nothing is left unstudied--the influences of air1 light1 heat1 and chemistry2 all the facts of their growth1 division1 range of variation1 grades of virulence1 vitality1 and products2 the entire life and death of each species1 and everything that it is1 and does1 and can be made to do4 ,the difficulties of bacteriology are written across every page of the text-books3 above all1 the difficulties of attenuating or intensifying the virulence of bacteria1 and of immunising animals1 and of procuring from them an immunising serum of exact and constant strength4 ,every antitoxin is the outcome of an immeasurable expenditure of hard international work1 unsurpassed in all science for the fineness of its methods and the closeness of its arguments4 ,the older theories of disease had attributed infection to the intemperature of the weather1 the powers of the air1 or the work of the devil2 later1 men recognised that there must be a materies morbi1 something particulate1 transmissible1 and perhaps alive1 but it was still a nameless something4 ,therefore1 they over-estimated the constitutional1 personal aspect of a case of infective disease1 against the plain evidence of case-to-case infection or inoculation3 they studied with infinite care and minuteness the weather1 the environment1 the family history1 the previous illnesses of the patient--everything1 except the immediate cause of the trouble4 ,but modern pathology1 like ,pasteur1 says1 ,tenez1 voici sa figure4 ,the antiseptic method was based on bacteriology1 resting as it did on the proof afforded by ,pasteur that putrefaction was caused by bacteria1 and not by the oxygen of the air1 as had been previously believed4 ,if any man would measure one very small part of the lives that are saved by this method1 let him contrast the treatment of empyema fifty years ago with its treatment now4 ,if he would measure the saving1 not of lives but of limbs1 let him take the treatment of compound fractures4 ,if he would measure the saving of patients from pain1 fever1 and long confinement to bed1 let him take the ordinary run of surgical cases1 not only the major operations but all abscesses1 lacerated wounds1 foul sores1 and so forth4 ,a serum has also been used of late years for the treatment of micrococcus-infection1 and has given good results in many cases4 ,it has been used1 also1 to avert the risk of such infection in certain operations where the antiseptic method cannot be strictly carried out4 ,for the use of a polyvalent serum1 reference may be made to the recent paper by ,dr4 ,w4 ,s4 ,fenwick and ,dr4 ,parkinson4 7,trans4 ,roy4 ,med4 ,chir4 ,soc41 #aijf47 ,,ii ,,anthrax ,in animals1 anthrax is also called charbon1 splenic fever1 or splenic apoplexy3 in man1 the name of malignant pustule is given to the sore at the point of accidental inoculation1 and the name of woolsorter's disease is given to those cases of anthrax where the lungs are infected by inhalation of the spores of the bacillus anthracis4 ,the disease occurs among hide-dressers1 woolsorters1 brushmakers1 and rag-pickers3 among animals1 it occurs in sheep1 cattle1 horses1 and swine3-- ,many of the outbreaks of anthrax in ,england have been in the neighbourhood of ,bradford1 and have been traced to the use of infected wool-refuse as manure4 ,a map published by the ,board of ,agriculture shows that the outbreaks of anthrax are most frequent in those counties of ,great ,britain where dry foreign wools1 hairs1 hides1 and skins are manufactured into goods4 ,in #ahib1 there were forty-two outbreaks of anthrax in the ,west ,riding of ,yorkshire1 as against two in the ,north ,riding1 and one in the ,east ,riding4 ,an undoubted fact in connection with anthrax is its tendency to recur on certain farms4 ,during #ahie1 the disease reappeared on twenty-three farms or other premises in ,england1 and six in ,scotland1 where it had been reported in the previous year4 7,dr4 ,poore's ,milroy ,lectures1 ,on the ,earth in relation to ,contagia1 #ahii47 ,an admirable account of the disease1 as it occurs in man1 is given by ,dr4 ,hamer and ,dr4 ,bell1 in the valuable series of monographs edited by ,dr4 ,oliver of ,newcastle1 under the title ,dangerous ,trades 7,london1 ,john ,murray1 #aijb74 ,happily1 the disease is very rare among men1 even among those most exposed to it4 ,for its treatment in man1 an antitoxin has been used with some success3 but the cases are too few to be of much importance4#ae #ae ,dr4 ,legge1 in his ,milroy ,lectures1 #aije1 on ,industrial ,anthrax 7,lancet1 ,march and ,april #aije71 gives a full account of ,sobernheim's work up to ,march #aijd1 and a table of seventy-six cases1 treated with ,sclavo's serum4 ,the bacillus anthracis was first seen more than fifty years ago3 ,anthrax has the distinction of being the first infectious disease the bacterial nature of which was definitely proven4#af ,pollender in #ahdd1 ,roger and ,davaine in #ahej1 noted the petits btonnets in the blood of sheep dead of the disease1 and thought they were some sort of microscopic blood-crystals3 it was not till #ahfc1 after ,pasteur's study of lactic-acid fermentation1 that ,davaine realised they were living organisms4 ,afterward1 ,koch succeeded in making cultures of them1 and reproduced the disease by inoculating animals with these cultures2 yet it was said1 so late as #ahgf1 that the bacillus anthracis was not the cause of anthrax1 but only the sign of it3 ,along with the bacilli1 there are blood-cells and blood-plasma1 and these contain the true amorphous virus of anthrax4 ,then came ,pasteur's work1 and reached its end in the experiments at ,chartres1 and the famous test-inoculations 7#ahha7 at ,pouilly-le-,fort4 #af ,see ,dr4 ,flexner's account of the disease1 in volume xix4 of ,stedman's ,twentieth ,century ,practice4 ,in the ,agenda du ,chimiste 7#ahif7 ,m4 ,roux gives the following account of this work1 which he watched from first to last3-- ,vaccination against charbon has now been put to the test of practice for fourteen years4 ,wherever it is adopted1 there the losses from charbon have become insignificant4 ,it was followed by vaccination against swine-measles1 rouget des porcs1 the special study of our poor friend ,thuillier4 ,but the immediate result of ,pasteur's vaccinations is their least merit3 they have given men absolute faith in a science that could show such good works1 they have started a movement that is irresistible2 above all1 they have set going the whole study of immunity1 which is bringing us at last to a right way of treating infective diseases4 ,virulence is a quality that microbes can lose1 or can acquire4 ,suppose we came across the anthrax-bacillus so far attenuated1 in the way of ,nature1 that it had lost all power to kill--of course we should fail to recognise it2 we should take it for an ordinary bacillus of putrefaction3 you must watch it through each phase of its attenuation1 to know that the harmless organism is the descendant of the fatal virus4 ,but you can give back to it the virulence that it has lost1 if you put it1 to begin with1 under the skin of a very delicate subject1 a mouse only one day old4 ,with the blood of this mouse inoculate another1 a little older1 and it will die4 ,passing by this method from younger to older mice1 we come to kill adult mice1 guinea-pigs1 then rabbits1 then sheep1 etc4 ,thus1 by transmission1 the virus gains strength as it goes4 ,doubtless this increase of virulence1 that we bring about by experiment1 occurs also in ,nature2 and it is easy to see how a microbe1 usually harmless to this or that species of animals1 might become deadly to it4 ,is not this the way that infective diseases have appeared on the earth from age to age8 ,see how far we have come1 from the old metaphysical ideas about virulence1 to these microbes that we can turn this way or that way--stuff so plastic that a man can work on it1 and fashion it as he likes4 ,pasteur's note on the attenuation of anthrax was presented to the ,acadmie des ,sciences on #bhth ,february #ahha2 and the test-inoculations at ,pouilly-le-,fort were made in ,may of that year4 ,it was hardly to be expected that every country1 in every year1 should obtain such results as ,france now takes as a matter of course2 and at one time1 about twenty-one years ago1 there was in ,hungary a conscientious objection to the inoculation of herds against the disease4 ,but in ,italy1 from #ast ,may #ahig to #cjth ,april #ahih1 the issue of anti-charbon vaccine from one institute alone1 the ,sero-,therapeutic ,institute at ,milan1 was #afe1jjj tubes1 enough to inoculate #cc1gcd cattle and #ih1gib sheep4 ,and in ,france1 between #ahhb and #ahic1 more than three million sheep1 and nearly half a million cattle1 were inoculated4 ,the work done in ,france was published by ,m4 ,chamberland1 in the ,annales de ,l',institut ,pasteur1 ,march #ahid4 ,the following translation of his memoir--,rsultats pratiques des ,vaccinations contre le ,charbon et le ,rouget en ,france--shows something of the national influence of the ,pasteur ,institute3-- #a4 ,charbon ,after the famous experiments at ,pouilly-le-,fort1 ,,mm4 ,pasteur and ,roux entrusted to me the whole method and practice of the vaccinations against charbon4 ,twelve years have passed1 and it is now time to put together the results1 and to make a final estimate of the value of these preventive inoculations4 ,every year we ask the veterinary surgeons to report-- #a4 ,the number of animals they have vaccinated4 #b4 ,the number that have died after the first vaccination4 #c4 ,the number that have died after the second vaccination1 within the twelve days following it4 #d4 ,the number that have died during the rest of the year4 #e4 ,the average annual mortality before the practice of vaccination4 ,the sum total of all the reports is given in the following tables3-- ,,vaccination ,,against ,,charbon 7,,france74 ,sheep4 ---------------------------------------- ------------------- ,mortality4 ,animals ---------------------- ,total ,vaccinated,after ,after ,during ,number of ,number according ,first ,second the rest ,animals of to ,reports,vacci- ,vacci- of the ,years4,vaccinated4,reports4received4 nation4nation4 ,year4 ---------------------------------------- ----------------- #ahhb #bgj1jdj #aab #bdc1aii #gef #hdg #a1jcg #ahhc #bfh1eje #ajc #aic1aai #dcf #bgb #ghd #ahhd #caf1eec #aji #bca1fic #ggj #ddd #a1jcc #ahhe #cdb1jdj #add #bhj1ajg #hhd #gce #iij #ahhf #cac1bhh #hh #bjb1jfd #feb #cjc #ead #ahhg #bic1egb #ajg #ahg1haa #gah #gcg #ifh #ahhh #bfi1egd #ej #aja1hcd #adi #aha #cjj #ahhi #bci1igd #dc #hh1dhc #bch #bhe #eja #ahij #bbc1faa #fi #fi1hfe #cca #bfa #bdd #ahia #bah1fbi #fe #ec1fdj #aha #ajb #gg #ahib #bei1fif #gj #fc1abe #cai #ahc #abf #ahic #bha1ccc #cj #gc1ici #bcd #ef #bbd ---------------------------------------- ----------------- ,total#c1bif1hae #iij #a1ghh1hgi #e1ffh #d1djf #f1gih ---------------------------------------- ----------------- ------------------------- ,average ,total loss ,total4 lossbefore per ,vacci- ,years4 #ajj4nation4 ------------------------- #ahhb #b1fdj #a4jh #aj #ahhc #a1dib #j4gg #ahhd #b1bdg #j4ig #ahhe #b1fji #j4ic #ahhf #a1dfi #j4gb #ahhg #b1dbc #a4bi #ahhh #fcj #j4fb #ahhi #a1jbd #a4af #ahij #hcf #a4bj #ahia #cfj #j4fg #ahib #fbh #j4ii #ahic #ead #j4fi ------------------------- ,total#af1hgb #j4id #aj ------------------------- ,,vaccination ,,against ,,charbon 7,,france74 ,cattle4 ---------------------------------------- ------------------- ,mortality4 ,animals ---------------------- ,total ,vaccinated ,after ,after ,during ,number of ,number according ,first ,secondthe rest ,animals of to ,reports,vacci- ,vacci- of the ,years4,vaccinated4,reports4received4 nation4nation4 ,year4 ---------------------------------------- ----------------- #ahhb #ce1fed #abg #bb1iaf #bb #ab #dh #ahhc #bf1dec #acj #bj1eja #ag #a #df #ahhd #cc1ijj #aci #bb1faf #bj #ac #eb #ahhe #cd1jjj #aib #ba1jgc #cb #h #fg #ahhf #ci1aed #ace #bb1aac #ah #g #ci #ahhg #dh1dhd #adh #bh1jhc #bc #ah #fh #ahhh #cd1dfd #fa #aj1ibj #h #d #ce #ahhi #cb1bea #fh #aa1faj #ad #g #ca #ahij #cc1ife #ga #aa1jeg #e #d #ad #ahia #dj1gcf #fh #aj1dgf #f #d #d #ahib #da1fji #ga #i1geg #h #c #ae #ahic #ch1aed #de #i1hdj #d #a #ac ---------------------------------------- ----------------- ,total #dch1hbd #a1bee #bjj1ifb #agg #hb #dcb ---------------------------------------- ----------------- ------------------------- ,average ,total loss ,total4 lossbefore per ,vacci- ,years4 #ajj4nation4 ------------------------- #ahhb #hb #j4ce #e #ahhc #fd #j4ca #ahhd #he #j4cg #ahhe #ajg #j4ej #ahhf #fd #j4bi #ahhg #aji #j4ci #ahhh #dg #j4dc #ahhi #eb #j4de #ahij #bc #j4ba #ahia #ad #j4ac #ahib #bf #j4bf #ahic #ah #j4ah ------------------------- ,total #fia #j4cd #e ------------------------- ,comparing the figures in the fourth column with those in the second1 we see that a certain number of veterinary surgeons neglect to send their reports at the end of the year4 ,the number of reports that come to us even tends to get less each year4 ,the fact is1 that many veterinary surgeons who do vaccinations every year content themselves with writing1 ',the results are always very good2 it is useless to send you reports that are always the same4' ,we have every reason to believe1 as a matter of fact1 that those who send no reports are satisfied2 for if anything goes wrong with the herds1 they do not fail to let us know it at once by special letters4 ,anyhow1 thanks chiefly to new veterinary surgeons who do send reports1 we see that in the twelve years1 up to #ast ,january of this year1 we have had exact returns as to #a1ghh1hgi sheep and #bjj1ifb cattle--about half of all those that were vaccinated4 ,the mortality among sheep and cattle is slightly higher after the first vaccination than after the second4 ,this fact seems to us easy to explain4 ,the animals reported dead include both those that died as the result of the vaccinations1 and those that1 being already infected at the time1 died of the actual disease4 ,but1 at the time of second vaccination1 the animals are already more or less protected3 hence a lower mortality from the actual disease1 and a lower sum total4 ,the whole loss of sheep is about #a per cent43 the average for the twelve years is #j4id4 ,so we may say that the whole average loss of vaccinated sheep1 whether from vaccination or from the disease itself is about #a per cent4 ,the loss of vaccinated cattle is still less3 for the period of twelve years1 it is #j4cd1 or about #a_/c per cent4 ,these results are extremely satisfactory4 ,it is to be noted especially that the average annual death-rate from charbon1 before vaccination--the average given in these reports--is estimated at #aj per cent4 among sheep1 and #e per cent4 among cattle4 ,but even if we put it at #f per cent4 for sheep1 and #c-a_/c per cent4 for cattle1 and say that the worth of a sheep is #cj francs1 and of an ox or a cow #aej francs--which is well below their real value--even then it is obvious that the advantage of these vaccinations to ,french agriculture is about five million francs in sheep1 and two million in cattle4 ,and these figures are rather too low than too high4 #b4 ,rouget ,some years after the discovery of vaccination against charbon1 ,m4 ,pasteur discovered the vaccine for a disease of swine known under the name of rouget4 ,from #ahhf1 these vaccines were prepared and sent out under the same conditions as the vaccines against charbon4 ,the following table gives the reports that have come to us of this disease3#ag-- ,,vaccination ,,against ,,rouget 7,,france74 ---------------------------------------- ------------------- ,mortality4 ,animals ---------------------- ,total ,vaccinated,after ,after ,during ,number of ,number according ,first ,second the rest ,animals of to ,reports,vacci- ,vacci- of the ,years4,vaccinated4,reports4received4 nation1nation4 ,year4 ---------------------------------------- ----------------- ,for these two years #ahhf ,france #di #g1jhg #ia #bd #ef and other countries #ahhg are put #di #g1dfg #eg #aj #bc together4 #ahhh #ae1ieh #ca #f1ifh #ca #be #ch #ahhi #ai1cch #da #aa1beg #ib #ab #dj #ahij #ag1feh #da #ad1iib #aah #fd #gc #ahia #bj1ehc #dg #ag1eef #ajb #cd #gj #ahib #cg1ijj #ch #aj1abh #dc #ai #df ---------------------------------------- ----------------- ,total #aaa1dcg #bif #ge1dee #ecd #ahh #cde ---------------------------------------- ----------------- ------------------------- ,average ,total loss ,total4 lossbefore per ,vacci- ,years4 #ajj4nation4 ------------------------- #ahhf #aga #b4da #bj #ahhg #ij #a4ba #ahhh #id #a4ce #ahhi #add #a4bh #ahij #bed #a4gj #ahia #bjf #a4ag #ahib #ajh #a4jg ------------------------- ,total #a1jfg #a4de #bj ------------------------- #ag ,the reports for #ahic are at present too few to be utilised for this table4 ,the total average of losses during the past seven years is #a4de per cent41 or about #a-a_/b per cent4 ,this average is appreciably higher than the average for charbon4 ,but it must be noted that the mortality from rouget among swine1 before vaccination1 was much higher than that from charbon among sheep4 ,it was about #bj per cent42 a certain number of reports speak of losses of #fj and even #hj per cent43 so that almost all the veterinary surgeons are loud in their praises of the new vaccination4 ,the rest of ,m4 ,chamberland's paper is concerned with the defects1 such as they are1 of the vaccinations1 and the need of absolute cleanliness in the making of them3 which is somewhat difficult for this vast number of vaccinations of animals all over ,france1 and in other parts of the world4 ,the whole story of the discovery is told in ,m4 ,vallry-,radot's ,life of ,pasteur3 and the whole story of rouget1 in the same most fascinating book1 vol4 ii41 p4 #ahj4 ,,iii ,,tubercle ,before ,laennec1 tubercle had been taken for a degenerative change of the tissues1 much like other forms of degeneration4 ,it was ,laennec who brought men to see that it is a disease of itself1 different from anything else2 and this great discovery of the specific nature of tubercle1 and his invention of the stethoscope1 place him almost level with ,harvey4 ,he founded the facts of tubercle1 and on that foundation ,villemin built4 ,in #ahfe1 ,villemin communicated to the ,acadmie des ,sciences his discovery that tubercle is an infective disease2 that he had produced it in rabbits1 by inoculating them with tuberculous matter4 ,en voici les preuves1 he said4 ,he appealed to these inoculations to prove his teaching3-- ,la tuberculose est une affection spcifique4 ,sa cause rside dans un agent inoculable4 ,l'inoculation se fait trs-bien de l'homme au lapin4 ,la tuberculose appartient donc la classe des maladies virulentes4 ,it was no new thing to say1 or to guess1 that phthisis was or might be infective4 ,so far back as #aejj1 ,frascatorius had said that phthisis came by the gliding of the corrupt and noisome humours of the patient into the lungs of a healthy man4 ,surely1 if clinical experience could suffice1 men would have made something out of this wisdom of ,frascatorius4 ,they made nothing of it2 they waited three hundred years for ,villemin to inoculate the rabbits1 and then the thing was done--,en voici les preuves4 ,three years later1 ,chauveau produced the disease in animals1 not by inoculation1 but by the admixture of tuberculous matter with their food4 ,then1 as the work grew1 there came a short period of uncertainty3 different species of animals are so widely different in their susceptibility to the disease that the results of further inoculations seemed to go against ,villemin2 and it was not till #ahhj that ,cohnheim finally established ,villemin's teaching1 and even went beyond it1 making inoculation the very proof of tubercle3-- ,everything is tuberculous1 that can produce tuberculous disease by inoculation in animals that are susceptible to that disease3 and nothing is tuberculous1 that cannot do this4 ,then1 in #ahha1 came the welcome news that ,koch had discovered the bacillus of tubercle4 ,in his first published account of it 7#bdth ,march #ahhb7 he says3-- ,henceforth1 in our warfare against this fearful scourge of our race1 we have to reckon not with a nameless something1 but with a definite parasite1 whose conditions of life are for the most part already known1 and can be further studied4444 ,before all things1 we must shut off the sources of the infection1 so far as it is in the power of man to do this4#ah #ah ,in ,zukunft wird man es im ,kampf gegen diese schreckliche ,plage des ,menschengeschlechtes nicht mehr mit einem unbestimmten ,etwas1 sondern mit einem fassbaren ,parasiten zu thun haben1 dessen ,lebensbedingungen zum grssten ,theil bekannt sind und noch weiter erforscht werden4 ,es mssen vor allen ,dingen die ,quellen1 aus denen der ,infektionsstoff fliesst1 so weit es in menschlicher ,macht liegt1 verschlossen werden4 ,in ,november #ahij he announced1 in the ,deutsche ,medizinische ,wochenschrift1 the discovery of tuberculin4 ,its failure was one of the world's tragedies4 ,the defeat may not be final1 and we may live to see phthisis fought and beaten with its own weapons3 but1 for the present1 it is more to the purpose to consider what other benefits have been gained1 from the discovery of the tubercle-bacillus in #ahha1 in every civilised country in the world4 #a4 ,it has given to everybody a more reasonable and hopeful view of phthisis and the diseases allied to it4 ,the older doctrine of heredity1 that the child inherits the disease itself1 has given way to the doctrine that the inheritance1 in the vast majority of cases1 is not that of the disease itself1 but that of a tendency or increased susceptibility to the disease4 #b4 ,it has brought about an immense improvement in the early and accurate diagnosis of all cases4 ,the bacillus found in the sputa1 or in the discharges1 or in a particle of tissue1 is evidence that the case is tuberculous4 #c4 ,it has given evidence1 which till #aija was hardly called in question1#ai that tabes mesenterica1 a tuberculous disease which kills thousands of children every year1 is due in many cases to infection from the milk of tuberculous cows4 ,in ,england alone1 in #ahie1 the number of children who died of this disease was #gchi1 of whom #chee were under one year old4 #ai ,at the ,british ,congress on ,tuberculosis1 ,london1 #aija1 ,koch stated that bovine tuberculosis and human tuberculosis are not one and the same disease1 and that the risk of milk-infection is so small that burdensome restrictions ought not to be enforced4 ,in the general judgment of men well qualified to study the subject1 he failed to prove his point4 #d4 ,it has proved1 and has taught everybody to see the proof1 that the sputa of phthisical patients are the chief cause of the dissemination of the disease4 ,by insisting on this fact1 it has profoundly influenced the nursing and the home-care of phthisical patients2 and it has begun to influence public opinion in favour of some sort of notification of the disease1 and in favour of enforcing a law against spitting in public places and conveyances4 ,in some of the principal cities of the ,united ,states1 laws on this subject have already been enacted4 #e4 ,it has greatly helped to bring about the present rigorous control of the meat and milk trades4 ,the following paragraph1 taken almost at random1 will suffice here3-- ,bacteriological examinations during the past year have shown that more milks are tuberculosis-infected than is generally supposed1 and the importance of carefully supervising milk supplies is becoming more and more acknowledged4 ,veterinary surgeons are practically agreed that tuberculin is a reliable and safe test for diagnosing the presence of tuberculosis in animals1 but affords no index of the extent or degree of the disease4 ,the test1 however1 will not produce tuberculosis in healthy animals1 and has no deleterious effect upon the general health of the animals4 ,the ,london ,county ,council have decided that all cows in ,london cowsheds shall be inspected by a veterinary surgeon regularly once in every three months1 and that a systematic bacteriological examination shall be conducted of milks collected from purveyors4 7,medical ,annual1 #aija47 #f4 ,tuberculin has come into general use for the detection of tuberculosis in cattle1 to shut off the sources of the infection4 ,a full account of this method in different countries was given by ,professor ,bang1 of ,copenhagen1 at the ,fourth ,congress on ,tuberculosis1 ,paris1 #ahih4 ,the injection of tuberculin is followed in eight to twelve hours by a well-marked rise of temperature1 if the animal be tuberculous4 ,of this test1 ,professor ,mc,fadyean1 ,principal of the ,royal ,veterinary ,college1 ,london1 says3-- ,i have no hesitation in saying that1 taking full account of its imperfection1 tuberculin is the most valuable means of diagnosis in tuberculosis that we possess4444 ,i have most implicit faith in it1 when it is used on animals standing in their own premises and undisturbed4 ,it is not reliable when used on animals in a market or slaughter-house4 ,a considerable number of errors at first were found when ,i examined animals in slaughter-houses after they had been conveyed there by rail1 etc4 ,since that1 using it on animals in their own premises1 ,i have found that it is practically infallible4 ,i have notes of one particular case1 where twenty-five animals in one dairy were tested1 and afterwards all were killed4 ,there was only one animal which did not react1 and it was the only animal not found to be tuberculous when killed4 ,two instances of the validity of this test will suffice4 ,in #ahii1 it was applied to #bgj cows on some farms in ,lancashire4 ,of these cows1 #ahj reacted to the test1 #he did not react1 and #e were doubtful4 ,tuberculous disease was actually found1 when they were killed1 in #age out of the #ahj #ig4b per cent4 7,lancet1 #eth ,august #ahii47 ,in #aija1 ,arloing and ,courmont published a critical account of the whole subject1 and gave the following facts4 ,in #hj calves1 which on examination after death were found not tuberculous1 the test was negative3 in #gj older cattle1 which were tuberculous1 the test was positive in every case but one1 though the dilution of the serum was #a in #aj4bj ,it would be easy to add instances of the value of this test1 for it is practised far and wide over the world4 #bj ,for references to this paper1 and to evidence put forward against the validity of the test1 and for criticism of such evidence1 see ,gould's ,year-,book of ,medicine and ,surgery1 #aijb 7,philadelphia1 ,w4 ,b4 ,saunders ,company74 #g4 ,more recently1 the discovery of the opsonic index1 and its use by ,sir ,almroth ,wright and others1 has given a great advance to the observation and treatment of cases of tuberculosis4 ,the administration of the new tuberculin is now timed and measured with an accuracy which was absolutely impossible a few years ago4 ,it is a far cry1 from the present method of counting how many tubercle-bacilli are taken up by a single blood-cell1 back to ,villemin's rabbits4 ,every inch of the way1 from #ahha onward1 the pathological study of every form of tuberculosis1 medical or surgical1 human or bovine1 has been dependent on bacteriology2 that is to say1 on experiments on animals4 ,,iv ,,diphtheria ,the bacillus of diphtheria1 the ,klebs-,loeffler bacillus1 was first described by ,klebs in #ahge1 and was first obtained in pure culture by ,loeffler in #ahhd4 ,its isolation was a matter of great difficulty1 and the work of many years1 because of its association in the mouth with other species of bacteria4 ,the following table1 from ,hewlett's ,manual of ,bacteriology1 is a good instance of one of many practical difficulties4 ,out of #cec cases of diphtheria1 bacteriological examination found the diphtheria-bacillus alone in #baf cases4 ,in the remaining #acg it was associated with the following organisms3-- ,streptococci #f ,staphylococci #ee ,bacilli #ai ,torul #i ,sarcin #f ,streptococci and micrococci #b ,micrococci and bacilli #i ,streptococci and bacilli #a ,torul and bacilli #a ,micrococci and sarcin #f ,micrococci and torul #d ,many forms present together #ai ---- #acg ---- ,in ,december #ahij came the news that ,behring and ,kitasato had at last cleared the way for the use of an antitoxin3-- ,our researches on diphtheria and on tetanus have led us to the question of immunity and cure of these two diseases2 and we succeeded in curing infected animals1 and in immunising healthy animals1 so that they have become incapable of contracting diphtheria or tetanus4 ,aronsen1 ,sidney ,martin1 ,escherich1 ,klemensiewicz1 and many more1 were working on the same lines2 and in #ahic1 ,behring and ,kossel and ,heubner published the first cases treated with antitoxin4 ,then1 in #ahid1 came the ,congress of ,hygiene and ,demography at ,budapest1 and ,roux's triumphant account of the good results already obtained4 ,thus the treatment is not many years old2 but1 if the whole world could tabulate its results1 the total number of lives saved would already be somewhere above a quarter of a million4 ,men found it hard at first to believe the full wonder of the discovery3 the medical journals of #ahie and #ahif still contain the fossils of criticism--all the may be and must be of the earlier debates on the new treatment4 ,the finest of all these fossils is embedded in the ,saturday ,review of #bnd ,feb4 #ahie--;,it is a pity that the ,english ,press should continue to be made the cat's-paw of a gang of foreign medical adventurers4 ,to get at the truth1 we must reckon in thousands3 take1 out of a whole mass of evidence1 all just alike1 the reports from ,london1 ,berlin1 ,munich1 ,vienna1 ,strasbourg1 ,cairo1 ,boston1 and ,new ,york2 these to begin with4 ,or the following facts1 cut almost at random out of the medical journals3-- ,the medical report of the ,french army states that since the introduction of the serum-treatment of diphtheria1 the mortality among cases of that disease had fallen from #aa per cent4 to #f per cent4 7,brit4 ,med4 ,journ41 #crd ,september #ahih47 ,professor ,krnlein 7,zrich7 exhibited statistical tables1 showing that the prevalence of diphtheria in the canton of ,zrich had been nearly uniform during the past fifteen years2 and that the mortality rapidly decreased as soon as antitoxic serum was used on a somewhat larger scale4 ,in his clinic1 all the patients were examined bacteriologically1 and serum was administered in every case of diphtheria without exception4 ,of #accf cases treated before the serum-period1 #eed #ci4d per cent4 died2 whilst during the serum-period there were #ee deaths among #dcg cases #ab per cent4 ,in cases of tracheotomy1 the death-rates before and during the serum-period were #ff and #ch4h per cent4 respectively4 7,lancet1 #gth ,may #ahih1 ,report of ,german ,surgical ,congress at ,berlin47 ,dr4 ,krmn was entrusted by the ,hungarian ,government with the task of instituting measures for preventing the spread of diphtheria in a village and its neighbourhood4 ,as general hygienic regulations accomplished nothing1 he tried preventive inoculation4444 ,among #aad children thus treated1 there was during the next two months no case of diphtheria1 although the disease was prevalent in the village up to the date at which inoculation commenced1 and continued to rage in the surrounding villages afterwards4 ,during those two months1 only one case of diphtheria appeared in the village1 and that was in an uninoculated child2 while1 in the previous five months1 #ah4c per cent4 of the village children had been attacked1 of whom eight died1 six not having been treated with serum4 ,considering the wretched hygienic condition of the village1 the harmlessness of preventive inoculations1 and the continuance of the disease in the neighbouring villages1 where diphtheria-vaccination was not carried out1 the extraordinary value of the inoculations1 in the prophylaxis of diphtheria1 can hardly be denied4 7,brit4 ,med4 ,journ41 #afth ,january #ahig47 ,the most striking confirmation of the value of antitoxin has been afforded where the supply ran short during an epidemic4 ,in ,baginsky's clinic1 the interruption of the serum-treatment promptly raised the mortality from #ae4f to #dh4d per cent4 7,brit4 ,med4 ,journ41 #bjth ,october #ahie47 ,in an analysis of the ratio of mortality in #bff ,german cities of about #ae1jjj inhabitants1 it was found that the ratio of mortality per #ajj1jjj of the living1 before antitoxin was used1 varied from #acj to #hd from #ahhf to #ahic1 while the ratio from #ahid to #ahig varied from #aja to #ce4 ,it is a significant fact that during #ahid1 when1 although antitoxin was used to a certain extent1 it was not in general use1 the ratio was #aja2 that when antitoxin was used more extensively1 in #ahie1 the ratio was #ec2 that in #ahif it was #dc2 that in #ahig1 when antitoxin was very generally used1 the rate fell to #ce4 7,trans4 ,massachusetts ,med4 ,soc41 #ahih47 ,dr4 ,gabritchefski points out that in recent years the number of persons 7in ,russia7 attacked by the disease has increased1 the figures for the whole of ,russia rising from about #ajj1jjj or #abj1jjj1 ten years ago1 to considerably over #bjj1jjj in #ahig4 ,the introduction of the serum treatment has1 however1 had a marked effect on the mortality of the disease2 and the actual number of deaths from diphtheria has either not increased at all1 or has slightly diminished4 7,lancet1 #eth ,aug4 #ahii47 ,of course there will still be bad diphtheria years and good diphtheria years3 for example1 the death-rate of the population of ,england1 from diphtheria1 was higher during the years #ahic-ahii than during the years #ahhi-ahib4 ,antitoxin can no more prevent a bad diphtheria year than an umbrella can prevent a wet day4 ,but in limited outbreaks of diphtheria1 such as occur in a village1 an asylum1 a school1 or a large family of young children1 it can be used1 and is used1 as a prophylactic1 and with admirable results4 ,the example of ,dr4 ,krmn1 just quoted1 is one of the earliest instances of this preventive use of antitoxin3 other instances1 of equal importance1 are given in the ,boston ,medical and ,surgical ,journal1 ,december #ahig and ,march #ahih2 and in the ,lancet1 #bnd ,april #ahih1 and #bhth ,january #ahii4 ,a summary of later experiences of this preventive use of antitoxin in different countries is given by ,dr4 ,wilcox of ,new ,york1 and ,dr4 ,stevens of ,philadelphia1 in ,gould's ,year-,book for #aijb3-- ,at a meeting of the ,socit de ,pdiatrie 7,paris71 held ,june #aija1 a resolution was adopted affirming that preventive inoculations present no serious dangers1 and confer immunity in the great majority of cases for some weeks1 and recommending their employment in children's institutions and in families in which scientific surveillance cannot be exercised4 ,netter stated that he had collected #cb1dhd observations 7cases7 of prophylactic injections1 and after eliminating cases in which the disease developed in less than twenty-four hours after injection1 or more than thirty days after1 there were #f per cent4 of failures4 ,on the other hand1 the author stated that he had recently made ninety preventive injections with but #b4ag per cent4 of failures4 ,potter reports a series of twenty-four families in which preventive injections were used4 ,only one case of diphtheria occurred4 ,in another series of cases1 in which no prophylactic injections were given1 the disease occurred secondarily in one-third of the houses1 and one-sixth of the inmates contracted the disease1 in spite of the fact that a large number of the primary cases were removed to the hospital4 ,blake reports a series of thirty-five prophylactic injections4 ,the treatment was instituted after three cases of diphtheria had developed in a children's home4 ,no secondary cases developed4 ,voisin and ,guinon describe an epidemic of diphtheria in the ,salpetrire ,hospital among idiots and epileptics4 ,prophylactic injections were given to all those exposed to the contagion4 ,after that1 but four cases appeared1 all mild in character4 ,one severe case developed1 however1 two weeks later1 ending fatally in twenty-four hours1 showing that the prophylactic action of the antitoxin1 while efficacious1 is not of very long duration4 ,it would be easy to prolong ad infinitum the proofs of the curative and preventive efficacy of the antitoxin3 it would be impossible to find any evidence to be weighed for one moment against these proofs4 ,there are three early records that ought to be quoted more fully3 the #ahid report from the ,hospital for ,sick ,children1 ,paris2 the #ahif report of the ,american ,pdiatric ,society2 and the #ahih report of the ,clinical ,society of ,london4 ,i ,the report from the ,hospital for ,sick ,children1 ,paris1 is contained in a memoir1 ,srum-,thrapie de la ,diphtrie1 the joint work of ,,mm4 ,roux1 ,martin1 and ,chaillon 7,annales de l',institut ,pasteur1 ,september #ahid74 ,it gives the results of the serum-treatment during ,february to ,july #ahid4 ,the cases were not selected3 the antitoxin was given in every case that was proved1 by bacteriological examination1 to be diphtheria--with the exception of #bj cases where the children were just dying when they were brought to the hospital4 ,no change was made either in the general treatment or in the local applications to the throat2 these were the same that had been used in former years3 le srum est le seul lment nouveau introduit4 ,in #ahij-ahic1 before the serum-treatment1 #ciga children were admitted to the diphtheria wards1 and #bjbi of them died4 ,the percentage of these deaths was-- ,in #ahij #ee4hh #ahia #eb4de ,average #ea4ga4 #ahib #dg4fd #ahic #dh4dg ,the serum was used from #ast ,february to #bdth ,july #ahid4 ,during this period #ddh children were admitted1 of whom #aji died #bd4e4 ,during the same period 7,february to ,june7 the ,trousseau ,hospital1 where the serum was not used1 had #ebj cases1 with #caf deaths #fj4j4 ,the cases at the ,hospital for ,sick ,children must be divided into those that required tracheotomy and those that did not require it3-- ,,mortality ,,among ,,cases ,,not ,,requiring ,,tracheotomy4 ,in #ahij #dg4cj #ahia #df4fd ,average #cc4id4 #ahib #ch4h #ahic #cb4jb ,during the serum-period1 the mortality of these cases was #ab4j4 ,at the ,trousseau ,hospital1 without the serum1 the mortality of these cases during the same period was #cb4j4 ,,mortality ,,among ,,cases ,,requiring ,,tracheotomy4 ,in #ahij #gf4ce #ahia #fh4cf ,average #gc4di4 #ahib #gd4f #ahic #gc4de ,during the serum-period1 the mortality of these cases was #di4j4 ,at the ,trousseau ,hospital1 without the serum1 the mortality of these cases during the same period was #hf4j4 ,setting aside1 out of the #ddh children1 those cases of membranous sore throat or pseudo-diphtheria1 in which the ,klebs-,loeffler bacillus was not found1 there remain #cbj cases where it was found4 ,of these #cbj children1 #bj were just dying on admission1 and did not receive the serum4 ,of the #cjj who received it1 #gh died #bf4j4 ,before the serum-period1 the mortality of these cases at the same hospital was about #ej4j4 ,the complications of diphtheria1 such as paralysis1 were much less frequent during the serum-period than they had been before it4 ,,ii ,report of the ,american ,pdiatric ,society's ,collective ,investigation into the use of ,antitoxin in the treatment of diphtheria in private practice4 7,eighth ,annual ,meeting1 ,montreal1 ,may #ahif47 ,from the ,new ,york ,medical ,record1 #dth ,july #ahif4 ,this vast collection of cases is of special interest1 because they occurred in private practice4 ,in most of them the nature of the disease was proved by bacteriological examination2 in the rest1 the clinical evidence was decisive3 ,it is possible that among the latter we have admitted some streptococcus cases1 but the number of such is certainly very small4 ,all other doubtful cases1 #bdd in number1 were excluded4 ,three thousand three hundred and eighty-four cases were reported by #fac physicians from #aad cities and towns1 in #ae different ,states1 the ,district of ,columbia1 and the ,dominion of ,canada4 ,to these #cchd cases were added #idb cases from tenement-houses in ,new ,york1 and #adfh cases from tenement-houses in ,chicago4 ,the ,new ,york and ,chicago cases were1 most of them1 treated by a corps of inspectors of the ,health ,board of the city2 and the municipal surveillance was very strict at ,chicago3-- ,there are very few hospitals in ,america that receive diphtheria patients4444 ,it was the custom in ,chicago to send an inspector to every tenement-house case reported1 and to administer the serum unless it was refused by the parents4 ,these cases were therefore treated much earlier1 and the results were correspondingly better than were obtained in ,new ,york1 although the serum used was the same in both cities1 viz41 that of the ,new ,york ,health ,board4 ,the sum total of results was #egid cases1 with #gac deaths #ab4c per cent41 including every case returned2 but #bah were moribund at the time of injection1 or died within twenty-four hours of the first injection4 ,should these be excluded1 there would remain #eegf cases in which the serum may be said to have had a chance1 with a mortality of #h4h per cent4 ,of #iif cases injected on the first day of the disease1 #di died #d4i #afaf on the second #abj #g4d #aejh on the third #acd #h4h #geh on the fourth #adg #bj4g #fij on or after the fifth #bdd #ce4c ,and in #bcb cases1 where the day of injection was unknown1 there were #ai deaths #h4b per cent4 ,no one feature of the cases of diphtheria treated by antitoxin has excited more surprise among the physicians who have reported them than the prompt arrest1 by the timely administration of the serum1 of membrane which was rapidly spreading downward below the larynx4 ,such expressions abound in the reports as 'wonderful1' 'marvellous1' 'in all my experience with diphtheria1 have never seen anything like it before1' etc4 ,turning now to the operative cases1 we find the same remarkable effects of the antitoxin noticeable4 ,operations were done in #efe cases1 or in #af4g per cent4 of the entire number reported4 ,intubation was performed #ecc times1 with #ach deaths1 or a mortality of #be4i per cent4 ,in the above are included #i cases in which a secondary tracheotomy was done1 with #g deaths4 ,in #cb1 tracheotomy only was done1 with #ab deaths1 a mortality of #cg4d per cent4 ,of the #efe operative cases1 #ff were either moribund at the time of operation or died within twenty-four hours after injection4 ,should these be deducted1 there remain #dii cases operated upon1 by intubation or tracheotomy1 with #hd deaths1 a mortality of #af4i per cent4 ,let us compare the results of intubation1 in cases in which the serum was used1 with those obtained with this operation before the serum was introduced4 ,of #eedf intubation cases in the practice of #bdb physicians1 collected by ,m',naughton and ,maddren 7#ahib71 the mortality was #fi4e per cent4 ,since that time1 statistics have improved materially by the general use 7in and about ,new ,york1 at least7 of calomel fumigations4 ,with this addition1 the best results published 7those of ,brown7 showed in #bgi cases a mortality of #ea4f per cent4 ,but even these figures do not adequately express the benefit of antitoxin in laryngeal cases4 ,witness the fact that over one-half the laryngeal cases did not require operation at all4 ,formerly1 #aj per cent4 of recoveries was the record for laryngeal cases not operated upon4 ,surely1 if it does nothing else1 the serum saves at least double the number of cases of laryngeal diphtheria that has been saved by any other method of treatment4 ,,iii ,in #ahih1 the ,clinical ,society published the ,report of their ,special ,committee1 based on #fcc cases 7,trans4 ,clin4 ,soc41 xxxi41 #ahih1 pp4 #a-ej74 ,the whole report should be read carefully2 but there is room here for nothing more than the latter part of it4 ,this is given at length4 ,a ,table showing the ,general ,mortality of cases treated1 on the same day of the disease1 with and without ,antitoxin4 ---------------------------------------- ------------------------- ,,metropolitan ,,asylums ,,board ,,antitoxin ,,committee3 #ahid3 ,difference #fcc ,cases treated #cjdb ,cases treated without of with ,antitoxin4 ,antitoxin4 ,per- ---------------------------------------- --------------- centage4 ,day of the ,c ,d ,m ,day of ,c ,d ,m ,disease on a e o ,admission a e o which s a r to s a r ,treatment e t t ,hospital4 e t t was begun4 s4 h i s4 h a s4 l s4 l i i t t y y 4 4 ---------------------------------------- ------------------- #ast #bj #b #aj4j #ast #acc #cj #bb4e #ab4e #bnd #ib #aj #aj4h #bnd #eci #adf #bg4j #af4b #crd #acc #bj #ae4j #crd #feb #aib #bi4d #ad4d #dth #acj #bf #bj4j #dth #eff #agi #ca4f #aa4f #eth #beh #ff #be4e #eth #a1aeb #cee #cj4h #e4c and after4 ---------------------------------------- ------------------- ,totals #fcc #abd #ai4e ,totals #c1jdb #ijb #bi4f #aj4a ---------------------------------------- ------------------- ,b ,summary and ,conclusions of the ,committee's ,report ,the material for the investigation of the clinical value of the antitoxin serum in the treatment of diphtheria was not obtained from selected1 but from consecutive1 cases1 reported from the general hospitals and the fever hospitals of the ,metropolitan ,asylums ,board2 all were made use of which fulfilled the requirements of the ,committee4 ,the ,committee rejected all cases in which satisfactory proof of the existence of true diphtheria was not shown1 either by the presence of the ,bacillus diphtheri upon bacteriological examination1 or by the occurrence of paralysis in the course of the illness4 ,all were also rejected in which the amount of antitoxin administered was stated in cubic centimetres and not in normal units1 the ,committee having no means by which the strength of the antitoxin could in these cases be determined4 ,six hundred and thirty-three cases form the basis on which the report is drawn up2 #edi were treated with antitoxin obtained from the laboratory of the ,royal ,colleges of ,physicians and ,surgeons2 the remainder1 #hd in number1 were injected with antitoxin obtained from other sources4 ,in nine instances1 antitoxin from two different sources was injected into the same patient4 ,statistics of the disease before the use of antitoxin are introduced as control series2 these were obtained from the fever hospitals of the ,metropolitan ,asylums ,board1 and from the general hospitals2 and1 like the antitoxin series1 are compiled from consecutive and not from selected cases4 ,the general mortality1 under the antitoxin treatment1 was #ai4e per cent42 a reduction of #aj on the percentage mortality of the cases treated in the hospitals of the ,metropolitan ,asylums ,board in #ahid4 ,if #ae fatal cases1 in which death took place within twenty-four hours of the first injection1 be deducted1 the mortality falls to #ae4f per cent42 which is very little more than half the mortality during #ahid under other forms of treatment4 ,the lessened mortality is especially noticeable in the earlier years of life1 the percentage mortality of children under five being #bf4c1 as opposed to #dg4d4 ,in the next period of five years1 the percentage of mortality is #af4j1 as opposed to #bf4j2 whilst after ten years of age the difference in the mortality is slight4#ba #ba ,after childhood1 the disease is much less fatal4 ,laryngeal diphtheria is admittedly the most dangerous form4 ,the laryngeal cases have a percentage mortality of #bc4f in the antitoxin1 as compared with #ff4j in the non-antitoxin series4 ,in the cases in which laryngeal symptoms are so severe as to necessitate tracheotomy1 the saving of life by the use of antitoxin is very marked1 the mortality being reduced one-half1 to #cf4j as opposed to #ga4f per cent4 ,the strongest evidence of the value of the antitoxin treatment is that1 in addition to reducing the general mortality by one-third1 the duration of life in the fatal cases is decidedly prolonged4 ,these two facts taken together conclusively prove the beneficial effects of the antitoxin treatment4 ,the incidence of paralysis is greater in the antitoxin than in the control series4 ,this increased number is partly explained by the lessened mortality1 and partly by the longer duration of life in the fatal cases affording time for the development of paralytic symptoms4 ,the percentage mortality of those who had some form or other of paralysis is lower in the antitoxin than in the control series2 so that1 notwithstanding the apparent greater risk of paralysis supervening1 the probability of final recovery is greater4 ,no definite conclusion can be drawn1 for the reasons stated in the body of the report1 as to the advantage of administering the whole of the antitoxin within forty-eight hours of the first injection1 or continuing it for a longer period2 but evidence is afforded of the importance of its administration as early as possible in the course of the disease2 the percentage mortality in cases injected on the first and second days of the disease being #aj4g1 as compared with #be4e for those first receiving the injection on the fifth or some subsequent day4 ,no conclusion can be drawn1 from the cases reported on1 as to the amount of antitoxin which should be used to produce the best effects2 but they show that the administration of very large doses is followed by no pronounced ill effects4 ,the injection of antitoxin is responsible for the production of rashes1 joint-pains1 and possibly for the occurrence of late pyrexia4 ,in #cd4g per cent4 the injections were followed by rashes4 ,some amount of fever accompanied the rash in #fj per cent4 ,in only #i4d per cent4 of those in whom rashes were observed did death ensue4 ,joint-pains were observed in #dj1 or #f4c per cent4 of the whole number1 and all but five of them had a rash as well4 ,in #bf1 or #fe per cent4 of the joint-pains1 some rise of temperature accompanied the pain4 ,a rise of temperature during convalescence1 accompanied by either rash or joint-pain1 occurred in #bg1 or #d4b per cent4 of the whole number4 ,no connection could be traced between the amount of antitoxin administered and the occurrence of rashes or late pyrexia1 but the pain in and about the joints appears to have a relationship to the amount of antitoxin used4 ,the results of the ,committee's investigation tend to show that by the use of antitoxin-- #a4 ,the general mortality is reduced by one-third4 #b4 ,the mortality in tracheotomy falls by one-half4 #c4 ,extension of membrane to the larynx very rarely occurs after the administration of antitoxin4 #d4 ,the duration of life in the fatal cases is decidedly prolonged4 #e4 ,the number of fatal cases is less when antitoxin is used early in the illness than in those which do not receive it until a later period4 #f4 ,the frequency of the occurrence of paralysis is not diminished1 but the percentage of recoveries in cases with paralysis is slightly increased4#bb #g4 ,rashes are produced in about one-third of the cases1 and are attributable to the antitoxin4 #h4 ,pain1 and occasionally swelling about the joints1 are produced in a number of cases4 #i4 ,even when used in large doses1 no serious ill effects have followed the injection of antitoxin4 #bb ,for an exhaustive and wise study of the diphtheritic paralyses1 see ,dr4 ,woollacott's essay in the ,lancet1 #bfth ,august #ahii3 ,the use of antitoxic serum in the treatment of diphtheria has1 up to the present time1 in the ,london fever hospitals1 had two main results--the death-rate has fallen1 while the paralysis-rate has risen4 ,in the hospitals of the ,metropolitan ,asylums ,board1 the former has been reduced from #bi per cent4 to #ae4c per cent41 while the latter has risen from #ac per cent4 to as high as #ba per cent4 in #ahif4 ,this increase of paralysis is chiefly due to the fact that many more patients now recover from the primary disease1 and live long enough for paralysis to show itself4 ,during the last two years1 however1 the occurrence of paralysis has begun to diminish in frequency4444 ,the earlier antitoxin is given in diphtheria1 the less likely is paralysis to follow4 ,it is to be borne in mind that post-diphtheritic paralysis1 in the great majority of cases1 affects only a very small group of muscles2 of ,dr4 ,woollacott's tabulated cases1 #cgg were of this kind1 and #ig were severe4 ,and the type of paralysis has1 on the whole1 become less severe1 or at all events less dangerous to life4 99 99 99 99 99 ,the foregoing reports belong to ancient history4 ,let us leave them1 and study the record of the hospitals of the ,metropolitan ,asylums ,board4 ,they serve a city of #aba square miles1 and #d-a_/b millions of inhabitants4 ,the use of the antitoxin in the hospitals of the ,metropolitan ,asylums ,board began in #ahie4 ,it had been used in #ahid on a few cases only1 during the latter part of the year1 and had been procured with much difficulty from various sources1 chiefly from the ,institute of ,preventive ,medicine4 ,on #ith ,november #ahid1 the ,board applied to the ,laboratories' ,committee of the ,royal ,colleges of ,physicians and of ,surgeons1 asking them to undertake the supply4 ,arrangements were made for this purpose2 and the sum of #ajjj was given by the ,goldsmiths' ,company4 ,dr4 ,sims ,woodhead1 then ,director of the ,laboratories of the ,conjoint ,colleges1 now ,professor of ,pathology at ,cambridge1 was put in charge of the bacteriological work and the preparation of the serum1 with a host of expert colleagues3 the administration of the treatment was the work of the medical officers of the hospitals of the ,metropolitan ,asylums ,board4 ,the experiences of #ahie are given in the following passages from the joint report to the ,board from the medical superintendents3-- ,the period covered by the report extends from #ast ,january #ahie to #cast ,december of the same year4 ,during this time--with the exception of an interval of three months at the ,eastern ,hospital1 when its use was suspended2 of three months at the ,fountain1 and to a considerable extent throughout the year at the ,south-,eastern ,hospital1 when all cases were consecutively treated1 irrespective of their severity--the serum was administered only to cases which at the time of admission were severe1 or which threatened to become so4 ,in a certain number1 the patients being moribund at the time of their arrival1 and beyond the reach of any treatment1 no antitoxin was given4 ,no change has taken place during the year in the local treatment of the cases1 nor has there been any new factor in the treatment other than the injection of antitoxin4 ,it must be clearly understood that1 with the exceptions previously stated1 it has been the practice at each of the hospitals to administer serum to those cases only in which the symptoms on admission were sufficiently pronounced to give rise to anxiety1 the mild cases not receiving any4 ,no less than #df4d per cent4 of the antitoxin cases were under five years of age1 against #cb4e per cent4 in the non-antitoxin group2 and only #af4a per cent4 in the former class were over ten years of age1 against #cc4h per cent4 in the latter4 ,the high fatality of diphtheria in the earlier years of life is notorious4 ,it is obvious1 therefore1 that to compare the mortality of those treated with antitoxin with that of those which during the same period were not so treated1 would be to institute a comparison between the severe cases and those of which a large proportion were mild4 ,this would clearly be misleading4 ,the only method by which an accurate estimate can be obtained as to the merits of any particular form of treatment1 is by comparing a series of cases in which the remedy has been employed with another series not so treated1 but which are similar1 so far as can be1 in other respects4 ,this1 in the present instance1 is impossible2 but1 having regard to the fact that #fa4h of the #ahie cases were treated with serum1 an approximately accurate conclusion can be drawn by contrasting all cases of diphtheria completed during #ahie1 the antitoxin period1 with all cases completed during #ahid4 ,the year #ahid has been selected for the purpose of comparison1 not only because it is the year immediately preceding the antitoxin period1 but because the average severity of the cases has been1 in our opinion1 about equal4 ,moreover1 the death-rate in #ahid was slightly lower than it had been in any previous year4 444 ,of #cjdb patients of all ages treated during #ahid1 #ijb died--a mortality of #bi4f per cent42 whereas1 of #cebi cases treated during #ahie1 #gif died--a mortality of #bb4f per cent42 the difference in percentage between the two rates being therefore #g4a4 ,this1 assuming that the former rate would otherwise have been maintained1 represents a saving of #bej lives during the past year4 ,,influence ,,of ,,age4 ,table showing variations in reduction of mortality obtained with ,antitoxin at different ages4 ---------------------------------------- ---------------- ,antitoxin ,cases1 ,all ,cases1 #ahie4 #ahie4 ,ages4 ---------------------------------------- ---- ,cases4,deaths4,mortality,cases4,deaths4 ,mortality per cent4 per cent4 ---------------------------------------- ------------ ,under #e #ajac #cgi #cg4d #adec #dig #cd4b #aj #ahbi #ege #ca4d #bgbj #gdd #bg4c #ae #bjef #fjf #bi4d #cadd #ggi #bd4g ,all ages #bahb #fae #bh4a #cebi #gif #bb4e ---------------------------------------- ------------ ---------------------------------------- ---- ,all ,cases1 ,diff4 in #ahid4 ,mortalities1 ,ages4 ---------------------- #ahid ,cases4,deaths4,mortality and per cent4 #ahie4 ---------------------------------------- -- ,under #e #aaga #eef #dg4d #ac4b #aj #bbdf #hcf #cg4b #i4i #ae #bfji #hgg #cc4f #h4i ,all ages #cjdb #ijb #bi4f #g4a ---------------------------------------- -- ,for every age-group1 with the single exception of that comprising the years #ae to #bj 7the numbers of which are small71 the percentage mortality was less in the #ahie than in the #ahid cases4 ,the reduction in mortality was greatest in early life4 ,,influence ,,of ,,time ,,of ,,coming ,,under ,,treatment4 ,table showing percentage mortality in relation to day of disease on which cases came under treatment4 ---------------------------------------- -- ,day of ,disease4 #ahid4 #ahie4 ,difference4 ---------------------------------------- -- #ast #bb4e #aa4g #aj4h #bnd #bg4j #ab4e #ad4e #crd #bi4d #bb4j #g4d #dth #ca4f #be4a #f4e #eth and over #cj4h #bg4a #c4g ---------------------------------------- -- ,total #bi4f #bb4e #g4a ---------------------------------------- -- ,it will be seen that the percentage mortality of cases admitted on the same day of disease is less in every instance in the year #ahie4 ,the difference is most marked in the case of those patients who were admitted on the first and second day of illness1 viz41 #aj4h and #ad4e respectively4 ,both in #ahid and #ahie1 no less than over #cg per cent4 of the patients were admitted on1 or after1 the fifth day of disease4 ,and1 moreover1 while in #ahid as many as #ei4b per cent4 of the fatal cases were not brought under treatment until the fourth day1 or later1 in #ahie1 the antitoxin year1 the proportion was even higher1 viz41 #fg4g per cent4 ,laryngeal ,cases ,the tracheotomy results at each hospital are more favourable in the year #ahie than in #ahid1 the mortality ranging in the latter year at the different hospitals between #ij per cent4 and #ei4d per cent41 whereas in #ahie the range was from #ef4b to #dj4e4 ,the combined tracheotomy mortality for all the hospitals1 which in #ahid was #gj4d per cent41 has fallen to #di4d per cent4 in #ahie4 ,this is a lower death-rate than has ever been recorded in any single hospital of the ,board for a year's consecutive tracheotomies4 ,in other words1 rather more than #ej per cent4 of children on whom the operation has been performed have been saved since the employment of antitoxin4 ,in one of the hospitals no less than a fraction under #fj per cent4 survived1 although the recoveries in that hospital in any previous year did not exceed #be per cent41 and in the preceding year--viz41 #ahid--were as low as #aj per cent4 ,the improved results in the tracheotomy cases of #ahie have also been shared by analogous cases in which the operation was not performed4 ,the percentage mortality of all laryngeal cases has fallen from #fb in #ahid to #db4c in #ahie4 ,moreover1 the number of laryngeal cases which required tracheotomy has fallen in #ahie to #de4c per cent41 whereas in #ahid it was #ef per cent4 ,the following tables briefly summarise the foregoing results4 ,as no returns for #ahid were furnished by the ,fountain ,hospital by reason of the smallness of the numbers1 the ,fountain cases have also been omitted from the #ahie figures1 in order that the two series may be rendered strictly comparable3-- #a4 ,comparative ,mortality of ,laryngeal ,cases at all ,hospitals1 except the ,fountain4 ---------------------------- ,year4,cases4,deaths4,percentage ,mortality4 ---------------------------- #ahid #dff #bhi #fb4j #ahie #dfh #aif #da4h ---------------------------- #b4 ,comparative ,results in ,tracheotomy ,cases at all ,hospitals1 except the ,fountain4 ---------------------------- ,year4,cases4,deaths4,percentage ,mortality4 ---------------------------- #ahid #bfa #ahd #gj4d #ahie #bai #ajh #di4c ---------------------------- #c4 ,comparative ,number of ,laryngeal ,cases which required ,tracheotomy at all ,hospitals1 except the ,fountain4 --------------------------------------- ,year4,cases4,tracheotomies4,percentage of ,tracheotomies4 --------------------------------------- #ahid #dff #bfa #ef4j #ahie #dfh #bai #df4h --------------------------------------- ,on these tables further comment seems unnecessary4 ,summary ,the improved results in the diphtheria cases treated during the year #ahie1 which are indicated by the foregoing statistics and clinical observations1 are-- #a4 ,a great reduction in the mortality of cases brought under treatment on the first and second day of illness4 #b4 ,the lowering of the combined general mortality to a point below that of any former year4 #c4 ,the still more remarkable reduction in the mortality of the laryngeal cases4 #d4 ,the uniform improvement in the results of tracheotomy at each separate hospital4 #e4 ,the beneficial effect produced on the clinical course of the disease4 ,conclusions ,a consideration of the foregoing statistical tables and clinical observations1 covering a period of twelve months1 and embracing a large number of cases1 in our opinion sufficiently demonstrates the value of antitoxin in the treatment of diphtheria4 ,it must be clearly understood1 however1 that to obtain the largest measure of success with antitoxin it is essential that the patient be brought under its influence at a comparatively early date--if possible1 not later than the second day of disease4 ,from this time onwards1 the chance of a successful issue will diminish in proportion to the length of time which has elapsed before the treatment is commenced4 ,this1 though doubtless true of other methods1 is of still greater moment in the case of treatment by antitoxin4 ,certain secondary effects not unfrequently arise as a direct result of the injection of antitoxin in the form in which it has at present to be administered1 and even assuming that the incidence of the normal complications of diphtheria is greater than can be accounted for by the increased number of recoveries1 we have no hesitation in expressing the opinion that these drawbacks are insignificant when taken in conjunction with the lessened fatality which has been associated with the use of this remedy4 ,we are further of the opinion that in antitoxic serum we possess a remedy of distinctly greater value in the treatment of diphtheria than any other with which we are acquainted4 99 99 99 99 99 ,now let us take the whole record of all the hospitals together4 ,the disease was first admitted in #ahhh2 this year is therefore to be reckoned as incomplete4 ---------------------------------------- -------------------- ,year4 ,percentage,year4 ,percentage ,mortality4 ,mortality4 ---------------------------------------- -------------------- #ahhh #ei4ce #ahig #ag4fi #ahhi #dj4gd #ahih #ae4cg #ahij #cc4ee #ahii #ac4ie #ahia #cj4fc #aijj #ab4bg #ahib #bi4ce #aija #aa4ae #ahic #cj4db #aijb #aa4jd #ahid #bi4bi #aijc #i4fi #ahie1 first antitoxin year #bb4he #aijd #aj4jh #ahif #ba4bj #aije #h4c ---------------------------------------- -------------------- ,these results1 of course1 are but one instance of what has happened1 since #ahie1 in every country all over the civilised world4 ,securus judicat orbis terrarum4 ,we have ,siegert's tables 7#aijj71 based on no less than #dj1jch cases admitted in nine years to sixty-nine hospitals in ,germany1 ,austria1 ,switzerland1 and ,paris4 ,he divides these nine years into a pre-serum period1 an introduction year1 and a serum period4 ,in the pre-serum period the general mortality was #da4e1 and the mortality of cases requiring operation was #fj2 in the serum period1 the general mortality was #af4e1 and the mortality of cases requiring operation was #cg4e4 ,any bad results that have been recorded from the use of the antitoxin are so rare1 in comparison with the hundreds of thousands of injections made1 that they do not come to be considered here4 ,and1 even though a few have occurred1 we may be sure that some of them were due1 not to the antitoxin1 but to the natural course of the disease4#bc ,the lesser drawbacks1 the occurrence of joint pains and of rashes1 are transient and in no way serious4 #bc ,this1 of course1 does not apply to two instances1 in #aija1 of accidental contamination of serum4 ,see1 for an account of these1 ,the ,british ,medical ,journal1 ,november #aija4 ,it has been supposed1 and said1 that the use of the antitoxin increases the complications of the disease4 ,on this point1 the best authority is ,professor ,woodhead's monumental ,report 7#aija71 dealing with the ,metropolitan ,asylums ,board cases for #ahie and #ahif4 ,he sums up the matter thus3-- ,the free use of antitoxin does not raise the percentage of cases of albuminuria4 ,as regards vomiting1 the statistics give little information1 as vomiting is usually met with only in the very severe cases4 ,this also holds good of anuria4 ,the number of cases of adenitis appears to be distinctly reduced by the use of antitoxin1 as the percentage of cases falls as the injections of antitoxin are pushed4 ,the use of antitoxin has also had a perceptible effect in diminishing the cases of nephritis1 and it certainly has not aggravated the kidney complications of diphtheria4 ,there can be no doubt that in cases treated with antitoxin there is a greater percentage of cases in which joint-pains occur than in cases not so treated2 these1 however1 are transitory1 and are probably the result of some slight change in the blood set up by the action of the serum itself1 and not by the antitoxic substance in the serum4 ,the number of primary abscesses has undoubtedly been reduced by the use of antitoxin4 ,it may also be accepted that antitoxic serum has some effect in temporarily raising the temperature1 but only during the periods of joint-pains and serum rashes2 all these1 however1 are of comparatively slight importance as compared with the effect the antitoxin has in diminishing the percentage mortality and alleviating the more severe symptoms4 ,it is of importance to observe that amongst the cases of paralysis following diphtheria the death-rate 7#cb per cent47 was actually higher amongst those not injected with antitoxin than amongst those where antitoxin was used 7#cj4e per cent471 although the former paralyses must be looked upon as being the result of a comparatively mild attack of the disease4 ,from this it is evident that1 when once paralysis supervenes in these cases1 it is quite as fatal in its effects as in the cases 7usually those of a more severe type7 where antitoxin has been given4 ,antitoxin cannot cure the degeneration of the nerve1 but it can neutralise the diphtheria toxin1 and so put a stop to the advance of the degenerative changes due to its action4 ,in #ahif1 when1 of course1 antitoxin was given much more freely1 the percentage of deaths in the non-injected cases where paralysis had come on fell to #ah4d4 ,antitoxin rashes occur at a comparatively late stage of the disease4 ,they cannot be looked upon as in any way dangerous1 although the secondary rise of temperature1 and the irritation of the skin which usually accompany their presence are very undesirable complications1 and may retard somewhat the convalescence of nervous and irritable patients4 ,antitoxin appears to diminish the liability of the lungs to inflammatory change in severe attacks of diphtheria4 99 99 99 99 99 ,now let us take another point of view4 ,if anybody really doubts whether the antitoxin did really save these lives in the hospitals of the ,metropolitan ,asylums ,board1 what answer has he got to the following table8 ,it is published in the ,board's ,report for #aijd1 and was drawn up by ,dr4 ,mac,combie1 ,medical ,superintendent of the ,brook ,hospital4 ,it shows the supreme importance of giving the antitoxin at the very beginning of the disease4 ,the figures in brackets are the total numbers of the cases in the eight years3-- ,percentage ,mortality according to ,time of coming under ,treatment4 ---------------------------------------- --------------- ,day of ,disease4#ahig4ahih4ahii4aijj4aija4aijb4 aijc4aijd4 ---------------------------------------- --------------- 7#bjd7 #ast #j4j #j4j #j4j #j4j #j4j #j4j #j4j #j4j 7#abgh7 #bnd #e4d #e4j #c4h #c4f #d4a #d4f #d4b #e4dc 7#acgd7 #crd #aa4e #ad4c #ab4b #f4g #aa4i #aj4e #ag4faj4fc 7#ajhf7 #dth #ai4j #ah4a #bj4j #ad4i #ab4d #ai4h #af4gai4ea 7#achb7 #eth and after #ba4j #bb4e #bj4d #ba4b #af4f #ai4d #ag4cac4aa ---------------------------------------- --------------- ,here we see that in #adhb patients1 who got the antitoxin within forty-eight hours of the onset of the disease1 the mortality was #b-a_/d per cent4 ,in #abgh patients1 who did not get the antitoxin till the third day1 the mortality was #aa-c_/d per cent4 ,that is the result of one day's delay over sending the child into hospital4 ,again1 it is not only lives that are saved1 but suffering that is avoided4 ,just lately1 at a meeting of the ,chelsea ,clinical ,society 7,may #aijf71 reference was made to this point by ,dr4 ,foord ,caiger1 ,medical ,superintendent of the ,south-,western ,hospital4 ,the number of tracheotomies is less than half what it used to be2 and again1 ,instead of the spectacle of a number of patients in great distress1 with swollen necks and stuffed-up noses1 fretful and crying1 such cases are now quite the exception1 and1 in the few one does come across1 the condition lasts for a comparatively short time4 ,and again1 ,it was quite unusual 7before #ahie7 for a nurse to care to stay very long in charge of one of the diphtheria wards1 because she found the work so depressing4 ,but nowadays the diphtheria wards are perhaps the most popular in the hospital1 a fact which is mainly owing to the change in the general aspect of the patients and the greatly reduced mortality4 7,clinical ,journal1 ,may #bc1 #aijf47 ,v ,,tetanus ,before bacteriology1 the cause of tetanus 7lock-jaw7 was unknown1 and men were free to imagine that it was due to inflammation travelling up an injured nerve to the central nervous system4 ,this false and mischievous theory was abolished by the experimental work of ,sternberg 7#ahhj71 ,carle and ,rattone 7#ahhd71 and ,nicolaier 7#ahhd71 who proved1 once and for all1 that the disease is an infection by a specific flagellate organism4 ,their work was of the utmost difficulty1 for many reasons4 ,first1 because tetanus1 in some tropical countries1 is so common that it may fairly be called endemic2 and many of these tropical cases1 there being no record of any external infection1 had been taken as evidence that the disease can occur of itself4 ,of this frequency of tetanus in tropical countries1 ,sir ,patrick ,manson1 in his book on ,tropical ,diseases 7#ahih71 says3-- ,tetanus is an exceedingly common disease in some tropical countries4 ,in ,western ,africa1 for example1 a large proportion of wounds1 no matter how trifling as wounds they may be1 if they are fouled by earth or dirt1 result in tetanus4 ,the ,french in ,senegambia have found this to their cost4 ,a gentleman who had travelled much in ,congoland told me that certain tribes poison their arrows by simply dipping the tips in a particular kind of mud4 ,a wound from these arrows is nearly sure to cause tetanus4 ,in many countries1 so general and so extensive is the distribution of the tetanus-bacillus that trismus neonatorum 7tetanus of newly-born infants7 is a principal cause of the excessive infant mortality4 ,next1 because the tetanus-bacillus has its natural abode in the superficial layers of the soil3 here it is associated with a vast number of other organisms1 so that its identification and isolation were a work of immeasurable complexity4 ,what mixed company it keeps1 is shown by ,houston's estimate of the number of microbes per gramme in twenty-one samples of different soils4 ,this number ranged from #hcbf in virgin sand1 and #dge1bhb in virgin peat1 to #aae1jad1dib in the soil from the trench of a sewage-farm4 ,in all rich and well-manured soil the tetanus-bacillus may possibly be present2 but it was the work of years to dissociate it from the myriads of organisms outnumbering it4 ,next1 because it cannot be got to grow in cultures exposed to the air3 its proper place is below the surface of the soil1 away from the air2 it is strictly anarobic1 and the attempts to cultivate it by ordinary methods failed again and again4 ,it had to be cultivated below the surface of certain nutrient media1 or in a special atmosphere of nitrogen or hydrogen4 ,these and other difficulties for many years delayed the final proof of the true pathology of tetanus4 ,the success of the work was mainly due to ,nicolaier4 ,he started from the well-known fact that tetanus mostly comes of wounds or scratches contaminated with particles of earth--such mischances as the grinding of dirt or gravel into the skin1 or the tearing of it by a splinter of wood or a rusty nail2 as ,dr4 ,poore says1 in his ,milroy ,lectures 7#ahii71 ,every child who falls on the ground and gets an abrasion of the skin1 all tillers of the soil who get accidental wounds in the course of duty1 and every horse which 'breaks its knees' by falling in the ,london streets1 runs potentially a risk of inoculation with tetanus4 ,nicolaier therefore studied the various microbes of the soil1 and made inoculations of garden-mould under the skin of rabbits4 ,he was able1 by these inoculations1 to produce tetanus in them2 and the discharge from the points of inoculation1 put under the skin of other rabbits1 produced the disease again4 ,he also identified the bacillus1 and cultivated it2 but in these cultures it was mixed with other organisms1 and he failed to isolate it from them4 ,carle and ,rattone1 and ,rosenbach1 were able to produce tetanus in animals by inoculating them with discharge from the wounds of patients attacked by the disease4 ,finally1 ,kitasato1 in #ahhi1 found a way of obtaining pure cultures of the bacillus4 ,beginning with impure cultures such as ,nicolaier had made1 he kept these at a temperature of #cf ,c4 till the bacillus had spored2 then1 by repeated exposures of the cultures to a temperature of #hj ,c4 for three-quarters of an hour at a time1 he killed-off all organisms except the spores of the tetanus-bacillus2 then he kept these in an atmosphere of hydrogen1 at a temperature of #bj ,c41 and thus got pure cultures4 ,brieger1 ,frnkel1 ,cohen1 ,sidney ,martin1 ,kanthack1 and others1 have studied the chemical products of the disease1 have obtained them from cultures and from infected tissues1 and have been able with these toxins to produce the disease in animals4 ,as with the other infective diseases1 so with tetanus1 there have been two main lines of researches2 the one1 toward a fuller knowledge of the chemical changes in the blood and in the central nervous system2 the other1 toward a fuller knowledge of the nature and ways of the bacillus1 and its method of invasion4 ,before any study of immunity or immunisation1 or of neutralisation of the toxins in man by an antitoxin1 came the study of the toxins and of the bacillus4 ,it was proved1 by an immense quantity of hard work1 that the bacillus does not tend to invade the blood1 or to pass beyond the lymphatic glands in the immediate neighbourhood of the site of inoculation2 that it stays in and about the wound1 and there multiplies1 and from this site pours into the blood the chemical products which cause the disease2 and that these chemical substances have a selective action on certain nerve-cells in the brain and the spinal cord4 ,this is the bare outline of the facts2 and no account can be given here of the intricate problems of bacteriology and animal chemistry that have been answered1 or are still waiting an answer4 ,at least1 it is evident that the whole pathology of tetanus was found1 proved1 and interpreted by the help of experiments on animals2 and that these alone did away with the old false doctrine that the disease was due to rapid extension of inflammation up a nerve to the brain4 ,in #ahid came the use of an antitoxin in cases of the disease1 and1 in #ahie1 #db cases were reported1 with #bg recoveries4 ,it cannot be said that any one of the diverse preparations of tetanus-antitoxin1 up to this present time1 has triumphed over the disease4 ,tetanus is of all diseases the hardest to reckon with3 the first sign of it is the last stage of it2 there is no warning1 nothing1 it may be1 but a healed scratch1 till the central nervous system is affected with sudden and rapidly advancing degeneration of certain cells4 ,these and other difficulties have stood in the way of an antitoxin treatment2 and there is no less difficulty in estimating the efficacy of that treatment4 ,the recovery1 under antitoxin1 of a chronic case cannot always or altogether be attributed to the treatment2 and in a very acute case1 antitoxin1 like everything else1 has but small chance of success4 ,various reports on the antitoxin treatment1 published during #ahig-ahii1 give the following figures3-- #bf cases1 with #ab recoveries4 #ih #eg #cf #be #bb #aa #ea #cf #aj #g ,probably the paper by ,dr4 ,lambert of ,new ,york1 in the ,medical ,news1 ,july #aijj1 gives fairly the general opinion of the treatment1 so far as the subcutaneous administration of antitoxin is concerned3-- ,the following cases of tetanus1 treated with antitoxin1 comprise published and unpublished cases4 ,we have a total of #bgi cases1 with a mortality of #dd4jh per cent43 but of these we must rule out #ag cases--#d deaths from intercurrent diseases1 #h deaths in cases in which the antitoxin was given but a few hours before death1 and #e recoveries in which antitoxin was not given until after the twelfth day 7as they probably would have recovered without it74 ,we have left #bfb cases1 with #aea recoveries1 and #aaa deaths1 a mortality of #db4cf per cent4 ,dividing the cases into acute and chronic1 we have #abd acute cases1 with #ce recoveries and #hi deaths1 a mortality of #ga4gg per cent41 and #ach chronic cases1 with #aaf recoveries and #bb deaths1 a mortality of #ae4id per cent4 ,in interpreting critically these statistics1 we see that in acute cases the mortality is but slightly reduced1 being but #gb per cent4 instead of #hh per cent4 ,but1 in the less acute cases1 there is a decided improvement1 from #dj per cent4 to #af per cent4 ,taking the statistics as a whole1 there is a distinct improvement in the mortality of tetanus since the introduction of antitoxin4 ,it would be foreign to the present purpose to pursue this matter further3 for the other treatments1 used by ,baccelli and by ,krokiewicz1 and the sub-dural use of antitoxin1 are also founded on experiments on animals2 and the same will be true of any better method that shall be developed out of them4 ,the preventive use of the tetanus-antitoxin1 for the immunisation of human beings or of animals1 has given excellent results4 ,horses are very apt to be infected by tetanus2 and the antitoxin has been used in veterinary practice1 both for prevention and for cure4 ,the curative results are not1 at present1 very good4 ,but1 as regards protection against the disease1 there is evidence that horses can be immunised against tetanus by the antitoxin with almost mechanical accuracy4 ,in some parts of the world1 the loss of horses by tetanus is so common that their immunity is a very important matter2 and that the antitoxin does confer immunity on them is shown by statistics from ,france and from the ,united ,states3-- #a4 ,france4--,the results of ,nocard's method of preventive inoculations in veterinary practice are most striking4 ,among #fc veterinarians1 there have been inoculated #bgcg animals with preventive doses of antitoxin1 and not a single case of tetanus developed2 while during the same period1 in the same neighbourhoods1 #bei cases of tetanus developed in non-inoculated animals4 7,med4 ,news1 #gth ,july #aijj47 #b4 ,united ,states4--,joseph ,mac,farland and ,e4 ,m4 ,ranck1 in addition to a synopsis of the method of manufacture of tetanus-antitoxin1 give some facts of interest and importance in regard to its use for prophylaxis and treatment4 ,the studies were made upon several hundred horses used for the production of various immunised serums in one of the large laboratories of the ,united ,states4 ,the horses1 because of the constant manipulations1 frequently became infected with tetanus1 and in #ahig and #ahih1 when scrupulous cleanliness and disinfection were the only precautions employed to prevent the disease1 the death-rate varied from #h to #aj per cent4 ,during #ahii nearly two hundred horses were subjected to systematic immunisation with tetanus-antitoxin2 and1 in spite of otherwise similar conditions1 the death-rate descended to #a per cent4 7,medical ,annual1 #aija47 ,the preventive use of the antitoxin has1 of course1 a very limited range outside veterinary surgery4 ,tetanus1 thanks to the use of antiseptic or aseptic methods1 not only in hospital surgery but also in amateur and domestic surgery1 has become a very rare disease1 except in tropical countries4 ,it is no longer a hospital disease2 and1 even in war1 it no longer has anything like the frequency that it had1 for instance1 in the ,war of the ,rebellion4 ,a student may now go all his time at a large hospital without seeing more than a very few cases4 ,but1 now and again1 attention is called to some wholly unsuspected risk of the disease4 ,for example1 certain cases of tetanus occurred in ,dundee among workers at the jute-mills there3-- ,the last victim was a female worker in the jute-mill1 who1 six days after a crushed and lacerated wound of the foot1 developed tetanus and died within twenty-four hours4 ,some of the dust1 taken from under the machine in which the foot was crushed1 was found to contain an unusually large number of tetanus-bacilli4 ,the source of the jute used is ,india4 7,medical ,news1 ,august #aijj47 ,again1 at the ,gebaer ,anstalt at ,prague1 in #ahii1 an outbreak of tetanus occurred1 with several deaths2 but it was stopped when a preventive dose of the antitoxin was given to the new patients on admission4 ,again1 an amazing number of deaths from tetanus1 in the ,united ,states1 are due to wounds of the hands with toy-pistols4 ,it is said that after the ,fourth of ,july festivities in #ahii1 no less than #hc cases of tetanus were reported1 #bf of them in and around ,new ,york4 ,almost all of them were due to gunshot wounds of the hand with toy-pistols3 the unclean wad of the cartridge1 made of refuse paper picked up in the streets1 penetrates deep into the tissues of the hand1 taking the germs of the disease with it1 out of the reach of surgical disinfection4 ,these cases of tetanus in the ,united ,states from toy-pistol wounds are so frequent1 that immunisation has been recommended for them4 ,the ,medical ,news1 #ast ,june #aija1 has the following note3--,h4 ,g4 ,wells states that tetanus is endemic in ,chicago1 the specific organism being present in the dirt of the streets4 ,every ,fourth of ,july an epidemic occurs1 because these bacilli are carried deeply into wounds before wads from blank cartridges4444 ,the writer thinks that such cases should receive a prophylactic dose1 say1 #e c4c4 of tetanus-antitoxin1 as soon as possible after the wound is first seen4 ,it seems certain that if antitoxin prophylaxis were adopted1 there would be no further ,fourth of ,july epidemics1 and this end would justify the means4 ,again1 a man might receive a lacerated wound under conditions especially favourable to infection3 he might tear his hand in a stable where horses had died of tetanus1 or he might cut his finger while he was working at the disease in a pathological laboratory1 or he might receive a poisoned arrow-wound out in ,africa4 ,in any such emergency1 he could safeguard his life with a protective dose of antitoxin4 ,it remains to be added1 that the modern study of tetanus has brought into more general use the old rule that the wounded tissues in a severe case of tetanus should be at once excised4 ,before ,nicolaier's work1 while the theory still survived that the disease was due to ascending inflammation of a nerve1 this rule was neither enforced nor explained4 ,the results published during the last few years 7,medical ,annual1 #aije-aijf7 seem to show that the antitoxin has neither gained nor lost ground as a remedy4 ,it is1 of course1 used in conjunction with all other remedies4 ,perhaps1 in a few years more1 something better will be discovered4 ,and that discovery1 when it comes1 will be1 as it were1 ,nicolaier's gift4 ,the whole study of the disease goes back straight to the rabbits inoculated in #ahhj-ahhd3 neither is it possible that the disease should be further studied1 without the help of bacteriology4 ,,vi ,,rabies ,pasteur's study of rabies began in #ahhj2 and the date of the first case treated--,joseph ,meister1 a shepherd-boy of ,alsace--is ,july #ahhe4 ,the first part of the work was spent in a prolonged search for the specific microbe of rabies4 ,it was not found3 its existence is a matter of inference1 but not of observation4#bd ,in his earlier inoculations1 ,pasteur made use of the saliva of rabid animals2 and ,m4 ,vallry-,radot tells the story1 how ,pasteur took him on one of his expeditions3-- ,the rabid beast was in this case a huge bull-dog1 foaming at the mouth and howling in his cage4 ,all attempts to induce the animal to bite1 and so infect one of the rabbits1 failed4 ',but we must1' said ,pasteur1 'inoculate the rabbits with the saliva4' ,accordingly a noose was made and thrown1 the dog secured and dragged to the edge of the cage1 and his jaws tied together4 ,choking with rage1 the eyes bloodshot1 and the body convulsed by a violent spasm1 the animal was stretched on a table1 and kept motionless1 while ,pasteur1 leaning over his foaming head1 sucked up into a narrow glass tube some drops of the saliva4 #bd ,this sentence was written before the publication of ,professor ,negri's observations 7see ,medical ,annual1 #aijf1 p4 #dah74 ,but these inoculations of saliva sometimes failed to produce the disease2 and1 when they succeeded1 the incubation-period was wholly uncertain3 it might be some months before the disease appeared4 ,thus ,pasteur was led to use1 instead of the saliva1 an emulsion of the brain or spinal cord2 because1 as ,dr4 ,dubou had suggested1 the central nervous system is the chief seat1 the locus electionis1 of the virus of rabies4 ,but these inoculations also were not always successful1 nor did they give a definite incubation-period4 ,therefore he followed with rabies the method that he had followed with anthrax4 ,as he had cultivated the virus of anthrax1 by putting it where its development could be watched and controlled1 so he must put the virus of rabies in the place of its choice4 ,it has a selective action on the cells of the central nervous system1 a sort of affinity with them2 they are1 as it were1 the natural home of rabies1 the proper nutrient medium for the virus3 therefore the virus must be inoculated not under the skin1 but under the skull4 ,these sub-dural inoculations were the turning-point of ,pasteur's discovery4 ,the first inoculation was made by ,m4 ,roux3-- ,next day1 when ,i informed ,pasteur that the intracranial inoculation offered no difficulty1 he was moved with pity for the dog4 ',poor beast1 his brain is doubtless injured3 he must be paralysed4' ,without reply ,i went down to the basement to fetch it1 and let it come into the laboratory4 ,pasteur did not like dogs1 but when he saw this one1 full of life1 inquisitively rummaging about in all directions1 he exhibited the greatest delight1 and lavished most charming words upon it4 ,henceforth all uncertainty was at an end1 and the way was clear ahead3 ,pasteur had now to deal with a virus that had a definite period of incubation1 and a suitable medium for development4 ,the central nervous system was to the virus of rabies what the test-tube was to the virus of fowl-cholera or anthrax4 ,as he had controlled these diseases1 had turned them this way and that1 attenuated and intensified them1 so he could control rabies4 ,by transmitting it through a series of rabbits1 by sub-dural inoculation of each rabbit with a minute quantity of nerve-tissue from the rabbit that had died before it1 he was able to intensify the virus1 to shorten its period of incubation1 to fix it at six days4 ,thus he obtained a virus of exact strength1 a definite standard of virulence1 virus fixe3 the next rabbit inoculated would have the disease in six days1 neither more nor less4 ,as he was able to intensify the virus by transmission1 so he was able to attenuate it by gradual drying of the tissues that contained it4 ,the spinal cord1 taken from a rabbit that has died of rabies1 slowly loses virulence by simple drying4 ,a cord dried for four days is less virulent than one that has been dried for three1 and more virulent than one dried for five4 ,a cord dried for a fortnight has lost all virulence3 even a large dose of it will not produce the disease4 ,by this method of drying1 ,pasteur was enabled to obtain the virus in all degrees of activity3 he could always keep going one or more series of cords1 of known and exactly graduated strengths1 according to the length of time they had been dried--ranging from absolute non-virulence through every shade of virulence4 ,and1 as with fowl-cholera and anthrax1 so with rabies2 a virus which has been attenuated till it has been rendered innocuous1 can yet confer immunity against its more virulent forms3 just as vaccination can protect against smallpox4 ,a man1 bitten by a rabid animal1 has at least some weeks of respite before the disease can break out2 and1 during that time of respite1 he can be immunised against the disease1 while it is still dormant3 he begins with a dose of virus attenuated past all power of doing harm1 and advances day by day to more active doses1 guarded each day by the dose of the day before1 till he has manufactured within himself enough antitoxin to make him proof against any outbreak of the disease4 ,the cords used for treatment are removed from the bodies of the rabbits1 by an aseptic method1 and are cut into lengths and hung in glass jars1 with some chloride of calcium in them1 for drying4 ,the jars are dated1 and then kept in glass cases in a dark room at a constant temperature4 ,to make sure that the cords are aseptic1 a small portion of each cord is sown on nutrient jelly in a test-tube1 and watched1 to see that no bacteria occur in the tube4 ,for each injection1 a certain small quantity of cord is rubbed-up in sterilised fluid2 and these subcutaneous injections give no pain or malaise worth considering4 ,of course1 the treatment is adjusted to the gravity of the case4 ,a bite through naked skin is more grave than a bite through clothing2 and bites on the head or face1 and wolf-bites1 are worst of all4 ,the number and character of the scars are also taken into account4 ,an excellent description of the treatment1 by a patient1 was published in the ,birmingham ,medical ,review of ,january #ahih4 ,it gives the following tables of treatment3-- #a4 ,ordinary ,treatment4 ,day of ,days of ,drying ,treatment4 of ,cord4 #a #ad and #ac #b #ab and #aa #c #aj and #i #d #h and #g #e #f #f #f #g #e #h #d #i 7#a_/b dose7 #c #aj 7full dose7 #e #aa #e #ab #d #ac #d #ad 7#a_/b dose7 #c #ae 7full dose7 #c #b4 ,cases of ,moderate ,gravity4 ,same treatment1 up to #acth day4 ,day of ,days of ,drying ,treatment4 of ,cord4 #ad #c #ae #e #af #d #ag 7#a_/b dose7 #c #ah 7full dose7 #c #c4 ,grave ,cases4 ,same treatment1 up to #ajth day4 ,day of ,days of ,drying ,treatment4 of ,cord4 #aa #d #ab #c #ac #e #ad #e #ae #d #af #d #ag 7#a_/b dose7 #c #ah 7full dose7 #c #ai #e #bj #c #ba #d #bb #c #d4 ,very ,grave ,cases4 ,same treatment as #c1 and in addition4 ,day of ,days of ,drying ,treatment4 of ,cord4 #bc #e #bd #d #be 7#a_/b dose7 #c #bf 7full dose7 #c ,furious criticism1 unbelief1 and flagrant misstatement of facts began at once1 and lasted more than two years4 ,of ,pasteur's opponents1 the chief was ,m4 ,peter1 who besought the ,acadmie des ,sciences1 about once a week1 that they should close ,pasteur's laboratory1 because he was not preventing hydrophobia but producing it4 ,the value of ,m4 ,peter's judgment may be estimated by what he had said1 a few years earlier1 about bacteriology in general--,i do not much believe in that invasion of parasites which threatens us like an eleventh plague of ,egypt4 ,after so many laborious researches1 nothing will be changed in medicine1 there will only be a few more microbes4 ,m4 ,pasteur's excuse is that he is a chemist1 who has tried1 out of a wish to be useful1 to reform medicine1 to which he is a complete stranger4 ,but it does not matter what was said twenty years ago4 ,in ,england1 the ,report of the #ahhf ,committee1 and the ,mansion ,house meeting in ,july #ahhi1 mark the decline and fall of all intelligent opposition to the work4 ,among so many thousand cases1 during so many years1 it would be a miracle indeed if not a single case had failed or gone amiss2 but we are concerned here with the thousands4 ,take1 to begin with1 four reports from ,athens1 ,palermo1 ,rio1 and ,paris4 ,it is to be noted that the patients1 alike at ,paris and at other ,institutes1 are divided into three classes3-- ,a4 ,bitten by animals proved to have been rabid by the development of rabies in other animals inoculated from them4 ,b4 ,bitten by animals proved to have been rabid by dissection of their bodies by veterinary surgeons4 ,c4 ,bitten by animals suspected to have been rabid4 ,it is to be noted also1 as a fact proved beyond doubt1 that the full benefit of the treatment is not obtained at once2 the highest degree of immunity is reached about a fortnight after the discontinuance of the treatment4 ,those few cases1 therefore1 where hydrophobia has occurred1 not only in spite of treatment1 but within a fortnight of the last day of treatment1 are counted as cases where the treatment came too late4 ,finally1 what was the risk from the bite of a rabid animal1 in the days before #ahhe8 ,it is a matter of guess-work4 ,one writer1 and one only1 guessed it at #e per cent42 another guessed it at #ee1 and a third came to the safe conclusion that it was somewhere between these limits4 ,leblanc1 who is probably the best guide1 put it at #af2 and ,pasteur himself put it between #ae and #bj4 ,but suppose it were only #aj2 that1 before ,pasteur1 out of every #ajj men bitten by rabid animals1 #ij would escape and only #aj would die of hydrophobia2 then take this fact1 that in one year1 at one ,institute alone1 there were #adb patients in class ,a1 bitten by animals that were proved1 by the unanswerable test of inoculation1 to have been rabid2 and #a death4 ,and every year the same thing2 and in all the twelve years together1 #bhgb such cases 7,a7 and #bj deaths--a mortality not of #aj per cent41 but of less than #a per cent4 #a4 ,athens ,the ,annales de l',institut ,pasteur1 ,june #ahih1 contain ,dr4 ,pampoukis' report of three years' work at the ,hellenic ,institute1 from ,august #ahid to ,december #ahig4 ,during this period #gig cases were treated--#eij male and #bjg female4 ,the animals that bit them were--dogs1 #gcb2 cats1 #cd2 wolf1 #a2 other animals1 #ac2 and the #ag other patients had been exposed to infection from the saliva of hydrophobic patients4 ,of the #gig cases1 #bde were of class ,a1 #aab ,b1 and #ddj ,c4 ,among the #gig persons treated1 there are #b deaths1 one in class ,b and the other in class ,c4 ,thus the mortality has been #j4be per cent4 ,besides these #b who died of rabies there are #e more1 in whom the first signs of rabies showed themselves in less than fifteen days after the last inoculation4 ,finally1 beside these #gig cases1 there is #a other case1 bitten by a wolf1 in which the treatment failed4 ,if we reckon this last case in the statistics of mortality1 we have #c deaths in #gih cases #j4cg per cent4 ,beside these #gih cases treated at the ,institute1 there have been others that have not undergone the antirabic treatment1 having trusted the assurances of those who are called in ,greece empirics4 ,among these non-treated cases there are #dj who have died of rabies4 #b4 ,palermo ,the ,annales for ,april #ahif give the report by ,dr4 de ,blasi and ,dr4 ,russo-,travali of the work of the ,municipal ,institute at ,palermo during #h-a_/b years1 from ,march #ahhg to ,december #ahie4 ,the number of cases was #bbba2 in #abdj 7class ,a71 the animals were proved to have been rabid by the result of inoculations2 in #iha1 there was reason to suspect rabies4 ,setting aside #e patients who died during the course of the treatment1 and #e others who died less than fifteen days after the end of the treatment1 we have had to deplore only #i failures #j4d per cent4 ,even if we count against ourselves the #aj other cases1 the mortality is still only #j4he4 #c4 ,rio de ,janeiro ,the ,annales for ,august #ahih give ,dr4 ,ferreira's report of ten years' work 7,february #ahhh to ,april #ahih7 at the ,pasteur ,institute at ,rio4 ,the number of cases treated was #bfdg1 of whom #aihg were male and #ffj female4 ,beside these #bfdg there were #abcd who were not treated1 because it was ascertained that they were in no danger of rabies2 #c who were brought to the ,institute1 already suffering from the disease2 and #ei who refused treatment4 ,of the #bfdg persons treated1 #aj had pricked their hands at work in the laboratory1 #c had exposed chance scratches on their hands to the saliva of rabid animals1 and #a had been bitten by a rabid patient4 ,of the rest1 #ahhf had been bitten on the bare skin1 and #gdg through clothing4 ,in #bcf cases the rabies of the animal had been proved by inoculation4 ,in #aagc it had been recognised by the signs of the disease4 ,in #abch there was good reason to suspect that the animal had been rabid4 ,of the #bfdg patients1 in #cj cases the treatment was stopped1 because the animals were at last traced1 after treatment was begun1 and were found not to be rabid4 ,in #fe cases the patients1 after treatment was begun1 refused to go on with it1 and #c of them died of rabies4 ,in #f cases rabies developed during treatment2 #e of them had been very badly bitten about the head1 and #a did not come for treatment till the twenty-first day after the bite1 and was attacked by rabies two days later4 ,and #e cases died of other maladies that had nothing to do with rabies4 ,setting aside these #ajf cases1 there remain #beda cases1 with #bj deaths #j4gh per cent4 ,but1 of these #bj deaths1 #i occurred within fifteen days of the end of treatment1 before protection was fully established4 ,if these #i deaths be excluded1 the figures stand at #becb cases1 with #aa deaths #j4dc per cent4 #d4 ,paris ,dr4 ,pottevin's report on the work of the ,pasteur ,institute 7,paris7 during #ahig 7,annales1 ,april #ahih7 must be given word for word1 without abbreviation4 ,i ,during #ahig1 #aeba patients received the anti-treatment at the ,pasteur ,institute3 #h died of rabies4 ,the notes of their cases will be found at the end of this paper4 ,if we exclude #b of these #h cases--the cases of ,heniquet and ,morin1 where death occurred before it was possible for the vaccinations to produce their effect--the results of the vaccinations in #ahig are ,patients treated #aeai ,deaths #f ,mortality per cent4 #j4ci ,in the following table these figures are compared with those of preceding years3-- ------------------------------------- ,year4 ,patients ,deaths4 ,mortality treated4 per cent4 ------------------------------------- #ahhf #bfga #be #j4id #ahhg #aggj #ad #j4gi #ahhh #afbb #i #j4ee #ahhi #ahcj #g #j4ch #ahij #aedj #e #j4cb #ahia #aeei #d #j4be #ahib #agij #d #j4bb #ahic #afdh #f #j4cf #ahid #achg #g #j4ej #ahie #aebj #e #j4cc #ahif #acjh #d #j4cj #ahig #aeba #f #j4ci ------------------------------------- ,,ii ,patients treated at the ,pasteur ,institute are divided into three classes1 as follows3-- ,a4 ,the rabies of the animal was proved by experiment1 by the development of rabies in animals inoculated with its bulb 7the upper end of the spinal cord74#be #be ,it is satisfactory to know that rabbits affected with rabies do not suffer in the same way as dogs and some other animals1 but become subject to a painless kind of paralysis4 ,b4 ,the rabies of the animal was proved by veterinary examination 7dissection of its body74 ,c4 ,the animal was suspected of rabies4 ,we give here the patients treated in #ahig1 under these three classes3-- ---------------------------------------- ----------------------- ,,bites ,,of ,,the ,,bites ,,on ,,the ,,bites ,,of ,,the ,,total4 ,,head4 ,,hands4 ,,limbs4 ---------------------------------------- -------------- ,p ,m p ,p ,m p ,p ,m p ,p ,m p a ,d o e a ,d o e a ,d o e a ,d o e t e r r t e r r t e r r t e r r i a t i a t i a t i a t e t a c e t a c e t a c e t a c n h l e n h l e n h l e n h l e t s i n t s i n t s i n t s i n s 4 t t s 4 t t s 4 t t s 4 t t 4 y 4 4 y 4 4 y 4 4 y 4 ---------------------------------------- -------------- ,a #ae #j #j #ha #j #j #df #a #b4a #adb #a #j4g ,b #ajf #j #j #eci #d #j4gd #bgc #a #j4d #iah #e #j4fe ,c #cj #j #j #bdd #j #j #ahg #j #j #dfa #j #j ---------------------------------------- -------------- #aea #j #j #hfd #d #j4df #ejf #b #j4d #aeba #f #j4ci ---------------------------------------- -------------- ,the following tables1 giving the results obtained since the vaccinations were first used1 show that the gravity of the bites varies with their position on the body1 and that the mortality is always below #a per cent4 among patients bitten by dogs undoubtedly rabid3-- ---------------------------------------- ----- ,patients4,deaths4,mortality4 ---------------------------------------- ----- ,bites of the ,head #a1gei #ba #a4a ,bites of the ,hands #aa1aah #ec #j4dg ,bites of the ,limbs #g1bhi #bb #j4cj ---------------------------------------- ----- #bj1aff #if #j4df ---------------------------------------- ----- ----------------------------- ,patients4,deaths4,mortality4 ----------------------------- ,a #b1hgb #bj #j4fi ,b #ab1edg #fa #j4dh ,c #d1gdg #ae #j4ca ----------------------------- #bj1aff #if #j4df ----------------------------- ,,iii ,in regard to their nationality1 the #aeba patients treated at the ,pasteur ,institute in #ahig were as follows3-- ,germany #h ,england #hc ,belgium #ad ,egypt #b ,united ,states #a ,greece #a ,india #cc ,switzerland #cc ,that is1 #age foreigners and #acdf ,french4 ,,iv ,notes of the eight cases where the treatment failed3-- #a4 ,camille ,bourg1 #bf4 ,bitten #aath ,april2 treated at the ,pasteur ,institute1 #acth to #cjth ,april2 died of rabies at the ,lariboisire ,hospital1 #bfth ,may4 ,six penetrating bites on the ball of the left thumb4 ,the dog was examined by ,m4 ,grenot1 a veterinary surgeon at ,paris1 and the dissection gave evidence of rabies4 ,another person bitten and treated at the same time as ,bourg is now in good health4 #b4 ,louis ,fiquet1 #bc4 ,bitten #bbnd ,april2 treated at the ,pasteur ,institute1 #bcrd ,april to #ajth ,may2 died of rabies at the ,necker ,hospital1 #dth ,june4 ,five bites1 two of them deep1 round the right thumb4 ,they had been cauterised five hours after infliction4 ,the dog was examined by ,m4 ,causs1 a veterinary surgeon at ,boulogne1 and the dissection gave evidence of rabies4 ,another person bitten at the same time as ,fiquet is now in good health4 #c4 ,annette ,beaufort1 #ai4 ,licked on the hands1 which were chapped1 on #aeth ,april4 ,the dog was killed next day1 examined1 and declared to have been rabid by ,m4 ,lachmann1 a veterinary surgeon at ,saint-tienne4 ,treated at the ,pasteur ,institute1 #bjth ,april to #gth ,may4 ,died of rabies #adth ,october4 ,two other persons bitten by the same dog and treated at the ,pasteur ,institute are now in good health4 #d4 ,julien ,heniquet1 #ec4 ,bitten #aath ,march1 by a dog that ,m4 ,jenvresse1 veterinary surgeon at ,beaumont-sur-,oise1 declared after dissection to have been rabid4 ,one bite had torn the lower lip1 the wound had been sutured2 three other wounds on the nose4 ,the wounds had not been cauterised4 ,treated at the ,pasteur ,institute1 #ahth ,may to #eth ,june4 ,first symptoms of rabies showed themselves #dth ,june1 before the treatment was finished2 died #gth ,june4 ,as the disease had its onset during the course of the inoculations1 this case should be excluded from the number of those who died of rabies after treatment4 #e4 ,germain ,segond1 #g4 ,penetrating bite on the bare right fore-arm1 #bcrd ,may4 ,cauterised an hour later with a red-hot iron4 ,treated #bfth ,may to #ith ,june2 died of rabies #bbnd ,july4 ,the dog's bulb had been sent to the ,pasteur ,institute4 ,a guinea-pig inoculated in the eye #bfth ,may was seized with rabies #ajth ,september4 #f4 ,suzanne ,richard1 #h4 ,bitten #abth ,june on the left leg by a dog1 found on dissection to have been rabid by ,m4 ,touret1 veterinary surgeon at ,sannois4 ,the bite1 penetrating #c cm4 long1 had been sutured2 it had been made through a cotton stocking1 and had been cauterised in half-an-hour4 ,treated #acth to #cjth ,june2 died of rabies #bnd ,august4 7,notes from ,m4 le ,dr4 ,margny1 at ,sannois47 #g4 ,joseph ,vaudale1 #cc4 ,bitten on the left hand1 #hth ,august4 ,six penetrating bites on the back of the hand2 had not been cauterised4 ,the dog was declared rabid by ,m4 ,verraert1 veterinary surgeon at ,ostend4 ,treated at the ,pasteur ,institute1 #aath to #bhth ,august2 died of rabies #bgth ,september4 #h4 ,paul ,morin1 #ch4 ,bitten #bdth ,august on the left cheek1 a single bite1 #b cm4 long2 no cauterisation4 ,the dog was sent to the ,alfort ,school1 #beth ,august1 and found to be rabid4 ,treated at the ,pasteur ,institute1 #bfth ,august to #aeth ,september4 ,died of rabies some days after the end of treatment 7three weeks after the bite1 says a note sent to us74 ,the interval between the end of the treatment and the onset of the disease being less than fourteen days1 ,morin must not be counted in the number of patients inoculated under conditions which permit successful inoculation4 99 99 99 99 99 ,we hardly need follow the work of the remaining years4 ,the figures are as follows3-- ------------------------------------- ,year4 ,patients ,deaths4 ,mortality treated4 per cent4 ------------------------------------- #ahih #adfe #c #j4b #ahii #afad #d #j4be #aijj #adbj #d #j4bh #aija #acah #e #j4ch #aijb #aaje #b #j4ah #aijc #fbh #b #j4cb #aijd #gee #c #j4ci ------------------------------------- ,the falling off in the number of patients at the ,paris ,institute is related to the establishment of similar ,institutes at ,lyon1 ,marseilles1 ,bordeaux1 ,lille1 and ,montpellier4 ,but is it not possible that a patient1 after treatment at the ,paris ,institute1 should die at home of rabies1 and his death not be notified to the ,institute8 ,the answer is1 that the ,institute is very careful1 so far as possible1 to keep in touch with its old patients4 ,for instance1 in #aijc1 it recorded the case of a carpenter in a ,welsh village1 who had died of rabies nearly two years after treatment4 ,and1 of course1 an ,institute patient1 wherever he was1 would be of interest to his neighbours3 and a death from rabies would excite attention1 and would hardly fail to be reported4 ,it is not impossible that some sort of intensive modification of ,pasteur's treatment may be found1 not for the prevention1 but for the cure of hydrophobia2 and two successful cases of this kind have been reported in the ,annales of the ,paris ,institute4 ,apart from this faint hope1 the cure of hydrophobia is where it was in the days of the ,tonquin medicine and the ,tanjore pills4 ,,vii ,,cholera ,the study of cholera was the hardest of all the hard labours of bacteriology2 it took years of work in all parts of the world1 and the difficulty and disappointments over it are past all telling4 ,koch's discovery of the comma-bacillus 7#ahhc7 raised a thousand questions that were solved only by infinite patience1 international unity for science1 and incessant research2 and the ,hamburg epidemic 7#ahib7 marks the time when the comma-bacillus was at last recognised as the cause of cholera4 ,a mere list of the men who did the work would fill page after page2 it was bacteriology in excelsis1 often dangerous1#bf and always laborious4 #bf ,in order to prove that this vibrio is the cause of ,asiatic cholera1 several tests upon themselves have been voluntarily made by investigators in laboratories4 ,these were carried out in ,munich and in ,paris4 ,the results to the experimenters were sufficiently severe to indicate positively the pathogenic character of the spirillum1 and its capacity to produce cholera-like infections4 ,such experimentation is1 of course1 to be deprecated2 indeed1 the occurrence of accidental laboratory infections1 one of which ended fatally1 furnished the necessary final proof of the specificity of the cholera vibrio1 and rendered unnecessary any exposure to the risks belonging to voluntary inoculation4 7,dr4 ,flexner1 ,stedman's ,twentieth ,century ,practice1 vol4 xix41 #aijj47 ,there is the same heroic note in the story of the preventive treatment of cholera by ,haffkine's method2 one of the men in whom ,pasteur seems to live again4 ,he began in #ahhi1 under ,pasteur's guidance1 to study the immunisation of animals against the cholera-bacillus4 ,other men1 of course1 were working on the same lines--,pfeiffer1 ,brieger1 ,metchnikoff1 ,fischer1 ,gamalea1 ,klein1 ,wassermann1 and many more--and by #ahib the immunisation of animals was proved up to the hilt4 ,then came the advance from animals to men1 from laboratories to ,indian cities1 villages1 and cantonments2 and here the honour is ,haffkine's1 and his alone4 ,ferran's inoculations 7,spain1 #ahhe7 had failed4 ,haffkine1 having tested his method on himself and his friends1 went to ,india1 with a commendatory letter from the ,british ,government3-- ,researches on cholera1 with special reference to inoculation1 were undertaken and carried on in my laboratory1 in the ,pasteur ,institute in ,paris1 between #ahhi and #ahic4 ,the experiments resulted in the elaboration of the present method1 which when tried on animals was found to render them resistant against every form of cholera-poisoning otherwise fatal to them4 ,the physiological and pathological effect on man was then studied on some sixty persons1 mostly medical and scientific men interested in the solution of the problem4 ,the effect was found to be harmless to health4 ,the next step was to transfer the operations to the ,east4 7,haffkine's ,report to the ,government of ,india1 #ahie47 ,he reached ,calcutta in ,march #ahic1 and at the request of ,mr4 ,hankin#bg was invited to ,agra2 here1 in ,april1 he vaccinated over #ijj persons1 including many ,english officers4 ,from ,agra to ,aligarh2 and from ,aligarh he was asked to more places than he could visit4 ,in #ahie his health failed1 and no wonder2 and he came back to ,europe for a short time3-- ,my actual work in ,india lasted twenty-nine months1 between the beginning of ,april #ahic and the end of ,july #ahie4 ,during this period the anti-cholera vaccination has been applied to #bid ,british officers1 #cbjf ,british soldiers1 #ffbi native soldiers1 #hfi civil ,europeans1 #abe ,eurasians1 and #ca1jef natives of ,india4 ,the inoculated people belonged to #ih localities in the ,north-,west ,provinces and ,oudh1 in the ,punjab1 in ,lower ,bengal and ,behar1 in the ,brahmaputra ,valley1 and in ,lower ,assam4 ,no official pressure has been brought on the population1 and only those have been vaccinated who could be induced to do so by free persuasion4 ,in every locality1 efforts were made to apply the operation on parts of large bodies of people living together under identical conditions1 in order to compare their resistance in outbreaks of cholera with that of non-inoculated people belonging to the same unit of population4 ,this object has been obtained in #fd ,british and native regiments1 in #i gaols1 in #de tea-estates1 in the fixed agricultural population of the villages parallel to ,hardwr pilgrim road1 in the bustees of ,calcutta1 in a certain number of boarding-schools1 where the parents agreed to the inoculation of their children1 in orphanages1 etc4 ,the vast majority of inoculated people lived thus under direct observation of the sanitary and medical authorities of ,india4 7,haffkine1 ,lecture in ,london4 ,british ,medical ,journal1 #bast ,dec4 #ahie47 #bg ,mr4 ,hankin1 whose name is had in remembrance by ,cambridge men1 is ,chemical ,examiner and ,bacteriologist to the ,north-,west ,provinces and ,oudh1 and to the ,central ,provinces4 ,altogether1 upwards of #gj1jjj injections on #db1agi people--without having to record a single instance of mishap or accident of any description produced by our vaccines4 ,consider the colossal difficulties of this new treatment3 the frequent running short of the vaccine1 preventing a second injection2 the absolute necessity1 at first1 of using very small doses of a weak vaccine1 lest one disaster should occur2 the impossibility of avoiding1 now and again1 some loss of strength in the vaccine2 the impossibility of knowing how long the protection would last4 ,surely in all science there is nothing to beat this first voyage of adventure single-handed to fight the cholera in ,india4 ,later than ,haffkine's #ahie report1 we have ,dr4 ,simpson's #ahif report3 ,two ,years of ,anti-choleraic ,inoculations in ,calcutta4 ,w4 ,j4 ,simpson1 ,m4,d41 ,m4,r4,c4,p41 ,d4,p4,h41 ,health ,officer1 ,calcutta4 ,the date of this report is #hth ,july #ahif2 and it gives not only the ,calcutta results1 but all that are of any use for exact judgment3#bh-- ,the results of ,calcutta are fully confirmed by those obtained in other parts of ,india1 wherever it was possible to make all the necessary observations with precision1 and wherever the cases were sufficiently numerous to show the effect of the inoculation4 ,outside ,calcutta1 since the commencement of the inoculations in ,india in ,april #ahic1 opportunities for an exact comparison of the respective powers of resistance against cholera of inoculated and non-inoculated persons presented themselves2 7#a7 in ,lucknow1 in the ,east ,lancashire ,regiment2 7#b7 in ,gaya1 in the jail2 7#c7 in ,cachar1 among the tea-garden coolies2 7#d7 in ,margherita1 among coolies of the ,assam-,burmah ,railway ,survey2 7#e7 in ,durbhanga1 in the jail2 7#f7 in the coolie camp at ,bilaspur2 7#g7 in ,serampur1 among the general population4 #bh ,for a summary of this report1 see the ,lancet1 #hth ,august #ahif4 ,for more recent results1 see ,surgeon-,captain ,vaughan and ,assistant-,surgeon ,mukerji1 in the thirtieth annual report of the ,sanitary ,commissioner for ,bengal 7#ahig74 ,also the note published by ,surgeon-,captain ,nott1 in the ,indian ,medical ,gazette1 ,may #ahih4 ,here1 then1 in this #ahif report1 are all the results that give an answer to the question1 ,what will happen when cholera breaks out among a number of people living under the same conditions1 of whom some have received preventive treatment1 and the rest have been left to ,nature8 ,i4 ,calcutta 7#ahid-ahif7 ,the number of people inoculated during the period under review was #gfij2 of these1 #ehec are ,hindus1 #adgf ,mahomedans1 and #cfa other classes4444 ,considering that the system is a new one1 that the inoculations are purely voluntary1 and everything connected with them has to be explained before the confidence of the people can be obtained1 and considering how long new ideas are in taking root among the general population--and in this case it is not merely the acceptance of an idea1 but such faith in it as to consent to submit to an operation--the number is certainly satisfactory for a beginning4 ,the present problem can be compared with the introduction of vaccination against smallpox into ,calcutta4 ,it took #be years before the number of vaccinations reached an average of #bjjj2 whereas the inoculations against cholera have in two years nearly doubled that average4 ,this is a proof that1 in spite of the difficulties which every new movement naturally has to meet with1 there are large numbers of people anxious to avail themselves of the protective effect of the inoculations4 ,although all sorts and conditions of individuals1 weak and strong1 sickly and healthy1 young and old1 well nourished and badly nourished1 and often persons suffering from chronic diseases1 have been inoculated1 in every instance1 without exception1 the inoculations have proved perfectly harmless4 ,the investigations on the effect of the inoculation are made exclusively in those houses in which cholera has actually occurred1 the object being to ascertain and compare the incidence of cholera on the inoculated and not inoculated in those houses in which inoculations had been previously carried out4 ,for this purpose1 affected houses in which inoculations have not been performed1 and inoculated houses in which cholera has not appeared1 are excluded4 ,nature gave a demonstration in #gg houses4 ,in one house1 and one only1 all the household had been inoculated2 in #gf1 inoculated and non-inoculated were living together2 but of these #gf houses1 #f are excluded from the table of results1 because the inoculated in them were so few--less than one-tenth of the household--that their escape from cholera might be called chance4 ,the cholera came1 and left behind it this fact3-- #fed uninoculated individuals had #ga deaths #aj4hf per cent4 #djb inoculated in the same households had #ab deaths #b4ii per cent4 ,if we add the #f houses which ,dr4 ,simpson excludes1 we find that in #gg houses there were #hi deaths from cholera1 #gg being among the uninoculated and #ab among the inoculated4 ,moreover1 of these #ab deaths1 #e occurred during the first five days after inoculation--that is to say1 during the period in which the protective influence of the vaccine was still incomplete4 ,then came a period of more than a year1 during which the uninoculated had #db deaths1 and the inoculated had one death4 ,the remaining #f of the #ab deaths occurred more than a year after inoculation1 and #e of these #f had received only one inoculation of the weak vaccine that was used early in #ahid4 ,take a good instance that came at the very beginning of the work3-- ,a local epidemic took place around two tanks in ,kattal ,began bustee1 ward #ai1 occupied by about #bjj people4 ,in this bustee1 about the end of ,march1 #b fatal cases of cholera and #b cases of choleraic diarrhoea occurred4 ,the outbreak led to the inoculation of #aaf persons in the bustee out of the #bjj4 ,since then1 #i cases of cholera1 of which #g were fatal1 and #a case of choleraic diarrhoea have appeared in the bustee1 and it is a very extraordinary fact that all these #aj cases of cholera have occurred exclusively among the uninoculated portion of the inhabitants1 which1 as stated1 forms the minority in the bustee2 while none of the inoculated have been affected4 7,cholera in ,calcutta in #ahid4 ,w4 ,j4 ,simpson47 #b4 ,lucknow 7#ahic7 ,the story of the outbreak of cholera in the ,east ,lancashire ,regiment must be read carefully3-- ,rumour magnified the events connected with this outbreak1 and distorted the facts connected with the inoculations2 and as a result1 the current of public opinion1 which had previously been in favour of inoculation1 set in strongly in the opposite direction4 ,the advocates of anti-choleraic inoculations were abused in no particularly measured terms1 and the inoculations were held up to be the source of every possible evil and danger 444 of the most loathsome diseases1 and of every ill which man is heir to4 ,the distrust engendered by these misrepresentations and fulminations was1 however1 only of a temporary nature2 and when the exact circumstances came to be known and understood1 the confidence created by the ,calcutta experience began to be considerably restored4 ,inoculations were performed in ,may #ahic1 in the ,east ,lancashire1 ,royal ,irish1 #afth ,lancers1 #gth ,bengal ,infantry1 #gth ,bengal ,cavalry1 and general populations in the ,civil ,lines4 ,in #ahid1 cholera appeared among the native population of ,lucknow1 in the form of an epidemic distinguished by its extreme virulence1 patients succumbing in the course of a few hours4 ,it is stated that the epidemic was of a most malignant type4 ,in the latter part of ,july it entered the cantonments1 and attacked the ,east ,lancashire1 almost exclusively confining its ravages to that regiment4 ,in the ,east ,lancashire1 #ahe men were inoculated in ,may #ahic4 ,from the statistical returns obtained from the military authorities at ,lucknow1 it appears that at the time of the outbreak1 in ,july #ahid1 the strength of the men1 including those in hospital1 was #ggc2 and of these1 #acc had been inoculated1 as recorded in the inoculation register1 and #fdj had not been inoculated4 ,the following table shows the total number of attacks and deaths in not inoculated and inoculated3-- ---------------------------------------- ------ ,attacks4 ,deaths4 ---------------------------------------- ------ ,per cent4 ,per cent4 ,non-inoculated1 #fdj #abj #ah4ge #gi #ab4cd ,inoculated1 #acc #ah #ac4ec #ac #i4g ---------------------------------------- ------ ,the men were moved into camp2 but this movement seemed only to make things worse3 the epidemic in the camp appears to have been twice as severe as in the cantonment4#bi #bi ,the moving into camp1 notwithstanding this example1 is all the same an excellent measure of defence1 and would with reason be adopted in every outbreak4 7,simpson1 loc4 cit47 ,lucknow came so early in the work of inoculation1 that weak vaccines were used in small doses4 ,the cholera1 when it broke out1 was of a most malignant type1 senior medical officers of long experience in the country stating that such a virulent cholera had not been seen by them for very many years past4 ,more than a year had elapsed between the inoculations and the outbreak of the cholera4 ,it is no wonder that the regiment was not well protected3-- ,the small amount of protection which the inoculations afforded in this case may have depended on the mild effects which the injections produced on the men at the time of the operation in #ahic1 in comparison with the severity of the epidemic which attacked the regiment4 ,it is recorded in the ,lucknow ,inoculation ,registers that only in two men1 out of the #ahe inoculated in #ahic1 a marked febrile reaction was obtained2 in #gg individuals the vaccinal fever was only slight1 while in #ff there was no reaction3 an effect which was due to the weakness of the vaccines procurable at that period of work1 and to the small doses used4 ,the influence of the vaccines was possibly further reduced1 at the time of the epidemic1 by a lapse of fourteen to fifteen months4 7,haffkine1 #ahie ,report47 #c4 ,gaya ,jail ,on #ith ,july #ahid1 an outbreak of cholera occurred in the ,gaya jail1 and by #ahth ,june there had been #f cases and #e deaths4 ,on that day and the next day1 #bae prisoners were inoculated4 ,the average number of the prisoners during the outbreak was #bjg inoculated1 and #bjb not inoculated4 ,surgeon-,major ,macrae1 superintendent of the jail1 reports3-- ,the inoculations being purely voluntary1 no selection of prisoners was possible1 but all classes of the jail were represented--male and female1 old and young1 habituals and less frequent offenders1 strong and weakly1 convalescent and even hospital patients sent their representatives2 no difference of any kind was made between inoculated and non-inoculated2 they were under absolutely identical conditions as regards food1 water1 accommodation1 etc41 in fact in every possible respect4 ,of course1 the best results could hardly be obtained1 because the cholera was already at work3 it took about ten days for the #ahid vaccine to produce its full effect2 and two inoculations were generally made1 one five days after the other4 ,this gradual action of the vaccine is well shown in ,dr4 ,simpson's table3-- ---------------------------------------- --------------------- ,,non-,,inoculated1 ,,inoculated1 #bjb4 #bjg4 ---------------------------------------- --------------------- ,cases4 ,deaths4 ,cases4 ,deaths4 ---------------------------------------- ------------------- ,during #e days after #ast #g #e #e #d inoculation ,during #c days after #bnd #e #c #c #a inoculation ,after #c days after #bnd #h #b #j #j inoculation ---------------------------------------- ------------------- ,haffkine's comment on these figures must be noted here3-- ,in the ,gaya jail1 the inoculations were for the first time applied in a prevalent epidemic1 and very weak doses of a relatively weak vaccine were used4444 ,far higher results have been obtained by an application of stronger doses4 ,in the bustees situated round the tanks in ,calcutta1 where cholera exists in a permanent state1 the disease occurred in #cf houses with inoculated people4 ,in each of these houses there was one part of the family inoculated and another not4 ,the observations were continued for #dei days1 with the following results3-- ,during the first period of #e days1 subsequent to the inoculation with first vaccine1 cholera occurred in #h houses4 #ge non-inoculated had #e cases1 with #c deaths4 #eb inoculated had #c cases1 with #c deaths4 ,during the second period of #e days1 subsequent to the second inoculation1 cholera occurred in #b houses4 #h non-inoculated had #b cases1 with #b deaths4 #ag inoculated had no cases4 ,after the #aj days necessary for the preventive treatment had expired1 and up to the #deith day1 the disease visited #bf houses4 #bfc non-inoculated had #ch cases1 with #cd deaths4 #acg inoculated had #a case1 with #a death1 in a child that had not been brought up for the second inoculation4 #d4 ,assam-,burmah ,railway ,for a good instance of lives saved even during an outbreak1 take the ,assam-,burmah ,railway coolies3-- ,three hundred and fifty#cj ,khassia ,hill coolies had been collected for the survey party of the ,assam-,burmah ,railway1 and put under the escort of a detachment of ,goorkhas1 when cholera broke out amongst them4 ,the largest part of the coolies immediately submitted to the preventive inoculation1 the rest remained uninoculated4 ,the result was that among the not-inoculated minority there were #cd cases1 with #cj deaths2 whereas the inoculated had #d fatal cases4 7,haffkine1 #ahie1 ,lecture in ,london47 #cj ,the exact number is #cee1 of whom #aif were inoculated2 the coolies numbered #cdc1 and the ,goorkhas #ab4 7,see ,dr4 ,simpson's #ahif ,report47 #e4 ,durbhanga ,jail 7#ahif7 ,the figures in this instance are small3 but ,surgeon-,captain ,e4 ,harold ,brown's report is very pleasant reading4 ,cholera broke out in the jail on #cast ,march #ahif1 and by #ith ,april there had been #h cases4 ,next day1 #agb prisoners were moved into camp #ab miles away2 and #ec were left behind1 the sick in the jail hospital1 the patients in the cholera huts1 with their attendants1 the old and infirm1 and a few cooks and sweepers4 ,that day1 #c cases occurred in the camp1 and #a in the jail2 and on the #aath1 at #b and #d ,a4,m41 #b more cases were reported in camp4 ,at #g4cj ,a4,m41 ,haffkine and ,dr4 ,green came to the camp3-- ,the prisoners were spoken to on the subject1 and seemed to be pleased with the idea1 the word tika 7inoculation71 which was familiar to them from its association with smallpox1 appearing to appeal to them4 ,they were accordingly arranged in four rows facing the tent1 in front of which ,dr4 ,haffkine was about to commence operations4 ,i was the first subject to be inoculated2 and after me the jailor1 assistant jailor1 hospital assistant1 and three warders4 ,the first prisoner in the front rank was next brought up and submitted cheerfully2 after which1 every alternate man was taken1 so that no selection of cases was made1 until one-half of the total number were inoculated4 ,those who had not been inoculated were far from pleased at having been passed over2 and1 to our surprise1 they rose almost to a man1 and begged to be inoculated2 nor were they satisfied when told that the medicine was exhausted4 ,the dose administered on this occasion 7#aath ,april #ahif7 was stronger than the ,gaya jail dose 7#ahth ,july #ahid73 it acted in a few hours1 and the reaction was well marked4 ,there were fresh cases of cholera that day at #ab 7noon71 #f1 #g1 and #g4cj ,p4,m41 and at midnight1 all in those who had not been inoculated1 and all terminating fatally1 despite the greatest care and the most prompt and assiduous treatment4 ,on the #abth two further cases occurred1 both among the uninoculated1 and both died2 there being thus eight cases in succession1 all from the men who were not inoculated1 and all proving fatal4 ,the inoculations were made at #g4cj ,a4,m4 ,surgeon-,captain ,brown had pain within half-an-hour1 and fever in three hours1 with temperature #ajd1 but this was probably due to the fact that ,i was not able to rest4 ,the prisoners1 of course1 went to bed3 they all reacted before #d ,p4,m41 but did not have so much trouble over it4 ,the last case was on the #aeth4 ,the outbreak was a bad type of cholera2 out of #cj cases #bd died1 some of them in #a-a_/b to #d hours4 ,to summarise the combined results of the camp and the jail1 we find that of a daily average of #ii non-inoculated there were #aa cases1 all fatal #aa4aa per cent42 of #aaj inoculated there were #e cases1 with #c deaths #b4gc per cent4 #f4 ,bilaspur and ,serampur ,here again the figures are small1 but worth noting4 ,in a coolie camp at ,bilaspur 7,central ,provinces7 #ajj non-inoculated had #e deaths1 and #aej inoculated had #a death4 ,in ,serampur1 among the general population1 #ea non-inoculated had #e cases and #c deaths1 and #db inoculated had #b cases and #a death4 #g4 ,the ,cachar ,tea-,gardens 7#ahie7 ,this series of inoculations was begun in ,february #ahie1 for the protection of the coolies on various tea-estates4 ,the results are excellent1 and deal with large numbers4#ca ,the latest report from ,dr4 ,arthur ,powell1 the ,medical ,officer1 is quoted in ,dr4 ,simpson's #ahif report3-- ,at ,kalain-- #ajgi not inoculated had #ej cases1 with #cj deaths4 #abej inoculated--#c cases1 with #b deaths4#cb ,at ,kalaincherra-- #fhe not inoculated had #aj cases1 with #g deaths4 #aee inoculated--no cases4 ,at ,degubber-- #bed not inoculated had #ab cases1 with #aj deaths4 #djg inoculated--#e cases1 all recovered4 ,at ,duna-- #aba not inoculated had #d cases1 with #b deaths4 #bi inoculated--no cases4 ,at ,sandura-- #ded not inoculated had #b cases1 with #a death4 #ea inoculated--#b cases1 with #a death4 ,at ,karkuri-- #aih not inoculated had #ae cases1 with #i deaths4 #ddc inoculated--#c cases1 with #a death4 ,at ,craig ,park-- #ahe not inoculated had #a fatal case4 #df inoculated--no cases4 ,,total4 ,not inoculated1 #bigf1 with #id cases and #fj deaths4 ,inoculated1 #bcha1 with #ac cases and #d deaths4 #ca ,as a field for testing the value of inoculation1 the tea-factories of ,india possess many advantages4 ,the labourers being under contract1 the after-history of those inoculated is easily followed up4 ,each morning the adults are paraded for roll-call2 and all sick must attend hospital1 where a record is made of their disease and treatment4 7,dr4 ,powell1 ,lancet1 #acth ,july #ahif47 #cb ,it is unfortunate that neither of the fatal cases among the inoculated was seen by any medical man1 not even an unqualified doctor ,babu4 ,dr4 ,powell does not think1 from what was told him1 that one of them was cholera4 ,to the preceding instances1 which are rather old now1 must be added the following more recent report1 from the ,indian ,medical ,gazette1 ,september #aija3-- ,we are glad to see1 from a paragraph in the ,report of the ,sanitary ,commissioner for ,bengal 7,major ,h4 ,j4 ,dyson1 ,i4,m4,s41 ,f4,r4,c4,s471 that an increased number of anti-cholera inoculations were performed during the year #aijj4 ,assistant-,surgeon ,g4 ,c4 ,mukerjee1 who was in charge of this work1 reports that in the ,puralia ,coolie ,depot no less than #ac1bia persons were inoculated against cholera1 including over #ajjj children4 ,all these cases of inoculation were among labour emigrants proceeding to the tea-gardens of ,assam and ,cachar4 ,the employers of labour are beginning to realise the value of cholera inoculation4 ,it is unfortunately not always easy1 or even possible1 to follow up the after-history of persons inoculated2 but ,major ,dyson has quoted a table1 received from the ,superintendent of ,emigration1 which shows the number of cases among the inoculated and the non-inoculated at ,goalundo4 ,from this table1 it is seen that out of #aebg non-inoculated coolies1 who passed through ,goalundo1 #cc1 or #b4ji per cent41 got cholera2 whereas of #hgc inoculated coolies1 only #b1 or #j4b per cent41 were attacked by the disease2 that is1 the unprotected suffered about ten times as much as the inoculated4 ,assistant-,surgeon ,mukerjee also reports that during his cold-weather tour he passed through some villages in the ,manbhum district1 in which he had practised inoculation the previous year3 and1 though there had been epidemics of cholera in them1 the inoculated persons escaped4 ,they came to him in numbers1 stating that they owed their safety to the inoculation4 ,of course1 the preventive treatment touches points only here and there on the map of ,india1 with its #cjj1jjj1jjj people4 ,probably it will never become so general in ,india as vaccination4 ,cholera in ,india recalls what ,ambroise ,par1 more than #djj years ago1 wrote of the plague1 ,here in ,paris it is always with us4 ,but1 wherever preventive inoculation has been done1 there it has done good4 ,the ,medical ,annual for #aije contains an account of some preventive inoculations recently made during an epidemic in ,japan4 ,among the inoculated1 the attack-rate was much lower than among the uninoculated2 and the mortality was #de4e per cent41 as against #ge per cent4 ,another most important result of the discovery of the cholera bacillus is its use in diagnosis4 ,for example1 if a case of suspected cholera is landed at a ,british port1 the sanitary authority at once takes steps to ascertain whether the specific microbe is present2 and1 according to the answer given by bacteriology1 either allows the patient to proceed on his journey1 or adopts measures of isolation to prevent the spread of the disease to others4 ,thus1 thanks to the insular position of ,great ,britain1 this dreadful disease has for many years been prevented from invading her population4 ,,viii ,,plague ,the bacillus pestis was discovered by ,kitasato and ,yersin1 working independently1 in #ahid4 ,yersin's discovery was made at ,hong ,kong1 whither the ,french ,government had sent him to study plague3 an excellent account of his work is given in the ,annales de l',institut ,pasteur1 ,september #ahid4 ,the first experiments in preventive inoculation1 in animals1 were made by ,yersin1 ,calmette1 and ,borrel1 working conjointly1 in #ahie4 ,they found that it was possible to confer on animals a certain degree of immunity1 by the hypodermic injection of dead cultures of the bacillus4 ,these experiments were made on rabbits and guinea-pigs4 ,haffkine's fluid was first used on man in ,january #ahig4 ,it is a bouillon containing no living bacilli1 and nothing offensive to the religious beliefs of ,india4#cc ,he proved its efficacy on rabbits2 and then1 on #ajth ,january #ahig1 inoculated himself with a large dose1 four times as strong as the subsequent standard dose4 ,a few days later1 ,lieut4-,col4 ,hatch1 ,principal of the ,grant ,medical ,college1 ,bombay1 and other members of the ,college ,staff1 were inoculated4 ,these first inoculations were described by ,haffkine in a lecture 7#aija7 at ,poona3-- ,in a short time1 a number of the most authoritative physicians in ,bombay1 ,european and native1 official medical officers and private practitioners1 submitted themselves for inoculation4 ,it is a matter of gratification to me to be able to quote1 among these authorities1 the ,head of the ,medical ,service of the ,presidency1 ,surgeon-,general ,bainbridge1 who not only got himself inoculated1 but inoculated also the members of his family4 ,previous to that1 ,surgeon-,general ,harvey1 the able ,director-,general of the ,indian ,medical ,service1 submitted himself to inoculation in #ahic against cholera2 and1 in #ahih1 against plague4 ,it was the example of these gentlemen1 whose competence in the matter of health could not be disputed1 that encouraged thousands of people1 rich and poor1 in ,bombay and elsewhere1 to come forward for inoculation4 ,thus his ,excellency the ,viceroy thought it right to tell you here1 in ,poona1 that previous to his starting for the plague-stricken districts he and his staff had also undergone the prophylactic inoculation4 ,in due course1 mothers brought their children to be protected by the new 'vaccination4' #cc ,it is said that the ,jains object to inoculations on the grounds of religion2 and one or two witnesses before the ,plague ,commission gave evidence to the same effect4 ,but1 at ,bombay1 the high-priest of a great religious community addressed a meeting of #ejjj in favour of the new treatment2 and the rush of suppliants for inoculation at ,hubli and ,gaday proves that there is no real religious difficulty4 ,doctors have been assaulted1 as at ,poona1 so at ,oporto2 in neither case can we say ,tantum relligio potuit suadere malorum4 ,within a few months1 #hadb persons in or near ,bombay were inoculated4 ,it was not possible1 in ,bombay1 during the rush of plague-work1 to follow up every one of these #hadb persons4 ,but there is reason to believe1 making some allowance for oversights1 that only #ah #j4b per cent4 of them1 were attacked during the epidemic2 that1 of these #ah1 only #b died3 and that these #b died within twenty-four hours of inoculation1 i4e41 had the plague in them already at the time of inoculation4 ,and1 with regard to a small group of the inoculated1 there are the following more definite facts4 ,this group lived outside ,bombay1 across the harbour1 in a village called ,mora4 ,the population of ,mora1 at the time of the epidemic1 was estimated at less than #ajjj4 ,out of this number #dbi were inoculated2 which1 if the population be reckoned at #ajjj exactly1 left #ega uninoculated4 ,among the #dbi inoculated1 there were #g cases of plague1 with no deaths3 among the uninoculated there were #bf cases1 with #bd deaths4 ,just a week after ,haffkine had informed the ,indian ,government that he had tested his fluid on himself1 plague broke out in the ,byculla ,house of ,correction1 ,bombay1 on #bcrd ,january #ahig4 ,between the #bcrd and the afternoon of the #cjth1 there were #ad cases1 with #g deaths4 ,on the afternoon of the #cjth1 #aeb prisoners were inoculated1 and #agb were left uninoculated4 ,the outbreak ceased on #gth ,february4 ,the figures1 as corrected by the ,plague ,commission1 are1 among the inoculated1 #a case1 which recovered2 among the uninoculated1 #g cases1 with #b deaths4 ,for a full and severe examination of the reports1 statistics1 and other evidence concerning this and other outbreaks in which preventive inoculations were made1 the ,report 7#aija7 of the ,indian ,plague ,commission must be studied4 ,the ,commissioners1 ,professor ,t4 ,r4 ,fraser1 ,mr4 ,j4 ,p4 ,hewett1 ,professor 7now ,sir7 ,a4 ,e4 ,wright1 ,mr4 ,a4 ,cumine1 ,dr4 ,ruffer1 and ,mr4 ,c4 ,j4 ,hallifax1 ,secretary1 travelled and took evidence in ,india from ,november #ahih to ,march #ahii3 during which time they held #gj sittings and examined #bfj witnesses1 some at great length4 ,the evidence and the report are published in five large volumes4 ,the report1 #edj pages in all1 deals exhaustively with the whole subject4 ,it represents the very least--what might almost be called the very worst--that can be said of ,haffkine's fluid3 and1 of course1 it reads rather differently from the reports of the men who1 with their lives in their hands1 and worked almost past endurance1 fought plague themselves4 ,the following paragraphs give1 so far as possible1 the bare facts of various outbreaks of the disease in #ahig-ii1 in which ,haffkine's fluid was used4 #a4 ,daman ,plague broke out in ,daman1 a town in ,portuguese territory1 north of ,bombay1 and in constant communication with ,bombay by sea1 in ,march #ahig4 ,by the end of the month1 when a ,government cordon was placed round the town1 about #bjjj out of #aj1ijj had fled4 ,the outbreak reached its height in mid-,april1 and was practically over by the end of ,may4 ,inoculations were begun on #bfth ,march4 ,the total population on that day 7#bjjj having gone out1 and #fgj having died of plague7 is estimated at #hbcj4 ,of these1 #baig were inoculated1 and #fjcc were left uninoculated4 ,among the inoculated there were #cf deaths #a4f per cent42 among the uninoculated #adhb deaths #bd4f per cent4 ,the ,commissioners criticise these figures severely1 and do not accept them as exact4 ,but they admit the evidence as to the results of inoculation among the ,parsee community of ,daman4 ,of this community1 #cjf in number1 #bgg were inoculated1 and only #bi were left uninoculated4 ,among the inoculated there was #a death #j4cf per cent43 among the uninoculated there were #d deaths #ac4h per cent4 ,they admit1 also1 the house-to-house investigations made by ,major ,lyons1 ,i4,m4,s41 ,president of the ,bombay ,government ,plague ,committee4 ,at the end of ,may1 he visited #hi houses1 in #fb of which both inoculated and uninoculated were living together4 ,he found that out of #chb inoculated1 #cf had died #i4d per cent42 out of #abc uninoculated1 #ch had died #cj4i per cent4 #b4 ,lanauli ,plague attacked ,lanauli1 a small hill-station and railway depot1 during ,april to ,september #ahig4 ,the entire population was estimated at about #bjjj4 ,inoculations were begun on #bdth ,july in two wards of the town1 and a daily house-to-house inspection was instituted4 ,the figures reported1 on the basis of the average daily strength of the two groups1 are as follows3-- ,inoculated1 #cbc1 with #ad cases1 of which #g died #b per cent4 ,uninoculated1 #cgg1 with #gh cases1 of which #eg died #ae per cent4 ,the ,commissioners criticise the method on which these figures are based1 and do not accept them as accurate4 ,but they agree that inoculation exerted a distinct preventive effect2 and they admit ,major ,baker's evidence--,in the place where inoculation had been made use of1 the town was thriving and full of people2 and the other part of the town was absolutely empty4 ,one side had plague1 and the other had none4 #c4 ,kirki ,the figures here were obtained under especially favourable circumstances2 and the ,commissioners have1 practically1 no fault to find with their accuracy4 ,the following account is by ,surgeon-,major ,bannerman1 ,superintendent of the ,plague ,research ,laboratory1 ,bombay3-- ,plague broke out in ,kirki1 in the artillery cantonment1 situated four miles from ,poona2 and the followers of the four batteries stationed there suffered severely4 ,these men were living with their families in lines on a sloping plain1 under military discipline1 and in circumstances far superior in a sanitary sense to those of the average villager4 ,when the disease appeared1 the lines were isolated1 so that none could enter or leave without the knowledge of the military4 ,a special hospital was erected close by1 where all sick persons were sent as they were discovered by the search parties of ,european artillerymen1 who visited each house thrice daily4 ,it is therefore probable that all cases of plague were promptly discovered and removed to hospital3 and in each case the usual disinfection was thoroughly and systematically carried out4 ,yet1 in spite of all this1 it was found that1 in those not protected by inoculation1 #a out of every #f of the population was attacked1 and #b out of every #c attacked died4 ,the epidemic was1 therefore1 a severe one4 ,the population of the lines numbered #aecj2 and1 out of these1 #fga volunteered for inoculation4 ,at the close of the epidemic1 the plague-hospital admission and discharge book was examined1 and compared with the register of those inoculated1 when the following result was got4 ,the population operated on being under military discipline1 and confined to their lines1 makes the accuracy of the figures undoubted3-- ,inoculated1 #fga1 with #cb cases1 of which #ag died #b4e per cent4 ,uninoculated1 #hei1 with #adc cases1 of which #ih died #aa4d per cent4 ,here1 then1 is seen a body of people divided into two groups by the fact that one had undergone inoculation and the other not1 but differing in no other way1 reacting towards plague in such a markedly different manner that the conclusion is forced on one1 that the inoculation must be the cause4 ,seeing the absolute similarity of conditions1 the #fga inoculated should have had proportionately #aab cases and #gg deaths1 if they had remained as susceptible to the disease as their uninoculated brothers1 sisters1 parents1 wives1 husbands1 children2 but1 instead of that1 they had only #cb cases and #ag deaths4 ,this death-rate would doubtless have been still further reduced1 but for the fact that a very much weakened vaccine had to be used1 owing to the demand having got beyond the resources of the laboratory at that time4 #d4 ,belgaum ,in ,belgaum1 a town of ,southern ,india with a normal population of about #cj1gjj1 two outbreaks of plague occurred in quick succession4 ,the first outbreak lasted from ,november #ahig to ,may #ahih2 the second1 from ,july #ahih to ,january #ahii4 ,during the two epidemics1 #bdff persons were inoculated4 ,of these1 it was reported that only #fa 7or #fb7 had been attacked1 of whom #cc died #a4cd per cent4 ,but these figures1 in the judgment of the ,commission1 cannot be accepted as even approximately correct4 ,there are1 however1 two groups of these ,belgaum cases1 one of which the ,commission admits as substantially accurate1 and the other as absolutely accurate4 ,these groups are1 7#a7 the ,army cases2 7#b7 the cases reported by ,major ,forman1 ,r4,a4,m4,c41 ,senior ,medical ,officer of the ,station4 7#a7 ,the ,army ,cases4-,these cases occurred in the #bfth ,madras ,infantry1 which was living in lines close to the cantonment and the city4 ,the first case of plague in the regiment was on #abth ,november #ahig4 ,ten days later1 the regiment was moved out into camp4 ,inoculation was begun1 by ,surgeon-,major ,bannerman1 on #bcrd ,december1 up to which time there had been1 among the regiment and its families and followers1 #gh cases1 with #di deaths4 ,the following account of the inoculations is given by ,surgeon-,major ,bannerman3-- ,no difficulty was experienced in persuading the men to consent to inoculation1 when it was explained to them that they would be free to return to their houses in the lines after being operated on4 ,general ,rolland was the first to be operated on1 and his example1 combined with that of the officer commanding1 and their medical officer1 who were all operated on in front of the men1 sufficed to convince the ,sepoys of the harmlessness of the operation3 and the only difficulty that then remained was to perform the operation fast enough4444 ,the community was1 practically1 completely inoculated by the end of the year4 ,the total operated on was #affe1 out of a population of #agdf living in the lines at that date4 ,the #ha not operated on were infants1 women far advanced in pregnancy1 and the sick in hospital chiefly1 though one solitary ,sepoy has1 up to the present time1 refused to submit to operation4 ,from this time onward to the end of the first epidemic1 though the disease was at its height in ,january in the neighbouring city and cantonment1 and though the men were allowed to go freely to these places after inoculation1 only #b out of the #affe were attacked1 and both recovered4 ,when the second epidemic came1 in ,july #ahih1 the troops1 families1 and followers1 were reinoculated at their own request1 #ahja in all4 ,practically no one was left in the lines unprotected by inoculation4 ,from this time onward to the end of the second epidemic1 though it was much more severe than the first1 only #ab cases occurred4 ,in the first epidemic1 before inoculation1 #gh cases occurred1 and #b after it3 in the second1 and much more severe1 epidemic1 though the sanitary measures adopted in both epidemics were similar1 only #ab cases occurred4 ,it would hardly appear to be open to doubt1 says the ,commission1 that the practical immunity of the regiment1 during the second outbreak1 was due to inoculation4 7#b7 ,major ,forman's evidence before the ,commission is very striking1 though the figures are small4 ,the following abstract of it is given in the ,report of the ,commission3-- ,the groups of persons1 concerning whom ,major ,forman gave us evidence1 were his private servants1 and the hospital attendants of the ,belgaum ,station ,hospital with their wives and children4 ,he inoculated these groups when plague first broke out in the town1 and was able to keep in touch with them continuously after that time4 ,regarding the first group1 he says1 bringing down their history to #crd ,march #ahii1 ',of my private servants there were in all1 including their wives and children1 #bh people inoculated4 ,there have been no cases of plague1 and no deaths up to date4 ,there were #c uninoculated4 ,one was a child of #i years of age1 whose father refused to allow it to be inoculated4 ,it died of plague #ab days after the other people were inoculated4 ,the other #b cases that were not inoculated were not so distinctly under my own observation4 ,one was a sweeper employed in the cantonment1 and sleeping in my compound3 he1 ,i am told1 died of plague some months afterwards4 ,the other was my water-carrier3 he threw himself into a well3 ,i was informed that he had buboes and fever1 and ran away to escape segregation4 ,of the #bh inoculated1 none died of plague3 and of #c uninoculated1 #b are said to have died of plague1 and #a undoubtedly died of plague4' ,regarding the second group of which he gave us particulars1 ,major ,forman said that1 out of #ij hospital servants1 #hg were inoculated4 ,of the inoculated persons1 #a died from fever and endocarditis1 and #a died of plague4 ,excepting these two1 the rest of the inoculated were alive and well in ,march #ahii4 ,only #c persons remained uninoculated4 ,of these1 one was not operated upon1 because she had recently been delivered2 another was not operated upon1 because she was pregnant2 and the third was a boy of #af years of age1 whose father refused to let him be inoculated4 ,the boy died of plague1 two months after the inoculation of the rest of the hospital servants had been done4 ,one of the two uninoculated women died of plague two days after the boy1 she having been in attendance upon him4 ,the other uninoculated woman remained well4 #e4 ,the ,umarkhadi ,jail1 ,bombay ,plague broke out in this jail on the last day of #ahig1 and #c prisoners died4 ,next day1 #ast ,january #ahih1 all the prisoners were paraded1 and all were willing to be inoculated4 ,but it was decided to divide them into two equal groups1 and inoculate one group4 ,there were #djb altogether3 #b1 when their turn came1 refused to be inoculated3 thus #aii were inoculated1 and #bjc were left uninoculated4 ,no distinction was made between the two groups3 ,they had the same food and drink1 the same hours of work and rest1 and the same accommodation4 ,the plague did not come wholly to an end till ,march4 ,the figures1 since the inmates of a jail are a shifting population1 are based on the average daily number of each group3 this was #adg for the inoculated1 and #abg for the uninoculated4 ,the figures are3-- ---------------------------------------- ,average ,daily ,number4 ,cases4 ,deaths4 ---------------------------------------- ,inoculated #adg #c #j ,uninoculated #abg #i #e ---------------------------------------- ,the ,commission draw attention to the important fact that1 during the whole period of the outbreak1 the number of attacks among the inoculated was only one-third of the number among the uninoculated2 and that the disease among the inoculated was remarkably mild1 resembling mumps more than plague1 though the cases among the uninoculated were of average severity4 ,according to ,surgeon-,major ,bannerman1 the hospital authorities were doubtful whether these three cases among the inoculated were plague at all4 #f4 ,undhera ,the figures for ,undhera are very valuable3 ,the conditions1 says ,surgeon-,major ,bannerman1 approached very nearly the strictness of a laboratory experiment4 ,even the ,commissioners are enthusiastic here4 ,undhera is an agricultural village1 #f miles from ,baroda4 ,plague broke out in it1 in ,january #ahih4 ,a careful census was taken1 and showed a population of #ajbi4 ,by #abth ,february there had been #gf deaths4 ,on that day the village was visited by ,mr4 ,haffkine1 ,surgeon-,major ,bannerman1 and other experts1 and #eac persons were inoculated3--,by reference to the census papers1 the whole of the inhabitants were called out1 house by house1 and the half of each household inoculated4 ,in this way1 an endeavour was made to inoculate half the men1 half the women1 and half the children in each family1 and to arrange that a fairly equal proportion of the sickly-looking should be placed in each division4 ,the plague lasted #db days after the inoculations1 and affected #bh families4 ,on #dth ,april a house-to-house investigation was made by ,mr4 ,haffkine1 ,surgeon-,general ,harvey1 ,surgeon-,major ,bannerman1 and ,captain ,dyson4 ,the figures are as follows3-- ---------------------------------------- -------------------- ,population on ,cases4,deaths4 ,mortality4 #abth ,february4 ---------------------------------------- --------------------- #ajbi - #gf #iec ,inoculated1 #eac #h #c #j4f per cent4 ,uninoculated1 #ddj #bh #bg #f4j per cent4 ---------------------------------------- -------------------- ,thus1 out of #bh families1 where the protected and the unprotected lived and ate and slept together1 the protected1 #ga1 had #c deaths2 and the unprotected1 #fd1 had #bg4 ,the percentage of attacks was four times higher among the unprotected2 the percentage of deaths was ten times higher4 #g4 ,khoja ,community1 ,bombay ,the head of this community1 ,h4,h4 ,sir ,sultan ,shah1 ,aga ,khan1 ,k4,c4,i4,e41 opened a private station for the inoculation of the community in ,march #ahig1 and again in ,december of that year4 ,he was himself inoculated three times1 and many of the community so often as five times4 ,the work of inoculation went on daily1 and by #bjth ,april #ahih the number of persons inoculated or reinoculated was #eahd4 ,the whole community1 according to a careful census taken at the beginning of #ahih1 numbered #icej2 but1 since many families had fled to avoid the infection1 this number is too low4 ,the ,commissioners guess #iggj3 ,haffkine1 to the disadvantage of his own statistics1 guesses so high as #ac1ccj4 ,the number of the inoculated or reinoculated shifted1 of course1 as the work went on3 their average daily number during the four months of plague1 ,january to ,april #ahih1 was #chad4 ,during these four months1 the number of deaths from all causes in the whole community was #ahd4 ,according to the average mortality of the community in times of no plague1 the deaths from all causes during four months would be #ajb4 ,it may fairly be assumed that the extra deaths1 #hb1 were due to plague3 and1 indeed1 #fd plague-deaths were either acknowledged by the relatives1 or certified by the burial-books of the community4 ,of these #hb deaths1 #c occurred among the inoculated or reinoculated1 and #gg among the uninoculated4 ,the ,commissioners find fault with these figures3 ,nevertheless1 quite apart from the statistics put before us1 which we think inaccurate1 we do not doubt that inoculations had a good effect1 especially as much weight must be allowed to the opinion of a community so intelligent as that of the ,khojas4 #h4 ,hubli ,this1 the greatest and most amazing of all instances of preventive plague-work1 was done in a town of #ej1jjj persons4 ,the following report1 by ,surgeon-,captain ,leumann1 was forwarded to the ,plague ,commissioners by ,mr4 ,e4 ,k4 ,cappel1 ,collector of ,dhrwr1 with this comment3-- ,the town of ,hubli--a mercantile town of over #ej1jjj inhabitants--was attacked by plague in an epidemic form at the commencement of the monsoon rains4 ,the average rainfall between ,april and ,october amounts to more than #bh inches4 ,under these circumstances1 although a large and weather-proof health camp had been prepared for emergencies1 complete evacuation of the infected townsite was impossible2 and the attempt to effect it would have led to the severest hardships and to the immediate spread of the disease into surrounding villages and districts4 ,it was for this reason that the determination was formed to make a bold and comprehensive experiment with the prophylactic1 and not on any priori grounds4 ,if this experiment had failed1 the results1 judged by the actual mortality among the uninoculated1 would have been appalling4 ,all possible sanitary measures in the shape of disinfection1 unroofing of houses1 and segregation1 were applied concurrently with inoculation1 as ,government are already aware2 but the rate of mortality among those who held back from inoculation rose at one time to a height which1 ,i believe1 has never been approached elsewhere4444 ,however1 the experiment1 in the hands of ,dr4 ,leumann1 did not fail1 and it has afforded a demonstration of success which is of ,imperial importance4 ,many thousands of lives have undoubtedly been saved1 and at the present moment the plague mortality is merely sporadic1 and ,hubli is steadily regaining its normal population and trade1 though surrounded by infected villages4 ,the ,hubli report must be put at full length1 for the vivid picture it gives of plague in ,india1 and of the difficulties besetting the magnificent work of the ,indian ,medical ,service4 ,it is a story that ,mr4 ,kipling ought to write4 ,and it is to be noted that ,surgeon-,captain ,leumann1 who saved ,hubli1 recognised the extreme importance of other methods than inoculation--disinfection1 isolation of cases1 evacuation of infected districts4 ,he says3-- ,while paying the highest tribute to the value of ,mr4 ,haffkine's inoculation method1 which ,i claim1 here in ,hubli1 to have put to perhaps the severest test to which it has yet been subjected1 ,i am of the opinion that individual protection is1 on however great a scale conducted1 of less importance to that of general protection and hygiene 7considering each method separately1 that is to say71 for it seems to me more radical1 if not more rational1 to eradicate a disease than to leave it to pursue its course and only protect people against its ravages4 ,sanitation1 therefore1 was ,dr4 ,leumann's faith4 ,now for his works3-- ,i first started inoculation here on #aath ,may4444 ,when ,i began my inoculations1 ,i operated first of all on some ,european or native gentlemen in front of a crowd of poor and low-caste people1 whom ,i had gathered together in the worst-affected area1 and they were thus soon induced to ask for inoculation themselves4444 ,they have presented themselves1 by the hundred1 at all times of the day1 before myself and others1 for the purpose of being inoculated4#cd 444 ,i have never experienced the slightest difficulty in inoculating ,mussulmanis or any other purdh women in ,hubli4444 ,the very men who1 in ,march last1 created a disturbance in ,hubli1 were not only the first and the most willing to undergo inoculation1 but also to bring their wives and families to my hospital1 or to invite me to their homes to inoculate them4 #cd ,compare the account of the inoculations at ,gaday1 in the ,lancet1 #aath ,february #ahih3 ,to see the crowd waiting and struggling to pass the barrier is a strange sight2 old men and women1 young children1 and mothers with babes in their arms1 form a daily crowd numbered by hundreds1 who wait for hours to get their chance of the day's inoculation4 ,inoculated persons holding certificates of double inoculation have1 at my special wish and order1 been left in their homes throughout this epidemic2 only their clothes1 house1 and property being disinfected on the occurrence of a plague case or death in their house4 ,as the vast majority of plague cases have never been notified before death in ,hubli 7nor1 in my experience of nearly two years1 elsewhere1 if native supervision be largely resorted to71 it will readily be understood that the majority of the inoculated have actually been living in the same house1 or even room1 with a plague case 7often of the pneumonic type1 whose terrible power of spreading the disease was first shown by ,professor ,childe1 ,i4,m4,s41 of ,bombay7 during the whole of the time that case was living1 probably attending on the patient1 breathing the same stuffy air1 and1 perhaps1 sharing the same blanket2 and ,i attach at the end of this report a long series of cases where such conditions have occurred1 the non-inoculated dying of plague1 and the inoculated escaping1 almost to a man4 ,various critics on my work1 not knowing what the actual facts were and are1 have at different times asserted that the inoculated inhabitants of ,hubli left the town in larger numbers than the non-inoculated4 ,exactly the reverse was the case4 ,the ,british officers on plague duty here1 and all the ,divisional ,superintendents1 invariably replied 7officially and in writing when so required7 that the non-inoculated left ,hubli in far greater numbers and proportion than the inoculated2 and my own observations entirely bear out this statement4 ,it has been urged that those who received inoculation were of a class or classes better protected than others against plague by reason of their habits1 the food they eat1 the houses they live in1 etc4 ,in reply1 ,i unhesitatingly state that if there be but one town in ,india where that line of argument will not hold good1 it certainly is ,hubli2 for not only were the poorer1 dirtier1 lower-caste people the first to be persuaded to receive inoculation1 but ,i made it my personal and special duty to work amongst them4 ,my first few thousand inoculations were almost entirely amongst the lowest and poorest of the people4 ,the ,brahmins are1 perhaps1 of all castes1 supposed to be the most cleanly in their houses1 habits1 etc41 yet the ,brahmins of ,hubli 7who at first1 imagining themselves immune1 were the foremost and greatest perverters of the truth concerning its efficacy1 and the last to apply for the protection inoculation affords71 simply inundated the various inoculation centres1 as soon as plague began to spread in their midst1 clamouring for the very method of which they had only lately tried to prevent others from availing themselves4 ,unfortunately1 the average native1 educated or not1 appears to have the very greatest aversion to notifying any case of sickness--plague or other--and hence1 in my opinion1 it becomes more necessary than ever to protect the people by inoculation1 since they will not help to protect themselves by the foremost and simplest of sanitary and hygienic measures4#ce ,with so few police 7and those none too good7 to help one2 an inadequate ,british ,staff2 with so much reliance placed in ,native ,superintendents and ,supervisors1 and a ,municipality so bankrupt that it could not apparently afford to buy enough blankets out of its own funds for the patients in the ,plague ,hospitals--the work of segregation1 house-to-house inspection1 etc41 became1 from a medical point of view1 absurdly insufficient4 ,the total number of inoculations performed in ,hubli1 both on actual inhabitants and on people from outside 7villages7 between #aath ,may and #bgth ,september1 amounts to some #gh1jjj altogether4 #ce ,compare the account given by the ,rev4 ,h4 ,haigh 7,methodist ,recorder1 ,december #ahih71 of the plague at ,bangalore3 ,the native population do all they can to elude the vigilance of the authorities4 ,in order to escape segregation1 the householders in many instances refrain from reporting plague1 and not infrequently bury the corpse secretly4 ,not only is any spare piece of ground used as a burial-place1 but the body is at times thrown into a well or tank1 or dropped over the wall of some ,european compound4 ,during one week three plague corpses were found1 badly decomposed1 in reservoirs commonly resorted to for drinking purposes4 ,i ---------------------------------------- ---------------------- ,plague-deaths among3 ,dates4 ,census of ,non- ,inoculated4------------------ ,hubli4 ,inoculated4 ,non- ,inocul- ,inoculated4 ated4 ---------------------------------------- --------------------- ,five weeks ,fell from from ,may #aaej1jjj to to ,june #ad #dg1dbg #dd1egc #b1hed #dg #a ,week ending3 ,june #ba #dg1jhb #da1did #e1ehh #bb #c ,june #bh #dg1dhe #ci1jdb #h1ddc #bi #a ,july #e #df1ecg #cf1jbj #aj1eag #ee #f ,july #ab #df1eah #cc1bee #ac1bfc #cd #f ,july #ai #de1bdj #bi1gaf #ae1ebd #hb #g ,july #bf #dc1hji #bd1aab #ai1fig #ajj #ae ,aug4 #b #dc1gjg #ba1jca #bb1fgf #adj #af ,aug4 #i #db1gfh #ae1ehd #bg1ahd #bgb #ai ,aug4 #af #dj1dda #aj1fhe #bi1gef #chf #fa ,aug4 #bc #ci1djj #f1cfg #cc1jcc #cga #da ,aug4 #cj #ch1baj #d1jid #cd1aaf #cbh #bh ,sept4 #f #ch1chb #b1gca #ce1dfi #bbg #cd ,sept4 #ac #ch1djh #a1aaf #cg1bib #ach #dg ,sept4 #bj #ci1adb #icg #ch1bje #ajf #ee ,sept4 #bg #ci1cae #fjc #ch1gab #eh #bj ---------------------------------------- --------------------- ,,ii ---------------------------------------- ---------------------- ,plague death-rate4 ,comparison per #ajjj ,percentage reduction ,dates4 between of ,plague death-rate ------------------------ in favour of the ,non- ,inoculated4 ,inoculated4 ,inoculated4 ---------------------------------------- --------------------- ,five weeks from ,may #aa to ,june #ad #a4jbb 4#cej ,over #fe per cent4 ,week ending3 ,june #ba 4#ecj 4#ebg ,about #a per cent4 ,june #bh 4#gdb 4#aah ,nearly #he per cent4 ,july #e #a4ebd 4#egj ,about #fc per cent4 ,july #ab #a4jbb 4#deb ,nearly #ef per cent4 ,july #ai #b4gic 4#dej #hd per cent4 ,july #bf #d4adg 4#gfa #hb per cent4 ,aug4 #b #f4fef 4#gje #hi per cent4 ,aug4 #i #ag4cbe 4#fih ,over #if per cent4 ,aug4 #af #cc4fid #b4jhc #id per cent4 ,aug4 #bc #eg4jaa #a4bda #ih per cent4 ,aug4 #cj #hj4aaf 4#hbj #ih per cent4 ,sept4 #f #hc4aab 4#ieh #ii per cent4 ,sept4 #ac #aab4ijc #a4bfj ,over #ii per cent4 ,sept4 #bj #aac4abg #a4dci ,over #ii per cent4 ,sept4 #bg #if4ahe 4#eag ,over #ii per cent4 ---------------------------------------- --------------------- ,it appears that if the #dg1dbg inhabitants had remained1 as they did--in their town1 without running away by rail or otherwise1 or without camping out in a mass--and if no inoculation had been resorted to--they would have lost #bd1hii souls1 or a little over half of their number4 ,the official records show that this has actually occurred1 during the present terrible outbreak1 in a number of large villages1 of #bjjj inhabitants and over1 in the ,hubli taluka and elsewhere in the ,dhrwr ,district1 where no inoculation was done1 and no camping-out was possible on account of the wet weather4 7,haffkine's commentary on ,dr4 ,leumann's report47 ,that is the story of ,hubli2 and1 as it stands1 it is almost incredible4 ,the ,commissioners1 by very strict inquiry1 reduced it to credibility without robbing it of glory4 ,the inquiry brought out more instances of the immeasurable difficulty of the work4 ,natives who wished to avoid inoculation would escape through the back door at the sight of a plague officer3 bribery1 personation1 sale or transfer of certificates of inoculation1 concealment of cases and of deaths1 were all practised by those who wished not to be inoculated1 or to get the privileges of the inoculated without inoculation1 or to save their infected houses from being disinfected and unroofed4 ,again1 with the people dying like flies1 and many of them bearing no mark of identification1 and with the medical officers overworked past human endurance1 the wonder is1 not that the statistics were faulty1 but that there are any statistics at all4 ,certainly1 the ,commission is well within the mark in saying1 ,it is quite clear that a very large number of lives must have been saved in ,hubli by inoculations during the whole course of the epidemic there4 ,moreover1 we may note that an arithmetical estimate is not the only criterion by which we can appreciate the value of inoculations4 ,and in ,hubli their value is approved by the consensus of opinions of officers who have seen probably far more of this process and its results in practice than any other persons in ,india1 and who1 having every facility for forming a sound judgment as to its effect where plague was really virulent1 are satisfied as to its great value4 ,finally1 as at ,daman so at ,hubli1 there are lesser groups of statistics1 of that kind which is approved by the consensus of opinions of officers4 ,these are1 7#a7 ,lieutenant ,keelan's house-to-house investigation2 7#b7 the ,southern ,mahratta ,spinning ,mills2 7#c7 the ,southern ,mahratta ,railway employs4 #a4 ,lieutenant ,keelan made a house-to-house visitation of #bjj houses1 in each of which there were protected and unprotected persons living together1 and in each of which there had been one or more cases of plague4 ,the figures for #fi of these houses are appended to ,captain ,leumann's report4 ,they are as follows3-- ---------------------------------------- --------------- ,inmates4 ,cases4 ,deaths4 ,mortality4 ---------------------------------------- --------------- ,inoculated #ccf #aa #d #a4ai ,uninoculated #add #hd #hj #ee ---------------------------------------- --------------- ,these #fi houses were selected3 there was nothing unfair in the method of selection1 still1 they were good houses2 they are not1 therefore1 exact for statistics2 but1 as the ,commissioners say1 they are of interest as quite special examples of successful inoculation4 #b4 ,in the ,southern ,mahratta ,spinning and ,weaving ,company's ,mills1 a careful record of inoculation was kept and checked by the manager4 ,the number of the workpeople at the time when inoculation was begun1 #bast ,june1 was #aagc4 ,at the end of the epidemic the figures were3-- ---------------------------------------- ---------- ,deaths4 ,mortality per cent4 ---------------------------------------- ---------- ,inoculated twice #ajdj #bb #b4aa ,inoculated once #eh #h #ac4gi ,uninoculated #ge #bj #bf4ff ---------------------------------------- ---------- ,here1 again1 the figures have not a statistical value3 ,we are not informed whether the inoculations were performed simultaneously2 or at what stage of the outbreak the average strength of the inoculated was reached4 ,all the same1 what ,major ,bannerman says of them is true--,the experience in this company's mill at ,hubli should be an object lesson to all mill-owners in plague-stricken towns4 #c4 ,the figures for the ,southern ,mahratta ,railway are given by ,major ,bannerman in his ,statistics 7#aijj73 they are not mentioned in the ,report of the ,plague ,commission4 ,they are of great value1 because the daily shifting of the numbers was recorded as the work of inoculation went on1 and the date of each case of plague was also noted4 ,major ,bannerman gives the following account3-- ,the railway employs were living in barracks1 and in the railway yard1 apart from the general population of ,hubli town4 ,they were under close daily inspection by ,english officials1 who formed a committee for this purpose1 with ,dr4 ,chenai as their medical adviser4 ,the results may therefore be regarded as accurate in a high degree1 the numbers dealt with not being excessive1 and the supervision strict4 ,the figures1 based on the average numbers in each group1 are as follows3-- ---------------------------------------- ---------------- ,cases4 ,deaths4 ,mortality per cent4 ---------------------------------------- ---------------- ,twice inoculated #iij #f #a #j4a ,once inoculated #bgj #e #a #j4c ,uninoculated #gfj #ce #ba #b4g ---------------------------------------- ---------------- ,these eight instances must suffice3 many must be left out--among them1 ,dhrwr and ,gadag1 where ,miss ,corthorn1 ,m4,b41 did work as splendid as ,leumann's work at ,hubli2 and ,mr4 ,anderson's work in the ,ahmednagar villages2 and many more4 ,these plague-reports are to be read1 not for their record of heroic zeal and resourcefulness1 but only as one more example of many thousand lives saved by a method learned from experiments on animals4 ,but1 of course1 there is not1 and perhaps there never will be1 a national acceptance and adoption of this method through the length and breadth of ,india4 ,it does not work miracles2 it is an uncomfortable process to submit to2 privileges must be offered with it1 or the native will often prefer to take his chance2 the protection is of uncertain duration2 all sorts of lies are told about it1 partly by anti-vivisectionist writers1 partly by native political agitators1 partly by the hakims4 ,for instance1 at a meeting of hakims at ,masti1 ,lahore1 on #aath ,april #ahih1 the following resolutions were passed3-- ,that in the opinion of this meeting the bubonic plague is not a contagious disease4 ,it originates from poisoned air1 and this poison is created in the air on account of atmospherical germs and the excess of terrestrial humidities4 ,that this meeting1 having carefully considered the ,resolution of the ,punjab ,government 7#aath ,january #ahih71 is of opinion that the rules embodied in that ,resolution 7isolation1 disinfection1 etc471 are unnecessary under the principles of ,unani medical science4 ,and among statements to be made to the ,plague ,commissioners was the following1 from a native practitioner in ,bombay 7,april #ahii73-- ,i do not think the plague was imported in ,bombay from ,hong ,kong or anywhere else4 ,i attribute three sources of causes of outbreaks of plague in ,bombay3 7a7 ,the predisposing cause was the ,bombay ,municipality2 7b7 ,the exciting cause was the ,nature herself2 7c7 ,the aggravating cause was the ,plague ,committee4 ,all these difficulties were well stated by ,surgeon-,general ,harvey1 ,director-,general of the ,indian ,medical ,service1 at the discussion on ,haffkine's discourse before the ,royal ,society1 ,june #ahii3-- ,the people of ,england should consider the difficulties attending the work of a bacteriologist in ,india4444 ,he had no doubt as to the value of the inoculations4 ,at ,undhera he carefully examined the results of the experiment1 and1 as far as he could judge1 there was no possibility of error4 ,the results in that experiment were such as to be #ij per cent4 in favour of the inoculated against the uninoculated4 ,the natives of ,india were1 however1 a strange people1 and it was difficult to prophesy how they would act4 ,in ,calcutta1 the mention of inoculations had driven in hot haste from the city #cjj1jjj people1 many of whom afterwards returned and were inoculated2 while at ,hubli he had seen the inhabitants come in their thousands to be inoculated and pay for the inoculations4 ,the medical officer in charge at ,hubli had performed about #hj1jjj inoculations1 and had only observed some #ab abscesses4 ,he thought that #ab abscesses only1 in #hj1jjj inoculations1 showed good results4 ,but1 after all1 what were the numbers of inoculations performed to the #cjj1jjj1jjj inhabitants of ,india8 ,he felt that even if every one consented to be inoculated it was impossible to provide the vaccine or the medical officers for such a demand4 ,it was accordingly to sanitary improvements that he looked with the most confidence to protect ,india against the plague4 ,therefore1 now and for many years to come1 preventive inoculation must fall into line with the other world-wide ways of fighting plague--quarantine1 notification1 isolation1 all sanitary measures1 destruction of rats--le rat1 le gnie de la peste--evacuation of infected towns1 disinfection or unroofing of infected houses4 ,happily1 this is just what it does4 ,that admirable paper1 the ,indian ,medical ,gazette 7,september #aija71 has put this fact very simply3 ,no one ever imagined that inoculation was the only means of fighting plague4 ,its great value consists in its immediate application4 ,to sanitate1 ventilate1 and practically rebuild a town or village takes time2 and in the meantime thousands die4 ,for sudden outbursts of plague--since rats are one chief source of infection1 and notification is fundamentally abhorrent to native custom1 and evacuation may ruin trade1 or spread infection1 or be impossible by reason of the rains--since ,east is ,east1 and ,west is ,west--it is not always possible to provide1 for an ,indian village smitten by plague1 the excellent arrangements of the ,western world4 ,in all such cases1 and in all cases of epidemic plague within narrow limits1 as in jails1 barracks1 mills1 and the like centres of human life2 and in all inner communities1 such as the ,parsee community at ,daman1 or the ,jewish community at ,aden--by every test of this kind1 the saving power of preventive inoculation has been proved1 again and again1 past all doubt4 ,as for those larger death-traps1 ,hubli1 ,dhrwr1 and the rest of them1 here1 though the statistics are inexact1 we have the word of the men and women themselves who stood between the dead and the living1 and the plague was stayed4 ,such faults as there were1 in #ahii1 in the treatment--the contamination of this or that stock of the fluid1 and the inadequate method of standardisation--have been duly noted by the ,commission4 ,the rush for the fluid in #ahii may be estimated from the following paragraphs3-- 7i47 ,paris4 ,the preparation of anti-plague serum is being rapidly proceeded with2 up to the present time the ,institute has supplied it1 in response to all the very numerous requests which have come from ,portugal1 ,spain1 ,italy1 and ,turkey1 without encroaching on the reserve kept in readiness for ,paris and the departments4 7,lancet1 #afth ,september #ahii47 7ii47 ,india4 ,the spread of plague westward to ,spain and ,portugal seems to have excited more or less general alarm1 and ,i hear that an unprecedented demand has suddenly arisen for the plague prophylactic fluid4 ,the ,government of ,india have been asked the cost of supplying from #ej1jjj to #ajj1jjj doses1 and the earliest date at which this quantity could be despatched4 ,it is also desired to know if in case of need #ej1jjj doses a week could be sent to ,london4 ,russia desires to obtain a considerable stock for ,port ,arthur4 ,italy has been making inquiries for home use2 and also ,portugal1 in order to inoculate at ,mozambique4 ,the present laboratory is at ,government ,house1 ,parel1 ,bombay1 and has only recently been fitted up by the ,government of ,india4 ,about #aj1jjj doses a day can be turned out1 but it is thought that still further enlargements will be required if the demand should increase beyond this amount4 7,lancet1 #bcrd ,september #ahii47 99 99 99 99 99 ,it would take too long for the present purpose to consider what has been done1 not only for the prevention of plague1 but also for its cure by a serum treatment4 ,the results obtained by this treatment in ,india have not been very good2 but ,yersin and others report better results in other countries4 ,good results are reported from ,amoy 7#ahif71 ,nhatrang 7#ahih71 ,oporto 7#ahii71 and ,buenos ,ayres 7#ahii-aijj74 ,in ,glasgow1 the prophylactic use of ,yersin's serum seems to have done excellent service3 the success of its curative use was not very striking4 ,the curative results at ,nhatrang 7,yersin1 ,annales de l',institut ,pasteur1 ,march #ahii7 are notable4 ,nhatrang is an ,annamese fishing-village2 and the plague1 when it was left to itself1 killed every case that it got3-- ,la peste s'est montre excessivement meurtrire chez les ,annamites4 ,sur #gb cas de peste1 #ci personnes chez lesquelles la maladie a volu normalement1 ou qui n'ont t traits que par des mdecins indignes1 sont mortes sans exception4 ,les #cc autres cas ont pu tre traits par le srum1 quelquefois dans de bonnes conditions1 mais le plus souvent quelques heures seulement avant la mort4 ,malgr cela1 nous avons obtenu #ai gurisons et #ad dcs1 ce qui fait une mortalit de #db per cent41 chez les traits4 ,ainsi1 d'une part1 #ajj pour #ajj de mortalit chez les non-traits2 de l'autre1 #db per cent4 chez les malades qui ont reu du srum4 ,ces chiffres confirment les rsultats que j'avais obtenu en ,chine en #ahif4 ,a long review of this curative treatment1 fairly hopeful but nothing more1 is given in the ,report of the ,plague ,commission1 vol4 v41 pp4 #bfi-cbj4 ,the ,commissioners are of opinion that it ought not yet to be extended1 as a general measure1 over all the districts affected with plague2 and that there is need of more work in bacteriology before it can be thus extended4 ,we desire to record our opinion that1 though the method of serum-therapy1 as applied to plague1 has not been crowned with a therapeutic success in any way comparable to that obtained by the application of the serum method to the treatment of diphtheria1 none the less the method of serum-therapy is in plague1 as in other infectious diseases1 the only method which holds forth a prospect of ultimate success4 ,it is a strange contrast1 between this opinion and the statements made by the opponents of all experiments on animals4 ,some of these statements will be found in ,part ,,iv4 of this book4 ,happily for the world1 no amount of foul language can hinder the good work2 and1 when we talk of ,empire-building1 and of deeds that win the ,empire1 we must reckon bacteriology among them3 as ,lord ,curzon did1 in his speech at ,calcutta1 ,march #c1 #ahii--,what is this medical science we bring to you8 ,it is built on the bed-rock of pure irrefutable science2 it is a boon which is offered to all1 rich and poor1 ,hindu and ,mohammedan1 woman and man4 ,,ix ,,typhoid ,,fever4 ,,malta ,,fever ,,typhoid ,,fever ,the names of ,klebs1 ,eberth1 and ,koch1 are associated with the discovery1 in #ahhj-ha1 of the bacillus of enteric fever1 bacillus typhosus2 and it was obtained in pure culture by ,gaffky in #ahhd4 ,it has been studied from every point of view1 in man and in animals2 in the blood1 tissues1 and excretions2 in earth1 air1 water1 milk1 and food2 in its distribution1 methods of growth1 and chemical products4 ,especially1 the study of its chemical products has been directed toward 7#a7 immunisation against the disease1 7#b7 bacteriological diagnosis of the disease at an early stage4 ,the date of the first protective inoculations against typhoid is ,july to ,august #ahif3 they were made at ,netley ,hospital1 by ,professor ,wright and ,surgeon-,major ,semple4 ,the first inoculations in ,germany1 made by ,pfeiffer and ,kolle1 were published two months later4 ,the story of these famous ,netley inoculations is told in the ,british ,medical ,journal1 #cjth ,january #ahig4 ,eighteen men offered themselves-- ,a good deal of fever was developed in all cases1 and sleep was a good deal disturbed4 ,these constitutional symptoms had to a great extent passed away by the morning1 and laboratory work went on without interruption4444 ,with two exceptions1 all these vaccinations were performed upon ,medical ,officers of the ,army or ,indian ,medical ,services1 or upon ,surgeons on ,probation who were preparing to enter those services4 ,good luck attend all eighteen of them1 and immunity against typhoid1 wherever they are4 ,the doses that they received were estimated in proportion to the dose that would kill a guinea-pig of #cej-djj grammes weight2 and the protective fluid contained no living bacilli3-- ,the advantages which are associated with the use of such 'dead vaccines' are1 first1 that there is absolutely no risk of producing actual typhoid fever by our inoculations2 secondly1 that the vaccines may be handled and distributed through the post without incurring any risk of disseminating the germs of the disease2 thirdly1 that dead vaccines are probably less subject to undergo alterations in their strength than living vaccines4 ,the first use of the vaccine during an outbreak of typhoid was in ,october #ahig1 at the ,kent ,county ,lunatic ,asylum4 ,the treatment was offered to any of the working staff who desired it3-- ,all the medical staff1 and a number of attendants1 accepted the offer4 ,not one of those vaccinated--#hd in number--contracted typhoid fever3 while of those unvaccinated and living under similar conditions1 #af were attacked4 ,this is a significant fact1 though it should in fairness be stated that the water was boiled after a certain date1 and other precautions were taken1 so that the vaccination cannot be said to be altogether responsible for the immunity4 ,still1 the figures are striking4 7,lancet1 #aith ,march #ahih2 see also ,dr4 ,tew's paper1 in ,public ,health1 ,april #ahih47 ,certainly1 they are striking2 so is the story of the eight young subalterns on the ,khartoum expedition1 of whom six were vaccinated1 and two took their chance4 ,the six escaped typhoid1 the two were attacked by it1 and one died4 ,but these figures are too small to be of much value4 ,the first anti-typhoid inoculations on a large scale were made among ,british troops in ,india 7,bangalore1 ,rawal ,pindi1 ,lucknow71 when the ,plague ,commission1 of which ,professor ,wright was a member1 was in ,india1 ,november #ahih to ,march #ahii4 ,these inoculations were voluntary1 at private cost1 and without official sanction2 though the original proposal for them1 in #ahig1 had come from the ,indian ,government4 ,pending official sanction1 they were stopped4 ,then1 on #beth ,may #ahii1 the ,indian ,government made application to the ,secretary of ,state for ,india that they should be sanctioned1 and should be made at the public cost4 ,the application is as follows3-- ,the annual admissions per mille for enteric fever amongst ,british troops in ,india have risen from #ah4e in #ahij to #cb4d in #ahig1 while the death-rate has increased from #d4ja to #i4ja2 and we are of opinion that every practicable means should be tried to guard against the ravages made by this disease4 ,the anti-typhoid inoculations have been1 we believe1 on a sufficiently large scale to show the actual value of the treatment1 while the results appear to afford satisfactory proof that the inoculations1 when properly carried out1 afford an immunity equal to or greater than that obtained by a person who has undergone an attack of the disease2 further1 the operation is one which does not cause any risk to health4 ,in these circumstances1 we are very strongly of opinion that a more extended trial should be made of the treatment2 and we trust that your ,lordship will permit us to approve the inoculation1 at the public expense1 of all ,british officers and soldiers who may voluntarily submit themselves to the operation4 ,on #ast ,august1 the ,secretary of ,state for ,india announced in ,parliament that this treatment1 at the public expense1 had been sanctioned4 ,on #bjth ,january #aijj1 ,professor ,wright published in the ,british ,medical ,journal an account of these #ahih-ii inoculations in ,india4 ,they were undertaken under conditions which were very far from ideal4 ,in particular1 there is reason to suppose that the results obtained may have been unfavourably influenced by a weakening of the vaccine1 brought about by repeated re-sterilisation4 ,in no case was reinoculation done4 ,the statistics were compiled from information furnished by officers of the ,royal ,army ,medical ,corps actually in charge of troops in the various stations2 and were supplemented by reports received from the commanding officers of the various inoculated regiments4 ,they are as follows3-- ---------------------------------------- ----------- ,numbers under ,cases4,deaths4,percentage,percentage ,observation4 of ,cases4 of ,deaths4 ---------------------------------------- ----------- ,inoculated #bhce #bg #e #j4ie #j4b ,uninoculated #hdfj #bac #bc #b4e #j4cd ---------------------------------------- ----------- ,if the inoculated had been attacked equally with the uninoculated throughout the period of observation1 they would have had #ga cases instead of #bg4 ,these inoculations belong to the early part of #ahii4 ,during the rest of the year1 inoculations were made in ,india1 ,egypt1 and ,malta3 the results are given in an appendix to the ,report of the ,royal ,army ,medical ,department1 #ahii4 7,see ,british ,medical ,journal1 #bast ,september #aija47 ,the great majority of the troops tabulated were in ,india4 ,of the troops stationed at ,malta1 #fa were inoculated1 #bdef not inoculated2 among the former there were no cases1 among the latter there were #ag cases and #e deaths4 ,in ,egypt1 of #dhce troops1 #dfa were inoculated2 among these there were no cases1 among the uninoculated there were #cj cases and #g deaths4 ,in ,india1 of #cj1cec troops1 #dejb were inoculated1 leaving #be1hea not inoculated2 among the inoculated there were #dd cases and #i deaths1 among the non-inoculated #feg cases and #adf deaths4 ,taking the ,indian statistics1 and estimating percentage to strength1 we find1 amongst the inoculated1 admissions #j4ih1 deaths #j4b2 amongst the non-inoculated1 admissions #b4e1 deaths #j4ef4 ,the cases which occurred amongst the inoculated men were in the majority of instances of a mild character4 ,taking ,malta1 ,egypt1 and ,india together1 it appears that the inoculated1 if they had suffered equally with the non-inoculated1 would have had #ajh cases and #bd deaths1 instead of #dd cases and #i deaths4 ,at the end of #ahii1 this treatment1 only just out of the hands of science1 was suddenly demanded for the protection of a huge army at war in a country saturated with typhoid4 ,still1 the ,south ,african results1 and other results during #ahii to #aija1 show a good balance of lives saved4 ,the following paragraphs give all results published from the beginning of #aijj to ,may #aijb4 ,they are put in order of publication4 ,doubtless a few other reports have been overlooked in compilation2 but the list includes all that were easily accessible4 #a4 ,manchester1 ,england4 ,the ,british ,medical ,journal1 #bhth ,april #aijj1 contains a note by ,dr4 ,marsden1 ,medical ,superintendent of the ,monsall ,fever ,hospital1 ,manchester1 on the inoculation of #ad out of #bb nurses engaged in nursing typhoid patients4 ,of the remaining #h1 #d had already had typhoid4 ,the inoculations were made in ,october #ahii4 ,the following table shows the subsequent freedom from typhoid of the nursing staff3-- ---------------------------------------- ---------------------- ,year4 ,number of ,cases among ,typhoid ,patients4,nursing ,staff4 ---------------------------------------- ---------------------- #ahie #bbi #c #ahif #bch #c #ahig #cjb #d #ahih #dbf #h ,to end of ,september #ahii #afc #e ,from ,october #ahii to ,march #aijj #adf #j ---------------------------------------- ---------------------- #b4 ,ladysmith1 ,south ,africa4 ,the ,lancet1 #adth ,july #aijj1 contains a short note by ,professor ,wright1 on the distribution of typhoid among the officers and men of the military garrison1 during the siege of ,ladysmith4 ,the figures are as follows3-- ---------------------------------------- ----------------------- ,number4,no4 of,proportion,no4 of ,proportion ,case- ,cases4of ,cases4 ,deaths4of ,deaths4mortality4 ---------------------------------------- ----------------------- ,not inoculated #aj1ebi #adhi #a in #g4jg #cbi #a in #cb #a in #d4eb ,inoculated #a1gje #ce #a in #dh4g #h #a in #bac #a in #d4d ---------------------------------------- ----------------------- ,the wide difference between the two groups1 as regards the incidence of the disease1 is well marked2 but the case-mortality is practically the same in each group4 7,the statistics of the ,general ,hospital1 ,ladysmith1 also tell in favour of the preventive treatment3 see ,surgeon-,major ,westcott's letter1 ,british ,medical ,journal1 #bjth ,july #aija1 in answer to ,dr4 ,melville's letter1 ,british ,medical ,journal1 #bjth ,april #aija47 #c4 ,the ,portland ,hospital3 ,modder ,river and ,bloemfontein4 ,the ,british ,medical ,journal1 #ajth ,november #aijj1 contains an account by ,dr4 ,tooth of the cases of typhoid in this hospital4 ,concerning the preventive treatment1 he says3 ,the experience of my colleague ,dr4 ,calverley and myself may be of interest1 though we fear that the numbers are too few for safe generalisation4 ,personnel of the ,portland ,hospital4 ,we take first the relation of disease and inoculation among the personnel of the hospital4 ,twenty-four non-commissioned officers1 orderlies1 and servants of the ,portland ,hospital1 and #d of the medical staff1 were inoculated on the voyage out4 ,all these showed the local symptoms at the time2 that is1 pain1 stiffness1 and local erythema2 #ag also presented well-marked constitutional symptoms--general feeling of illness1 fever1 and headache4 ,of the orderlies1 #i had enteric fever subsequently4 ,two had refused inoculation1 and both of these had the disease very severely2 in fact one died4 ,of the inoculated cases1 #e had the disease lightly1 and #b fairly severely4 ,one of the sisters had the disease rather severely1 and she had not been inoculated4 ,officers and men admitted to the ,portland ,hospital4 ,we had under treatment at the ,portland ,hospital #bca cases of enteric fever1 most of which came under our care at ,bloemfontein4 ,we have not included in these figures a number of patients who came in convalescent for a short time only1 and on their way to the base1 and who would therefore appear in the admission and discharge book of the hospital4 ,if we did so1 of course our percentages would be lower4 ,of these #bca patients1 #ec had been inoculated at home or on the voyage out1 and of them #c died1 making a percentage of deaths among the inoculated of #e4f per cent42 #agh had not been inoculated1 of whom #be died2 that is1 a mortality among the non-inoculated of #ad per cent4 ,the general mortality in enteric fever with us was #bh deaths out of #bca cases2 that is1 #ab4a per cent41 which seems to compare favourably with the experience of the ,london hospitals4 ,it is interesting to record our experience among the officers taken separately4 ,thirty-three officers were admitted with enteric fever2 #ba had been inoculated2 that is1 #fc4f per cent42 a much larger percentage than among the men4 ,only one of these officers died1 and he had not been inoculated4 ,these figures are small1 but such as they are they are significant1 and they dispose us to look with favour upon inoculation4 ,so also does our clinical experience with our patients1 for among the inoculated the disease seemed to run a milder course4 #d4 ,no4 #i ,general ,hospital1 ,bloemfontein4 ,the ,medical ,chronicle for ,january #aija contains an account1 by ,dr4 ,j4 ,w4 ,smith1 of the work of this hospital4 ,he says3 ,the general impression amongst the medical officers in our hospital was that a single inoculation probably did not confer an immunity lasting very long--the lapse of time differing in individuals--and also that there was a tendency in the cases of enteric in inoculated patients to abort at the end of ten or fourteen days4 ,i should say1 however1 that a very considerable number of our detachment who had been inoculated suffered from enteric1 of whom #d at least died4 ,of the medical staff1 the only member of the junior staff who had not been inoculated died of enteric4 #e4 ,scottish ,national ,red ,cross ,hospital1 ,kroonstadt4 ,the ,british ,medical ,journal1 #abth ,january #aija1 contains an account of the work of this hospital by ,surgeon-,colonel ,cayley1 ,officer in ,charge4 ,he says3 ,the first section of the hospital1 consisting of #fa persons--officers1 nursing sisters1 and establishment--left ,southampton on #bast ,april #aijj4 ,during the voyage out1 all except #d were inoculated twice1 at an interval of about ten days2 #b were inoculated once2 and #b 7who had had typhoid7 were not inoculated4 ,immediately we reached the ,cape1 the hospital was sent up to ,kroonstadt in the ,orange ,river ,colony1 and remained there as a stationary hospital till the middle of ,october4 ,during this period there were always many cases of enteric under treatment in hospital4 ,further1 some of the medical officers and student orderlies had charge of the ,kroonstadt ,hotel temporary hospital1 which was crowded up with enteric cases2 and the nursing sisters1 for three weeks1 did duty in the military hospitals at ,bloemfontein in ,may and ,june1 when enteric fever was at its worst4 ,there was not a single case of enteric among the personnel of this first section of the hospital4 ,the second section of the hospital--medical officers1 nurses1 and establishment1 #hb in all--left ,southampton in ,may #aijj4 ,on board ship nearly all of them were inoculated1 but many of them only once4 ,the material for inoculation had been on board for some time1 and was not so fresh as in the first instance4 ,of this second section1 #a nurse had enteric at ,kroonstadt4 ,she was the only one1 out of a total of #cf nurses1 who suffered from enteric2 and she was the only nurse who was not inoculated1 excepting the #b who were protected by a previous attack of enteric4 ,a third section of the hospital1 consisting of #d medical officers and #af nurses1 went out in ,july2 they were all inoculated1 and none of them had enteric4 ,of the second section1 #e orderlies had enteric fever at ,kroonstadt1 of whom #b died4 ,of these #e1 there were #b inoculated 7once7 and #c non-inoculated4 ,of the #b who died1 #a had been once inoculated1 the other had not been inoculated4 #f4 ,meerut1 ,india4 ,the ,british ,medical ,journal1 #ith ,february #aija1 gives a short note by ,professor ,wright on inoculations in the #aeth ,hussars4 ,he says3 ,through the kindness of ,lieutenant-,general ,sir ,george ,luck1 commanding the ,bengal ,army1 ,i am permitted to publish the following officially compiled statistics1 dealing with the effects of anti-typhoid inoculations in the case of the #aeth ,hussars3-- ,from #bbnd ,october #ahii to #bbnd ,october #aijj4 ---------------------------------------- -------- ,strength4,inoculated4,cases4,deaths4 ---------------------------------------- -------- ,officers #bb #ai #j #j ,n4,c4,o4 and ,men #dha #cag #b #a ,women #cf #bd #j #j ---------------------------------------- -------- --------------------------------------- ,not ,inoculated4,cases4,deaths4 --------------------------------------- ,officers #c #j #j ,n4,c4,o4 and ,men #afd #aa #f ,women #ab #j #j --------------------------------------- ,it would thus appear that the incidence of enteric in the inoculated was represented by #j4ee per cent41 and the mortality by #j4bg per cent42 while the incidence in the uninoculated was #f4ad per cent41 and the death-rate #c4ce per cent4 ,if the inoculated had suffered equally with the uninoculated1 they would have had #bb cases with #aa deaths1 instead of #b cases with #a death4 #g4 ,the ,edinburgh ,hospital1 ,south ,africa4 ,the ,scottish ,medical and ,surgical ,journal1 ,march #aija1 contains an account of the work of the ,edinburgh ,hospital1 by ,dr4 ,francis ,boyd4 ,of the staff1 #eh were inoculated 7#bg once1 and #ca twice74 ,among these #eh1 there were #i cases of typhoid fever1 with ,i death1 in a patient who had old mitral disease4 ,our experience has been that1 while inoculation appears to modify the disease1 completely modified attacks are met with in the uninoculated4 ,again1 very severe attacks1 with complications and relapse1 occur in those who have been inoculated4 ,one cannot from this conclude that inoculation has been valueless1 for had not the patient been inoculated1 the attack might have been still more severe4 #h4 ,egypt and ,cyprus4 ,the ,british ,medical ,journal1 #dth ,may #aija1 gives a short note by ,professor ,wright on inoculations during #aija in ,egypt and ,cyprus4 ,he says3 ,i am indebted to the kindness of ,colonel ,w4 ,j4 ,fawcett1 ,r4,a4,m4,c41 ,principal ,medical ,officer in ,egypt1 for the following statistics dealing with the incidence of enteric fever1 and the mortality from the disease1 for the year #aijj1 in the inoculated and uninoculated among the ,british troops in ,egypt and ,cyprus3-- ---------------------------------------- -------------------------- ,average ,annual,cases4,deaths4,percentage,percen tage ,strength4 of ,cases4 of ,deaths4 ---------------------------------------- --------------------- ,uninoculated #bffi #fh #aj #b4ej #j4dj ,inoculated #gbj #a #a #j4ad #j4ad ---------------------------------------- -------------------------- ,these figures testify to a nineteen-fold reduction in the number of attacks of enteric fever1 and to a threefold reduction in the number of deaths from that disease1 among the inoculated4444 ,the only case which occurred among the inoculated was that of a patient admitted to hospital on the thirty-third day after inoculation4 ,it would seem that the disease was in this case contracted before anything in the nature of protection had been established by the inoculation4 #i4 ,imperial ,yeomanry ,hospital1 ,pretoria4 ,dr4 ,rolleston1 ,consulting ,physician to this hospital1 writes in the ,british ,medical ,journal1 #eth ,october #aija3 ,among the personnel of the hospital 7#ag medical officers1 #ej nursing sisters1 #hc orderlies1 etc471 total1 #aej1 there were #bb cases of enteric fever1 or an incidence of #ad4f per cent4 ,of the #aej1 #ce were inoculated1 and of these1 #f1 or #ag per cent41 suffered from enteric2 while1 of #aae non-inoculated members of the personnel1 #af1 or #ac4i per cent41 suffered from enteric fever2 the percentage is therefore higher among the inoculated4 ,there were #b deaths1 both in non-inoculated patients4 ,in #ajj cases of enteric fever among non-commissioned officers and men1 taken mainly from convalescent patients1 only #h had been previously inoculated2 there were #c fatal cases1 all among non-inoculated patients4 ,among #db officers who had enteric1 no fewer than #ai had been previously inoculated2 #f of these #ai cases were severe in character1 but none were fatal2 of the #bc non-inoculated cases1 #g were severe1 and of these #g1 #c ended fatally4 ,the interval between inoculation and the subsequent incidence of enteric fever varied between one and twenty-one months1 but in only four instances was the interval less than six months4 ,the average interval between inoculation and the onset of enteric fever in these #ai cases was thirty-eight weeks4 ,as far as these scanty figures go1 they point to the conclusion 7#a7 that anti-typhoid inoculation does not absolutely protect against a future attack of typhoid fever2 7#b7 that when enteric occurs in an inoculated person1 there is1 as a rule1 an interval of about six months2 7#c7 that inoculation protects against a fatal termination to the disease4 #aj4 ,richmond ,asylum1 ,dublin4 ,the ,british ,medical ,journal1 #bfth ,october #aija1 contains a note by ,professor ,wright on an outbreak of typhoid in this asylum during ,august to ,december #aijj4 ,inoculations were begun on #fth ,september1 by ,dr4 ,cullinan1 and by #cjth ,november #eaa persons were inoculated4 ,after careful criticism of all doubtful cases1 ,professor ,wright gives the following figures3-- ,comparative ,incidence of ,typhoid ,fever in ,inoculated and ,non-,inoculated1 calculated upon the average strength of the representative groups during the period intervening between the commencement of the inoculations and the termination of the epidemic4 ---------------------------------------- ----------------- ,average ,cases4 ,deaths4,percentage,percentage ,strength4 of ,cases4 of ,deaths4 ---------------------------------------- ----------------- ,uninoculated #bih #cj7-a87 #d #aj4a #a4c ,inoculated #cci #e7a87 #a #a4c #j4c ---------------------------------------- ----------------- ,it may be noted1 he says1 that the result is in conformity with that of all the statistical returns of anti-typhoid inoculation which have reached me4 #aa4 ,deelfontein4 ,the ,lancet1 #ahth ,january #aijb1 contains a paper by ,dr4 ,washbourn and ,dr4 ,andrew ,elliot1 on #bfb cases of typhoid fever in the ,imperial ,yeomanry ,hospital at ,deelfontein during the year ,march #aijj to ,march #aija4 7,see ,dr4 ,washbourn's earlier letter1 ,brit4 ,med4 ,jour41 #afth ,june #aijj47 ,they say3 ,in #baa of our cases1 it was definitely recorded whether the patient had been inoculated or not3 #ahf of these cases had not been inoculated1 with #bj deaths1 or a mortality of #aj4g per cent42 #be had been inoculated1 with #d deaths1 or a mortality of #af per cent4 ,the mortality was thus higher among the inoculated than among the non-inoculated4 ,of the personnel of the hospital1 there were #ei inoculated1 with #d cases1 and #be not inoculated1 with #d cases4 #ab4 ,winburg4 ,the ,lancet1 #eth ,april #aijb1 contains a short note by ,professor ,wright1 on the #eth ,battalion1 ,manchester ,regiment4 ,he says3 ,in view of the dearth of statistics bearing on the incidence of typhoid fever in ,south ,africa in inoculated and uninoculated persons respectively1 the following1 for which ,i am indebted to ,lieutenant ,j4 ,w4 ,west1 ,r4,a4,m4,c41 ,winburg1 ,orange ,river ,colony1 may not be entirely without interest4 ,the statistics here in question give the results obtained in the case of the #eth ,battalion1 ,manchester ,regiment1 for the six months which have elapsed since their landing in ,south ,africa4 ,the figures1 which relate to a total strength of #gdg men and officers under observation1 are as follows3-- ---------------------------------------- ----------------- ,number4 ,cases4 ,deaths4,percentage,percentage of ,cases4 of ,deaths4 ---------------------------------------- ----------------- ,uninoculated #edg #bc #g #d4b #a in #c4c ,inoculated #bjj #c #j #a4e #j ---------------------------------------- ----------------- ,the three attacks in the inoculated are reported to have been of exceptionally mild type1 contrasting in a striking manner with the severe attacks which occurred in the uninoculated4 ,at the time of sending in the report1 some of the uninoculated patients were 'not yet out of danger4' 99 99 99 99 99 ,certainly1 these instances show a good balance of lives saved1 not only under the adverse conditions of the war1 but also in ,egypt1 ,india1 and the ,united ,kingdom4 ,but the bacteriological work on typhoid fever has been directed also to the working out of a very different problem3 and that is the method of diagnosis which is called ,widal's reaction4 ,the practical uses of this reaction are of the utmost importance4 ,it is the outcome of work in different parts of the world--by ,wright and ,semple and ,durham in ,england1 ,chantemesse and ,widal in ,france1 ,pfeiffer and ,kolle and ,grber in ,germany1 and many more4 ,the first systematic study of it was made by ,durham and ,pfeiffer2 and ,widal's name is especially associated with the application of their work to the uses of practice4 ,admirable accounts of the whole subject are given by ,dr4 ,cabot in his book1 ,the ,serum-,diagnosis of ,disease 7,longmans1 #ahii71 and by ,mr4 ,foulerton in the ,middlesex ,hospital ,journal1 ,october #ahii and ,july #aija4 ,widal's reaction is surely one of the fairy tales of science4 ,the bacteriologist works not with anything so gross as a drop of blood1 but with a drop of blood fifty or more times diluted2 one drop of this dilution is enough for his purpose4 ,take1 for instance1 an obscure case suspected to be typhoid fever3 a drop of blood taken from the finger is diluted fifty or more times1 that the perfect delicacy of the test may be ensured2 a drop of this dilution is mixed with a drop of nutrient fluid containing living typhoid bacilli1 and a drop of this mixture of blood and bacilli is watched under the microscope3-- ,the motility of the bacilli is instantaneously or very quickly arrested1 and in a few minutes the bacilli begin to aggregate together into clumps1 and by the end of the half-hour there will be very few isolated bacilli visible4 ,in less marked cases1 the motility of the bacilli does not cease for some minutes2 while in the least marked ones the motility of the bacilli may never be completely arrested1 but they are always more or less sluggish1 while clumping ought to be quite distinct by the end of the half-hour4 ,the result of this clumping is also plainly visible to the naked eye1 by the subsidence of the agglutinated bacteria to the bottom of the containing vessel3 and thus an easy practical mode of diagnosis is afforded by it4 ,as with typhoid1 so with ,malta fever1 cholera1 and some other infective diseases4 ,and the unimaginable fineness of this reaction goes far beyond the time of the disease4 ,months1 even years1 after recovery from typhoid1 a fiftieth part of a drop of the blood will still give ,widal's reaction3 and it has been obtained in an infant whose mother had typhoid before it was born4 ,a drop of dried blood1 from a case suspected to be typhoid1 may be sent a hundred miles by post to be tested2 and typhoid1 like diphtheria1 may now be submitted to the judgment of an expert far away1 and the answer telegraphed back4 ,it would be difficult to exaggerate the practical importance of this reaction for the early diagnosis of cases of typhoid fever1 especially those cases that appear1 at the onset1 not severe4 ,,malta ,,fever ,the specific organism of ,malta fever 7,mediterranean fever71 the bacillus ,melitensis1 was discovered in #ahhg by ,surgeon-,major ,david ,bruce1 of the ,army ,medical ,staff4 ,its nature and action were proved by the inoculation of monkeys4 ,the use of ,widal's reaction is of great value in this disease3-- ,the diagnosis of ,malta fever from typhoid is1 of course1 a highly important practical matter4 ,it is exceedingly difficult in the early stages4 7,manson1 loc4 cit47 ,as with typhoid1 so with ,malta fever1 ,netley led the way to the discovery of an immunising serum4 ,in the course of the work1 one of the discoverers was by accident infected with the disease3-- ,he was indisposed when he went to ,maidstone to undertake anti-typhoid vaccination1 and after fighting against his illness for some days1 he was obliged to return to ,netley on #ith ,october4 ,examination of blood-serum 7,widal's reaction7 showed that he was suffering from ,malta fever4 ,it appears that he had scratched his hand with a hypodermic needle on #agth ,september1 when immunising a horse for the preparation of serum-protective against ,malta fever2 and his blood1 when examined1 had a typical reaction on the micrococcus of ,malta fever in #ajjj-;fold dilution4 ,the horse1 which has been immunised for ,malta fever for the last eight months1 was immediately bled1 and we are informed that the patient has now had two injections1 each of #cj cub4 cm4 of the serum4 ,he is doing well1 and it is hoped that the attack has been cut short4 7,british ,medical ,journal1 #afth ,october #ahig47 ,about fifty cases had up to ,september #ahii been treated at ,netley with marked benefit3 whereas they found that all drug-treatment failed1 the antitoxin treatment had been generally successful4#cf ,a good instance of the value of the serum-treatment of ,malta fever is published in the ,lancet1 #aeth ,april #ahii4 ,for a later account of this treatment and of its efficacy1 see the ,philadelphia ,medical ,journal1 #bdth ,november #aijj4 #cf ,for the whole subject1 see ,lancet1 #ith ,september #ahii1 paper by ,surgeon-,major ,birt and ,surgeon-,captain ,lamb4 ,two other cases of accidental inoculation occurred at ,netley4 ,another point is noted by ,sir ,patrick ,manson1 in his recent ,lane ,lectures 7,constable1 #aije74 ,for some time back1 he says1 a commission of experts1 working under the direction of the ,royal ,society1 has been studying this disease in ,malta4 ,the commission has accumulated much detailed information2 but the most important observation it has published is the fact that a large percentage of the goats in ,malta are infected with ,micrococcus melitensis1 and that the milk of the infected goats contains the bacterium4 ,may not this account for the great prevalence of ,mediterranean fever there and in other places having perhaps a similar milk-supply8 ,x ,,the ,,mosquito3 ,,malaria1 ,,yellow ,,fever1 ,,filariasis ,within the last few years1 it has been proved that the mosquito is an intermediate host1 between man and man1 of malaria1 yellow fever1 and filariasis 7elephantiasis74#cg ,just as the grosser parasites1 the tapeworms1 must alternate between man and certain animals1 and cannot otherwise go through their own life-changes and reproduce their kind1 so the micro-parasites that are the cause of malaria alternate between man and the mosquito1 having the mosquito as an intermediate host4 ,these organisms1 once they get into the mosquito1 pick out certain structures1 and there carry out a definite cyclical phase of their lives1 whereby their progeny make their way into the stylets of the mosquito1 and so get back to man1 who is their definite host4 ,thus1 malaria is not1 strictly speaking1 a disease of man2 it is one phase in man of micro-organisms that have another phase in mosquitoes4 ,so also with filariasis2 the filari in man1 their ova1 and their embryo-worms1 are one phase of filariasis2 and the embryo-worms in certain structures of the mosquito are another phase4 ,the plasmodium malari and the filaria are instances of a law of animal life that holds good also of plant life3-- ,all plants and animals possess parasites1 and thousands of different species of parasites have been closely studied by science2 we therefore know much about their general ways of life4 ,as a rule1 a particular species of parasite can live only in the particular species of animal in which1 by the evolution of ages1 it has acquired the power of living4 ,it is therefore not enough for the parasites of an individual animal--say a man--to be able to multiply within that individual1 but they must also make arrangements1 so to speak1 for their progeny to enter into and infect other individuals of the same species4 ,they cannot live for ever in one individual2 they must spread in some way or other to other individuals4 ,the shifts made by parasites to meet this requirement of their nature are many and various1 and constitute one of the wonders of nature4 ,some scatter their spores and eggs broadcast in the soil1 water1 or air1 as it were in the hope that some of them will alight by accident on a plant or animal suitable for their future growth4 ,many parasites employ1 in various ways1 a second species of animal as a go-between4 ,thus1 some tapeworms1 and the worms which cause trichinosis1 spend a part of their lives in the flesh of swine1 and transfer themselves to human beings when the latter eat this flesh4 ,to complete the cycle1 the parasites return to swine from human offal2 so that they propagate alternately from men to swine1 and from swine to men4 ,the blood-parasites which cause the deadly tsetse-fly disease among cattle in ,south ,africa are transferred from one ox to another on the proboscis of the ox-biting or tsetse-fly4 ,the progeny of the flukes of sheep enter a kind of snail1 which spreads the parasites upon grass4 ,the progeny of the guinea-worm of man enter a water-flea4 ,the progeny of the parasites which cause ,texas cattle-fever1 and which are very like the malarial parasites1 live in cattle-ticks1 and are transferred by the young of these ticks into healthy cattle4 7,ross1 ,malarial ,fever1 #aijb47 #cg ,for ,dr4 ,graham's experiments at ,beyrout1 which seem to prove that the mosquito can also convey dengue or dandy-fever1 see the ,new ,york ,medical ,record1 #hth ,february #aijb4 #a4 ,,malaria ,the plasmodium malari was discovered by ,laveran in #ahhj1 in the blood of malarial patients4 ,for many years his work stopped there1 because it was impossible to find the plasmodium in animals3 the difficulties surrounding the subject were so great that this discovery seemed to be almost hopeless4 ,in #ahid1 ,sir ,patrick ,manson--who had proved mosquitoes to be the intermediate host in the case of the parasitic nematode filaria--suggested1 as a working theory of malaria1 that the plasmodium was carried by mosquitoes4 ,this belief1 not itself new1 he made current coin4 ,he observed that there is a flagellate form of the plasmodium1 which only comes into existence after the blood has left the body3 and he suggested that the flagella might develop in the mosquito as an intermediate host1 a halfway-house between man and man4 ,then1 in #ahie1 ,ross set to work in ,india1 keeping and feeding vast numbers of mosquitoes on malarial blood2 and for two years without any conclusive result4 ,about this time came ,mac,callum's observations1 at the ,johns ,hopkins ,university1 on a parasitic organism1 halteridium1 closely allied to the plasmodium malari2 he showed that the flagella of the halteridium are organs of impregnation1 having observed that the non-flagellated form1 which he regarded as the female1 after receiving one of the flagella1 changed shape1 and became motile4 ,in ,august #ahig1 ,ross found bodies1 containing pigment like that of the malarial parasite1 in the outer coat of the stomach of one kind of mosquito1 the grey or dapple-winged mosquito1 ,anopheles maculipennis1 that had been fed on malarial blood4 ,in ,february #ahih1 he was put on special duty under the ,sanitary ,commissioner with the ,government of ,india1 to study malaria1 and started work again in ,calcutta3-- ,arriving there at a non-fever season1 he took up the study of what may be called 'bird malaria4' ,in birds1 two parasites have become well known--7#a7 the halteridium1 7#b7 the proteosoma of ,labb4 ,both have flagellated forms1 and both are closely allied to the plasmodium malari4 ,using grey mosquitoes and proteosoma-infected birds1 ,ross showed by a large number of observations that it was only from blood containing the proteosoma that pigmented cells in the grey mosquito could be got2 therefore that this cell is derived from the proteosoma1 and is an evolutionary stage of that parasite4 ,next1 ,ross proceeded to find out its exact location1 and found that it lay among the muscular fibres of the wall of the mosquito's stomach4 ,it grows large 7#dj-gj micro-millimetres7 and protrudes from the external surface of the stomach1 which under the microscope appears as if covered with minute warts4 7,manson1 at ,edinburgh meeting of ,british ,medical ,association1 #ahih47 ,these pigmented spherical cells give issue to innumerable swarms of spindle-shaped bodies1 germinal rods2 and in infected mosquitoes ,ross found these rods1 in the glands that communicate with the proboscis4 ,thus the evidence was complete1 that the plasmodium malari1 like many other parasites1 has a special intermediate host for its intermediate stage of development2 and that this host is the dapple-winged mosquito4 ,it is impossible to over-estimate the infinite delicacy and difficulty of ,ross's work2 for instance1 in his ,abstract of ,recent ,experiments with ,grey ,mosquitoes1 he says that out of #bde grey mosquitoes fed on birds with proteosoma1 #agh1 or #gb per cent41 contained pigmented cells2 out of #bdi fed on blood containing halteridium1 immature proteosoma1 c41 not one contained a single pigmented cell4 ,another time 7,april #ahih7 he counted these pigment-cells under the microscope3-- ,ten mosquitoes fed on the sparrow with numerous proteosoma contained #ajji pigmented cells1 or an average of #aja each4 ,ten mosquitoes fed on the sparrow with moderate proteosoma contained #bib pigmented cells1 or an average of #bi each4 ,the mosquitoes fed on the sparrow with no proteosoma contained no pigmented cells4 ,finally1 he completed the circle of development by infecting healthy sparrows by causing mosquitoes to bite them4 ,in #ahii1 there went out a ,german ,commission to ,german ,east ,africa1 a ,royal ,society's ,commission to ,british ,central ,africa1 and an expedition from the ,liverpool ,school of ,tropical ,medicine2 in #aijj1 another ,german ,commission1 this time to the ,east ,indies1 and another expedition from the ,liverpool ,school2 by ,july #aija1 the ,liverpool ,school was organising its seventh expedition4 ,italy1 of course1 has given infinite study to the disease3-- ,it has been decided that1 in addition to the stations of observation and experiment in the provinces of ,rome1 ,milan1 ,cremona1 ,mantua1 ,gercara1 ,foggia1 ,lecce1 others shall be established in the provinces of ,udine1 ,verona1 ,vicenza1 ,padua1 ,ravenna1 ,pisa1 ,basilicata1 and ,syracuse4 ,besides epidemiological researches1 applications on a large scale will be made of preventive measures for the protection of the agricultural population against the scourge4 ,another extensive experiment on the prophylaxis of malaria will be made on the ,emilian littoral4 ,moreover1 in all the malarious regions of the ,italian peninsula the provincial and communal administrations and many private persons will co-operate in the application of preventive measures4 ,from all this it may be gathered that during the summer and autumn the war against malaria will be carried on in ,italy with great vigour and thoroughness4 7,british ,medical ,journal1 #fth ,july #aija47 ,in ,india1 the work started in #aijj by the ,royal ,society ,commissioners1 and by the ,nagpur ,conference1 has been widely extended2 especially by such researches as those of ,major ,buchanan1 ,i4,m4,s41 ,superintendent of the ,central ,jail1 ,nagpur4 ,the following paragraph1 from the report of the ,sanitary ,commissioner with the ,government of ,india1 refers to ,major ,buchanan's published work1 ,malarial ,fevers and ,malarial ,parasites in ,india3-- ,a remarkable note is struck at the outset1 in the acknowledgment made1 by the author1 of the capable assistance rendered in these researches by several of his ,burmese prisoners1 whom he trained to the use of the microscope1 and who soon became expert in detecting and distinguishing the various kinds of parasites4444 ,besides a systematic clinical account of the different forms of fever and the associated parasites1 which is the first attempt of the kind in ,india1 there are a summary of the facts showing the relation of the seasonal prevalence of ,anopheles to the incidence of attacks2 experiments exhibiting the protective effects of mosquito-curtains2 inoculation-experiments2 researches on the blood-parasites of birds2 and many other points4444 ,nor can we pause to notice the many attempts now being made by health officers and others to pursue the methods of prophylaxis indicated2 these efforts are necessarily in the tentative stage1 but1 so far1 and especially where carried out in connection with small communities and institutions1 they are giving promise of gratifying success4 ,the famous experiment made by ,dr4 ,sambon and ,dr4 ,low in #aijj1 must be recalled here3-- ,dr4 ,luigi ,sambon and ,dr4 ,g4 ,c4 ,low1 both connected with the ,london ,school of ,tropical ,medicine1 volunteered to live from ,june till ,october1 that is to say1 through what may be called the height of the malaria season1 in a part of the ,campagna near ,ostia1 which is so infested by the disease that no one who spends a night there under ordinary conditions escapes the effect of the poison4 ,dr4 ,sambon1 ,dr4 ,low1 ,signor ,terzi1 and their servants1 have now exposed themselves to the pestilential influence of this valley of the shadow of death for over two months4 ,they live in a mosquito-proof hut2 they take no quinine or other drug which might be regarded as prophylactic4 ,not one of the experimenting party has the least sign of infection4#ch444 ,what for practical purposes may be regarded as an experiment of the same kind is being conducted in ,west ,africa4 ,dr4 ,elliot1 a member of the ,liverpool expedition sent to ,nigeria some time ago to investigate the subject of malarial fever1 has recently returned to this country4 ,he reports that the members of the expedition have been perfectly well1 although they have spent four months in some of the most malarious spots4 ,they lived practically amongst marshes and other places hitherto supposed to be the most deadly4 ,they have not kept the fever off by the use of quinine1 and they attribute their immunity to the careful use of mosquito-nets at night4 7,british ,medical ,journal1 #bbnd ,september #aijj47 #ch ,sir ,patrick ,manson1 in the ,british ,medical ,journal1 #bith ,september #aijj1 gives the following account of this experiment3--,a wooden hut1 constructed in ,england1 was shipped to ,italy and erected in the ,roman ,campagna1 at a spot ascertained by ,dr4 ,l4 ,sambon1 after careful inquiry1 to be intensely malarial1 where the permanent inhabitants all suffer from malarial cachexia1 and where the field-labourers1 who come from healthy parts of ,italy to reap the harvest1 after a short time all contract fever4 ,this fever-haunted spot is in the ,king of ,italy's hunting-ground near ,ostia1 at the mouth of the ,tiber4 ,it is waterlogged and jungly1 and teems with insect life4 ,the only protection employed against mosquito-bite and fever by the experimenters who occupied this hut was mosquito-netting1 wire screens in doors and windows1 and1 by way of extra precaution1 mosquito-nets round their beds4 ,not a grain of quinine was taken4 ,they go about the country quite freely--always1 of course1 with an eye on ,anopheles--during the day1 but are careful to be indoors from sunset to sunrise4 ,up to #bast ,september1 the date of ,dr4 ,sambon's last letter to me1 the experimenters and their servants had enjoyed perfect health1 in marked contrast to their neighbours1 who were all of them either ill with fever1 or had suffered malarial attacks4 ,a similar experiment1 of the utmost importance1 was made in #aijj by ,professor ,grassi4 ,it concerned the workmen and their families along the ,battipaglia-,reggio railway1 #ajd in all1 including #cc children4 ,the great majority of them had suffered from malaria in the preceding year2 and only #aa1 including #d children1 had never suffered from it4 ,pending the arrival of the malarial season1 quinine was given to all who needed it4 ,the first ,anopheles with its salivary glands infected was found on #adth ,june4 ,twelve days later came a case of malaria outside the zone of experiment1 in a person who had never had malaria before4 ,the twelve days correspond to the incubation-period after infection4 ,anopheles having come1 and the malarial season with him1 the experiment was begun4 ,the houses were carefully protected with wire netting1 chimneys and all2 the siesta was taken under wire netting2 the workmen1 if they were out in the evening or at night1 wore veils and gloves2 and ,anopheles was to be killed wherever he was found4 ,quinine was altogether given up and forbidden1 except for three workmen who had escaped or evaded its use before ,june1 and had1 indeed1 never before been treated with quinine2 one of them1 moreover1 had been sleeping outside the zone of experiment in ,july4 ,except these three1 all the #ajd and their doctors remained absolutely free from malaria up to #afth ,september1 the date of ,professor ,grassi's report3-- ,rightly to estimate the value of these facts1 it is necessary briefly to describe the surroundings of the protected area4 ,towards the north1 coming from ,battipaglia1 three railway cottages are situated1 at a distance of #a1 #b1 and #c kilometres respectively4 ,the #be inhabitants of these cottages1 although they were put under the tonic and quinine treatment in the non-malarial season1 all without exception were taken ill with malarial fevers1 in many cases obstinate4 ,experiments of voluntary exposure to bite from an infected mosquito were made at or about this time1 in ,london1 ,new ,york1 ,italy1 and ,india4 ,the ,london consignment of mosquitoes had been allowed to bite a malaria-patient in ,rome4 ,the experiment had to be very carefully planned3-- ,to have sent mosquitoes infected with malignant tertian parasites might have endangered the life of the subject of the experiment2 and quartan-infected insects might have conferred a type of disease which1 though not endangering life1 is extremely difficult to eradicate4 ,the cases1 therefore1 on which the experimental insects were fed had to be examples of pure benign tertian--a type of case not readily met with in ,rome during the height of the malarial season2 the absolute purity of the infection could be ascertained only by repeated and careful microscopic examination of the blood of the patient4 7,british ,medical ,journal1 #bith ,september #aijj47 ,the mosquitoes were forwarded1 through the ,british ,embassy in ,rome1 to the ,london ,school of ,tropical ,medicine4 ,the two brave gentlemen who let themselves be bitten by some thirty of the mosquitoes were in due time attacked by malaria1 and the tertian forms of the parasite were found in their blood4 ,nine months later1 one of them had a relapse1 and the parasite was again found in his blood4 ,it is not possible to sum up the wealth of work on malaria published in #aijj-aija4 ,good accounts of it are in the ,transactions of the ,section of ,tropical ,diseases1 at the ,annual ,meeting of the ,british ,medical ,association 7,cheltenham1 #aija71 and in the ,thompson ,yates ,laboratories ,reports1 vol4 iii41 pt4 #b1 #aija4 ,everything had to be studied3 not only the nature and action of the plasmodium in all its phases1 but also the whole natural history and habits of the ,anopheles of different countries2 and1 above all1 the incidence of the disease on natives and on ,europeans in ,china1 ,india1 and ,africa4 ,all that can be done here is to try to indicate the principal lines followed in the present world-wide campaign against malaria4 ,the following paragraphs are taken mostly from the accounts given by ,dr4 ,christophers and ,dr4 ,annett1 in the ,thompson ,yates ,laboratories ,report1 #aija3-- #a4 ,elimination of the ,infection at its ,source4 ,this is the method employed with success by ,professor ,koch in ,new ,guinea1 viz41 to search out all cases of malaria 7the concealed ones in particular71 and to render them harmless by curing them with quinine4 ,at ,stephansort1 by thus hunting up all infected cases1 and as it were1 sterilising them by the systematic administration of quinine1 he was able to achieve a great reduction of the disease in the next malarial season1 even under adverse conditions4 ,he says1 in his report to the ,german ,government3 ,the results of our experiment1 which has lasted nearly six months1 have been so uniform and unequivocal that they cannot be regarded as accidental4 ,we may assume that it is directly owing to the measures we have adopted that malaria here has1 in a comparatively short time1 almost disappeared4 ,this method1 of course1 is applicable only in small communities2 and1 within these limits1 it may become one of the most valuable of all methods1 being1 like the quality of mercy1 a blessing both to him who gives and to him who taketh4 ,but it cannot be practised on a vast scale4 ,this difficulty is well put by ,sir ,william ,mac,gregor1 ,k4,c4,m4,g41 ,governor of ,lagos1 ,west ,africa3-- ,in all probability1 the day will come before long1 when newly-appointed officers for places like ,lagos will have to undergo a test as to whether they can tolerate quinine or not4 ,a man that cannot1 or a man that will not1 take quinine1 should not be sent to or remain in a malarial country1 as he will be doing so at the risk of his own life1 and to the danger of others4444 ,the great difficulty is how to extend this treatment beyond the service1 more particularly to the uneducated masses of the natives4 ,it is simply impossible to protect the whole population by quinine administered as a prophylactic4 ,in the first place1 the great mass of natives would not take the medicine2 and1 in the second place1 the ,government could not afford to pay for the #gj tons of quinine a year that would be required to give even a daily grain dose to each of #c1jjj1jjj of people4 #b4 ,segregation of ,europeans from ,natives4 ,this method is strongly advocated by the members of the ,nigeria ,expedition of the ,liverpool ,school 7#aijj74 ,the distance of removal to half a mile is considered sufficient3 ,considerable evidence has now been accumulated to prove that the distance which is traversed by a mosquito is never very great1 and extremely rarely reaches so much as half a mile4 ,the arguments in favour of this method of segregation are of so great interest that they must be put here at some length4 ,the drawback is that the method cannot be followed everywhere to its logical issue without some risk of giving offence1 of seeming to abandon the native1 of damaging commerce1 and so forth4 ,but1 short of this1 much might be done for the protection of ,europeans in ,africa3-- ,this method is a corollary of the discovery that native children in ,africa practically all contain the malaria parasite1 and are the source from which ,europeans derive malaria4 ,koch showed in ,new ,guinea that in most places infection was very prevalent in native children1 so much so that in some villages #ajj per cent4 of those examined contained parasites4 ,he also showed that1 as the children increased in age1 immunity was produced1 so that in the case of adults a marked immunity was present1 and malarial infection was absent4 ,the ,malaria ,commission showed1 independently1 that a condition of universal infection existed among the children of tropical ,africa1 associated with an immunity of the adults4 ,this infection in children had many remarkable characteristics4 ,the children were in apparent health1 but often contained large numbers of parasites1 and a small proportion only of the children failed to show some degree of infection4444 ,the ,liverpool ,school ,expedition found a similar condition of affairs in all parts of ,nigeria visited by them4 ,with a knowledge of the ubiquity of native malaria1 the method of infection of ,europeans becomes abundantly clear4 ,the reputed unhealthiness or healthiness of stations is seen at once to be dependent on the proximity or non-proximity of native huts4 ,the attack of malaria after a tour up-country1 the malaria at military stations like ,prah-su1 the abundance of malaria on railways1 are all explicable when the extraordinary condition of universal native infection is appreciated4 ,it is evident that1 could ,europeans avoid the close proximity of native huts1 they would do away with a very obvious and great source of infection4444 ,when it is understood that each of these huts certainly contains many children with parasites in their blood1 and also scores or hundreds of ,anopheles to carry the infection1 then the frequency with which ,europeans suffer from malaria is scarcely to be wondered at4444 ,the accompanying plan is that of a new railway settlement on the ,sierra ,leone ,railway4 ,miles of land free from huts exist along the line1 but the close neighbourhood of native huts has been selected4 ,at the time of building of these quarters1 it lay in the power of the engineers to have a malaria-free settlement2 instead of which1 by the non-observance of a simple fact1 the station is most malarious3 in this particular instance1 much ingenuity has been shown in providing each set of ,european quarters with plenty of malarial infection4 ,in towns only is there any difficulty in carrying out the principle of segregation4 ,in two instances1 however1 this has been carried out in towns1 with the result that the segregated communities of ,europeans are notoriously the most healthy on the ,west ,coast4 ,even when no scheme of complete segregation can be carried out1 the principle should always be borne in mind1 and1 whenever opportunity offers1 huts should be removed1 and ,european houses built in the open4444 ,it is almost universally the rule in ,west ,africa to find ,european houses built round by native quarters1 a practice which long experience in ,india has taught ,europeans to avoid carefully4 ,at ,old ,calabar1 many of the factories are almost surrounded1 except in front1 by native habitations2 similarly1 at ,egwanga1 the small native town is built by the side and back of one of the factories4 ,also at the ,niger ,company's factory at ,lokoja1 the native houses are very close up to the ,company's boundary railings4 ,akassa engineers' quarters may be1 again1 mentioned as an example where the engineering artisans1 chiefly natives of ,lagos1 ,accra1 and ,sierra ,leone1 are housed with their families alongside the ,european house4 ,a large proportion of these native children were found by us to contain malarial parasites4 ,similarly also at ,asaba1 the proximity of the barracks of the ,hausa soldiers1 who have their wives and children with them1 is a dangerous menace to the officers at the ,force ,house4 ,examples of the opposite condition of affairs might also be given4 ,for instance1 at ,old ,calabar1 the ,government offices and ,consulate1 ,vice-,consulate1 and medical house1 are comparatively free from malarial fever2 it having been established that the natives shall not build on the ,european side of the creek separating the two slopes on which the native town and ,european quarters are built4 ,this creek is at a distance of about half a mile from the houses mentioned4 ,it is plain1 from these and other instances given by the members of the ,nigeria ,expedition1 that a modified sort of segregation can be effected in many places1 without any injury either to native feelings1 or to politics1 or to commerce2 and that by such segregation the risk of malaria among ,europeans in ,africa would be diminished4 #c4 ,protection against ,anopheles4 ,manson1 in his ,tropical ,diseases 7#aije71 says1 ,the question is often asked1 ,is there any other way by which malaria can be contracted than through a mosquito-bite8 ,for many reasons1 ,i believe not4 ,it is difficult to prove a negative2 but1 so far1 there is no observation capable of bearing investigation that would lead us to suppose that malaria can be acquired1 under natural conditions1 except by mosquito-bite1 ,all authorities are agreed that1 practically1 the fight against malaria and the fight against ,anopheles are one and the same thing2 and the experiments by ,sambon1 ,low1 and ,grassi1 show what can be done1 in this war against the mosquito1 by way of defence4 ,but what is practicable in ,italy might not be generally practicable on the ,west ,african coast2 as ,sir ,william ,mac,gregor says of ,lagos3-- ,it is not likely that in a place like ,lagos as good results can be obtained from the use of mosquito-proof netting as in ,italy4 ,one great objection to it here is the serious and highly disagreeable way it checks ventilation4 ,this is a difficulty that cannot be fully brought home to one in a cold climate4 ,but1 in a low-lying1 hot1 and moist locality like ,lagos1 it comes to be a choice of evils1 to sit inside the netting stewed and suffocated1 or to be worried and poisoned by mosquitoes outside4 ,the netting is hardly a feasible remedy as regards native houses4 ,it is not possible to protect even ,european quarters completely by it4 ,few officers or others are so occupied that they could spend the day in a mosquito-proof room4 ,certain it is that any man that suffers from the singular delusion that mosquitoes bite only during the night1 would have a speedy cure by spending a few days1 or even a few hours1 in ,lagos4 ,operations here 7,september #aija7 are being limited to supplying one mosquito-proof room to the quarters of each officer4 ,in this he will be able to spend the evening free from mosquitoes if he chooses to do so4 ,the ,european wards of the hospital are similarly protected4 ,the ,european in ,africa1 as ,ross says1 is generally neglectful of his health2 and the unhealthiness of the ,african coast is to some extent due to the life that men lead there3-- ,let us compare the habits of a ,european in a business-house in ,calcutta with the habits of a ,european in ,west ,africa4 ,in ,calcutta he sleeps under a punkah or mosquito-net1 or both2 he dresses and breakfasts under a punkah2 in the evening he takes vigorous exercise1 and he dines under a punkah4 ,he wears the lightest possible clothing1 he lives in a solid1 cool1 airy house1 and he obtains very good food2 once in five or six years1 he returns to ,europe for leave4444 ,in ,africa1 the houses are frequently very bad2 in ,freetown1 for instance1 they are the same as the houses of natives1 and are mingled with them4 ,the ,anglo-,african seems to imagine that he can live in the tropics in the same manner as he lives in ,england4 ,he seldom uses a punkah1 except perhaps for an hour at dinner-time1 and1 not seldom1 he neglects even the mosquito-net4 ,the food is often1 or generally1 execrable4 ,owing to the frequent absence of gymkhanas and clubs1 the exile obtains little suitable exercise4 ,but whatever risks the old resident may choose to take1 the newcomer can at least use a proper and efficient mosquito-net at night1 and avoid sleeping in a native house1 and protect himself in these and the like ways against malaria4 #d4 ,the keeping down of ,anopheles4 ,the breeding places of ,anopheles are ponds1 swamps1 and puddles1 roadside ditches1 tanks1 and cisterns1 old disused canoes1 and the like collections of stagnant water3 also the smaller receptacles that are more generally occupied by ,culex1 such as broken bottles1 old tins1 pots1 and calabashes1 and barrels1 whatever will hold water--all the dbris and broken rubbish round huts or houses4 ,in all these places1 ,anopheles' eggs or larv are found2 and1 with practice1 it is easy to detect them4 ,of course1 it is not easy to wage war against the adult mosquito3 the work is1 ,venienti occurrere morbo1 to organise gangs of workmen1 or of prison labour1 and mosquito brigades2 to clear the ground of cartloads of old biscuit-tins1 broken gin-bottles1 and other dust-heap things1 in and around the place2 to cover-in the cisterns1 rain-barrels1 and wells2 to clean pools and duck-ponds of weed1 and stock them with minnows2 to put a film of kerosene to the puddles1 or sweep them out1 or fill them up and turf them over2 everywhere1 to drain1 and level1 and clean-up the surface soil2 and everywhere1 by these and the like methods1 to break the cycle of the life of the plasmodium malari3-- ,draining and cultivation where the land will repay the expenditure1 permanent and complete flooding where it will not1 and such flooding is possible2 proper paving of unhealthy towns1 and the filling-in of stagnant1 swampy pools2 these--in other words1 all measures calculated to keep down mosquitoes--are the more important things to be striven for in attempting the sanitation of malarious districts4 ,in ,england1 in ,holland1 in ,france1 in ,algeria1 in ,america1 and in many other places1 enormous tracts of country1 which formerly were useless and pestilential1 have been rendered healthy and productive by such means4 7,manson47 ,and1 short of such great enterprises as ,government works of drainage1 much has already been done1 in many ,african towns1 and in ,india1 by the work of a few men and women3 not only by practical sanitary improvements1 but by insistent teaching and lecturing4 ,for the admirable results recently obtained in ,ismailia1 ,algeria1 ,formosa1 and the ,malay ,states1 see the ,medical ,annual1 #aije and #aijf4ci #ci ,this paper1 by ,dr4 ,stephens1 gives also the reasons why equally good results were not obtained at ,mian ,mir1 ,punjab4 ,the whole paper is of great interest4 ,before leaving the subject of malaria1 it must be added that the discovery and study of the parasite which causes it have cleared up the mystery of the specific action of quinine upon the disease4 ,it operates simply by its germicidal effect upon the microbe4 ,but1 beyond this1 we have now a clue which we never had before to guide us to the most advantageous manner of administering the drug4 #b4 ,,yellow ,,fever ,the specific organism of malaria may become active again and again in the blood1 causing relapses twenty years or more after the original infection4 ,the specific organism of yellow fever expends itself at once1 in one acute attack2 and1 if the patient recovers1 he is thenceforth more or less immune against infection4 ,that the inoculation of the disease1 by the application of a single mosquito recently contaminated1 is calculated to produce a mild or abortive attack less dangerous than the average attack among the non-acclimatised1 was known to ,finlay1 and was confirmed in #ahii by the ,army ,commission of the ,united ,states4 ,of the mortality of the disease1 ,sir ,patrick ,manson1 in #aijj1 wrote as follows3-- ,it is better for women and children than for men2 better for old residents than for newcomers2 worst of all for the intemperate4 ,according to a table of #bic carefully observed cases given by ,sternberg1 the mean mortality in the whole #bic cases was #bg4g per cent4 ,this may be taken as a fairly representative mortality in yellow fever among the unacclimatised1 something between #be and #cj per cent41 although in some epidemics it has risen as high as #ej or even #hj per cent4 of those attacked4444 ,some of these epidemic visitations bring a heavy death-bill2 thus1 in ,new ,orleans1 in #ahec1 #gigj people died of yellow fever2 in #ahfg1 #cjic2 in ,rio1 in #ahej1 it claimed #dafj victims2 in #aheb1 #aidc2 and in #ahhf1 #acig4 ,in ,havana1 the annual mortality from this cause ranges from #ejj to #afjj or over4 ,the earlier attempts to reproduce the disease1 by inoculation with its products1 failed altogether3-- ,in #ahaf1 ,dr4 ,chervin1 of ,point--,pitre 7,antilles71 drank repeatedly large quantities of black vomit without feeling the least disturbance4 ,some years before1 other ,north ,american colleagues1 ,doctors ,potter1 ,firth1 ,catteral1 and ,parker1 did everything possible to inoculate themselves with yellow fever4 ,after having uselessly attempted experiments on animals1 they experimented on themselves1 inoculating the black matter at the very moment in which the moribund patient rejected it1 placing this matter in their eyes1 or in wounds made in their arms1 injecting it more than twenty times in various parts of their body 444 in short1 devising every sort of daring means for experimentally transmitting yellow fever4 ,all these experiments were without result1 and in the ,united ,states during many years it was believed that this terrible malady was non-contagious4 7,british ,medical ,journal1 #crd ,july1 #ahig47 ,the history of the subject1 from #ahab to #ahhj1 is given by ,dr4 ,finlay of ,havana1 in the ,new ,york ,medical ,record 7#ith ,february #aija74 ,in #ahhj1 two very important reports on the disease were published2 one by a ,havana ,commission of the ,national ,board of ,health of the ,united ,states1 the other by the ,united ,states ,navy ,department4 ,they tended to show that yellow fever is a germ-disease2 that it is not wind-borne2 and that there may be some change1 outside the body of the patient1 whereby the virulence of the active principle of the disease is heightened4 ,from these reports1 ,dr4 ,finlay advanced his doctrine that the mosquito receives and transmits the germs of the disease3-- ,it was upon the above line of reasoning 7in these reports71 that ,i conceived the idea that the yellow-fever germ must be conveyed from the patient to the non-immunes by inoculation1 a process which could be performed in nature only through the agency of some stinging insect whose biological conditions must be identical with those which were known to favour the transmissibility of the disease4 ,in #ahha he inoculated himself and six soldiers with infected mosquitoes1 and obtained1 as he had calculated1 mild attacks and subsequent immunity4 ,during the years #ahha-aijj he inoculated by this method #ajd persons3-- ,in these inoculations1 be it remembered1 my principal object was rather to avoid than to seek the development of a severe attack2 in point of fact1 only seventeen showed any appreciable pathogenic effects after their inoculation4 ,i felt sure1 however1 that severe or fatal result might follow an inoculation either with several mosquitoes contaminated from severe cases of the disease1 or from a single insect applied several days or weeks after its contamination1 having come to this last conclusion in view of the facts connected with the ,anne ,marie1 and the epidemic of ,saint ,nazaire4 ,dr4 ,finlay's discovery that the mosquito can convey yellow fever1 and that the germ of the disease is more virulent after a prolonged sojourning in the mosquito1 was proved beyond all question by the work of #ahhi-aija4 ,but1 so far as immunisation is concerned1 few people would submit themselves to be bitten by an infected mosquito1 even with perfect assurance that the germs contained in it were of a low degree of virulence3 the urgent need1 therefore1 was for an immunising serum4 ,in #ahif1 at ,flores1 ,sanarelli discovered the bacillus icteroides2 and by ,october #ahig1 he had prepared an immunising serum which was able to give a considerable amount of protection to animals4#dj ,next year 7,annales de l',institut ,pasteur1 ,may #ahih7 came the news that he had advanced against yellow fever with its own weapons--,premires expriences sur l'emploi du srum curatif et prventif de la fivre jaune4 ,of the first #h cases 7,rio de ,janeiro71 #d recovered4 ,then came the #bb cases at ,san ,carlos do ,pinhal1 in ,saint-,paul au ,brsil 7,january #ahih71 with #af recoveries1 and only #f deaths4 ,and it is to be noted that he submitted his method of treatment to the utmost test that was possible2 he chose the bad cases1 and the country where the fever was most fatal3-- ,chaque cas tait choisi de commun accord entre nous1 dans le but de mettre bien en vidence l'action thrapeutique du srum1 mettant toujours de ct tous les cas qui se prsentaient avec des symptmes vagues ou attenus ou en forme lgre ou fruste4 ,on ne conservait donc que des cas o1 d'aprs la violence des phnomnes d'invasion1 on devait considrer comme trs peu probable une crise spontane de la maladie4444 #dj ,it is not denied here that he made five experiments on human beings4 ,see ,part ,,iv4 chap4 ii4 ,furthermore1 ,sanarelli was able to show the preventive value of the serum4 ,at the end of ,february #ahih1 yellow fever broke out in the jail at ,san ,carlos3-- ,la premire victime fut un condamn1 qui vivait avec tous les autres dans une salle o les conditions hyginiques taient assez mauvaises4 ,le lendemain1 la sentinelle1 qui tait en rapport continuel avec la salle des condamns1 tombait malade4 ,quelques jours aprs1 un autre condamn suivait le sort du premier1 et bientt un quatrime cas1 mortel aussi1 finit par signaler la prison comme un nouveau foyer d'infection qui venait s'allumer au centre d'un quartier de la ville encore rest indemne4 ,si on avait abandonn la chose elle-mme1 on aurait vu se produire le mme spectacle qu'avaient fourni1 dans les conditions identiques1 pendant les dernires pidmies1 les prisons de ,rio-,claro1 de ,limeira1 et d'autres villes de l'tat de ,saint-,paul4 ,every prisoner1 except one who had already had the fever1 was therefore given the preventive treatment4 ,at once the outbreak stopped2 no more cases occurred1 though only a weak serum was used1 though the state of the prison and its occupants was unhealthy1 though the fever1 two months later1 was still raging round the prison1 in the town4 ,in ,october #aijj1 the ,united ,states ,commission on ,yellow ,fever published a preliminary report on #aa cases of mosquito-inoculation4 ,of these1 the majority gave a negative result1 and were found susceptible to infection1 at a later date1 from the blood of a yellow-fever patient4 ,two gave a positive result4 ,in the course of these experiments1 ,dr4 ,lazear1 a member of the ,commission1 died of the disease4 ,in ,february #aija1 and again in ,july1 the ,commission published further reports1 emphasising the fact that the mosquito conveys the disease1 and denying that the disease can be conveyed in clothing1 bedding1 and so forth3-- ,our observations appear to demonstrate that the parasite of this disease must undergo a definite cycle of development in the body of the mosquito before the latter is capable of conveying infection4 ,this period would seem to be not less than twelve days4 ,we also consider the question of house infection1 and are able to show that this infection is due to the presence of mosquitoes that have previously bitten yellow-fever patients2 and that the danger of contracting the disease may be avoided in the case of non-immune individuals who sleep in this building1 by the use of a wire screen4 ,we also demonstrate1 by observations made at this camp 7,fort ,lazear71 that clothes and bedding contaminated by contact with yellow-fever cases1 or by the excreta of these cases1 is absolutely without effect in conveying the disease4 ,in ,february #aija1 ,dr4 ,h4 ,e4 ,durham published an abstract of an interim report of the ,liverpool ,school ,yellow ,fever ,commission4 ,he and ,dr4 ,walter ,myers1 the two ,commissioners1 had both of them been attacked by the disease1 and ,dr4 ,myers had died of it4 ,the report gives evidence that the disease is due to a bacillus which is not the bacillus icteroides2 and it does not wholly favour the earlier report 7#aijj7 of the ,american ,commission4 ,a later ,commission to ,new ,orleans1 ,september #aija to ,january #aijb1 reported an extensive series of investigations1 which seem rather to support the belief that the bacillus icteroides is the cause of the disease4 ,later still1 this belief is again denied2 and1 as in rabies1 so in yellow fever1 the good work has gone on without waiting for the identity of this or that micro-organism4 99 99 99 99 99 ,immunisation1 by the direct use of an infected mosquito1 may be compared with the old custom of inoculation against smallpox4 ,the use of ,sanarelli's serum-treatment has not gone far4 ,there remains for consideration the method of keeping down infection by keeping down ,culex4 ,three reports1 in #aija-aijb1 come from ,dr4 ,guitras 7,havana71 ,surgeon-,major ,gorgas1 chief sanitary officer 7,havana71 and the ,commission at ,new ,orleans4 ,dr4 ,guitras reports that #f cases of yellow fever 7inoculation7 were treated in a large mosquito-proof building1 which also contained cases of other diseases4 ,no prophylaxis was enforced1 save the exclusion of mosquitoes2 non-immunes visited the yellow fever cases1 non-immunes nursed them1 and most of the attendants and labourers about the place were non-immunes2 but not a single case of infection occurred4 ,the ,new ,orleans ,commission reports that1 of #bjj cisterns1 c41 examined in the city for the presence of larv1 the larva of ,culex 7,stegomyia7 predominated in more than #fj per cent4 ,the report of ,surgeon-,major ,gorgas is very pleasant reading4 ,for two centuries1 ,cuba had been cursed with yellow fever2 then1 after the war with ,spain1 ,america took it over3-- ,the army took charge of the health department of ,havana1 when deaths 7from all causes7 were occurring at the rate of #ba1beb per year4 ,it gives it up1 with deaths occurring at the rate of #egbj per year4 ,it took charge1 with smallpox endemic for years4 ,it gives it up1 with not a case having occurred in the city for over eighteen months4 ,it took charge1 with yellow fever endemic for two centuries--the relentless foe of every foreigner who came within ,havana's borders1 which he could not escape1 and from whose attack he well knew every fourth man must die4 ,the army has stamped out this disease in its greatest stronghold4 ,make fair allowance for the wide variation1 from year to year1 of the number of yellow fever cases in any town within the geographical belt of the disease2 admit that a town may1 in the course of nature1 have many hundred cases in one year1 and only half a dozen in another year4 ,again1 make fair allowance for all other good influences of the ,american occupation of ,cuba1 beside those that were concerned with the stamping out of ,culex2 admit that the general death-rate of ,havana1 in the last ,february of ,spanish rule 7#ahih71 was #hb4cb per thousand1 and in ,february #aija1 was #ai4cb4 ,still1 there is an example here1 in the #aija work in ,havana1 for the world to follow1 wherever yellow fever exists4 ,the following abstract of ,surgeon-,major ,gorgas' results was published in the ,practitioner1 ,may #aijb1 by ,professor ,hewlett1 one of the foremost of ,english bacteriologists3-- ,commencing in ,february #aija1 orders were issued that every suspected case of yellow fever should be screened with wire gauze at the public expense1 so as to render the room or rooms mosquito-proof4 ,all mosquitoes in the infected house and in contiguous houses were destroyed4 ,after the middle of ,february1 #ajj men were employed in carrying out the destruction of the mosquito-larv in their breeding places1 putting oil in the cesspools of all houses1 clearing the streams1 draining pools1 and oiling the larger bodies of water4 ,up to ,june1 quarantine was enforced1 together with disinfection of the house and fomites4 ,after that1 however1 rigid quarantine of the patient was stopped1 and disinfection of fabrics and clothing ceased4 ,it was merely required that the patient should be reported1 his house placarded and screened1 and a guard placed over each case to report how general sick-room sanitation was carried out1 to see that the screen-door communicating with the screened part of the house was kept properly closed1 and to see that communication with the sick-room was not too free1 four or five non-immunes only being allowed in4 ,by the end of ,september1 the last focus of the disease had been got rid of1 and since then1 up to the beginning of ,january1 there has not been a single case4 ,whereas1 for the years since #ahhi1 from #ast ,april to #ast ,december1 yellow fever caused an average of #daj4ed deaths1 with a maximum of #aage for #ahif1 and a minimum of #gi for #ahii1 it caused in #aija #e deaths only4 ,in the months of ,october and ,november1 when the disease has hitherto been exceedingly rife in ,havana1 there has not been a single case4 ,for the first time in #aej years1 ,havana has been free from yellow fever4 ,sir ,patrick ,manson1 lecturing in ,america1 last year1 on tropical diseases1 summed up the work as follows3-- ,time will not permit--what to you is probably quite unnecessary--the recapitulation of the story of the labours of ,reed and his coadjutors4 ,i cannot pass on1 however1 to what ,i have to say in connection with this work without a word of admiration for the insight1 the energy1 the skill1 the courage1 and withal the modesty and simplicity of the leader of that remarkable band of workers4 ,if any man deserved a monument to his memory1 it was ,reed4 ,if any band of men deserve recognition at the hands of their countrymen1 it is ,reed's colleagues4 ,the principal outcome of the labours of these men has been the demonstration1 first1 that the ultra-microscopic germ of yellow fever is present in the blood of the patient during the first three days of the disease4 ,second1 that the first step in the passage of the germ from the sick to the sound is made1 under natural conditions1 in the stegomyia mosquito4 ,and third1 that after about twelve days and upwards in stegomyia1 the yellow fever germ1 when implanted by the said mosquito into another human host1 is capable of reproduction1 so that at the end of a further period of about three days it has established itself throughout the blood1 is causing the violent reaction1 the clinical manifestations of which we call yellow fever1 and is once more in a condition to re-enter the mosquito4 ,these are great etiological facts4 ,they are of supreme practical and scientific value4 ,acting on them1 the ,united ,states sanitary authorities expelled yellow fever from ,havana4 ,acting on them1 they should be able in the future to protect the ,united ,states themselves from such terrible visitations as in the past have swept through some of your cities4 #c4 ,,filariasis ,these same lectures contain an admirable account of the life-history of ,filaria4 ,it is not necessary here to describe the loathsome deformities which occur in the later stages of filariasis4 ,these deformities 7elephantiasis1 ,barbadoes leg71 which may attain colossal size1 are due to the blocking of the lymphatic vessels with filarial worms4 ,cases of the disease are hardly ever seen in this country2 but it is very frequent in some parts of the tropics4 ,in the endemic areas1 says ,manson1 #aj per cent4 is not an uncommon proportion of the population to be found affected with filariasis4 ,thirty and even #ej per cent4 may be affected4 ,in many of the ,pacific ,islands--the ,samoa group for instance--,i believe that even this proportion is exceeded4 ,that ,culex 7fatigans7 can carry the parasite1 has been proved past all doubt4 ,neither does anybody doubt1 that the keeping down of this mosquito would keep down filariasis4 ,a report of great interest1 from ,barbadoes1 was published in the ,british ,medical ,journal for #adth ,june #aijb4 ,it is written by ,dr4 ,low1 whose experiment on himself in the ,campagna has already been noted in this chapter4 ,dr4 ,low reports that there is no indigenous malaria in the island1 and that neither he nor ,mr4 ,lefroy could find a single ,anopheles larva1 though they hunted diligently in the swamps and other likely places4 ,but filariasis is terribly common1 and so is ,culex fatigans4 ,dr4 ,low examined the night-blood of #fjj cases of all kinds in the ,general ,hospital1 the ,central ,almshouse1 and elsewhere1 and found the filaria-embryos in no less than #gf #ab4ff per cent4 ,he caught and dissected a hundred mosquitoes 7,culex fatigans7 from the wards and corridors of the ,general ,hospital1 and found that no less than #bc of them were infected4 ,if it were not for ,culex1 and for men's indifference and apathy1 filariasis could be kept down all over the island3-- ,there is a perfect water supply1 and people can get their water fresh from the standpipes at their doors4 ,old wells ought to be filled up2 no water-barrels or tubs should be allowed1 or1 if kept1 they should be emptied every week or so4 ,tanks and collections of water in gardens should all be periodically treated with kerosene1 or be furnished with closely-fitting covers to prevent mosquitoes getting in4 ,these methods are simple and inexpensive1 and each householder should see that they are applied in his garden and grounds4 ,the difficulty begins when one has to take into account the inability of the negro to grasp anything of a hygienic nature4 ,the only way to get over this1 would be a system of sanitary inspection by a few competent men4 ,for individual prophylaxis1 mosquito-nets ought always to be used2 but many1 even educated people1 still persist in sleeping without them2 of course1 nothing in this line can be expected of the native population4 ,if such means were adopted for ,barbadoes1 the presence of filarial disease1 which at present is quite alarming1 could easily1 with little trouble and expense1 be greatly diminished1 and thus save much suffering1 as well as loss of time1 hideous deformity1 and doubtless in not a few instances loss of life4 ,thus1 in a few years1 from experiments on mosquitoes1 sparrows1 and men1 has come the present plan of campaign against malaria1 yellow fever1 and filariasis2 that is1 against ,anopheles and ,culex4 ,he who would know what is being done to check these diseases in ,italy1 ,india1 ,china1 ,africa1 and ,america1 must read ,prof4 ,ross' ,malarial ,fever1 its ,cause1 ,prevention1 and ,treatment 7#aijb71 and ,mosquito ,brigades1 and how to organise them 7#aijb74 ,there has been nothing like it since ,pasteur died4 ,far and wide1 from ,staten ,island to ,cuba1 from ,hong ,kong to ,lagos1 the work of keeping down the larv of ,anopheles and ,culex is going on4 ,henceforth we have to reckon not with a nameless something1 but with a definite parasite1 whose conditions of life are known4 ,before all things1 we must shut off the sources of the infection4 ,for centuries1 men had believed in exhalations and miasmata lying all over the land3 and1 behold1 the agents of malaria are in the puddles round a man's house1 and the agents of yellow fever are in the water-butt and the broken bottles and old sardine-tins4 ,science has given the word1 and now there are ,anopheles brigades and ,culex brigades set going2 labourers with brooms and rubbish-carts1 sweeping out the stagnant pools1 draining the surface soil1 and carrying off the odd receptacles that serve to hold mosquito eggs and larv4 ,the job1 like all sanitary jobs1 must be steady1 year in1 year out3 it must be limited to infected places1 a whole continent cannot be treated4 ,but there the work is1 and will grow2 and saves1 by unskilled labour1 and at a trivial expense1 those non-acclimatised lives that have hitherto been thrown away as recklessly as the larv that are now swept out of the puddles and ditches round ,african settlements4 ,,xi ,,parasitic ,,diseases ,the foregoing chapters are concerned with bacteriology alone1 and with those curative or preventive methods of treatment that have come out of inoculation-experiments on animals4 ,the lives that are saved1 or safeguarded1 by these methods1 even in one year1 must be many thousands in each country of the civilised world4 ,and1 beside human lives1 there is the protection of sheep and cattle against anthrax1 swine against rouget1 horses against tetanus1 cattle against rinderpest4 ,in ,cape ,colony alone1 so far back as #ahii1 about half a million cattle had received preventive treatment against rinderpest2 and the sum total of human and animal lives saved or safeguarded1 in all parts of the world1 must be reckoned in millions by this time4 ,the present chapter1 and the next two chapters1 are concerned with methods that have come out of experiments on animals1 but not out of bacteriology4 ,it is plain that the grosser parasites of the human body1 tapeworms and the like1 could not be explained or understood without the help of feeding-experiments on animals4 ,by this method1 and by this alone1 their life-history was discovered4 ,they were known to ,aristotle and to ,hippocrates2 but nothing was understood about them4 ,they were never studied1 for this among other reasons1 that men believed in spontaneous generation2 and the presence of lower forms of life inside human bodies was attributed to the fault of the patient1 or the work of the devil4 ,then1 at last1 ,redi 7#agab71 and ,swammerdam 7#ageb7 in his ,bibel der ,natur1 struck at the doctrine of spontaneous generation1 saying that it did not apply to insects2 and in #agha ,pallas boldly declared that the internal parasites of man came out of eggs1 like insects1 and not of themselves4 ,it would be a good theme for an essay--,the paralysing effect1 on medicine and surgery1 of the doctrine of spontaneous generation4 ,rudolphi 7#ahjh7 and ,bremser 7#ahai7 opposed ,pallas2 and von ,siebold 7#ahce7 and ,eschricht 7#ahcg7 supported him4 ,then came the great students of this part of biology--,cobbold1 ,busk1 ,davaine1 van ,beneden1 ,leuckart1 ,kchenmeister4 ,in #ahdb1 ,steenstrup had discovered1 in certain insects1 the alternation of generations2 in #aheb1 ,kchenmeister proved that the generations of internal parasites are similarly alternate4 ,by feeding carnivorous animals with measly meat1 he produced tapeworms in them2 and by feeding herbivorous animals with the ova of tapeworms1 he made their muscles measly4 ,the feeding of animals was the only possible way to understand the bewildering transformations and transmigrations of the thirty or more entozoa to which flesh is heir4 ,this chapter of pathology makes up in tragedy what it lacks in romance2 for these animal parasites have killed whole hosts of people4 ,take1 for instance1 the trichina spiralis1 a minute worm discovered in #ahce encysted in countless numbers in the muscles of the human body2 it was studied by ,virchow1 ,leuckart1 and others1 by feeding-experiments on animals1 and was proved to come from infected half-cooked ham and pork1 and to make its way from the alimentary canal all over the body4 ,the name of trichiniasis or trichina-fever was given to the acute illness that came of the sudden dissemination of these myriad parasites into the tissues4 ,trichiniasis had killed hundreds of people by a most painful death2 outbreaks of it1 in ,germany and elsewhere1 had swept through villages like cholera or plague3 then ,leuckart and ,virchow traced it to its source1 and it was stopped there--,above all things1 we must shut off the sources of the infection--the butchers' shops were kept under sanitary inspection1 people were warned against half-cooked ham and pork1 and there was an end of it4 ,or take hydatid disease1 which occurs in all parts of the world1 and in some countries 7,australia1 ,iceland7 is terribly common4 ,the nature of this disease--that it is an animal parasite transmissible between men and dogs--was proved by feeding-experiments on animals4 ,in ,iceland1 where men and dogs live crowded together in huts1 there is an appalling number of deaths from hydatid disease2 ,leuckart1 in #ahfc1 of it3-- ,at present1 almost the sixth part of all the inhabitants annually dying in ,iceland fall victims to the echinococcus epidemic4 ,before ,kchenmeister's experiments in #aheb1 there was no general knowledge of the exact pathology of entozoic disease4 ,the advance was not made by the experimental method alone2 other things helped3 but among them was neither clinical experience1 nor what ,sir ,charles ,bell called the observation of the just facts of anatomy and of natural motions4 99 99 99 99 99 ,beside the entozoa1 there are also vegetable parasites4 ,of these1 the most important is the streptothrix actinomyces1 the cause of actinomycosis in man and cattle4 ,israel1 in #ahgg1 gave the first accurate account of it in man2 and ,bllinger1 the same year1 studied it in cattle4 ,ponfick1 in #ahhb1 recognised the identity of the disease in man and animals4 ,in #ahhe1 ,israel published the collected records of #cg cases in man1 tabulated according to the site of the primary infection4 ,bostrm1 about this time1 made cultures of the fungus3 but all the earlier attempts at inoculation failed2 and it was not till #ahia that ,wolff and ,israel published their successful inoculations1 and thus completed the evidence that actinomycosis is a parasitic infection1 a growth of vegetable threads and spores1 transmissible between men and animals1 and able to keep its vitality outside its host2 so that men who are employed with cattle1 or have the habit of chewing straws or ears of corn1 incur some slight risk of infection4 ,before #ahgg1 the disease was hardly suspected in man1 and was not understood in cattle4 ,,xii ,,myxoedema ,on #dth ,october #ahgc1 ,sir ,william ,gull read a short paper before the ,clinical ,society of ,london1 ,on a ,cretinoid ,state supervening in ,adult ,life in ,women4 ,this famous first account of myxoedema was based on five cases3 it is less than five pages long1 it does not suggest a name for the disease1 and it says nothing about the thyroid gland4 ,four years later 7#bcrd ,october #ahgg71 ,dr4 ,ord read a paper before the ,medico-,chirurgical ,society of ,london1 ,on ,myxoedema2 a term proposed to be applied to an essential condition in the ',cretinoid' ,affection occasionally observed in ,middle-aged ,women4 ,his work had begun so far back as #ahfa2 and in this #ahgg paper he gave not only clinical observations1 but also pathological and chemical facts2 and he noted1 as one among many changes1 wasting of the thyroid gland4 ,he also pointed out the close resemblance between cases of myxoedema and cases of sporadic cretinism4 ,in #ahhb1 ,reverdin stated before the ,medical ,society of ,geneva that signs like those of myxoedema had been observed in some cases of removal of the thyroid gland on account of disease 7gotre74 ,in ,april #ahhc1 ,kocher of ,berne read a paper on this subject1 before the ,congress of ,german ,surgeons2 but he attributed this myxoedema after removal of the gland 7cachexia strumipriva7 not directly to the loss of thyroid-tissue1 but rather to some sort of interference with free respiration1 due to operation4 ,on #bcrd ,november1 ,sir ,felix ,semon brought the subject again before the ,clinical ,society2 and on #adth ,december #ahhc1 the ,society appointed a ,committee of ,investigation to study the whole question4 ,their report1 #bae pages long1 with tabulated records of #aai cases of myxoedema1 was published in #ahhh4 ,it is a monument of good work1 historical1 clinical1 pathological1 chemical1 and experimental4 ,twenty years ago1 the purpose of the thyroid gland was unknown3 a few experiments had been made on it1 by ,sir ,astley ,cooper and others1 and had failed2 and ,claude ,bernard1 in his ,physiologie ,opratoire 7published in #ahgi1 soon after his death71 makes it clear that nothing was known in his time about it4 ,he is emphasising the fact that anatomy cannot make the discoveries of physiology3-- ,the descriptive anatomy1 and the microscopic characters1 of the thyroid gland1 the facts about its blood-vessels and its lymphatics--are not all these as well known in the thyroid gland as in other organs8 ,is not the same thing true of the thymus gland1 and the suprarenal capsules8 ,yet we know absolutely nothing about the functions of these organs--we have not so much as an idea what use and importance they may possess--because experiments have told us nothing about them2 and anatomy1 left to itself1 is absolutely silent on the subject4 ,therefore1 in #ahhb-hc1 things stood at this point--that the removal of a diseased thyroid gland had been followed1 in some cases1 by a train of symptoms such as ,sir ,william ,gull had recorded in #ahgc4 ,would the same symptoms follow removal of the healthy gland8 ,the answer was given by ,sir ,victor ,horsley's experiments1 begun in #ahhd4 ,he was able1 by removal of the gland1 to produce in monkeys a chronic myxoedema1 a cretinoid state1 the facsimile of the disease in man3 the same symptoms1 course1 tissue-changes1 the same physical and mental hebetude1 the same alterations of the excretions1 the temperature1 and the voice4 ,it was now past doubt that myxoedema was due to want of thyroid-tissue1 and to that alone2 and that cachexia strumipriva was due to the loss1 by operation1 of such remnants of the gland as had not been rendered useless by disease4 ,the advance had still to be made from pathology to treatment4 ,here1 so far as ,england is concerned1 honour is again due to ,sir ,victor ,horsley4 ,on #hth ,february #ahij1 he published the suggestion that thyroid-tissue1 from an animal just killed1 should be transplanted beneath the skin of a myxoedematous patient3-- ,the justification of this procedure rested on the remarkable experiments of ,schiff and von ,eisselsberg4 ,i only became aware in ,april #ahij1 that this proposal had been in fact forestalled in #ahhi by ,dr4 ,bircher1 in ,aarau4 7,the date of ,dr4 ,bircher's operation was #afth ,january #ahhi47 ,kocher had tried to do the same thing in #ahhc1 but the graft was soon absorbed2 but early in #ahhi he tried it again1 in five cases1 and one greatly improved4 ,the importance of this treatment1 by transplantation of living thyroid-tissue1 must be judged by the fact that in #ahhh no practical use had yet been made of the scientific work that had been done4 ,the ,clinical ,society's ,report1 published that year1 gives but half a page to treatment1 of the old-fashioned sort2 and not a word of hope4 ,then1 at last1 in #ahia1 came ,dr4 ,george ,murray's paper in the ,british ,medical ,journal1 ,note on the ,treatment of ,myxoedema by ,hypodermic ,injections of an ,extract of the ,thyroid ,gland of a ,sheep4 ,later1 hypodermic injections of thyroid-extract gave way to sandwiches1 made with thyroid gland 7,dr4 ,hector ,mackenzie1 and ,dr4 ,fox of ,plymouth71 and these in their turn were eclipsed by tabloids4 ,it is a strange sequence1 from #ahgc onward3 clinical observation1 post-mortem work1 calamities of surgery1 experimental physiology1 transplantation1 hypodermic injections1 sandwiches1 and tabloids4 ,and far more has been achieved than the cure of myxoedema4 ,even if the discovery stopped here1 it would still be a miracle that little bottles of tabloids should bring men and women back from myxoedema to what they were before they became thick-witted1 slow1 changed almost past recognition1 drifting toward idiocy4 ,but it does not stop here4 ,the same treatment has given good results in countless cases of sporadic cretinism1 restoring growth of body and of mind to children that were hopelessly imbecile4 ,it is of great value also for certain diseases of the skin4 ,moreover1 physiology has gained knowledge of the purpose of the thyroid gland1 and a clearer insight into the facts relating to internal secretion4 ,,xiii ,,the ,,action ,,of ,,drugs ,long after the ,renaissance1 the practice of medicine was still under the influence of magic4 ,whatever things were rare and precious were held to be good against disease--gold1 amber1 coral1 pearls1 and the dust of mummies2 whatever took strange forms of life--toads1 earthworms1 and the like2 whatever looked like the disease1 after the doctrine of signatures--pulmonaria for the lungs1 because the spots on its leaves were like tubercle1 a kidney-shaped fruit for the kidneys1 a heart-shaped fruit for the heart1 and yellow carrots for the yellow jaundice4 ,among the drugs in the #afah ,pharmacopoeia are cranium humanum1 mandibula lucii1 nidus hirundinum1 sericum crudum1 linum vivum1 and pilus salamandr4 ,in the ,pharmacopoeia of #affg are exuvi serpentis1 tel aranearum1 saliva jejuni1 cranium hominis violent morte extincti1 and worse obscenities4 ,soon after the publication of this ,pharmacopoeia1 on #adth ,february #afhe1 ,king ,charles ,,ii4 died2 and in the ,library of the ,society of ,antiquaries there is a manuscript account in ,latin1 by ,dr4 ,scarbrugh1 how the case was treated4 ,the ,king had sixteen physicians1 and nine consultations in five days2 and to say everything was done that was possible gives no idea of the vigour of the treatment4 ,finally1 the day he died1 they gave him1 eleven of them in consultation--totus medicorum chorus ab omni spe destitutus--they gave him1 as more generous cardiacs1 the lapis ,go1 and the ,bezoar-stone4 ,the lapis ,go was a dust of topaz1 jacinth1 sapphire1 ruby1 pearl1 emerald1 bezoar1 coral1 musk1 ambergris1 and gold1 all made into a pill and polished2 and the bezoar is a calculus found in the intestines of herbivorous animals4 ,half a century later1 the ,pharmacopoeia of #agba still included ants' eggs1 teeth1 lapis nephriticus1 and other horrors2 and in the ,pharmacopoeia of #agdf1 though the dust of ,egyptian mummies was ruled out1 vipers and wood-lice were retained4 ,certainly these last enchantments of the ,middle ,ages were slow to depart4 ,clinical observation1 anatomy1 and pathology1 had all failed to bring about a right understanding of the actions of drugs4 ,it was the physiologists1 not the doctors1 who first formulated the exact use of drugs2 it was ,bichat1 ,magendie1 and ,claude ,bernard4 ,that is the whole meaning of ,magendie's work on the upas-poison and on strychnine1 and ,claude ,bernard's work on curari and digitalis4 ,of these four substances1 two only are of any use in practice2 yet ,magendie's study of strychnine#da was of immeasurable value1 not so much because it gave the doctors a more generous cardiac1 though that was a great gift1 but because it revealed the selective action of drugs4 ,contrast his account of strychnine with ,ambroise ,par's story how they tested the bezoar-stone on the thief instead of hanging him2 contrast ,bernard's chapter on curari with ,dr4 ,scarbrugh's notes on the ,king's death1 with all the ,crown jewels inside him3 you are in two different worlds4 ,the selective action of drugs--the affinity between strychnine and the central nerve-cells1 between curari and the terminal filaments of the motor nerves--that was the revolutionary teaching of science3 and it came1 not by experience1 but by experiment4 #da ,for a full statement of the great value of this study of strychnine1 see ,cl4 ,bernard1 ,leons de ,physiologie ,opratoire1 #ahgi1 p4 #hi4 ,take ,professor ,fraser's address on ,the ,action of ,remedies1 and the ,experimental ,method at the ,international ,medical ,congress in ,london1 #ahha3-- ,the introduction of this method is due to ,bichat2 and1 by its subsequent application by ,magendie1 pharmacology was originated as the science we now recognise4 ,bichat represents a transition state1 in which metaphysical conceptions were mingled with the results of experience4 ,magendie more clearly recognised the danger of adopting theories1 in the existing imperfections of knowledge2 and devoted himself to the supplementing of these imperfections by experiments on living animals4 ,the advantages of such experiments he early illustrated by his investigation on the upas-poison2 and afterwards by a research on the then newly-discovered alkaloid1 strychnia4444 ,he demonstrated the action of this substance upon the spinal cord1 by experiments upon the lower animals1 so thoroughly1 that subsequent investigations have added but little to his results4 ,or take ,professor ,fraser's account of digitalis3-- ,it was introduced as a remedy for dropsy2 and1 on the applications which were made of it for the treatment of that disease1 a slowing action upon the cardiac movements was observed1 which led to its acquiring the reputation of a cardiac sedative4 ,numerous observations were made on man by the originators of its application1 by ,dr4 ,sanders and many other physicians1 in which special attention was paid to its effects upon the circulation2 but no further light was thrown upon its remarkable properties1 with the unimportant exception that in some cases it was found to excite the circulation4 ,it was not until the experimental method was applied in its investigation1 in the first instance by ,claude ,bernard1 and subsequently by ,dybkowsky1 ,pelikan1 ,meyer1 ,boehm1 and ,schmiedeberg1 that the true action of digitalis upon the circulation was discovered4 ,it was shown that the effects upon the circulation were not in any exact sense sedative1 but1 on the contrary1 stimulant and tonic1 rendering the action of the heart more powerful1 and increasing the tension in the blood-vessels4 ,the indications for its use in disease were thereby revolutionised1 and at the same time rendered more exact2 and the striking benefits which are now afforded by the use of this substance in most 7cardiac7 diseases were made available to humanity4 ,or take ,sir ,t4 ,lauder ,brunton's account of the action of nitrite of amyl in angina pectoris3-- ,the action of nitrite of amyl in causing flushing was first observed by ,guthrie1 and ,sir ,b4 ,w4 ,richardson recommended it as a remedy in spasmodic conditions1 from the power he thought it to possess of paralysing motor nerves4 ,in the spring of #ahfg ,i had opportunities of constantly observing a patient who suffered from angina pectoris1 and of obtaining from him numerous sphygmographic tracings1 both during the attack and during the interval4 ,these showed that during the attack the pulse became quicker1 the blood-pressure rose1 and the arterioles contracted4444 ,it seemed probable that the great rise in tension was the cause of the pain1 and it occurred to me that if it was possible to diminish the tension by drugs instead of by bleeding1 the pain would be removed4 ,i knew from unpublished experiments on animals by ,dr4 ,a4 ,gamgee that nitrite of amyl had this power1 and therefore tried it on the patient4 ,my expectations were perfectly answered4 ,the pain usually disappeared in three-quarters of a minute after the inhalation began1 and at the same time the pulse became slower and much fuller1 and the tension diminished4 ,of course it would be easy to lengthen out the list4 ,aconite1 adrenalin1 belladonna1 calcium chloride1 colchicum1 cocain1 chloral1 ergot1 morphia1 salicylic acid1 strophanthus1 the chief diuretics1 the chief diaphoretics--all these drugs1 and many more1 have been studied and learned by experiments on animals4 ,then comes the answer1 that drugs act differently on animals and on men4 ,the few instances1 that give a wise air to this foolish answer1 were known long ago to everybody3 they do not so much as touch the facts of daily practice3-- ,the action of drugs on man differs from that on the lower animals chiefly in respect to the brain1 which is so much more greatly developed in man4 ,where the structure of an organ or tissue is nearly the same in man and in the lower animals1 the action of drugs upon it is similar4 ,thus we find that carbonic oxide1 and nitrites1 produce similar changes in the blood of frogs1 dogs1 and man1 that curare paralyses the motor nerves1 alike in them all1 and veratria exerts upon the muscles of each its peculiar stimulant and paralysing action4 ,where differences exist in the structure of the various organs1 we find1 as we would naturally expect1 differences in their reaction to drugs4 ,thus the heart of the frog is simpler than that of dogs or men1 and less affected by the central nervous system2 we consequently find that while such a drug as digitalis has a somewhat similar action upon the hearts of frogs1 dogs1 and men1 there are certain differences between its effect upon the heart of a frog and on that of mammals4 ,belladonna offers another example of apparent difference in action--a considerable dose of belladonna will produce almost no apparent effect upon a rabbit1 while a smaller dose in a dog or a man would cause the rapidity of the pulse to be nearly doubled4 ,yet in all three--rabbits1 dogs1 and men--belladonna paralyses the power of the vagus over the heart4 ,the difference is that in rabbits the vagus normally exerts but little action on the heart1 and the effect of its paralysis is consequently slight or hardly appreciable4 7,professor ,fraser47 ,it would be strange indeed1 if experts who work in micromillimetres and decimal milligrammes1 and study the vanishing-point of microscopic structures1 and measure and ordain infinitesimal changes in invisible organisms1 were blind to such gross and palpable differences as exist between men and pigeons in their susceptibility to a dose of opium4 ,ansthetics must be reckoned among the drugs that have been studied on animals3 but1 for the discovery of them1 men experimented on themselves4 ,the first use of nitrous oxide 7laughing gas7 in surgery was #aath ,december #ahdd1 when ,horace ,wells1 of ,connecticut1 had it administered to himself for the removal of a tooth4 ,the first use of ether was made by ,dr4 ,long1 of ,athens1 ,georgia2 but he did not publish the case1 or follow up the work3 and the honour of the discovery of ether went to ,morton1 of ,boston1 who made repeated experiments1 both on animals and on himself4 ,the date when he first rendered himself absolutely unconscious for seven or eight minutes1 is #cjth ,september #ahdf2 and the first operation under ether was done on #afth ,october1 in the ,massachusetts ,general ,hospital4 ,the first use of chloroform was #dth ,november #ahdg1 that famous evening when ,simpson1 ,george ,keith1 and ,matthews ,duncan took it together4 ,the whole history of ansthesia is to be found in the ,practitioner1 ,oct4 #ahif4 ,it is sometimes said that the men who make experiments on animals ought to make them on themselves4 ,but they do1 hundreds of them1 and suffer for it3 ,heaven knows the list is long enough--the discoverers of ansthesia1 ,hunter1 ,garr1 ,koch1 ,klein1 ,moor1 ,haffkine1 ,grassi1 ,bochefontaine1 ,quesada1 ,sanarelli1 ,pettenkofer--these and hosts more1 here or abroad1 have done it1 as part of the day's work2 and some--by accidental infection1 like ,chabry and ,villa1 or by deliberate self-inoculation1 like ,carrion--have been killed3-- ,dr4 ,angelo ,knorr1 ,privat-docent in the ,veterinary ,school of ,munich1 died on #bbnd ,february from acute glanders1 contracted in the course of an experimental research on mallein4 ,helmann1 the ,russian investigator who discovered mallein1 himself fell a victim to accidental inoculation of the glanders virus4 ,some time afterwards another ,russian1 ,protopopow1 died of glanders contracted in a ,french laboratory4 ,an ,austrian physician1 ,dr4 ,koffman-,wellenhof1 died of the same disease1 contracted in the ,institute of ,hygiene at ,vienna4 ,on #agth ,january of the present year ,dr4 ,guiseppe ,bosso1 of the ,university of ,turin1 died of infection contracted in the course of cultivations of tubercle-bacilli made in his laboratory4 ,not long before1 ,dr ,lola1 assistant in the maternity department of the ,czech ,university ,hospital of ,prague1 died of tetanus caused by an experimental inoculation made on himself4 ,some fourteen or fifteen years ago1 a medical student of ,lima proved that 'verruga ,peruana' is an infectious disease by inoculating himself with it1 an act of scientific devotion which cost him his life4#db ,besides those who have died1 there are many who have only escaped with their lives after long and painful illness4 ,professor ,kourloff contracted anthrax in a laboratory at ,munich1 and was saved only by vigorous surgery4 ,dr4 ,nicolas supplied1 in his own person1 the first example of tetanus produced in man by inoculation of the pure toxin of the bacillus of ,nicolaier4 7,brit4 ,med4 ,journal1 #ahth ,march #ahii47 #db ,daniel ,carrion1 born #ahei at ,cerro de ,pasco1 proved1 by self-inoculation1 the identity of the two forms of the disease1 #bgth ,august #ahhe2 died of the disease1 #eth ,october4 ,see ,ann4 de l',inst4 ,past41 ,sept #ahih4 ,this list is seven years old now2 it is twice the length by this time4 ,typhoid1 malaria1 yellow fever1 have all taken toll of those who study them4 ,it is a long record of the men who fell ill1 or died1 or killed themselves over their work2 and the deaths of ,barisch1 ,dr4 ,mller1 and ,nurse ,pecha1 from plague at ,vienna 7,october #ahih7 are another instance that there is danger in the constant handling of cultures4 ,but these deaths at ,vienna were due to the great carelessness of one man4 ,in laboratories in all parts of the world there are stored cultures of all sorts of organisms1 yet no harm comes of it4 ,more cases of infection occur amongst young medical men attending fever cases1 whether in private practice or hospital wards1 in a single month1 than have occurred in the whole of the laboratories in the world since they were established4 7,british ,medical ,journal1 #bith ,october #ahih47 ,outside the laboratory1 outside the fever hospitals1 the risk is something less than a negligible quantity3-- ,apart from plague and cholera1 in all the big laboratories studies are uninterruptedly pursued1 from one end of the year to the other1 upon anthrax1 glanders1 influenza1 ,malta fever1 various tropical diseases which do not exist at all or are rare in the countries where they are being studied4 ,the laboratories in question are situated in the largest and most important towns of their respective countries2 and1 within those towns1 very often in the most fashionable or most populous centres4444 ,on no occasion was there even a suspicion aroused of an epidemic having been produced by any of the above-mentioned institutes1 or by those tens of thousands of operations against cholera performed in ,india4 7,haffkine1 ,madras ,mail1 #hth ,december #ahih47 ,,xiv ,,snake-,,venom ,the ,report of the #ahge ,commission said3-- ,it is not possible for us to recommend that the ,indian ,government should be prohibited from pursuing its endeavours to discover an antidote for snake-bites2 or that1 without such an effort1 your ,majesty's ,indian subjects should be left to perish in large numbers annually from the effects of these poisons4 ,certainly it was not possible2 and the numbers are large indeed4 ,during #ahig1 #dbbg persons were killed by wild animals in ,india1 and #bj1iei by snakes4 7,british ,medical ,journal1 #eth ,november #ahih47 ,sir ,joseph ,fayrer's name must be put in the highest place of all those who have studied the venomous snakes of ,india4 ,sewell1 in #ahhg1 showed that animals could be rendered immune1 by repeated inoculation with minute quantities of rattlesnake-venom1 to a dose seven times as large as would kill an unprotected animal4 ,kanthack1 in #ahia1 immunised animals in the same way against cobra-venom4 ,he also made experiments to ascertain whether the blood-serum of these animals acted as an antidote to the venom4 ,then came the work of ,calmette1 ,fraser1 ,phisalix1 ,bertrand1 ,martin 7,australia71 ,stephens1 and ,meyers4 ,professor ,fraser's observations on the antidotal properties of the bile are1 of course1 of the utmost importance2 not only in preventive medicine1 but also in physiology4 ,the results obtained by ,calmette are a good instance of the fineness and accuracy of the experimental method4 ,it is to be noted that the animals were inoculated with a fine needle1 not thrust into cages with snakes1 as at zoological gardens2 and that an animal thus poisoned has a painless death4 ,the different venoms were measured in decimal milligrammes1 and their potency was estimated according to the body-weight of the animal inoculated4 ,as with tetanus1 so with snake-venom1 there must be a standard1 or unit of toxicity4 ,the following table gives the relative toxicity1 for #a kilogr4 of rabbit1 of the different venoms that ,i have tested4 ,to denote this toxicity ,i use terms such as ,behring1 ,roux1 and ,vaillard used for the toxin of tetanus1 taking the number of grammes of animal killed by one gramme of toxin3-- #a4 ,venom of naja #j4be mgr4 per kilogr4 of rabbit4 ,one gramme of this venom kills #djjj kilogrammes of rabbit2 it has1 therefore1 an activity of #d1jjj1jjj #b4 ,venom of hoplocephalus #j4bi mgr #c1dej1jjj #c4 ,venom of pseudechis #a4be mgr #hjj1jjj #d4 ,venom of pelias berus #d4jj mgr #bej1jjj ,of course1 this estimation of virulence is not absolute2 it varies considerably according to the species of animal tested4 ,thus the guinea-pig1 and still more the rat1 are extremely sensitive4 ,for instance1 #j4ae mgr4 of viper-venom is enough to kill1 in less than #ab hours1 #ejj grammes of guinea-pig2 so that the activity of this venom with a guinea-pig is #c1ccc1jjj1 but with a rabbit is not more than #fej1jjj4 ,with more resistant animals1 the opposite result is obtained2 about #aj mgr4 of cobra-venom are necessary to kill a dog of #f4ej kilogrm4 weight2 but to kill the same weight of rabbit #a4fe mgr4 is enough4 ,thus the virulence of this venom with the rabbit is #d1jjj1jjj2 but with the dog not more than #fej1jjj4 ,by experiments in test-tubes1 ,calmette studied these venoms under the influences of heat and various chemical agents4 ,he found how to attenuate their virulence1 and how to diminish the local inflammation round the point of inoculation2 and it was in the course of these test-tube experiments and inoculations that he discovered the value of calcium hypochlorite as a local application4 ,working1 by various methods1 with attenuated venoms1 he was able to immunise animals3-- ,i have come to immunise rabbits against quantities of venom that are truly colossal4 ,i have got several1 vaccinated more than a year ago1 which take1 without the least discomfort1 so much as #dj mgr4 of venom of naja tripudians at a single injection2 that is to say1 enough to kill #hj rabbits of #b kilogr4 weight1 or #e dogs4 ,five drops of serum from these rabbits wholly neutralise in vitro 7in a glass test-tube7 the toxicity of #a mgr4 of naja-venom4 ,by #ahid he had found that the serum of an animal1 thus immunised by graduated doses of one kind of venom1 neutralised other kinds of venom3-- ,if #a mgr4 of cobra-venom1 or #d mgr4 of viper-venom1 be mixed1 in a test-tube1 with a small quantity of serum from an immunised rabbit1 and a fresh rabbit be inoculated with this mixture1 it does not suffer any discomfort4 ,it is not even necessary that the serum should come from an animal vaccinated against the same sort of venom as that in the mixture4 ,the serum of a rabbit immunised against the venom of the cobra or the viper acts indifferently on all the venoms that ,i have tested4 ,in #ahid he had prepared enough serum for the treatment to be tried by his own countrymen practising in some of the ,french colonies4 ,in ,april #ahie1 he gave the following account of his work3-- ,i have immunised two asses1 one having received #bbj mgr4 of naja-venom from #beth ,september to #cast ,december #ahid1 and the other #afj mgr4 from #aeth ,october to #cast ,december4 ,the serum of the first of these two animals has now reached this point1 that half a cubic centimetre destroys the toxicity of #a mgr4 of naja-venom4 ,four cubic centimetres of this serum1 injected four hours before the inoculation of a dose of venom enough to kill twice over1 preserve the animal in every case4 ,it is also therapeutic1 under the conditions that ,i have already defined2 that is to say1 if you first inoculate a rabbit with such a dose of venom as kills the control-animals in three hours1 and then1 an hour after injecting the venom1 inject under the skin of the abdomen #d to #e cubic centimetres of serum1 recovery is the rule4 ,when you interfere later than this the results are uncertain2 and in all my experiments the delay of an hour and a half is the most that ,i have been able to reach4 ,this antivenomous serum of asses has these same antitoxic properties with all kinds of snake-venom2 it is equally active in vitro1 preventive1 and therapeutic1 with the venoms of cerastes1 of trigonocephalus1 of crotalus1 and of four kinds of ,australian snakes that ,mr4 ,mac,garvie ,smith has sent to ,m4 ,roux4 ,i am still injecting these two animals with venom1 and ,i hope to give to their serum at last a much greater antitoxic power4 ,in #ahif four successful cases of this treatment in the human subject were reported in the ,british ,medical ,journal4 ,in #ahih ,calmette made the following statement of his results3-- ,it is now nearly two years since the use of my antivenomous serum was introduced in ,india1 in ,algeria1 in ,egypt1 on the ,west ,coast of ,africa1 in ,america1 in the ,west ,indies1 ,antilles1 c4 ,it has been very often used for men and domestic animals 7dogs1 horses1 oxen71 and up to now none of those that have received an injection of serum have succumbed4444 ,a great number of observations have been communicated to me1 and not one of them refers to a case of failure4 7,british ,medical ,journal1 #adth ,may #ahih47 ,good accounts of ,fraser's and ,calmette's work are given by ,dr4 ,stone in the ,boston ,medical and ,surgical ,journal1 #gth ,april #ahih1 and by ,staff-,surgeon ,andrews1 ,r4,n41 in the ,british ,medical ,journal1 #ith ,september #ahii4 ,for other cases see the ,pioneer1 #ajth ,august #ahii1 the ,lancet1 #beth ,november #ahii1 and the ,british ,medical ,journal1 #bcrd ,december #ahii4 ,in one of these cases1 recorded by ,dr4 ,rennie1 the patient was1 literally1 at the point of death1 but recovered after the serum had been injected4 ,two cases have also been recorded of cobra-bite during work in the laboratory3 both of them recovered after injection4 ,every ,government or private dispensary1 says ,surgeon ,beveridge1 should be supplied with antivenene1 which is certainly the best remedy for snake-bite available4 ,the cases are few at present2 but it does not appear that the treatment has failed in any case2 and1 with a new remedy of this kind1 it is fairly certain that failures would be published4 99 99 99 99 99 ,from all these instances in physiology1 pathology1 bacteriology1 and therapeutics1 we come to consider the ,act relating to experiments on animals in the ,united ,kingdom4 ,many subjects have been left out2 among them1 the work of the last few years on the suprarenal glands and adrenalin1 and ,dr4 ,william ,hunter's admirable work on pernicious anmia4 ,no attempt has been made to describe the researches of experts in many countries into the nature of malignant disease1 or to guess what may come of the discovery that mice can be immunised against that form of cancer which occurs in mice and is inoculable from mouse to mouse4 ,nothing has been said of the discovery that the ,african sleeping-sickness is due to a blood-parasite carried by flies from man to man4 ,nothing has been said about those discoveries in bacteriology that have not yet been applied to practice1 or of the many inventions of medical and surgical practice that owe only an indirect debt to experiments on animals4 ,artificial respiration1 the transfusion of saline fluid1 the hypodermic administration of drugs1 the use of oxygen for inhalation1 the torsion of arteries1 the grafting of skin1 the transplantation of bone1 the absorbable ligature1 the diagnostic and therapeutic uses of electricity1 the rational employment of blood-letting--all these good methods have been left out of the list2 only some facts have been presented1 those that mark most clearly the advance of knowledge and of practice1 and stand up even above the rest of the work4 ,there they will stand1 when we are all dead and gone3 and by them1 as by landmarks1 all further advance will be guided4 ,,part ,,iii ,,the ,,act ,,relating ,,to ,,experiments ,,on ,,animals ,,in ,,great ,,britain ,,and ,,ireland ,,act #ci ,,and #dj ,,vic4 c4 #gg ,the ,royal ,commission ,on the ,practice of subjecting ,live ,animals to ,experiments for ,scientific ,purposes1 was appointed on #bbnd ,june #ahge4 ,its members were--,lord ,cardwell 7chairman71 ,lord ,winmarleigh1 ,mr4 ,w4 ,e4 ,forster1 ,sir ,john ,karslake1 ,mr4 ,huxley1 ,mr4 7,sir ,john7 ,erichsen1 and ,mr4 ,hutton4 ,between #eth ,july and #cjth ,december1 #ec witnesses were examined1 and #feea questions were put and answered4 ,the report of the ,commission bears date #hth ,january #ahgf1 and in that year the present ,act received the ,royal ,assent4 ,the evidence before the ,commission was all1 or nearly all1 concerned with physiology1 with the work of ,magendie1 ,claude ,bernard1 and ,sir ,charles ,bell1 the action of curare1 the ,handbook of the ,physiological ,laboratory1 the teaching of physiology1 and so forth4 ,very little was said of pathology2 and of bacteriology next to nothing4 ,practically1 physiology alone came before the ,commissioners2 and such experiments in physiology as are now1 the youngest of them1 more than thirty years old4 ,bacteriology1 at the time of the passing of the ,act1 had hardly made a beginning4 ,therefore the ,act made no special provision for inoculations1 injections1 and the whole study of immunisation of animals and men against disease4 ,experiments of this kind have to be scheduled under one of the existing certificates1 to bring them under an ,act that was drafted without foreknowledge of them4 ,certificate ,a or ,certificate ,b has to be used for this purpose3-- ,certificate ,a4 ,we hereby certify that1 in our opinion1 insensibility in the animal on which any such experiment may be performed cannot be produced by ansthetics without necessarily frustrating the object of such experiment4 ,certificate ,b4 ,we hereby certify that1 in our opinion1 the killing of the animal on which any such experiment is performed before it recovers from the influence of the ansthetic administered to it1 would necessarily frustrate the object of such experiment4 ,under one or other of these certificates must be scheduled all inoculations1 injections1 feeding-experiments1 transplantations of particles of disease1 immunisations1 and the like4 ,they must be scheduled somehow2 and that is the only way of doing it4 ,where the act of inducing the disease would itself give any pain1 if an ansthetic were not administered--as in the subdural inoculation of a rabbit1 or the intra-peritoneal inoculation of an animal with a particle of cancerous tissue--there the licensee must hold1 together with the license1 ,certificate ,b1 because the act of inducing the disease is itself an operation1 done under an ansthetic4 ,if the animal be a dog or a cat1 he must hold ,certificates ,b and ,,ee2 if it be a horse1 ass1 or mule1 ,certificates ,b and ,f4 ,where the act of inducing the disease is not itself painful--as in ordinary inoculation1 and in feeding-experiments--the licensee must hold1 together with his license1 ,certificate ,a1 because the animal is not ansthetised4 ,it is not a painful operation2 the experiment consists not in the act of putting the hypodermic needle under the animal's skin1 but in the subsequent observation of the course of the disease4 ,take1 for instance1 the inoculation of a guinea-pig with tubercle-bacilli3 the experiment is the production of tubercle2 the experiment lasts till the animal is killed and found to be infected2 it is therefore scheduled under ,certificate ,a4 ,or take the testing1 on an animal1 of an antitoxin2 the experiment is not the injection1 but the observation of the result2 the animal may not suffer1 but the injection must still be done under ,certificate ,a4 ,and1 if the animal be a dog or a cat1 the licensee must hold ,certificates ,a and ,e2 or1 if it be a horse1 ass1 or mule1 ,certificates ,a and ,f4 ,this want of a special certificate for inoculations is an important matter1 because it has led to the belief that painful operations are performed1 without ansthesia1 in cases where the only instrument used is a needle4 ,it is hardly reasonable1 for instance1 that the inoculation of a mouse should be scheduled as a painful operation performed without ansthesia4 ,the disease1 thus painlessly induced1 may in many cases be called painless2 for instance1 snake-venom in the rat1 septicmia in the mouse1 malaria in small birds4 ,in other cases1 there are such pain and fever as are part of the disease4 ,the form that rabies take in rabbits may fairly be called painless4 ,inoculations not under the skin1 but into the anterior chamber of the eye1 are very seldom made2 they sound cruel1 but cocain renders the surface of the eye wholly insensitive1 and the anterior chamber is so far insensitive that a man with blood or pus 7hypopyon7 in the anterior chamber of the eye may suffer no pain from it4 ,a horse or an ass kept for the giving of an antitoxic serum has a more comfortable life than an omnibus horse2 and this preparation of the antitoxins1 since it is not an experiment1 but a direct use of animals in the recognised service of man1 does not require a license or certificates under the ,act4 ,but the testing of an antitoxin is an experiment1 and must be made under a license and ,certificate ,a4 ,it is not the business of this book to consider whether the sensitiveness of a dog1 a rabbit1 or a guinea-pig can fairly be stated in terms of the physical and mental sensitiveness of men and women4 ,in the world of animals1 as in the world of humanity1 there are differences of sensitiveness4 ,anyhow1 the pain inflicted on animals may in some cases be measured3-- ,a guinea-pig that will rest quietly in your hands before you commence to inject it1 will remain perfectly quiet during the introduction of the needle under the skin2 and the moment it is returned to the cage it resumes its interrupted feeding4 ,arteries1 veins1 and most of the parts of the viscera1 are without the sense of touch4 ,we have actual proof of this in what takes place when a horse is bled for the purpose of obtaining curative serum4 ,with a sharp lance a cut may be made in the skin so quickly and easily that the animal does nothing more than twitch the skin-muscle of the neck1 or give his head a shake1 whilst of the further proceeding of introducing a hollow needle into the vein the animal takes not the slightest notice4 ,some horses1 indeed1 will stand perfectly quiet during the whole operation1 munching a carrot1 nibbling at a wisp of hay1 or playing with a button on the vest of the groom standing at its head4 ,harrowing details concerning the horrors of trephining rabbits for ,pasteur's antirabic treatment are frequently supplied for popular consumption1 but how little real existence any suffering in connection with the operation has1 may be gathered from the fact that if1 as a preliminary measure1 the skin be benumbed with carbolic acid1 the whole operation1 from making the incision through the skin to cutting out the piece of bone with a fine trephine and passing a needle under the dura mater1 may be done without once causing the animal to withdraw its attention from the important business of munching a bit of cabbage-leaf or a scrap of succulent carrot4 7,prof4 ,woodhead1 ,medical ,magazine1 ,june #ahih47 ,it may be well to put here--7#a7 the full text of the ,act2 7#b7 an account of the ansthetics used for animals2 7#c7 the latest ,report of ,government ,inspectors appointed under the ,act4 #a4--;,,an ,,act ,,to ,,amend ,,the ,,law ,,relating ,,to ,,cruelty ,,to ,,animals #aeth ,august #ahgf ,whereas it is expedient to amend the law relating to cruelty to animals by extending it to the cases of animals which for medical1 physiological1 or other scientific purposes are subjected when alive to experiments calculated to inflict pain3 ,be it enacted by the ,queen's most ,excellent ,majesty1 by and with the advice and consent of the ,lords ,spiritual and ,temporal1 and ,commons1 in this present ,parliament assembled1 and by the authority of the same1 as follows3 #a4 ,this ,act may be cited for all purposes as ,the ,cruelty to ,animals ,act1 #ahgf4 #b4 ,a person shall not perform on a living animal any experiment calculated to give pain1 except subject to the restrictions imposed by this ,act4 ,any person performing or taking part in performing any experiment calculated to give pain1 in contravention of this ,act1 shall be guilty of an offence against this ,act1 and shall1 if it be the first offence1 be liable to a penalty not exceeding fifty pounds1 and if it be the second or any subsequent offence1 be liable1 at the discretion of the court by which he is tried1 to a penalty not exceeding one hundred pounds1 or to imprisonment for a period not exceeding three months4 #c4 ,the following restrictions are imposed by this ,act with respect to the performance on any living animal of an experiment calculated to give pain2 that is to say1 7#a47 ,the experiment must be performed with a view to the advancement by new discovery of physiological knowledge or of knowledge which will be useful for saving or prolonging life or alleviating suffering2 and 7#b47 ,the experiment must be performed by a person holding such license from one of ,her ,majesty's ,principal ,secretaries of ,state1 in this ,act referred to as the ,secretary of ,state1 as is in this ,act mentioned1 and in the case of a person holding such conditional license as is hereinafter mentioned1 or of experiments performed for the purpose of instruction in a registered place2 and 7#c47 ,the animal must1 during the whole of the experiment1 be under the influence of some ansthetic of sufficient power to prevent the animal feeling pain2 and 7#d47 ,the animal must1 if the pain is likely to continue after the effect of the ansthetic has ceased1 or if any serious injury has been inflicted on the animal1 be killed before it recovers from the influence of the ansthetic which has been administered2 and 7#e47 ,the experiment shall not be performed as an illustration of lectures in medical schools1 hospitals1 colleges1 or elsewhere2 and 7#f47 ,the experiment shall not be performed for the purpose of attaining manual skill4 ,provided as follows2 that is to say1 7#a47 ,experiments may be performed under the foregoing provisions as to the use of ansthetics by a person giving illustrations of lectures in medical schools1 hospitals1 or colleges1 or elsewhere1 on such certificate being given as in this ,act mentioned1 that the proposed experiments are absolutely necessary for the due instruction of the persons to whom such lectures are given with a view to their acquiring physiological knowledge1 or knowledge which will be useful to them for saving or prolonging life1 or alleviating suffering2 and 7#b47 ,experiments may be performed without ansthetics on such certificate being given as in this ,act mentioned1 that insensibility cannot be produced without necessarily frustrating the object of such experiments2 and 7#c47 ,experiments may be performed without the person who performed such experiments being under an obligation to cause the animal1 on which any such experiment is performed1 to be killed before it recovers from the influence of the ansthetic1 on such certificate being given as in this ,act mentioned1 that the so killing the animal would necessarily frustrate the object of the experiment1 and provided that the animal be killed as soon as such object has been attained2 and 7#d47 ,experiments may be performed not directly for the advancement by new discovery of physiological knowledge1 or of knowledge which will be useful for saving or prolonging life1 or alleviating suffering1 but for the purpose of testing a particular former discovery alleged to have been made for the advancement of such knowledge as last aforesaid1 on such certificate being given as is in this ,act mentioned that such testing is absolutely necessary for the effectual advancement of such knowledge4 #d4 ,the substance known as urari or curare shall not for the purposes of this ,act be deemed to be an ansthetic4 #e4 ,notwithstanding anything in this ,act contained1 an experiment calculated to give pain shall not be performed without ansthetics on a dog or cat1 except on such certificate being given as in this ,act mentioned1 stating1 in addition to the statements hereinbefore required to be made in such certificate1 that for reasons specified in the certificate the object of the experiment will be necessarily frustrated unless it is performed on an animal similar in constitution and habits to a cat or dog1 and no other animal is available for such experiment2 and an experiment calculated to give pain shall not be performed on any horse1 ass1 or mule except on such certificate being given as in this ,act mentioned that the object of the experiment will be necessarily frustrated unless it is performed on a horse1 ass1 or mule1 and that no other animal is available for such experiment4 #f4 ,any exhibition to the general public1 whether admitted on payment of money or gratuitously1 of experiments on living animals calculated to give pain shall be illegal4 ,any person performing or aiding in performing such experiments shall be deemed to be guilty of an offence against this ,act1 and shall1 if it be the first offence1 be liable to a penalty not exceeding fifty pounds1 and if it be the second or any subsequent offence1 be liable1 at the discretion of the court by which he is tried1 to a penalty not exceeding one hundred pounds1 or to imprisonment for a period not exceeding three months4 ,and any person publishing any notice of any such intended exhibition by advertisement in a newspaper1 placard1 or otherwise shall be liable to a penalty not exceeding one pound4 ,a person punished for an offence under this section shall not for the same offence be punishable under any other section of this ,act4 ,administration of ,law #g4 ,the ,secretary of ,state may insert1 as a condition of granting any license1 a provision in such license that the place in which any experiment is to be performed by the licensee is to be registered in such manner as the ,secretary of ,state may from time to time by any general or special order direct2 provided that every place for the performance of experiments for the purpose of instruction under this ,act shall be approved by the ,secretary of ,state1 and shall be registered in such manner as he may from time to time by any general or special order direct4 #h4 ,the ,secretary of ,state may license any person whom he may think qualified to hold a license to perform experiments under this ,act4 ,a license granted by him may be for such time as he may think fit1 and may be revoked by him on his being satisfied that such license ought to be revoked4 ,there may be annexed to such license any conditions which the ,secretary of ,state may think expedient for the purpose of better carrying into effect the objects of this ,act1 but not inconsistent with the provisions thereof4 #i4 ,the ,secretary of ,state may direct any person performing experiments under this ,act from time to time to make such reports to him of the result of such experiments1 in such form and with such details as he may require4 #aj4 ,the ,secretary of ,state shall cause all registered places to be from time to time visited by inspectors for the purpose of securing a compliance with the provisions of this ,act1 and the ,secretary of ,state may1 with the assent of the ,treasury as to number1 appoint any special inspectors1 or may from time to time assign the duties of any such inspectors to such officers in the employment of the ,government1 who may be willing to accept the same1 as he may think fit1 either permanently or temporarily4 #aa4 ,any application for a license under this ,act and a certificate given as in this ,act mentioned must be signed by one or more of the following persons2 that is to say1 ,the ,president of the ,royal ,society2 ,the ,president of the ,royal ,society of ,edinburgh2 ,the ,president of ,royal ,irish ,academy2 ,the ,presidents of the ,royal ,colleges of ,surgeons in ,london1 ,edinburgh1 or ,dublin2 ,the ,presidents of the ,royal ,colleges of ,physicians in ,london1 ,edinburgh1 or ,dublin2 ,the ,president of the ,general ,medical ,council2 ,the ,president of the ,faculty of ,physicians and ,surgeons of ,glasgow2 ,the ,president of the ,royal ,college of ,veterinary ,surgeons1 or the ,president of the ,royal ,veterinary ,college1 ,london1 but in the case only of an experiment to be performed under ansthetics with a view to the advancement by new discovery of veterinary science2 and also 7unless the applicant be a professor of physiology1 medicine1 anatomy1 medical jurisprudence1 materia medica1 or surgery in a university in ,great ,britain or ,ireland1 or in ,university ,college1 ,london1 or in a college in ,great ,britain or ,ireland1 incorporated by royal charter7 by a professor of physiology1 medicine1 anatomy1 medical jurisprudence1 materia medica1 or surgery in a university in ,great ,britain or ,ireland1 or in ,university ,college1 ,london1 or in a college in ,great ,britain or ,ireland1 incorporated by royal charter4 ,provided that where any person applying for a certificate under this ,act is himself one of the persons authorised to sign such certificate1 the signature of some other of such persons shall be substituted for the signature of the applicant4 ,a certificate under this section may be given for such time or for such series of experiments as the person or persons signing the certificate may think expedient4 ,a copy of any certificate under this section shall be forwarded by the applicant to the ,secretary of ,state1 but shall not be available until one week after a copy has been so forwarded4 ,the ,secretary of ,state may at any time disallow or suspend any certificate given under this section4 #ab4 ,the powers conferred by this ,act of granting a license or giving a certificate for the performance of experiments on living animals may be exercised by an order in writing under the hand of any judge of the ,high ,court of ,justice in ,england1 of the ,high ,court of ,session in ,scotland1 or of any of the superior courts in ,ireland1 including any court to which the jurisdiction of such last-mentioned courts may be transferred1 in a case where such judge is satisfied that it is essential for the purposes of justice in a criminal case to make any such experiment4 ,legal ,proceedings #ac4 ,a justice of the peace1 on information on oath that there is reasonable ground to believe that experiments in contravention of this ,act are being performed by an unlicensed person in any place not registered under this ,act1 may issue his warrant authorising any officer or constable of police to enter and search such place1 and to take the names and addresses of the persons found therein4 ,any person who refuses admission on demand to a police officer or constable so authorised1 or obstructs such officer or constable in the execution of his duty under this section1 or who refuses on demand to disclose his name or address1 or gives a false name or address1 shall be liable to a penalty not exceeding five pounds4 #ad4 ,in ,england1 offences against this ,act may be prosecuted and penalties under this ,act recovered before a court of summary jurisdiction in manner directed by the ,summary ,jurisdiction ,act4 ,in ,england ,summary ,jurisdiction ,act means the ,act of the session of the eleventh and twelfth years of the reign of ,her present ,majesty1 chapter forty-three1 intituled ,an ,act to facilitate the performance of the duties of justices of the peace out of sessions within ,england and ,wales with respect to summary convictions and orders1 and any ,act amending the same4 ,court of summary jurisdiction means and includes any justice or justices of the peace1 metropolitan police magistrate1 stipendiary or other magistrate1 or officer1 by whatever name called1 exercising jurisdiction in pursuance of the ,summary ,jurisdiction ,act3 ,provided that the court when hearing and determining an information under this ,act shall be constituted either of two or more justices of the peace in petty sessions1 sitting at a place appointed for holding petty sessions1 or of some magistrate or officer sitting alone or with others at some court or other place appointed for the administration of justice1 and for the time being empowered by law to do alone any act authorised to be done by more than one justice of the peace4 #ae4 ,in ,england1 where a person is accused before a court of summary jurisdiction of any offence against this ,act in respect of which a penalty of more than five pounds can be imposed1 the accused may1 on appearing before the court of summary jurisdiction1 declare that he objects to being tried for such offence by a court of summary jurisdiction1 and thereupon the court of summary jurisdiction may deal with the case in all respects as if the accused were charged with an indictable offence and not an offence punishable on summary conviction1 and the offence may be prosecuted on indictment accordingly4 #af4 ,in ,england1 if any party thinks himself aggrieved by any conviction made by a court of summary jurisdiction on determining any information under this ,act1 the party so aggrieved may appeal therefrom1 subject to the conditions and regulations following3--- 7#a47 ,the appeal shall be made to the next court of general or quarter sessions for the county or place in which the cause of appeal has arisen1 holden not less than twenty-one days after the decision of the court from which the appeal is made2 and 7#b47 ,the appellant shall1 within ten days after the cause of appeal has arisen1 give notice to the other party and to the court of summary jurisdiction of his intention to appeal1 and of the ground thereof2 and 7#c47 ,the appellant shall1 within three days after such notice1 enter into a recognizance before a justice of the peace1 with two sufficient sureties1 conditioned personally to try such appeal1 and to abide the judgment of the court thereon1 and to pay such costs as may be awarded by the court1 or give such other security by deposit of money or otherwise as the justice may allow2 and 7#d47 ,where the appellant is in custody the justice may1 if he think fit1 on the appellant entering into such recognizance or giving such other security as aforesaid1 release him from custody2 and 7#e47 ,the court of appeal may adjourn the appeal1 and upon the hearing thereof they may confirm1 reverse1 or modify the decision of the court of summary jurisdiction1 or remit the matter to the court of summary jurisdiction with the opinion of the court of appeal thereon1 or make such other order in the matter as the court thinks just1 and if the matter be remitted to the court of summary jurisdiction the said last-mentioned court shall thereupon re-hear and decide the information in accordance with the order of the said court of appeal4 ,the court of appeal may also make such order as to costs to be paid by either party as the court thinks just4 #ag4 ,in ,scotland1 offences against this ,act may be prosecuted and penalties under this ,act recovered under the provisions of the ,summary ,procedure ,act1 #ahfd1 or if a person accused of any offence against this ,act in respect of which a penalty of more than five pounds can be imposed1 on appearing before a court of summary jurisdiction1 declare that he objects to being tried for such offence in the court of summary jurisdiction1 proceedings may be taken against him on indictment in the ,court of ,justiciary in ,edinburgh or on circuit4 ,every person found liable in any penalty or costs shall be liable in default of immediate payment to imprisonment for a term not exceeding three months1 or until such penalty or costs are sooner paid4 #ah4 ,in ,ireland1 offences against this ,act may be prosecuted and penalties under this ,act recovered in a summary manner1 subject and according to the provisions with respect to the prosecution of offences1 the recovery of penalties1 and to appeal of the ,petty ,sessions 7,ireland7 ,act1 #ahea1 and any ,act amending the same1 and in ,dublin of the ,acts regulating the powers of justices of the peace or of the police of ,dublin metropolis4 ,all penalties recovered under this ,act shall be applied in manner directed by the ,fines 7,ireland7 ,act1 #ahga1 and any ,act amending the same4 #ai4 ,in ,ireland1 where a person is accused before a court of summary jurisdiction of any offence against this ,act in respect of which a penalty of more than five pounds can be imposed1 the accused may1 on appearing before the court of summary jurisdiction1 declare that he objects to being tried for such offence by a court of summary jurisdiction1 and thereupon the court of summary jurisdiction may deal with the case in all respects as if the accused were charged with an indictable offence and not an offence punishable on summary conviction1 and the offence may be prosecuted on indictment accordingly4 #bj4 ,in the application of this ,act to ,ireland the term the ,secretary of ,state shall be construed to mean the ,chief ,secretary to the ,lord ,lieutenant of ,ireland for the time being4 #ba4 ,a prosecution under this ,act against a licensed person shall not be instituted except with the assent in writing of the ,secretary of ,state4 #bb4 ,this ,act shall not apply to invertebrate animals4 ,,ii4--,,an,,sthetics ,,under ,,the ,,act ,in almost every case1 the ansthetic used is chloroform or ether2 sometimes it is combined with or followed by morphia or chloral4 ,the nature of the ansthetic used in each case must1 of course1 be stated in the returns sent to the ,home ,office4 ,of the use of ether1 it need only be said that animals take it well1 and that there is no difficulty in rendering them unconscious with it4 ,with some animals1 chloroform is equally good4 ,professor ,hobday1 of the ,royal ,veterinary ,college1 published in #ahih an account of #ejj administrations of chloroform to dogs1 for operations1 with only one death4 ,still1 for dogs and cats1 ether is used in preference to chloroform4 ,other animals take chloroform well4 ,morphia is seldom used alone2 but1 in some cases1 it is used after chloroform or ether4 ,that morphia is a real ansthetic is certain1 for there are deaths every year from an over-dose of it4 ,again1 it is certain that an animal1 so far under the influence of morphia that it lies still1 cannot be suffering1 for the drug does not act directly on the muscles but on the higher nervous centres4 ,very rarely a dog may fail to come readily under the influence of morphia1 may be excited by it1 not narcotized4 ,but this is altogether exceptional4 ,an animal in such a condition would not be suited for experiment1 and another ansthetic would be given4 ,except in these rare cases1 animals take morphia well and are profoundly influenced by it4 ,curare is not an ansthetic under the ,act4 ,it is illegal to use it as an ansthetic4 ,in this country it is seldom used at all1 and it is never used alone in any experiment involving any sort or kind of painful operation4 ,in every such case a recognised ansthetic must be given1 and is given4#dc #dc ,see ,part ,,iv41 ,curare4 ,a good account of curare was published in the ,edinburgh ,review1 ,july #ahii4 ,the ,act of #ahgf expressly forbids its use as an ansthetic4 ,when it is used1 it must be supplemented with some other drug to relieve pain4 ,a good deal of misconception exists as to the actual physiological effect of curare4 ,claude ,bernard believed that it did not in any way affect the sensory nerves1 and he described in theatrical terms the animal as being unable to stir1 but suffering horrible torture4 ,it is pretty certainly known now that ,claude ,bernard was wrong1 and that1 though curare acts first upon the motor nerves1 it also1 though less rapidly1 paralyses the sensory nerves4444 ,probably the truth is1 that1 like all other nerve-poisons1 the effect of curare varies with the dose4 ,the muscular nerves are the first affected1 then the sensory1 and finally the central nervous system4 ,as a matter of fact1 however1 morphia or some other narcotic is always given in addition to curare when it is used in laboratory work in ,england4 ,,iii4--,,latest ,,report 7#aije7 ,,of ,,inspectors ,,under ,,the ,,act 7,the various tables of names1 places1 c41 and the references to them1 which are contained in this ,report1 need not be reprinted here4 ,the ,report1 and other papers relating to the ,act1 may be bought for a few pence from ,wyman ,sons1 ,ltd41 ,fetter ,lane1 ,e4,c47 99 99 99 99 99 ,,england ,,and ,,scotland ,april #agth1 #aijf4 ,,sir1--,i have the honour to submit the following ,report on ,experiments performed in ,england and ,scotland during the ,year #aije1 under the ,act #ci #dj ,vict4 c4 #gg4444 ,six new places were registered for the performance of experiments1 and one place was removed from the register during the year4 ,all licensees were restricted to the registered place or places specified on their licenses1 with the exception of those who were permitted to perform inoculation experiments in places other than a registered place1 with the object of studying outbreaks of disease occurring in remote districts or under circumstances which render it impracticable to perform the experiment in a registered place4 ,the total number of licensees was #cha4 ,reports have been furnished by 7or1 in a few exceptional cases1 on behalf of7 these licensees in the form required by the ,secretary for ,state4 ,the reports show that #abb licensees performed no experiments4 ,the numbers given above include #bb licensees whose licences expired on ,february #bh1 #aije1 and who returned no experiments in #aije4 ,tables ,i41 ,,ii41 and ,,iii4 afford evidence1-- #a4 ,that licences and certificates have been granted and allowed only upon the recommendation of persons of high scientific standing2 #b4 ,that the licensees are persons who1 by their training and education1 are fitted to undertake experimental work and to profit by it2 #c4 ,that all experimental work has been conducted in suitable places4 ,table ,,iv4 shows the number and the nature of the experiments returned by each licensee mentioned in ,table ,,ii41 specifying whether these experiments were done under the licence alone or under any special certificate4 ,table ,,iv4 is divided into two parts1 ,a4 and ,b41 for the purpose of separating experiments which were performed without ansthetics from experiments in which ansthetics were used4 ,the total number of experiments included in ,table ,,iv4 7,a47 is #bejf4 ,of these there were performed1-- ,under ,licence alone#dd #acdh ,certificate ,c4 #ade ,certificate ,b4 #ffe ,certificate ,b4 ,,ee #cdf ,certificate ,b4 ,f4 #b #dd ,in experiments performed under licence alone1 the animal must during the whole of the experiment be under the influence of some ansthetic of sufficient power to prevent the animal feeling pain2 and the animal must1 if the pain is likely to continue after the effect of the ansthetic has ceased1 or if any serious injury has been inflicted on the animal1 be killed before it recovers from the influence of the ansthetic which has been administered4 ,certificate ,c4 allows experiments to be performed1 under the foregoing provisions as to the use of ansthetics1 in illustration of lectures4 ,certificate ,b4 exempts the person performing the experiment from the obligation to cause the animal on which the experiment is performed to be killed before it recovers from the influence of the ansthetic2 and when the animal is a dog or a cat1 ,certificate ,,ee4 is also necessary4 ,certificate ,a4 allows experiments to be performed without ansthetics2 and when the animal on which the experiment is performed is a dog or a cat1 ,certificate ,e4 is also necessary4 ,certificate ,f4 is required in all cases of experiments on a horse1 ass1 or mule4 ,table ,,iv4 7,b47 is devoted entirely to inoculations1 hypodermic injections1 and some few other proceedings1 performed without ansthetics4 ,it includes #ce1dbi experiments1 whereof there were performed1-- ,under ,certificate ,a4 #cd1ggh ,certificate ,a4 ,e4 #edi ,certificate ,a4 ,f4 #ajb ,the total number of experiments is #cg1ice1 being #ecgc more than in #aijd2 the increase in the number of experiments included in ,table ,,iv4 7,a47 is #bij1 and in ,table ,,iv4 7,b471 #ejhc4 ,all experiments involving a serious operation are placed in ,table ,,iv4 7,a474 ,the larger part of the experiments included in this ,table1 viz41 all performed under licence alone1 and under ,certificate ,c41 #adic in number1 come under the provision of the ,act that the animal must be kept under an ansthetic during the whole of the experiment1 and must1 if the pain is likely to continue after the effect of the ansthetic has ceased1 or if any serious injury has been inflicted on the animal1 be killed before it recovers from the influence of the ansthetic4 ,in the experiments performed under ,certificate ,b41 or ,b4 linked with ,,ee4 or with ,f41 #ajac in number1 the initial operations are performed under ansthetics1 from the influence of which the animals are allowed to recover4 ,the operations are required to be performed antiseptically1 so that the healing of the wounds shall1 as far as possible1 take place without pain4 ,if the antiseptic precautions fail1 and suppuration occurs1 the animal is required to be killed4 ,it is generally essential for the success of these experiments that the wounds should heal cleanly1 and the surrounding parts remain in a healthy condition4 ,after the healing of the wounds the animals are not necessarily1 or even generally1 in pain1 since experiments involving the removal of important organs1 including portions of the brain1 may be performed without giving rise to pain after the recovery from the operation2 and after the section of a part of the nervous system1 the resulting degenerative changes are painless4 ,in the event of a subsequent operation being necessary in an experiment performed under ,certificate ,b41 or ,b4 linked with ,,ee4 or with ,f41 a condition is attached to the licence requiring all operative procedures to be carried out under ansthetics of sufficient power to prevent the animal feeling pain2 and no observations or stimulations of a character to cause pain are allowed to be made without the animals being ansthetised4 ,in no case has a cutting operation more severe than a superficial venesection been allowed to be performed without ansthetics4 ,the experiments included in ,table ,,iv4 7,b471 #ce1dbi in number1 are all performed without ansthetics4 ,they are mostly inoculations1 but a few are feeding experiments1 or the administration of various substances by the mouth1 or the abstraction of a minute quantity of blood for examination4 ,in no instance has a certificate dispensing with the use of ansthetics been allowed for an experiment involving a serious operation4 ,inoculations into deep parts1 involving a preliminary incision in order to expose the part into which the inoculation is to be made1 are required to be performed under ansthetics1 and are therefore placed in ,table ,,iv4 7,a474 ,it will be seen that the operative procedures in experiments performed under ,certificate ,a41 without ansthetics1 are only such as are attended by no considerable1 if appreciable1 pain4 ,the ,certificate is1 in fact1 not required to cover these proceedings1 but to allow of the subsequent course of the experiment4 ,the experiment lasts during the whole period from the administration of the drug1 or injection1 until the animal recovers from the effects1 if any1 or dies1 or is killed1 possibly extending over several days1 or even weeks4 ,the substance administered may give rise to poisoning1 or set up a condition of disease1 either of which may lead to a fatal termination4 ,to administer to an animal such a poison as diphtheria toxin1 for example1 or to induce such a disease as tuberculosis1 although it may not be accompanied by acute suffering1 is held to be a proceeding calculated to give pain1 and therefore experiments of the kind referred to come within the scope of the ,act #ci #dj ,vict41 c4 #gg4 ,the ,act provides that1 unless a special certificate be obtained1 the animal must be kept under an ansthetic during the whole of the experiment2 and it is to allow the animal to be kept without an ansthetic during the time required for the development of the results of the administration that ,certificate ,a4 is given and allowed in these cases4 ,it must not be assumed that the animal is in pain during the whole of this time4 ,in cases of prolonged action of an injected substance1 even when ending fatally1 the animal is generally apparently well1 and takes its food as usual1 until a short time before death4 ,the state of illness may last only a very few hours1 and in some cases it is not observed at all4 ,in a very large number of the experiments included in ,table ,,iv4 7,b471 the results are negative1 and the animals suffer no inconvenience whatever from the inoculation4 ,these experiments are therefore entirely painless4 ,in the event of pain ensuing as the result of an inoculation1 a condition attached to the licence requires that the animal shall be killed under ansthetics as soon as the main result of the experiment has been attained4 ,the number of inoculations and similar proceedings recorded in ,table ,,iv4 7,b47 continues to increase in accordance with the progressive importance attached to biological tests generally in practical medicine for the diagnosis1 treatment and prevention of disease1 and to the more widely recognised need for such experiments on the part of those responsible for the care of the public health4 ,several ,county ,councils and ,municipal ,corporations have their own laboratories in which bacteriological investigations are carried on1 including the necessary tests on living animals2 and many others have arrangements by which similar observations are made on their behalf in the laboratories of ,universities1 ,colleges1 and other ,institutions4 ,a sewage farm is registered as a place in which experiments on living animals may be performed in order that the character of the effluent may be tested by its effects on the health of fish4 ,the ,board of ,agriculture has two laboratories which are registered for the performance of experiments having for their object the detection and study of the diseases of animals4 ,in other places experiments have been made on behalf of the ,home ,office1 the ,war ,office1 the ,india ,office1 the ,local ,government ,board1 the ,office of ,works1 the ,board of ,agriculture and ,fisheries1 and the ,metropolitan ,asylums ,board4 ,a very large proportion of the experiments in ,table ,,iv4 7,b47 have thus been performed either on behalf of ,official ,bodies with a view to the preservation of the public health1 or directly for the diagnosis and treatment of disease4 ,forty-one licensees return over #hjjj experiments which were performed for ,government ,departments1 ,county ,councils1 or ,municipal ,corporations2 #bahg experiments were made by four licensees for the ,royal ,commission on ,tuberculosis2 twelve licensees performed #fbfe experiments1 almost all inoculations1 for testing antitoxic sera and vaccines and standardising drugs2 and #ab1ahg experiments1 mostly inoculations into mice1 were performed on behalf of the ,imperial ,cancer ,research ,fund4 ,the number of injections made during the year #aije for the diagnosis of rabies in dogs is #bg2 these are placed in ,table ,,iv4 7,a474 ,during the year the usual inspections of registered places have been made by ,sir ,james ,russell1 by myself1 and by ,mr4 ,w4 ,b4 ,l4 ,trotter1 who was appointed temporary ,assistant ,inspector during my absence for three months4 ,we have found the animals suitably lodged and well cared for1 and the licensees attentive to the requirements of the ,act1 as well as to the conditions appended to their licences by the ,secretary of ,state4 ,the irregularities recorded during the year have been few1 and not of a serious character4 ,two licensees1 holding certificates 7,a47 entitling them to perform inoculations without ansthetics1 administered an ansthetic during some of their experiments1 whereas the ,act prescribes another form of certificate 7,b47 when an animal is ansthetised during an experiment and allowed to recover from the ansthetic4 ,a licensee1 through inadvertence1 performed #ed inoculation experiments in excess of the number allowed by his certificate4 ,another licensee1 not understanding that joint experiments are reckoned to both of the licensees1 took part in the performance of eight experiments in excess of the number allowed by his certificate4 ,by direction of the ,secretary of ,state a suitable admonition was addressed to the licensee in each of the above cases4 ,in the month of ,april #aije the attention of the ,secretary of ,state was directed to certain experiments which were performed in #aijc and the early part of #aijd by persons not holding a licence under the ,act #ci #dj ,vict4 c4 #gg4 ,the experiments consisted in vaccinating dogs against distemper and then exposing them to infection1 the object being to test the efficacy of a method of vaccination as a safeguard against this disease4 ,the ,secretary of ,state thereupon caused inquiries to be made1 and from these it appeared that the experiments1 in some instances at least1 had been accompanied by pain1 and were1 therefore1 illegal4 ,the persons1 who were not aware that their experiments were of such a kind as to come within the provisions of the ,act1 were suitably admonished and warned against any similar illegal action in the future4 ,the matter was not brought to the knowledge of the ,secretary of ,state until it was too late for further proceedings to be taken if such had been considered necessary4 ,it is as well to point out here that to expose an animal to an infectious and painful disease like distemper is a proceeding calculated to cause pain within the meaning of the ,act1 and that such experiments can only be legally performed by a person holding a licence and appropriate certificates4--,i have the honour to be1 ,sir1 your obedient servant1 ,g4 ,d4 ,,thane1 ,inspector4 ,the ,right ,hon4 ,,herbert ,,john ,,gladstone1 ,secretary of ,state for the ,home ,department4 ,,ireland #h ,,ely ,,place1 ,,dublin1 ,april #bfth1 #aijf4 ,,sir1--,i beg to submit ,tables showing the experiments performed in ,ireland during the year #aije1 under the ,act #ci #dj ,vict4 c4 #gg1 together with a list of the ,registered ,places in ,ireland4 ,twelve licences were in force during the year2 of these four expired1 and two were renewed4 ,one new license was granted4 ,the certificates in existence or allowed were3-- ,a4 to #d licensees4 ,b4 #g ,c4 #c ,e4 #b ,,ee4 #c ,f4 #a licensee4 ,one expired during the year1 and six new ones were allowed4 ,the experiments performed number #bah2 #ajf being under licence alone1 and #aab under certificates4 ,ten licensees performed experiments4 ,twenty certificates were in force among #ab licensees1 of whom #aj performed experiments1 viz43-- ,under ,certificate ,a4 #hh ,b4 #ad ,c4 #h ,f4 #b ,the animals experimented on were3-- ,guinea pigs #ee ,birds #ec ,rabbits #dh ,cattle #bg ,mice #ad ,dogs #ac ,cats #b ,horses #b ,goats #b ,sheep #b ,the experiments were mainly pathological inoculations1 done for the purposes of the investigation or diagnosis of various diseases1 such as canine rabies1 tuberculosis1 cancer1 glanders1 and typhoid fever4 ,a few were physiological1 for the investigation of the functions of the thymus gland1 and of the effects of chloroform and ether on renal activity4 ,all of these seem to have been of a reasonable character and intended to serve useful purposes in the elucidation of the phenomena of disease or of vital functions4 ,they are reported to have been free from pain4 ,experiments numbering eight were performed in illustration of lectures1 to demonstrate the phenomena of circulation and respiration and of nervous control4 ,in these experiments1 two dogs1 two cats1 and four rabbits were employed4 ,some of the investigations were devoted to the study of diseases in cattle1 horses1 goats1 and sheep1 and seem to be useful and of economic value4 ,the registered places were inspected and their condition found satisfactory4 ,the inspectors in ,belfast and ,cork report that in those places the provisions of the ,act have been satisfactorily complied with4--,i have1 c41 ,w4 ,,thornley ,,stoker1 ,inspector for ,ireland4 ,to the ,right ,honourable ,the ,chief ,secretary to the ,lord ,lieutenant of ,ireland4 ,this ,report gives a clear answer to certain false statements alleged against experiments on animals4 ,it shows that more than #ij per cent4 of these experiments are inoculations1 with a few feeding experiments1 administrations of substances by the mouth1 or abstractions of a minute quantity of blood for examination4 ,in no instance has a certificate dispensing with the use of ansthetics been allowed for an experiment involving a serious operation4 ,in no case has a cutting operation more severe than a superficial venesection been allowed to be performed without ansthetics4 ,it shows1 also1 that the results1 in a very large number of these inoculations1 are negative1 painless1 not even inconvenient4 ,the ,report shows1 also1 that the vast majority of all experiments are inoculations made on the smaller animals2 and that the larger animals 7dog1 cat1 horse1 mule1 or ass7 are seldom used for inoculation4 ,it shows1 also1 that a great proportion of these inoculations are made in the direct practical service of the public health and the public purse3 to standardise drugs1 to ensure the purity of food and of rivers1 to protect flocks and herds1 and to decide quarantine4 ,government ,departments1 ,county ,councils1 ,municipal ,corporations1 and a ,royal ,commission made more than one-third of the total number of inoculations2 and the ,imperial ,cancer ,research ,fund made more than one-third1 mostly on mice2 and a sixth was made over the testing and standardising of sera and of drugs4 ,the operations performed under the ,license ,certificate ,b1 or ,b ,,ee1 or ,b ,f1 were #c per cent4 of the whole number of experiments4 ,the majority of the animals were neither cats nor dogs4 ,they can hardly be compared to the same number of the larger animals mutilated by breeders and farmers3 for these mutilations may be inflicted1 and are inflicted1 without an ansthetic4 ,they can hardly be compared to the same number of pheasants or rabbits wounded1 but not killed1 in sport2 for the animals wounded in sport get no subsequent care1 and1 if they are in pain1 nobody need put them out of it4 ,they may fairly be compared to the same number of pet animals that have undergone surgical operations1 under ansthesia1 at the hands of a skilled veterinary surgeon2 only with this difference1 that many of them lose health1 or suffer disablement or disease1 and so die or are killed2 but1 if the wound suppurates1 the animal must be killed1 and1 after the wound has healed1 the animals are not necessarily1 or even generally1 in pain4 ,and there must be no further experiment without ansthesia4 ,no observations or stimulations of a character to cause pain are allowed to be made without the animals being ansthetised4 ,it is evident that good care is taken to ensure an irreducible minimum of pain4 ,,part ,,iv ,,the ,,case ,,against ,,anti-,,vivisection ,,the ,,case ,,against ,,anti-,,vivisection ,the following pages are taken1 with a few changes and omissions1 from a pamphlet which ,i published in #aijd4 ,i am glad to say that the tone of the ,anti-,vivisection ,societies is not quite so bad as it was a few years ago2 but ,i think that what ,i wrote in #aijd is still fairly accurate4 #a4 ,,anti-,,vivisection ,,societies ,the early history of the anti-vivisection movement is given in a pamphlet by ,dr4 ,leffingwell1 of ,brooklyn1 entitled ,the ,rise of the ,vivisection ,controversy2 and in a pamphlet published by the ,national ,anti-vivisection ,society1 entitled ,dates of the ,principal ,events connected with the ,anti-vivisection ,movement4 ,dr4 ,leffingwell calls attention to a fact not generally known--that the movement1 in this country1 was begun by the medical journals4 ,the ,medical ,times and ,gazette in #aheh1 the ,lancet in #ahfj1 and the ,british ,medical ,journal in #ahfa condemned in a very outspoken way certain experiments made on the ,continent1 and raised the question whether these or any experiments on animals could be justified4 ,later1 in #ahgb1 the ,medical ,times and ,gazette declared outright that all experiments1 from the time of ,magendie onward1 had done nothing for humanity that could be compared to the discovery and use of cod-liver oil and bark4 ,in #ahgd1 the ,royal ,society for the ,prevention of ,cruelty to ,animals took proceedings against those who had made certain experiments at ,norwich during a meeting of the ,british ,medical ,association4 ,these experiments1 and the publication of the ,handbook of the ,physiological ,laboratory1 roused public comment2 and during #ahge the opposition to all experiments on animals took more definite form4 ,on ,june #bbnd1 #ahge1 the ,royal ,commission was appointed2 on ,january #hth1 #ahgf1 its report was dated2 and on ,august #aeth1 #ahgf1 the present ,act received the ,royal assent4 ,at the time when the ,royal ,commission was appointed1 the only anti-vivisection society was that which ,mr4 ,jesse had just started2 and if any one will read ,mr4 ,jesse's cross-examination1 by ,professor ,huxley1 before the ,royal ,commission1 he will not attach much importance to that society4 ,the ,national ,anti-vivisection ,society was founded in ,november #ahge2 the ,irish ,society1 the ,london ,society1 and the ,international ,association in #ahgf2 the ,church ,anti-vivisection ,league in #ahhi1 the ,humanitarian ,league and the ,national ,canine ,defence ,league#de in #ahia1 and the ,british ,union about #ahih4 ,these dates show that the oldest of these societies came after the ,royal ,commission1 not before it2 the first societies and the ,royal ,commission were alike the expression of a widespread opinion1 thirty years ago1 that experiments on animals ought either to be forbidden or to be restricted4 ,this same opinion had been favoured1 fifteen years before that1 by the representative journals of the medical profession4 ,we have seen something of the work of the medical profession2 let us now see something of the work of the societies4 #de ,these two societies have other purposes beside that of opposition to experiments on animals4 ,the chief anti-vivisection societies in this country are the ,national ,society1 the ,london ,society1 the ,british ,union1 the ,church ,league1 and the ,canine ,defence ,league4 ,in ,february #ahih1 the ,national ,society declared itself in favour of restriction2 it set before itself abolition as its ultimate policy1 and restriction as its immediate practical policy4 ,thus1 at the present time1 these societies are divided into two parties3 one asks for restriction1 another asks for nothing short of abolition4 ,this division between them1 and the tone of the ,national ,society toward the smaller ,societies1 waste their energy and their funds1 and hinder them from working together4 ,the ,national ,society1 in its official journal 7,january #aijb71 speaks as follows of this schism1 in a leader entitled ,the ,folly of our ,subdivisions3-- ,nobody seems to know how many ,anti-vivisection ,societies there are4 ,a few hundred ,anti-vivisectionists divide themselves up into divisions1 subdivisions1 coteries1 and cliques1 without order1 without discipline1 without cohesion4 ,the ,anti-vivisectionists between them all contribute but a few thousands a year1 and dribble them around among multitudinous antagonistic associations4444 ,the pitiful absurdity of the disunion fostered by some ,anti-vivisectionists was illustrated very forcibly last year by the issue of a prospectus of a ,society with a world-embracing title1 in which its promoters declared that irreparable injury would be inflicted upon our cause if electoral work were not taken up by them4444 ,the accounts of this stupendous organisation showed that its total expenditure for the year was #ac1 #ais4 #d;d41 out of which ten shillings was devoted to 'electoral work4' 444 ,a much graver injury is done to the cause of mercy by the deplorable waste of money spent in perfectly unnecessary offices and salaries4 ,we say that one office would amply suffice for all the work1 and that one office would not need half-a-dozen paid ,secretaries4 ,the existence of many quite needless ,societies cannot be justified on any grounds of humanity combined with common sense4 ,nothing need be added to these very grave admissions1 written by ,mr4 ,coleridge himself4 ,he proposes a very simple remedy for these quite needless societies3-- ,the ,national ,society1 as the chief ,anti-vivisection organisation in the world1 is always ready to put an end to this grievous waste by receiving into its corporation any of the smaller ,societies4 ,but the leaders of smaller societies have two grounds of complaint against ,mr4 ,coleridge's society3 they do not believe in his policy1 and they will not submit to his discipline4 ,they call his society the weak-kneed brethren1 and say that its policy is miserable1 cowardly1 and misleading2 and they take it ill that he so often accuses them of inaccuracy4 ,he refers again and again 7see the official journal of the ,national ,society7 to this mode of discipline3-- ,december #aija4--;,i decline to be made responsible for the 'anti-vivisection party4' ,there happen to be small anti-vivisection associations whose chief occupation is the dissemination of quite inaccurate pamphlets4 ,i have nothing to do with them1 and cannot prevent anything they choose to do4 ,january #aijb4--,time after time has this sacred cause been undermined and betrayed by its professing friends by their reckless habit of making erroneous statements4 ,march #aijb4--;,i am quite aware that with many of my opponents in the exclusive total-abolition coterie1 the motives that actuate them are far removed from the question of the salvation of the wretched animals1 and have their foundation in emotions that seem to me singularly unworthy and petty4 ,may #aijb4--;,as representative of the ,national ,society1 ,i have again and again written to the representatives of some of the smaller anti-vivisection societies1 protesting in plain terms against their publication of inaccurate statements4 ,no society could submit to be thus taken to task four times in six months4 ,the ,church ,league writes to him1 ,what the ,church ,league may or may not think fit to say does not in the very least concern you1 who are not a member of the ,league4 ,interference in such a matter from an outsider is an obvious impertinence4 ,such rejoinders are met1 in their turn1 by angry leaders1 ,a ,stab in the ,back1 ,stabs in the ,back1 in the ,national ,society's official journal2 and the ,hon4 ,secretary of the ,london ,society1 who is a lady1 is accused of want of chivalry for ,mr4 ,coleridge4 ,the leader1 ,a ,stab in the ,back 7,april #aijb71 is a curious instance of the tone of one anti-vivisection society toward another3-- ,the time when a man is assailed by a large section of the press1 threatened with violence by laymen1 attacked on points relevant by vivisectors and points irrelevant by their supporters1 is scarcely the moment that a generous rival would have chosen for hurling a dart2 and yet1 incredible as it may appear1 the ,honorary ,secretary of another ,anti-vivisection ,society1 seizing an opportunity afforded by an article in the ,globe1 enters the arena1 and1 by a letter repudiating any connection with ,mr4 ,coleridge1 appears to sanction the unfriendly criticisms expressed in that paper4 ,it needed no chivalry to refrain from writing such a letter4 ,a small amount of good taste would have amply sufficed4444 ,this letter1 which will convince the public of nothing but the writer's lack of taste1 might well be ignored were it not that it is but one of the many attacks made by members of other societies1 either by open statement or innuendo1 against the ,honorary ,secretary of the ,national ,society4 ,but we cannot wonder at these occasional stabs4 ,for the ,national ,society does not stop at charging other societies with inaccuracy4 ,it makes yet graver charges against them4 ,here are three made by ,mr4 ,coleridge's society against ,miss ,cobbe's and ,mr4 ,trist's societies3-- ,march #aija4--,the ,february number of the ,abolitionist contains a leading article in which allusions are made to subjects that are never discussed by decent people even in private4 ,as the leading organ of the ,anti-vivisection movement1 we enter our solemn protest against the publication of this unspeakable article1 which must inevitably inflict the gravest injury upon our cause4 ,february #aijc4--;,it is our duty to inform our readers that ,mr4 ,trist has published the correspondence1 but that he has mutilated it1 omitting some of his own letters altogether1 and excising whole paragraphs of ,mr4 ,stewart's letters4 ,june #aijc4--,our amiable contemporary1 the ,abolitionist1 is good enough1 in a long article in its last issue1 to suggest to those preparing the libel action against ,mr4 ,coleridge what are the most vulnerable points in his armour4 ,thus divided in policy1 and quarrelling among themselves1 these societies are still agreed in appealing to the public for approval and for money4 ,here the ,london ,society's opposition to the ,national ,society comes out clearly4 ,in its annual report 7#aijc7 the ,london ,society says3-- ,join a really effective ,society with a frank and straightforward policy--namely1 the ,london ,anti-vivisection ,society1 #ac ,regent ,street1 ,london1 ,s4,w4 ,this is a ,national and ,international organisation4 ,it has greater medical support than any other4 ,it is the most 'alive' humane organisation in the world4444 ,get into touch with the society4 ,write to us4 ,we shall be glad to hear from you and answer any questions4 ,if you can provide for the ,society's future in your ,will1 may we beg of you to do so8 ,if you agree1 pray do it now4 ,thousands of pounds have been lost to the ,society and the ,cause by the fatal procrastination of well-meaning friends4 ,the pity of it6 ,legacies should be left in these exact words3 ',to the ,london ,anti-vivisection ,society4' ,,caution4 ,it is of great importance to describe very accurately the ,title of this ,society--namely1 ,,the ,,london ,,anti-,,vivisection ,,society--otherwise the benevolent intentions of the ,donor may be frustrated4 ,,please ,,note4--,those charitable persons who have left money to the ,society would do well to notify the same to the ,secretary4 ,contrast the tone of this appeal for money with the tone of the ,report3---- ,your ,society are glad to note that the ,christian ,churches are becoming alarmed at the pretensions of scientific authority4444 ,the ,christian laity has been largely uninstructed or misinformed on this grave question4444 ,happily1 the signs of the times are propitious2 not all of the leaders of religious thought in this country have succumbed to the dictation and pretensions of the professors of vivisection 444 a base and blatant materialism1 a practice which owes its inception to barbarism1 and which has developed in materialism of the lowest possible order4 ,surely such eloquence should avail to tear the money even out of the hands of the dying1 lest the ,national ,society should get it4 ,the ,national ,society1 oddly enough1 also says3 ,,caution4--,it is of great importance to describe very accurately the ,title of this ,society--namely1 ,,the ,,national ,,anti-,,vivisection ,,society--otherwise the benevolent intentions of the ,donor may be frustrated4 ,i do not know which of these two societies is the inventor of this phrase4 ,still1 it is not improbable that the ,national ,society receives more money than all the smaller societies together4 ,of course1 we cannot compare the working expenses of an anti-vivisection society with the working expenses of the ,society for the ,prevention of ,cruelty to ,animals1 or the ,society for the ,prevention of ,cruelty to ,children4 ,the former of these two societies in one year obtained #hgih convictions2 in one month alone1 #fhi convictions2 and it paid the full costs of committing #cd of the #fhi to prison4 ,the ,society for the ,prevention of ,cruelty to ,children has an equally good record4 ,but an anti-vivisectionist society cannot show results of this kind4 ,nor can we compare its working expenses to those of a missionary society2 for the missionaries give direct personal service to their fellow-men4 ,but we can fairly compare an anti-vivisection society to an anti-vaccination society or a ,church of ,christian ,science4 ,that is to say1 it is a publishing body4 ,in #aijb1 the ,national ,society's expenditure1 in round numbers1 was #igj on printing and stationery2 #aaic on rent1 salaries1 and wages2 #abee on books1 newspapers1 periodicals1 c41 including the ,illustrated ,catalogue and the ,hospital ,guide2 #achj on lectures1 meetings1 organising new branches1 c42 and about #ejj on all other expenses4 ,let us take1 to illustrate these figures1 what the ,national ,society says from time to time in its official journal3-- ,june #ahii4--7;,from the ,society's ,annual ,report73 ,the whole controversy has been collected and published in pamphlet form by your ,society1 and more than #aj1jjj copies have already been issued to the public4 ,over #bjj people have joined your ranks and become members of the ,society in consequence of it1 while two cheques of #ajjj each were received by ,mr4 ,coleridge in aid of the cause4 ,june #ahii4--,we have received more money within the past six months than we got in any two years previously4 ,june #ahii4--,we cannot better employ the funds at our disposal than in securing the constant help of experts to insure the accuracy of all our statements1 and in sending well-informed lecturers to every city in the kingdom4 ,june #aijj4--7;,from the ,society's ,annual ,report73 ,the receipts of the society from subscriptions and donations show an increase over those of the previous year4 ,this increase in itself1 however1 would hardly have justified the increase in the expenses which it has been found necessary to incur in almost every department1 and especially in the distribution of pamphlets and papers1 had it not been for some legacies which fell due1 notably one from----1 of #fchf4 ,may #aija4--,with heartfelt gratitude we have once more to announce that the ,national ,society has received a gift of a thousand pounds from an anonymous donor4 ,nothing could be more opportune for the ,cause than this munificent support1 coming as it does just as the issue of #bj1jjj copies of ,mr4 ,stephen ,coleridge's ,hospital ,guide has been made at so great a cost to the ,society4 ,june #aija4--,our editorial table is buried deep in press cuttings from all parts of the kingdom4 ,march #aijb4--,we employ two press-cutting agencies to send us cuttings from the journals of the whole ,english-speaking world4 ,july #aijc4--,we start branches in various towns1 and send lecturers to speak at working men's clubs and debating societies4 ,all this means a very large expense4 ,we very often issue a pamphlet likely to do good by the tens of thousands4 ,last year we issued #ej1jjj copies of the ',illustrated ,german ,catalogue of ,vivisectional ,instruments and ,appliances4' ,the smaller societies1 of course1 spend their funds in the same sort of way4 ,thus the ,national ,canine ,defence ,league says that its anti-vivisection work1 the most important of all its works1 is earnestly carried forward by 7#a7 ,the ,writer's ,league1 in a ceaseless flow of letters to the press2 7#b7 ,the circulation of lists of hospitals free from the shameful practice2 7#c7 ,the publication of twenty-one strong leaflets on the subject2 7#d7 ,the circulation of #cjj copies of a book on the subject4 ,this society in two years sent out #fej1jjj leaflets and pamphlets2 but they were not all of them about experiments on animals4 ,another ,society1 in a report published in #aijb1 enumerates the methods which it employs for the education of the public at large4 ,these include 7a7 the publication of literature2 7b7 the holding of public meetings in all parts of the ,united ,kingdom2 7c7 the delivery of lectures with or without limelight illustrations2 7d7 participation in debates even with high scientific authorities2 7e7 inducing the clergy and ministers of all ,churches to deliver sermons dealing with the subject2 7f7 organisation of a press bureau1 through which the newspaper press of the country is watched1 and correspondence and articles contributed4 ,this ,society has also a van1 the only one of its kind in existence4 ,no sooner is our winter and spring campaign concluded than the van takes up the thread of the work and carries it on through the summer1 and it may truly be said that the track of the van across country is white with the literature which the van circulates on its educational mission4 ,it is evident1 from these and the like statements1 that these ,societies1 during the last quarter of a century1 have published a vast quantity of literature4 ,we must examine the style of that literature during some recent years1 and the arguments which it puts forward4 ,but1 before we do this1 let us consider what attitude is taken by these ,societies1 or by well-known members of this or that ,society1 toward certain problems and interests that closely concern them4 ,i ,they do not hesitate to take advantage of all those improvements of medicine and surgery which have been made by the help of experiments on animals4 ,they denounce the work of the present2 but they enjoy all the results of the past1 and will enjoy all those of the near future4 ,if anything of value to medicine has been discovered by vivisection1 it would be as absurd to reject it on that account as it would be to abandon ,ireland because centuries ago we took it by force4 ,and again3 ,we are no more morally bound to reject benefits acquired by indefensible means than are the descendants of slaveholders bound to abandon wealth originally acquired by the detestable abomination of slavery4 ,and again1 the ,animal's ,friend 7,november #aijc7 takes as further instances the benefits derived from body-snatching1 political assassination1 and the ,french ,revolution4 ,but1 in the matter of experiments on animals1 it is the very same men and women who denounce these experiments and who profit by them4 ,what should we say of an anti-slavery reformer who was himself drawing a vast income out of the slave trade8 ,but there is one gentleman1 and1 so far as ,i know1 only one1 who did carry his opinions into practice4 ,he told the story at a debating meeting--how his little girl had a sore throat1 and the doctor wanted to give antitoxin1 and he forbade it1 and the child recovered4 ,of course1 he says1 it was only an ordinary sore throat4 ,truly1 a great victory1 and a brave deed1 to make an experiment on your own sick child4 ,,ii ,the attitude of these ,societies toward sport may seem at first sight purely negative2 but it is worth study4 ,i have the honour of knowing a very eminent physiologist who will never shoot1 because he thinks it cruel--a man much abused by the ,national ,society4 ,and ,lord ,llangattock1 the ,president of that ,society1 is well known as an a ardent sportsman4 ,this contrast is of some interest4 ,let us see what the ,national ,society says about sport4 ,of course1 it is not bound to attack sport4 ,but the reasons which it gives for remaining neutral are to be noted4 #a4 ,it says1 very truly1 that it is in great part supported by sportsmen4 #b4 ,it says1 further1 that the cruelties of sport lie outside its own proper work3-- ,our opponents frequently ask us why we do not attack some form of cruelty other than vivisection1 which they consider more heinous4 ,our ,honorary ,secretary recently summarised this argument in his own amusing manner thus3 ,we must not arrest the man in ,tooting for kicking his wife till we have stopped the woman in ,balham starving her children1 and we must not arrest the woman in ,balham for starving her children until we have stopped the man in ,tooting kicking his wife4 7#aija47 ,later 7#aijc7 the dramatis person are a man in ,east ,islington jumping on his wife1 and a woman in ,west ,islington stabbing her husband4 ,but this argument1 of course1 will not hold4 ,for it is the same men who denounce wounds made 7under ansthetics7 for physiology1 and who make wounds 7without ansthetics7 in sport4 #c4 ,it says that the object of the sportsman is to kill2 but the object of the experimenter is to torture3-- ,there is a vast difference between the killing of animals and the torturing of them before killing them4 ,the object of the sportsman is to kill his quarry2 the object of the vivisector is to keep his victim alive while he dissects it4--,mr4 ,wood 7#aijc74 ,the object of the sportsman is to kill1 and the object of the vivisector is to keep his victim alive while he cuts it up4--,lord ,llangattock 7#aija74 ,the vivisector is nothing if not a tormentor2 the sportsman is not a true sportsman if he seeks to inflict pain on his quarry4444 ,one 7the pain of a horse falling on asphalt7 is the result of an accident to be deplored1 the other 7the pain from an experiment7 is done of devilish malice prepense4--,leader in the ,society's official journal1 7#ahii74 ,i am not so mentally and ethically confused as to be unable to distinguish between the entirely different moral acts of killing and torturing4--,mr4 ,coleridge 7#aija74 ,here are four statements4 ,one is by ,mr4 ,wood1 the ,society's lecturer2 one by ,lord ,llangattock1 its ,president2 one is published in its official journal2 and one is by ,mr4 ,coleridge1 its honorary secretary and treasurer4 ,that is the sort of thing which seems good enough to the ,national ,society to say to its friends in ,parliament2 this childish nonsense about the true sportsman and his quarry4 ,,iii ,the attitude of these ,societies toward the medical profession1 and toward the ,hospitals1 must be studied4 ,let us look through some numbers of the official journal of the ,national ,society1 and see the attitude that it sometimes takes toward the medical profession3-- ,june #ahii4--,the charm of this sort of thing is that you are always sure of the post-mortem if of nothing else4 ,july #ahii4--,there is a disease1 well known to the vestrymen of ,london1 called 'the half-crown diphtheria4' ,this is common sore throat1 notified as diphtheria because the vestry pays a fee of half-a-crown to the medical notifier4 ,december #ahii4--,the patient died1 made miserable by the effect of inoculations which even on bacteriological grounds gave no promise of success1 but the scientific physician1 nowadays1 must inject something in the way of a serum4 ,march #aija4--,there will always be those who1 unable to think for themselves or exercise their independence on therapeutic methods1 are prone to bow down before authority which is self-assertive enough to compel the obedience of weak minds4 ,such men would inject antitoxin though every case died4 ,they administer it not knowing why4 ,april #aija4--7;,from ,our ,cause in the ,press73 ,what effort does the medical profession make to make clear to its clients what is well known to itself1 that disease is the result of wrong living8 ,practically none at all4 ,the medical profession as a whole have winked at sin1 and have merely sought to antidote its results4 ,september #aija4--,some day we shall have our surgeons disembowelling us just to see what daylight and fresh air will do for the stomach-ache4 ,december #aija4--,the new medicine demands a mere laboratory habit2 the patient is nothing1 the disease everything4 ,he is a test-tube2 such and such reagents are needed to produce a certain result1 and there you are4 ,the patient's malady1 be it what it may1 is due to a microbe1 a toxin1 or a ptomaine2 he must be inoculated with the serum or antitoxin which counteracts his disease1 and this must be done not secundum artem but secundum scientiam1 and the science means the inoculating syringe and so many cubic centimetres of filth wherewith to poison the man's blood and so cure his disease1 though the victims die4 ,december #aijc4--7;,from ,our ,cause in the ,press73 ,not only did we see great callousness in the field hospitals in ,south ,africa1 but conversation with the class that finds its way into our hospitals in ,england will reveal that a great deal of refined cruelty is constantly occurring4 ,why does the official journal of ,mr4 ,coleridge's society publish these things8 ,for this reason--that it must attack those methods that were discovered by the help of experiments on animals4 ,the medical profession uses these methods4 ,therefore1 that profession must be attacked4 ,the same reason1 of course1 helps to explain the ,national ,society's attack on the great ,hospitals of ,london4 ,it would take too long to tell here the whole story of that attack4 ,three charges were made against the ,hospitals3 7#a7 that they maltreat patients2 7#b7 that they promote the torture of animals2 7#c7 that they endow this torture at the cost of the patients4 ,they were accused1 to put it plainly1 of treachery and fraud2 and of course the ,council of the ,king's ,hospital ,fund got its share of abuse4 ,mr4 ,coleridge said on this subject3-- #a4 7,annual meeting at ,st4 ,james's ,hall1 ,may #aija73 ,how have ,lord ,lister1 the vivisector1 and his ,committee distributed the ,prince of ,wales's ,hospital ,fund8 ,they have so distributed this fund as to make it clear to hospital managers that the more they connect their hospitals with the torture of animals the larger will be the grant they may expect to get from the ,prince of ,wales's ,fund4 ,that fund1 therefore1 has been used as an insidious but powerful incentive to vivisection4 #b4 7,annual meeting at ,st4 ,james's ,hall1 #aijb73 ,sheltering itself now in its most repulsive form behind those ancient and glorious institutions1 founded and sustained for their ,christ-like work of healing the sick1 sapping their foundations and smirching their fair fame1 malignant cruelty has taken up its position in its last ditch4 ,there it has summoned to its aid vast interests1 ancient prejudices1 enormous endowments1 and under illustrious patronage it has pilfered the funds subscribed for the poor4 ,with these statements before us 7and it would be easy to add to them7 we cannot doubt that the plan of campaign against all experiments on animals is also hostile to the ,hospitals1 whenever that hostility seems likely to be of the very least use to the cause4 99 99 99 99 99 ,surely there are charities more worthy of subscriptions1 donations1 and legacies than these ,anti-vivisection ,societies4 ,they quarrel among themselves2 they spend vast sums of money on offices1 salaries1 press-cuttings1 reprints1 lectures and meetings1 tons of pamphlets and leaflets4 ,their members denounce all experiments done now1 while they enjoy the profit of all experiments done before now2 they say that the object of the physiologist is to torture his victim out of devilish malice prepense2 they accuse doctors of fraud1 and lying1 and refined cruelty1 and madness1 and winking at sin2 they blacklist and boycott the best ,hospitals4 ,and the whole costly business1 these thirty years1 has done nothing to stop these experiments2 they have increased rapidly4 ,surely1 if a man wishes to help and comfort animals1 he had better give his money to the ,home for ,lost ,dogs1 or the ,home of ,rest for ,horses4 ,,ii4 ,,literature4 ,we have now to examine the style of the literature of these societies4 ,but1 out of such a vast store of journals1 pamphlets1 and leaflets1 we can only take one here or there4 ,from time to time a book or a pamphlet is1 for good reasons1 withdrawn4 ,thus1 in #aijb1 the ,london ,society withdrew ,dark ,deeds4 7,the ,shambles of ,science1 now impounded1 was published by a chairman of committee of the ,national ,society1 but not by that society47 ,in #aijj the ,national ,society withdrew one or more pamphlets involving acceptance of ,dr4 ,bowie's mistranslation of ,harvey4 ,in #aijb it withdrew and destroyed a whole store of diverse pamphlets1 and appealed to its supporters to refrain from circulating any literature not issued from our office by the present committee2 that is to say1 it warned them to distribute no literature but its own1 and not all even of that4 ,but the withdrawal of a few books and pamphlets makes very little difference2 and most of them are revised and brought out again4 ,take1 for example1 the ,nine ,circles4 ,it was planned and compiled for ,miss ,cobbe2 ,mr4 ,berdoe was urgently requested by her to point out to her any scientific errors or possible inadvertent misrepresentations of fact1 and correct or expunge them2 and he carefully read through the proof-sheets4 ,the book purported to be an exact account1 from original sources1 of certain experiments1 some made abroad1 some in this country4 ,it was attacked by ,sir ,victor ,horsley at the ,church ,congress at ,folkestone1 ,october #ahib1 and was withdrawn1 revised1 and brought out again4 ,our only concern here is to see what the official journal of the ,national ,society said of the revised issue4 ,this official journal1 the ,zoophilist and ,animal's ,defender1 was started in ,may #ahha1 under the shorter title of the ,zoophilist4 ,it speaks of itself as a scientific journal1 and as the recognised organ of the anti-vivisection movement in ,england4 ,it is published monthly1 and may be obtained through any bookseller4 ,in #ahhc it was edited by ,miss ,cobbe2 in #ahhd by ,mr4 ,benjamin ,bryan2 in #ahih by ,mr4 ,berdoe4 ,in #aijc1 ,mr4 ,coleridge1 apologising for an error made in it in #ahih1 says3 ,at that time ,i had not the control over its pages that is at present accorded to me4 ,thus it is1 ,i believe1 still edited by ,mr4 ,berdoe1 and is1 or was in #aijc1 controlled by ,mr4 ,coleridge4 ,and we are bound to note here that ,mr4 ,berdoe was in great part responsible for the ,nine ,circles2 and in #ahig was responsible for certain statements as to the use of curare1 which the ,home ,secretary1 in the ,house of ,commons1 called absolutely baseless4 ,let us now examine the style of this official journal4 ,and1 to begin with1 what does it say about the ,nine ,circles8 ,to make this point clear1 let us put in parallel columns what was said by ,sir ,victor ,horsley of the original edition in #ahib1 and what was said by the ,zoophilist in #ahii of the revised edition3-- ,sir ,victor ,horsley1 ,oct4 #ahib4 ,i have taken the trouble to collect all the experiments in which cutting operations are described as having been performed by ,english scientists1 and in which ,i knew ansthetics to have been employed4 ,these experiments are #bf in number4 ,in all of them chloroform1 ether1 or other ansthetic agent was employed4 ,but of these #bf cases1 ,miss ,cobbe does not mention this fact at all in #bj1 and only states it without qualification in two out of the remaining six4 ,when we inquire into these #bj omissions in the #bf cases1 we find in the original that again and again ,miss ,cobbe has1 in making her extracts1 had directly under her eyes the words chloroform1 ether1 etherised1 chloroformed1 ansthetised1 during every experiment the animal has been deeply under the influence of an ansthetic1 and so forth4 ,the ,zoophilist1 ,july #ahii4 ,a revised edition has been issued1 which is a stronger indictment against the vivisectors than the original work4 ,there were some half-dozen omissions in the first edition concerning the administration of ansthetics in the preliminary operations1 but the cruelty of the experiments was in no case modified by the fact that a whiff of chloroform was possibly administered1 as stated in the reports1 at the beginning of the operation4 ,our opponents may boast of their success in detecting the omission to dot the i's and cross the t's in the first edition of the ,nine ,circles1 but there are some victories which are worse than a defeat4 ,we have replaced the lantern with which we examined the dark deeds of the laboratories by the electric searchlight4 ,the researcher will find it hard to discover a retreat where its rays will not follow and expose him4 ,for another instance of the inaccuracy of the ,zoophilist we have what it said about ,professor ,sanarelli's experiments in ,south ,america on five human beings4 ,nobody defends him here4 ,but the point is that the ,zoophilist in #ahii said that they had all been killed2 and in #aijb admitted that they had all recovered4 ,or1 for another instance1 we have what it said in #aijb about the case of ,his ,majesty the ,king4 7,for these statements1 see ,zoophilist1 ,august #aijb and ,september #aijc2 also its report1 ,october #aijb1 of ,mr4 ,wood's speech at ,exeter47 ,but let us take a wider view4 ,a journal1 like a man1 is known by the company that it keeps4 ,whose company does the ,zoophilist keep8 ,why does it talk of ,our excellent cotemporary1 ,humanity--,our valiant cotemporary1 ,le ,mdecine--,our excellent cotemporary1 ,the ,herald of the ,golden ,age8 ,again1 among the journals that it quotes1 some of them very frequently1 are the ,topical ,times1 ,broad ,views1 ,modern ,society1 ,madame1 the ,humanitarian1 the ,pioneer1 the ,vegetarian1 the ,voice of ,india1 the ,herald of ,health1 the ,rock1 the ,new ,age1 the ,journal of ,zoophily1 the ,homoeopathic ,world1 ,medical ,liberty1 and the ,honolulu ,humane ,educator4 ,this may be very good company1 but it is not all of it the best company for a scientific journal4 ,still1 it may be better company than the ,american ,medical ,brief1 the ,journal de ,mdecine de ,paris1 and the ,belgian ,le ,mdecine4 ,these journals1 being veritable medical journals1 are quoted in the ,zoophilist with the most amazing frequency and at great length2 which is a compliment that they do not receive from other medical journals4 ,they are1 indeed1 as vehemently anti-,pasteur and anti-antitoxin as the ,zoophilist itself4 ,take what the ,medical ,brief says3-- ,bacteriology originated in ,continental ,europe1 where the minds of a superstitious race were further unbalanced by constant delving in pathology1 putrefaction1 and morbid anatomy4 ,when it spread to the new world1 it also became blinded with the revolutionary and fanatical tendencies lying near the surface in such a civilisation4 ,they say if you give a calf rope enough1 he will hang himself4 ,bacteriology is equally clumsy and stupid4444 ,what excuse can be found for the cowardice and ferocious ignorance which1 under the shadow of the stars and stripes1 resurrects the sentiment of the ,middle ,ages to protect the fraud1 seeks to rob the individual physician of free judgment1 and denounces him for failing to use the nasty stuff8 ,all ,continental ,europe is suffering from a sort of leprosy of decadence1 mental and moral4 ,the spiritual darkness of the people affects all the learned professions1 but more especially medicine4 ,such is the ,medical ,brief1 which the official journal of ,mr4 ,coleridge's society quotes incessantly1 calling it an ,american monthly of great ability and without a trace of the scientific bigotry and narrow-mindedness which is so prominent a feature in some of our own organs of medical opinion4 ,next we come to the ,journal de ,mdecine de ,paris4 ,this is anti-,pasteur2 the editor1 ,dr4 ,lutaud1 came to ,london in #ahii1 and gave a lecture on the ,pasteur superstition at ,st4 ,martin's ,town ,hall4 ,from a report of it in the ,star we may take the following sentences3-- ,the result of the serum craze had been that the hospital was neglected for the laboratory4 ,microbes of all the diseases were found in perfectly healthy subjects4 ,microbes existed1 but as a consequence1 not a cause4 ,toxins which the seropaths professed to find were only the results of normal fermentation4 ,the ,english public had always supported him in his fifteen years' struggle against ,pasteurism4 ,dr4 ,lutaud1 says the ,national ,society1 is the great authority4 ,the ,new ,england ,anti-vivisection ,monthly in #aijj calls him one of the brightest scientists of modern times4 ,his ,journal de ,mdecine de ,paris recalls the ,medical ,brief3-- ,to wish to apply the same methods of treatment1 whether preventive or curative1 for two morbid conditions 7a wound with the point of entry abnormal and an infectious malady7 in essence so different1 is to commit a gross error4444 ,the sick are destroyed by that which cures their wounds4 ,these two medical journals1 the ,medical ,brief and the ,journal de ,mdecine de ,paris1 are upheld by the ,national ,society as though they were expert witnesses of irresistible authority1 and are quoted with a sort of ceaseless worship in that ,society's official journal4 ,also it quotes the ,herald of ,health2 and ,medical ,liberty1 a monthly publication issued by the ,colorado ,medical ,liberty ,league1 ,denver1 ,colo41 whose eloquent editor seems to be an uncompromising foe to medical bigotry and monopoly1 and humbugs of every description4 ,such are the medical journals which support the ,zoophilist as a scientific journal4 ,now let us take another point of view4 ,let us consider whom the ,zoophilist praises1 and whom it condemns4 ,that1 surely1 is a fair test of an official journal4 ,and we get a clear result4 ,the late ,lord ,salisbury and ,mr4 ,arthur ,balfour are notoriously pro-vivisectionist2 ,lord ,lister has apostatised from the anti-septic faith2 ,m4 ,pasteur is a remorseless torturer2 the late ,mr4 ,lecky was degenerate1 because he performed the volte-face and went over to our opponents2 and the late ,professor ,virchow was subjected to scathing criticism by one ,paffrath1 and was proved to be absurd4 ,but its praises are given to a very different set of men4 ,there is no room here to note the lighter moods of the ,zoophilist2 its jokes about cats and catacombs1 and two-legged donkeys and four-legged donkeys1 and how to catch mosquitoes by putting salt on their tails--and it will even break its jest on the dead--but it rebukes another journal for levity1 saying1 ,we regret to see our painful subject treated in this manner4 ,no room1 either1 for its description of anti-vivisectionist plays1 poems1 novels1 and sermons4 ,let us1 to finish with1 take a few statements from its pages1 almost at random2 some of them are reprinted there from other sources4 ,the supply is endless2 let us limit ourselves to six of them3-- #a4 ,as other bacteria 7beside those of malaria7 were found not to bear sunlight or air1 but to habitats in loca scuta situ 78 to inhabit loca senta situ71 in filth and noisomeness1 their habits and customs preached again the old doctrine1 ',let in sun and air and be clean1' as earnestly as those who thought health was due to sun and air and water and fire1 the four old elements1 and act accordingly1 without dissecting hecatombs of animals to prove a thousand times over that if you boiled or baked or drowned or freezed living creatures they would die1 or that microscopic parasites did pretty much what visible parasites have been always known to do4 7,loud applause7--,report of a speech by the ,bishop of ,southwell 7#aija74 #b4 ,it is just as well that you should have heard what the clever level-headed lawyer 7,mr4 ,coleridge7 thinks about this abominable conspiracy of cruelty and fraud and impious inquisitiveness which is called vivisection4 7,cheers47 444 ,we are sending out on the world in every direction multitudes of young men who have been trained as surgeons1 and they have lived by cutting 7reference here to the medical students in ,pickwick71 and we are sending these young men out with this cacothes secandi1 this mania for cutting for the mere sake of cutting4 ,i should not be surprised if they tackle our noses or our ears1 and set about mutilating us in that way4--,archdeacon ,wilberforce 7#aija74 #c4 ,the task of the crusader against vivisection is not to reason with the so-called scientist1 not to truckle to pedants in the schools1 or palter with callous doctrinaires1 but to inform and arouse the people2 and when ,john ,bull is prodded from his apathy1 and startled from his stertorous snore1 he will rise and bellow out a veto on the elegant butcheries of pedantic libertines1 and rush full tilt with both his horns against their abattoirs of cruelty and passion1 pharisaically vaunted as research1 until the gates of hell shall not prevail against him4--,the ,rev4 ,arthur ,mursell 7#aija74df #d4 ,it has been my experience of anti-vivisection among ,romanists1 that nothing suited my purpose better than taking it for granted that the worshippers of ,st4 ,francis1 ,st4 ,bernard1 c41 must1 of course1 be on our side4--7#aijb47 #e4 ,given money1 and influential patronage1 the vivisector now expects a time after his own heart1 while professedly engaged in investigating the supposed causes of cancer1 or the transmissibility of tuberculosis4 ,he can inflict the most horrible and prolonged tortures on miserable animals1 with such a plausible excuse in reserve1 that he is endeavouring all the while to find cures for the ailments of high personages and millionaires4--7#aijb47 #f4 ,the day of drugging and scientific butchery is drawing to a close4 ,already the calm1 reassuring voice of the new ,life ,science1 loud and clear to the few1 is faintly audible to the many4 ,the sharp1 crucial knife1 with its dangerous quiver so dear to the heart of the surgeon1 the poisonous drug1 will be things of the past4 ,wisdom1 thy paths are harmony and joy and peace4--7#aijb47 #df ,even the ,zoophilist1 which quotes this speech from the ,clapham ,observer1 seems to feel that it might have been put more simply4 99 99 99 99 99 ,such is the frequent level of the ,zoophilist1 the official journal of the ,national ,society1 edited by ,mr4 ,berdoe1 controlled by ,mr4 ,coleridge4 ,let us now take one more of that society's publications1 a pamphlet entitled ,medical ,opinions on ,vivisection4 ,here1 if anywhere1 should be the society's stronghold4 ,if it could show a large and important minority of the medical profession opposed to all experiments on animals1 its power would be greatly increased4 ,on three occasions1 many years ago1 the medical profession did express its opinion4 ,at two of the annual meetings of the ,british ,medical ,association1 and at a meeting of the ,london ,international ,medical ,congress1 resolutions were passed affirming the value and the necessity of these experiments4 ,at one of these meetings there was one dissentient vote2 at one1 two2#dg at one1 none4 ,these three meetings were truly representative2 they were the great meetings of the clans of the profession1 from all parts of the kingdom1 for a week of practical work tempered by festivities4 ,what more could any profession do than to go out of its way three times that it might record1 in fullest assembly1 its belief8 ,and most certainly it would do the same thing again1 if it thought that any further declaration were needed4 #dg ,i think it was two2 it was either one or two4 ,there are in this country about #dj1jjj medical men4 ,the ,national ,society's pamphlet quotes #ci1 or one in #ajjj4 ,it could quote more2 but we must take what it gives us4 ,of these #ci1 we may fairly exclude ,professor ,koch1 ,sir ,frederick ,treves1 and the late ,sir ,andrew ,clark1 who would certainly wish to be thus excluded4 ,sir ,frederick ,treves1 who is quoted with a sort of explanatory note1 has told us in the ,times what he thinks of the way in which his name has been used2 ,sir ,andrew ,clark is quoted1 also with an explanatory note1 for an obiter dictum2 and ,professor ,koch for no discoverable reason4 ,that leaves #cf4 ,of these #cf1 at least #aa 7probably more7 are dead2 one died about #ahch1 another was born in the eighteenth century1 another died more than twenty years ago4 ,of the remaining #be1 one is ,dr4 ,lutaud1 one is ,mr4 ,berdoe1 one an ,american doctor1 not famous over here1 one a veterinary surgeon1 one 7,i think7 opposed to vaccination1 and three inclined to homoeopathy2 one has mistranslated ,harvey to the advantage of the ,national ,society's cause1 one has written ,hints to ,mothers1 and one has written ,how to ,keep ,well4 ,of these #be gentlemen1 one belongs to a homoeopathic hospital1 two to provincial hospitals1 and one to a hydropathic institute and a children's sanatorium2 the rest of them hold no hospital or school appointment of any sort or kind4 ,i may be wrong over one or two of these names2 but1 so far as ,i can see1 ,i have given an exact account of the value of these ,medical ,opinions on ,vivisection4 ,and1 if we take the dates of these opinions1 we find one in #ahcj1 one in #aheh1 and seven in #ahgj-ahhj4 ,anyhow1 what is the value of an opinion that all experiments on animals are arrant and horrible ,sepoyism wearing the mask of ,art and ,science8 ,let us leave the ,national ,society1 and turn to the ,canine ,defence ,league1 and examine that part of its literature which is concerned with experiments on animals4 ,take the following sentences from pamphlets #agi and #bjd3-- ,among the general public the majority are under the impression that these so-called physiological experiments are conducted under the influence of ansthetics1 and that the subjects are rendered insensible to pain2 this1 however1 is not the case1 and ,i am informed that a large proportion--considerably more than half--of the licenses dispense with ansthetics entirely4 ,the phenomena of pain are absolutely essential to any practical issue4 ,all diseases have a mental or spiritual origin4 ,upon this subject a large treatise might be written4 ,i have carefully thought this matter over1 and can come to no other conclusion4 ,can we imagine any wild bird confined to its nest with rheumatism1 or neuralgia1 or consumption1 or asthma1 or any other affection whatever8 ,i believe them all to be entirely free from disease2 that is1 all which have retained their freedom1 and thus have not come under the baneful influence of man4 ,take1 again1 the fishes1 and ask whether any fisherman ever caught a fish found to be diseased4 ,this subject is an interesting1 though a somewhat melancholy one4 ,next1 as an example of the literature of the ,london ,society1 let us take a speech made at ,st4 ,james's ,hall1 ,may #bf1 #aijc1 by ,dr4 ,hadwen1 of ,gloucester1 who is also vehemently opposed to vaccination4 ,he and ,lieutenant-,general ,phelps1 at the time of the disastrous smallpox epidemic in ,gloucester in #ahif1 were leaders of the anti-vaccinationists4 ,it would be easy to give other instances of the sympathy between anti-vivisection and anti-vaccination4 ,but our business is not with ,dr4 ,hadwen at ,gloucester1 but with him at ,st4 ,james's ,hall4 ,he says to the ,london ,society3-- ,we are told we must pay attention to what the experts tell us4 ,my opinion is this3 ,if there is one person in the whole of ,god's creation that wants looking after1 it is the expert4 7,laughter47 ,of the ,house of ,commons1 he says3-- ,if there is one thing in the world that will move a member of ,parliament1 it is to know that any particular policy will carry votes along with it4 7,hear1 hear47 ,you can bring any member of ,parliament to your knees as long as you show him that he has his constituency at his back2 and with all due respect to our noble chairman1 ,i am bound to say that my experience of members of ,parliament is this--that their consciences go as far as votes1 and do not extend very much farther4 7,laughter and applause47 ,he describes an imaginary experiment under curare1 and is interrupted by a cry of ,demons6 ,he goes on3-- ,yes1 madam1 they are demons4 7,applause47 ,i know no other word to describe experimenters who can submit sentient and sensitive creatures1 almost human in intelligence and faith1 to diabolical experiments1 whilst their victims are rendered helpless and voiceless by a hellish drug4 7,applause47 ,i cannot understand how in a land like this1 that boasts of her ,christianity and of her liberty1 men1 women1 clergy1 and politicians can allow this cowardly science to stand before us1 and this demoniacal work to be carried on4 7,loud cheers47 99 99 99 99 99 ,we have now seen something of the style of the literature of these ,societies2 and1 in the next chapter1 we will consider its arguments4 ,i do not deny that its style is sometimes at a higher level than the examples which ,i have quoted4 ,but ,i do say that ,i could fill a book of #ajj pages with quotations from journals or pamphlets of the last few years1 all of them on the lower level4 ,and in this chapter ,i have practically quoted nobody but those who are the leaders of the opposition to all experiments on animals4 ,the official journal of this ,society1 the annual report of that ,society1 the leaflets which are sent in answer to a formal request for literature--,i have quoted these1 as they came to hand1 just going through them and marking those passages which were to my purpose4 ,,iii4 ,,arguments ,we have seen that the societies arose out of the ,act1 and not the ,act out of them2 that they are divided or hostile2 and that they have next to nothing to show for all the vast sums which they have received4 ,also we have noted the style of literature which they send broadcast over the country2 and the medical journals and medical opinions that are in favour of the cause2 and the general tone and frequent level of the official journal of the ,national ,society4 ,still1 a good cause may be ill served2 nobody minds1 after all1 the style of a thing1 so long as it is true4 ,let us come to the heart of the matter4 ,what is the nature of the arguments and evidences of these societies8 ,they desire to bring about the absolute prohibition1 as a criminal offence1 of all experiments on animals4 ,by what facts1 what records1 what statistics1 do they maintain this attempt to mend or end the present ,act8 ,here1 at the risk of repetition1 let me make quite clear what they are fighting against4 ,nine out of ten experiments are bacteriological4 ,that is to say1 #ij or #ie per cent4 ,of these inoculations1 more than a third are made in the direct service of the national health1 and as it were by the direct orders of ,government4 ,a vast number of them are wholly painless2 nothing happens2 the result is negative2 the thing does not take4 ,some are followed by disease1 and the animal is painlessly killed at the first manifestation of the disease1 or recovers1 or dies of the disease4 ,the fate of that animal is the fate of all of us2 it has got to die of something1 and it dies of it4 ,anyhow1 the talk about torture-troughs and cutting-up has no place here2 and the word vivisection1 by a gross and palpable abuse1 is false nine times out of every ten4 ,of the remaining #aj per cent4 of all experiments2 in those that are made under the ,license alone1 or under the ,license plus ,certificate ,c1 the question of pain does not arise4 ,the animal is ansthetised1 and is killed under that ansthetic4 ,the remaining #c per cent4 of all experiments are those that are made under the ,license plus ,certificate ,b 7or ,b ,,ee1 or ,b ,f74 ,the initial operation is done under the ansthetic2 the animal is allowed to recover2 it may be1 practically1 none the worse for it4 ,or it may be the worse for it1 and therefore die1 or be killed4 ,but ,certificate ,b is not allowed for any infliction of pain on the animal through the operation wound1 and never will be4 ,here are two sets of experiments3 those under ,certificate ,a1 and those under ,certificate ,b4 ,one is #ij per cent4 of all experiments2 the other is #c per cent4 ,nine out of ten experiments are inoculations1 and the operation of the tenth is done under an ansthetic4 ,that is the first fact1 which we must fix in our minds1 before we consider the arguments of the societies4 ,next1 the dates and the sources of their evidence4 ,they wish to stop the experiments that are now made in this country4 ,they are bound1 therefore1 to produce up-to-date evidence1 and from home sources2 not that which is thirty years old1 or comes from sources far away4 ,this present use of animals1 here and now1 under the restrictions of the ,act1 is what they are fighting2 they are bound to draw their instances from here and now4 ,but this would not suit them at all3 they could not bear to be thus limited to here and now4 ,their arguments and their instances extend over thirty or more years1 and are drawn from all parts of the world1 from the ,united ,kingdom1 the ,united ,states1 ,france1 ,germany1 ,italy1 from every country4 ,journals of ,physiology1 text-books1 reports1 medical journals1 ,british and foreign1 are ransacked to find evidence for the cause2 there is a regular system1 year in year out1 a sort of secret service or detective force1 a persistent hunting-up of all scraps and shreds of evidence4 ,one society advertised1 in a daily paper1 that it wanted confidential communications1 from medical students1 as to the practices of the laboratory4 ,another1 seeing the chance of a prosecution1 says1 ,special inquiries were made on the subject1 and the society's solicitor went to ,belfast to conduct these inquiries on the spot4 ,all this espionage is sure now and again1 in thirty years1 to detect something which it can magnify into a scandal4 ,and when a fault is found1 even a little one1 oh the joy in the ranks of the societies4 ,and1 at once1 the fault1 exaggerated1 and highly coloured1 is made a locus classicus1 a commonplace of every drawing-room meeting4 ,what is the date of it1 what was the place of it8 ,was it long ago1 was it far from here8 ,still1 never let it drop2 what one did then1 they are all doing now1 all of them of malice prepense2 let us proclaim the blessed news from every platform2 and please remember us in your ,wills4 ,among the arguments against all experiments on animals1 is this very common argument1 that the truth about them is too horrible to be told4 ,we dare not produce our brief1 says the ,rev4 ,nevison ,loraine1 at the annual meeting of the ,london ,society in #aija2 it is only the courage of a lady that dares to produce tales so harrowing as those that have been briefly alluded to to-day2 and it is part of the weakness of our cause with the public that we cannot tell the whole story4 ,but1 not long ago1 the courage of two ladies1 officers of a ,swedish ,anti-vivisection ,society1 honorary members of ,mr4 ,coleridge's society1 did produce a book full of harrowing tales2 they told the whole story to the ,lord ,chief ,justice and a jury4 ,was not that producing their brief8 ,i have here in my pocket something ,i have not got the nerve to read to you1 says ,archdeacon ,wilberforce1 at the annual meeting of the ,national ,society in #aija2 and the next minute a lady in the audience is crying out1 ,do not go on1 we cannot bear it2 and he says1 ,you have got to bear it4 ,good ,god1 they have got to suffer it4 ,is not that producing his brief8 ,mr4 ,coleridge1 in #aijb1 sends out #ab1jjj copies1 just to begin with1 of an illustrated ,german catalogue of laboratory instruments3 ,the question of thus scattering abroad this fearful document has been the subject of very grave consideration4444 ,we have launched upon the world this terrible proof of what vivisection really is1 with a full sense of our responsibility4 ,is not that producing his brief8 ,these things in the pocket1 and fearful documents1 and briefs that ,mr4 ,loraine dares not produce1 are apt to say little or nothing about ansthetics1 and to be silent over the fact that nine out of every ten experiments are bacteriological1 and to over-emphasise experiments made many years ago or a thousand miles away4 ,you bring the speaker down to now and here1 to the text of the ,act1 to the reports to ,government1 to the ,home ,secretary's own words in ,parliament2 and you are told that they are all in a conspiracy1 all liars more or less1 and that the truth is in the societies1 especially in one of them4 ,or you bring him down to the good that these experiments have done1 the lives that they have saved2 and at once he is off like the wind3-- ,the society does not concern itself with the results of vivisection1 whether good or bad1 and thinks it is beside the mark to discuss them4 7,report of the ,canine ,defence ,league1 #aijc47 ,when the angel of pity is driven from the heart2 when the fountain of tears is dry1 the soul becomes a serpent crawling in the dust of the desert4 7,colonel ,ingersoll47 ,i make no pretence to criticise vivisectional experiments on the ground of their technical failure or success4 ,i dogmatically postulate humaneness as a condition of worthy personal character4 7,mr4 ,bernard ,shaw47 ,the vivisector1 when he stands over his animal1 whether with ansthetics or without ansthetics1 is creating1 even if the physical health of the nation is enhanced by it1 a moral shroud not only for himself1 but a moral shroud the edges of which are continually extending into the thought atmosphere1 and so deadening the national conscience at large4 7,mr4 ,herbert ,burrows47 ,the developed taste for blood and cruelty must in the end find its full satisfaction in the vivisection of human beings when they have the misfortune to come under the power of our future doctors4 7,bishop ,bagshawe47 ,here1 in these five sentences taken merely out of the heap1 is the ethical argument2 so facile1 so pleasant to self1 so confident of a good hearing4 ,no wonder that the societies1 now that the facts of science are too strong for them1 are falling back on the facts of ethics4 ,in the beginning1 thirty years ago1 they were created out of ethics2 they were born auspiciously4 ,what a welcome they had6 ,tennyson and ,browning and ,ruskin1 ,westcott and ,martineau1 the late ,lord ,shaftesbury1 and her ,majesty the late ,queen--these all1 and many more1 among whom were some of the best men and women of the ,victorian ,age1 were their friends4 ,there never was a cause that enjoyed a better send-off4 ,everything was in its favour4 ,magendie and ,schiff and ,mantegazza had made people sick of experiments on animals4 ,the advocates of the method had not very much to show on its behalf2 no bacteriology1 save as a far-off vision2 no great discoveries lately in physiology or pathology4 ,thirty years ago1 good and true men fought a way for the ,act2 and there are few now who think the worse of them for it1 or grudge them that victory4 ,but1 though ethics may be the same always1 yet the arguments from them are not4 ,the ethical argument now--we try to find it1 and it takes all shapes1 and vanishes in a cloud of foul language4 ,that text about the sparrows1 which is never quoted in full2 that fear about the vivisection of hospital patients2 and all that nonsense about moral shrouds1 and serpents in the desert1 and developed tastes for blood2 and ,mr4 ,bernard ,shaw1 who on ,may #bbnd1 #aijj1 suggests to the ,national ,society that the laceration of living flesh quickens the blood of the vivisector as the blood of the hunter1 the debauchee1 or the beast of prey is undoubtedly quickened in such ways1#dh and a week later1 before the ,london ,society1 dogmatically postulates humaneness as a condition of worthy personal character2 and the lady who says1 ,oh1 ,pharisees and hypocrites6 ,oh1 cruel and ruthless egotists6 and the ,falstaff's army of the osteopath1 and the fruitarian1 and the anti this1 that1 and the other1 who follow the cause2 and all these discordant societies1 and the begging for money--where1 in all this confusion1 can we find the ethical argument8 ,mercy is admirable1 but ,i will wait till mercy and truth are met together4 ,let us leave the societies to their ethics1 and see what they have to say for themselves in the lower realms of science4 #dh ,mr4 ,r4 ,b4 ,cunninghame-,graham's variant on this theme1 in the ,daily ,news1 ,aug4 #bg1 #aijc1 is really too filthy to be put here4 ,like ,mr4 ,loraine1 ,i dare not produce my brief4 ,i ,first1 there are the general arguments4 ,that experiments on animals are useless1 or of very little use2 that they contradict each other2 that you cannot argue from animals to men1 or from an animal under experiment to a man not under experiment2 that the discoveries made by the help of experiments on animals might have been made as well1 or better1 without that help2 that the way to advance medicine and surgery has been1 and is1 and always will be1 not by experiments on animals1 but by clinical and post-mortem studies4 ,these and the like arguments we may call general2 they are the complement of the horrible stories and magic-lantern slides of the itinerant lecturer4 #a4 ,the vague statement that these experiments are of little use1 may be answered in several ways4 ,it does not come well from those who say that the question is ethical1 not utilitarian2 who neither know1 nor care1 nor are agreed1 what is the real value of these experiments4 ,i challenge you1 says one1 to show me what good they have done4 ,another says1 ,i admit that they may perhaps have done a little good2 but so little2 they are a bad investment2 you would get a better return from other methods of work4 ,another says1 ,i don't care whether they have or have not done good2 this is a matter of conscience2 we must not do evil that good may come2 ,i grant all1 or nearly all1 your instances--malaria1 and diphtheria1 and cerebral localisation1 and so forth2 but the question is a moral question1 and we must not inflict pain on animals1 save for their own good4 ,probably the best answer is1 that good has indeed come1 and is coming1 and so far as we can see will come1 out of these experiments2 that the instances given are indeed true2 that these results were won out of many failures1 and contradictions1 and fallacies1 and harkings-back2 and that they have stood the test of time1 and will underlie all better results1 all surer methods1 that shall take their place4 #b4 ,the statement that you cannot argue from animals to man is not true4 ,why should it be8 ,take tubercle1 tetanus1 or rabies4 ,the tubercle-bacillus is the same thing in a man1 a test-tube1 or a guinea-pig2 the virus of rabies is transmitted from dogs to men2 oysters harbour typhoid1 fleas carry the plague1 diverse mosquitoes carry malaria1 yellow fever1 filariasis1 and dengue4 ,take the circulation of the blood1 the nature and action of the motor centres of the brain1 the vaso-motor nerves1 the excretory organs1 the contractility of muscle1 the blood-changes in respiration--where are the differences to support this statement that you cannot argue from animals to men8 #c4 ,the twin statements1 that all the results got by the help of experiments might have been got some other way1 and that clinical study and post-mortem study are infinitely more fruitful than experimental study1 may be taken together4 ,we are told that anybody could have discovered the circulation by injecting the vessels of a dead body4 ,well1 ,malpighi tried to discover the capillaries by this method1 and failed4 ,we are asked to admit that phrenology1 long before physiology1 discovered the truth about the surface of the brain2 ,i have been told1 says ,mr4 ,coleridge at an annual meeting of his society1 that the physiologists can now triumphantly map out the human brain4 ,i think the phrenologists have always been able to do that1 and whether they or the vivisectors do it best does not much matter4 ,we are told that the use of thyroid extract could have been discovered right away by mere chemistry and thinking4 ,we hear of a proposal for a bacteriological laboratory on anti-vivisectionist principles1 where no inoculations shall be made4 ,this argument1 that the whole thing might have been done some other way1 must repair its wit1 and find better instances4 ,then comes the incessant appeal3 ,stick to clinical work2 study diseases at the bedside1 in the post-mortem room1 in the museum1 anywhere but in the laboratory4 ,the ,hospital taught you to neglect these methods2 it made experiments on its patients1 it cheated the public1 it sheltered malignant cruelty in its most repulsive form under illustrious patronage4 ,set aside pathology2 just sit by your patients long enough2 that is the way of discovery4 ,or the appeal takes another tone3 ,stick to sanitation4 ,if only everybody were healthy1 everybody would be well4 ,diseases are due to dirt1 to vice1 to overcrowding1 to want of common-sense4 ,abolish all slums1 disinfect all mankind1 body and soul1 make every house clean and wholesome1 no bad drainage1 or ventilation1 or water1 or food4 ,leave your torture-chambers1 and open your eyes to the blessed truth that1 if everybody were healthy1 and everybody were good1 everybody would be well4 ,what is the use of talking in this way8 ,suppose that all the physiologists suddenly rushed into practice1 and all the bacteriologists were turned into medical officers of health4 ,what would be gained8 ,what difference would it make8 ,the physiologists1 of course1 would merely vivisect their hospital patients2 and the bacteriologists would hardly feel the change1 for many of them are medical officers of health already1 public servants1 appointed by the ,state4 ,this argument1 that practice is fruitful of discoveries1 and science is barren of them1 reaches its highest absurdity in the ,national ,society's official journal2 which praises extravagantly those methods of practice which were not discovered by the help of experiments on animals2 praises them without experience1 criticism1 or understanding4 ,it finds a statement1 in the ,medical ,annual1 that a year has passed without any great improvement in practice2 and at once it lays the blame not on practice but on science4 ,it fights hard against a fact which began in science1 though it has been proved a thousand times over in practice4 ,it accuses the bacteriologists now of caring nothing for human suffering1 now of rushing after every new method of treatment and flooding the market with drugs4 ,there is money in the business--that is the phrase of the ,zoophilist4 ,but there is money1 also1 in the anti-vivisection business4 ,if you can provide for the society's future in your will1 may we beg of you to do so8 ,if you agree1 pray do it now1 says the ,london ,society3 this is the most alive humane organisation in the world4 ,but the ,national ,society says1 ,a grave injury is done to the cause of mercy by the deplorable waste of money spent in perfectly unnecessary offices and salaries4 ,we say that one office would amply suffice for all the work1 and that one office would not need half-a-dozen paid secretaries4 ,,ii ,let us leave the general arguments and come to the special arguments4 ,some of them are concerned with the experiments themselves1 some with the men who made them1 some with the administration of the ,act4 ,these special arguments must be arranged in some sort of order2 but they cross and recross1 and are of diverse natures1 and any attempt at strict arrangement would fail4 ,that the arrangement may be useful for immediate reference1 and may help anybody to answer statements made at debates and lectures1 a separate heading has been given to each argument4 ,those arguments are put first which are concerned with the experiments themselves1 or with the men who made them2 afterward come those which are concerned with the administration of the ,act4 ,,harvey ,it is perfectly true1 says ,mr4 ,berdoe1 that ,harvey again and again1 in the plainest terms1 declares that his experiments on living animals aided him in his discoveries4 ,i agree here with ,mr4 ,berdoe4 ,then comes this sentence3 ,but that is not so important as it appears to be4 ,why not8 ,what is gained by this attempt to explain ,harvey away8 ,dr4 ,bowie mistranslates him2 ,dr4 ,abiathar ,wall half-quotes him2 ,mr4 ,adams says that ,harvey did not ascribe his discoveries to experiments on animals2 ,mr4 ,berdoe says that he did2 and ,mr4 ,berdoe's society withdraws every pamphlet that involves acceptance of ,dr4 ,bowie's mistranslation4 ,why should we take1 on ,harvey's work1 any opinion but that of ,harvey8 ,,sir ,,charles ,,bell ,for the argument from ,sir ,charles ,bell's words1 and for the truth about his work1 see ,part ,i41 ,chap4 ,,vii4 ,,cerebral ,,localisation ,mr4 ,berdoe says that it is pure nonsense to argue from the motor areas of a monkey's brain to those of a man's brain4 ,why is it nonsense8 ,what is the difference between the movement of a group of muscles in a monkey's arm and the same movement of the same group of muscles in a man's arm8 ,with a very weak current1 so weak that it is not diffused beyond the area where it is applied1 the surface of a monkey's brain is stimulated at one spot2 and forthwith its opposite arm is flexed1 or its opposite leg is drawn up1 or whatever the movement may be1 according to the spot4 ,a man has some disease1 acute or chronic1 of his brain2 and1 as the disease advances1 twitchings occur in one arm or one leg1 little irrational useless movements1 or rigidity1 or loss of power1 according to the case4 ,is it pure nonsense to believe that the disease has reached a certain spot on the surface of his brain8 ,there is no question here of the mental differences between men and monkeys2 no question of consciousness or of will4 ,but ,dr4 ,hollnder1 who thinks very highly of ,gall's system of phrenology1 says1 ,is the laboratory-man1 the experimental physiologist1 to teach us the mental functions of the brain from his experiments on frogs1 pigeons1 rabbits1 dogs1 cats1 and monkeys8 ,that is the argument2 that we must not compare the monkey's motor areas with the man's motor areas1 for we cannot find the mind of a man in the brain of a frog4 ,but1 putting aside phrenology1 which is a broken reed for anti-vivisection to lean on1 what other arguments are urged against the facts of cerebral localisation8 ,first1 that the speech-centres were discovered without the help of experiments on animals4 ,that is true2 and there1 practically1 the work of discovery stopped1 till experiments on animals were made4 ,next1 that the physiologists have not always been agreed as to the facts of cerebral localisation2 that ,charcot doubted them1 that ,goltz criticised ,munk1 and so on4 ,what is the date of these doubts and criticisms8 ,they are twenty years old4 ,next1 that the surgery of the brain often fails to save life4 ,that is true2 and the anti-vivisection societies make frequent use of this fact4 ,but they are unable to suggest any better method4 ,mr4 ,berdoe tells us that he cannot remember hearing1 in his student days1 anything about brain-experiments on animals3-- ,our work was to observe as closely as possible the symptoms and physical signs exhibited by patients in the hospital wards who suffered from any form of nerve or brain disease1 and having carefully noted them in our case-books1 to avail ourselves1 when the patient died1 of any opportunity that was offered us in the post-mortem of correcting our diagnosis4 ,that is an exact picture of the state of things thirty years ago2 the student taking notes1 waiting for the post-mortem examination1 then correcting his notes there1 etc4 ,every case of brain-tumour in those days died1 but many are saved now2 and every case of brain-abscess in those days died 7one or two were saved by a sort of miracle of surgical audacity72 but many are saved now4 ,,antitoxins ,,and ,,carbolic ,,acid ,it is said by opponents of experiments on animals1 that the active principle1 in antitoxin1 is not the antitoxin1 but the carbolic acid which is added to it4 ,they take this statement from the ,medical ,brief2 and we have learned something of the style of that journal4 ,here is a sentence from the official journal of the ,national ,society3-- ,the ,medical ,brief calls antitoxin 'the fraud of the age1' and says3 ,would that physicians could all realise the hideous horror of using this nasty stuff as a remedial agent4 ,it would be nothing less than ghoulishness to inject the matter from an abscess into a child's arm1 yet antitoxin is not much better2 it is the decomposing fluid from a diseased horse1 partially neutralised by carbolic acid4 ,for a commentary on this sentence1 take the following letter from an eminent bacteriologist3-- ,as regards diphtheria antitoxin1 the addition of an antiseptic is by no means necessary or universal4 ,for fully two years ,i added none to the serum which ,i prepared1 but contented myself with filtration through a ,kieselguhr filter1 and bottling under aseptic conditions4 ,at one time ,roux used to put a small piece of camphor in each bottle as some sort of safeguard against putrefaction4 ,nowadays ,i believe that most makers preserve their sera by adding a trace of trikresol--,i am not quite sure of the amount1 but it is either 4#jd per cent4 or 4#jjd per cent46 ,but it is probable that the ,zoophilist will still accept the authority of the ,medical ,brief4 ,baccelli got good results1 in tetanus1 from the administration of carbolic acid2 therefore1 in diphtheria1 the good results from diphtheria-antitoxin are due to the carbolic acid in it4 ,that is the argument4 ,but there is no carbolic acid in it8 ,oh1 then the patient got well of himself1 the treatment didn't kill him1 it was not diphtheria after all1 the disease has altered its type lately1 he was well nursed1 the back of his throat was painted with something1 the doctor got half-a-crown by calling it diphtheria1 the bacillus diphtheri may be found in healthy mouths1 and all bacteriology is base and blatant materialism4 ,,the ,,argument ,,from ,,the ,,death-,,rate ,there is another argument against diphtheria-antitoxin2 we may call it1 for brevity1 the death-rate argument4 ,it is this4 ,the doctors say that the antitoxin does save lives2 they give us statistics from every part of the world4 ,but1 if it saves lives1 then the total mortality ought to go down4 ,but the ,registrar-,general's returns do not go down2 indeed1 they tend to go up4 ,therefore diphtheria-antitoxin is useless1 or worse than useless4 ,by this kind of logic1 umbrellas are useless4 ,if they were useful1 then the more umbrellas there were1 the less rain there would be4 ,but the increase in umbrellas coincides with a positive increase of rain4 ,therefore umbrellas are useless1 or worse than useless4 ,despite the absurdity of this argument1 ,mr4 ,coleridge and ,mr4 ,somerville ,wood1 the ,national ,society's lecturer1 have worked hard with it2 ,mr4 ,coleridge in the press1 ,mr4 ,wood on the platform4 ,surely this confusion between the total mortality and the case-mortality of an epidemic disease is a very serious offence4 ,that there may be no doubt of the confusion1 let us consider a set of quotations1 out of a correspondence published in ,september-,october #aijb1 between ,g4 ,p41 whose initials we may take to mean general practitioner1 and ,mr4 ,somerville ,wood4 ,this correspondence is a good instance of the argument in its usual form3-- ,g4 ,p43 ,the antitoxin treatment of diphtheria has lessened the mortality from that disease by nearly #ej per cent4 ,in the hospitals of the ,metropolitan ,asylums ,board the average case-mortality for the last five years of the pre-antitoxin period1 i4e4 previous to #ahie1 was #cj4f2 that for #ahie and the successive four years was #ah4a1 the successive figures being #bb4h1 #ba4b1 #ag4g1 #ae4d1 and #ac4f1 the mortality steadily falling with increased familiarity with the use of the remedy4 ,this has not been the result of a diminished virulence of the disease1 as similar experience has been gained all over the world4 ,the figures for ,chicago are even more striking1 as the averages are #ce4j and #f4gi for the pre-and the post-antitoxin periods respectively4 ,mr4 ,,wood3 ,nowadays1 almost every sore throat is called diphtheritic1 antitoxin is given1 and wonderful statistics are formulated to bolster up the latest medical craze4 ,the real test is whether the introduction of antitoxin has lowered the death-rate generally from diphtheria4 ,here are the ,registrar-,general's figures3 ,in #ahhg1 the death-rate from diphtheria per million persons in this country was #adj4 ,in #ahig1 after the treatment had been used several years1 the death-rate from this disease increased to #bdf per million4 ,g4 ,p43 ,mr4 ,wood's statistics do not vitiate my argument in the very slightest4 ,his selected figures1 using the lowest rate since #ahha1 merely show that diphtheria as a whole was more prevalent in #ahig than in #ahhg4 ,he cannot and does not attack the statement that the case-mortality has been lessened where antitoxin has been used1 and his test is no test at all4 ,mr4 ,,wood3 ,let me give the annual death-rate from diphtheria to a million living persons from #ahha to #aijj1 taken from the ,registrar-,general's returns4 7,gives them47 ,g4 ,p43 ,one last word in answer to ,mr4 ,wood4 ,i repeat that his figures show nothing more than the accepted fact that diphtheria as a whole has been increasing for the last #cj years4 ,this has no bearing at all on the also accepted fact that where antitoxin is used the mortality is lessened1 and ,mr4 ,wood has not1 in fact1 denied this4 ,his confusion of total mortality and case-mortality only shows that he does not understand the elementary principles of statistics4 ,a few weeks later1 at the ,bournbrook and ,selly ,oak ,social ,club1 ,mr4 ,wood gives his thrilling lecture1 with lantern views1 ,behind the ,closed ,doors of the ,laboratory3 one of his stock lectures4 ,in it1 he says3-- ,the proof of the pudding was in the eating4 ,in #ahha the death-rate from diphtheria was #abg per million2 in #aijj it was #bij per million4 ,he had but to state that the antitoxin treatment was introduced about #ahid4 ,four days later1 at an overflowingly-attended ,citizen ,social at ,birkenhead3-- ,the proof of the pudding lay in the eating4 ,in #ahha in each million of the population #aba persons died from diphtheria1 while in #aijj the mortality from the same disease was #bij persons in each million of the population1 and the antitoxin treatment was introduced in #ahid4 ,a few weeks later1 at ,ipswich1 the same thing4 ,this time1 he is challenged by letters in the ,east ,anglian ,daily ,times1 and again quotes the ,registrar-,general4 ,a few weeks later1 at the ,hyde ,labour ,church3 the ,closed ,doors of the ,laboratory again3-- ,he found from the ,registrar-,general's returns that the death-rate had gone up in cases in which they were told that wonderful things had been done by experiments on living animals4 ,if a lower death-rate could be shown1 then the vivisectionists might have something to go upon2 but they could not show a lower death-rate4 ,that was in ,january #aijc4 ,in ,december #aijc1 ,mr4 ,wood is still using the same argument2 this time it is a lecture at ,ashton on ,vivisection and the ,hospitals3 ,again and again had they defied the so-called scientific world to put their finger on the ,registrar-,general's returns1 and show them a single instance where the death-rate had been lowered by vivisection1 and they had not been able to do it4 ,on the contrary1 he found that the death-rate had gone up in the last #bj years1 despite the thousands of animals that had been experimented upon4 ,the death-rate in diphtheria was #ajj per million more than it was in #ahgh4 ,mr4 ,wood in the provinces1 and ,mr4 ,coleridge in the papers1 have used this argument hard4 ,let us look at it well4 ,it has been refuted again and again4 ,take a thousand cases of diphtheria from any civilised part of the world1 in the days before antitoxin2 how many of them died8 ,take a thousand cases now1 treated with antitoxin2 how many of them die8 ,why do ,mr4 ,wood and ,mr4 ,coleridge run away from that easy question8 ,there is nothing unfair in it2 they have all the reports before them2 they know the facts well4 ,we do not find any evidence that they are willing to acknowledge the truth of those facts4 ,follow ,mr4 ,somerville ,wood1 from place to place1 with his magic-lantern and his stock of lectures4 ,the lantern-pictures are many of them taken from foreign sources1 and some of them are of great age2 but they include a portrait of ,mr4 ,coleridge1 and some comic slides to be shown at the end of the lecture1 rabbits vivisecting a professor1 and so forth4 ,certainly1 he works hard2 #ie lectures in one year2 we cannot better employ the funds at our disposal than in sending well-informed lecturers to every city in the kingdom to rouse the just indignation of the people4 ,the year after that1 #gd lectures2 on two occasions he has spoken when unsupported to over #ajjj people1 and an audience of several hundreds is quite the rule4 ,here he is at ,windsor1 with ,bishop ,barry in the chair1 and he says to them3-- ,unhappily1 ,pasteur left his microscope and chemicals and took up the vivisectionist's knife4 ,in that he got utterly astray and became nothing more than a mere quack4 ,here1 with a different audience1 at the ,mechanics' ,lecture ,hall1 ,nottingham1 giving his lantern-lecture on ,pasteurism to a most respectable audience of working men1 their wives1 sons1 and daughters1 and in many cases children4 ,the thesis he set out to elaborate and maintain was that ,pasteurism produces hydrophobia rather than cures it2 that vivisection under any circumstances is both cruel and immoral2 and that with special reference to bacterial toxicology and the treatment by inoculation1 the preparation of toxins by the ,pasteur methods was the most horrible form of repulsive quackery and hideous cruelty4 ,here he is at ,birmingham1 asking for money1 and hinting that1 unless all experiments on animals are stopped1 the poor will be the ultimate victims4 ,here1 at ,gloucester1 saying that it is silly to experiment at all1 and that he is not going to take his views as to right and wrong from any man of science1 however learned he may be4 ,here1 at ,edinburgh1 with the ,closed ,doors again1 and the picture of the rabbit roasted alive3 three grains of opium1 he tells them1 would be enough to kill the strongest navvy in ,edinburgh1 but #af grains can be administered to a pigeon2 and the death-rate has gone up every year in spite of vivisection4 ,here1 at a drawing-room meeting1 asking for money2 here1 at a garden party1 with a considerable number of persons ranging themselves on the grass1 and he tells them that they have on their side all that is best in every department of public life2 here1 at ,blackburn1 with the ,closed ,doors again1 calling the law a sham and a farce2 here1 at ,cheltenham1 with ,bishop ,mitchinson in the chair1 still quoting the ,registrar-,general1 and saying that he does not think the outlook was ever more promising than it is to-day4 ,all over the kingdom1 he and his magic-lantern1 year after year1 goes ,mr4 ,wood4 ,he is a fluent speaker2 he has things in his pocket2 they are brought out1 if you contradict him2 or he challenges you1 or explains you away1 or says that you are not quite playing the game4 ,let him alone2 to-morrow he will pack up his lantern1 and be gone4 ,mr4 ,coleridge1 in his use of the death-rate argument1 carries it even further than ,mr4 ,wood2 for he applies it over a wider range4 ,look at myxoedema1 he says2 the doctors tell us that they can cure it with thyroid extract1 and that the use of thyroid extract was discovered by the help of experiments on animals4 ,very good4 ,myxoedema is due to some fault in the thyroid gland4 ,very good4 ,but here are the ,registrar-,general's returns of the annual death-rate for all diseases of that gland4 ,see1 the death-rate has gone up1 steadily1 during the last #bj years4 ,was there ever such an argument8 ,it is only of late years that myxoedema has been generally recognised4 ,till it was recognised1 it was not diagnosed2 till it was diagnosed1 it was not returned as a cause of death4 ,again1 there are many other diseases of the thyroid gland1 including various forms of malignant disease4 ,it is cancer of the thyroid gland that decides the death-rate4 ,the number of deaths from myxoedema1 especially since the discovery of thyroid extract1 must be small indeed4 ,moreover1 apart from ,mr4 ,coleridge's fallacy of argument1 it is impossible to see how he can really doubt the efficacy of the thyroid treatment1 both in myxoedema and in sporadic cretinism4 ,again1 ,look at the diseases of the circulation1 he says4 ,the doctors say that digitalis and nitrite of amyl act on the heart2 and that the action of these drugs was discovered by the help of experiments on animals4 ,very good4 ,the heart is concerned with the circulation4 ,very good4 ,but here are the ,registrar-,general's returns of the annual death-rate for all diseases of the circulation4 ,see how it has gone up1 from #acga per million persons in #ahha to #agji in #aijj4 ,therefore1 either these two drugs are never used1 or they are useless1 or the ,registrar-,general's returns are false4 ,it is impossible to understand how ,mr4 ,coleridge could bring himself to write thus4 ,digitalis has a certain effect on the heart-beat2 nitrite of amyl diminishes arterial tension4 ,the ,registrar-,general's returns for all diseases of the circulation include every sort and kind of organic disease of the valves of the heart2 include also pericarditis1 aneurism1 senile gangrene1 embolism1 phlebitis1 varicose veins1 and #ce1dii deaths from other and undefined diseases of heart or circulatory system4 ,,rabies ,for rabies1 ,mr4 ,berdoe praises the ,buisson ,bath ,treatment for the ,prevention and ,cure of ,hydrophobia4 ,the virtues of this treatment are proclaimed by the ,chairman of the ,canine ,defence ,league1 ,f4 ,e4 ,pirkis1 ,esq41 ,r4,n41 of ,nutfield1 ,surrey1 and it is founded1 we are told1 on the simple common-sense principle that if poison is injected into a person's veins the best thing to do is to get it out as quickly as possible4 ,this sentence1 and the reference to ,mr4 ,pirkis for further particulars1 and the fact that there is1 or was1 a ,buisson ,bath at the ,national ,anti-vivisection ,hospital1 bring us to the question1 ,what is the value of the evidence in favour of this treatment8 ,mr4 ,berdoe1 in his ,catechism of ,vivisection 7#aijc71 gives this evidence at considerable length4 ,the treatment1 he says1 is simplicity itself4 ,it is merely the use of the vapour bath1 which causes a free action of the skin to be set up1 this draws the blood to the surface of the body1 and so relieves the congestion of the internal organs4 ,let us consider this sentence4 7#a47 ,suppose that ,x---- were bitten by a mad dog1 say on ,march #ast1 and on ,march #hth he took a course of ,buisson ,baths1 for safety's sake4 ,there would be no congestion1 at that period1 of his internal organs2 what would be the good of drawing the blood to the surface of his body8 ,mr4 ,pirkis says that there would be poison in his veins2 it would be a very subtle poison4 ,how can ,mr4 ,pirkis tell that it is all in his veins and none of it elsewhere8 ,again1 ,x---- would be feeling perfectly well4 ,how would a vapour-bath get this poison out of his veins8 ,it could not do it by relieving the congestion of his internal organs1 for they would not be congested4 ,how would it do it8 ,and how would ,mr4 ,pirkis know when it had done it8 7#b47 ,suppose that ,x---- were bitten by a mad dog1 and1 in due time1 were seized by hydrophobia4 ,has ,mr4 ,pirkis ever seen a case of that disease--ever seen a case of hydrophobia8 ,are they going to tie ,x---- down1 or steam him under chloroform1 or what8 ,and how many baths would he want8 ,but there are cases2 there is evidence2 a mass of cures in ,asia4 ,let us look at them2 and let us divide them into cases of prevention and cases of cure4 ,let us take1 first1 the cases of cure4 ,there are five of these4 ,five1 and no more4 ,one is ,dr4 ,buisson2 cured by one bath1 while he was trying to commit suicide2 nothing said about the dog4 ,one is a case at ,kischineff1 near ,odessa1 #ah years ago2 no evidence is given that the dog was rabid4 ,one is a case at ,arlington1 ,new ,jersey1 #ah years ago2 no evidence is given that the dog was rabid4 ,one is the case of ,pauline ,kiehl2 no date2 no reference to say where the case is published2 no account of her symptoms4 ,and one is a case at the ,jaffna ,hospital1 ,ceylon2 no date2 and nothing said about the dog4 ,of these five cases1 three were a boy1 a lad1 and a little girl2 but their ages are not given4 ,five cases in #bj years2 they hail from all parts of the world1 ,france1 ,russia1 the ,united ,states1 ,ceylon1 and ,france again2 three of them happened #ah years ago1 or more4 ,and1 we may be certain1 not one of them is genuine4 ,spurious hydrophobia1 the simulation of the disease out of sheer terror of it1 as in ,dr4 ,buisson's case1 is well known4 ,now we come to the cases of prevention4 ,over #hj of them1 we are told2 but seven are especially noted4 ,four in #ahie1 under the care of ,dr4 ,ganguli of ,dinajpur2 two in #ahif1 under the care of ,dr4 ,dass of ,narainganj2 and one in #ahif1 ,mr4 ,kotwal of ,bassein4 ,of this mass of cures in ,asia1 we all know what would have been said if ,pasteur had been in charge of them2 that the dogs were not rabid1 that the bites were not infected1 that the wonder is that the poor deluded victims were not added to ,pasteur's hecatomb4 ,next1 what does ,mr4 ,berdoe say of the division of all patients at the ,pasteur ,institute into classes ,a1 ,b1 and ,c8 ,does he admit that a dog is proved to have been rabid1 if a minute portion of its nervous tissue1 taken from it after death1 and put into a rabbit1 causes the rabbit to have paralytic rabies8 ,no2 there are still two things left for him to say3-- #a4 ,he says1 on the authority of the ,veterinary ,record of ten years ago1 that the death of a rabbit with cerebral symptoms is not a positive indication of death from rabies4 #b4 ,he says that ,vulpian discovered that healthy human saliva was poisonous to rabbits1 and that it contained a micro-organism which ,pasteur had also found in the saliva of a rabid patient4 ,what does this statement prove or disprove8 ,it is twenty-five years old2 but ,mr4 ,somerville ,wood1 not long ago1 used it at a debating society with great fervour4 ,also ,mr4 ,berdoe quotes the late ,m4 ,peter1 ,dr4 ,lutaud's forerunner2 quotes an obiter dictum of ,professor ,billroth1 but without any date2 tells us that ,pasteur himself1 in a letter1 referring to one particular case1 declared cauterisation to be a sufficient preventive1 but does not tell us the date of the letter1 or the facts of the case2 and quotes a death-rate1 but stops at #ahij4 ,of course1 any method of treatment1 if you ransack its records over a sufficient number of years1 will show1 now and again1 failures or disasters4 ,take1 for instance1 those methods of light-treatment1 which ,mr4 ,berdoe praises so highly4 ,they have had many failures1 and one or two disasters4 ,if they had been discovered by the help of experiments on animals1 we might have had a pamphlet from the ,national ,society1 ,the ,roentgen ,cure3 its list of ,victims4 ,,certificate ,a ,,and ,,certificate ,b ,frequent use has been made of some words spoken by the ,home ,secretary in ,parliament1 on ,july #bdth1 #ahii4 ,he was asked whether he would state what rules were laid down with regard to the granting or signing of certificates dispensing with the use of ansthetics in experiments on animals2 and whether there was any limit to the number of such certificates which one person might sign1 or to the number of experiments upon different animals which might be performed by the person holding one such certificate4 ,there can be no doubt as to the meaning of these questions4 ,certificate ,a1 which is granted only for inoculation experiments or similar proceedings1 and never for any serious cutting operation1 dispenses wholly with ansthetics4 ,certificate ,b1 which is granted for any kind of operation plus observation of the animal after operation1 dispenses partly with ansthetics2 that is to say1 the operation is done under an ansthetic1 and the subsequent observation of the animal1 which is counted as part of the experiment1 is made without an ansthetic4 ,the questions come to this3 ,when the ,home ,office grants ,certificate ,a1 or ,certificate ,b1 what precautions does it take against any abuse of these certificates1 and what restrictions does it impose on them8 ,the ,home ,secretary answered3 ,it is the practice of the ,home ,office1 in addition to the fact that all certificates expire on ,december #cast of the year in which they are granted1 to limit the number1 and this is always done in the case of serious experiments in which the use of ansthetics is wholly or partly dispensed with4 ,the ,times says that the ,home ,secretary said serious experiments4 ,mr4 ,coleridge says that ,hansard says that the ,home ,secretary said serious operations4 ,we need not doubt that ,mr4 ,coleridge is right2 but we may doubt whether ,hansard underlines the word wholly1 as ,mr4 ,coleridge does4 ,anyhow1 it does not matter now whether the ,home ,secretary1 seven years ago1 said experiments or operations4 ,his meaning is clear enough2 that1 in all serious procedures1 whether they be under ,certificate ,a or under ,certificate ,b1 a limit is put to the number of experiments4 ,which is the plain truth1 as everybody knows who is concerned in the administration of the ,act2 and the limit may be very strict indeed4 ,after this statement by the ,home ,secretary in #ahii1 we still find ,dr4 ,abiathar ,wall1 the ,hon4 ,treasurer of the ,london ,anti-vivisection ,society1 saying in #aijj that a vivisector has only to say that he has a theory whereby he hopes to discover a cure for1 say1 neuralgia of the little finger1 and the ,home ,secretary promptly arms him with a license to torture as diabolically as he pleases and as many animals as he deems fit4 ,and the ,national ,society has made constant use of this phrase about serious experiments2 declaring that the ,home ,secretary himself has said that animals are tortured under the ,act4 ,here are three statements to that effect1 made by the ,national ,society's ,parliamentary ,secretary1 by its ,lecturer1 and by its ,hon4 ,secretary3-- #a4 7,annual ,meeting1 ,queen's ,hall1 ,may #aijj47--;,if you are still unconvinced--if any one is not thoroughly satisfied that there is ample cause for the anti-vivisectionist movement to-day--it is only necessary for me to refer you to the words of the ,home ,secretary1 as spoken in ,parliament1 in the year #ahih4di ,he said3 ',there are serious operations which are performed1 during which the use of ansthetics is wholly or partially dispensed with4' ,could there be any more sweeping indictment than that8 ,is there any need for me to attempt to convince you that the lower animals are vivisected painfully1 after the words officially spoken by the ,home ,secretary in the ,house of ,commons8 #b4 ,if you want any further proof ,i will quote from ,hansard1 ,july #bdth1 #ahii1 when the then ,home ,secretary stated in the ,house of ,commons that serious experiments take place under the law of ,england1 in which the use of ansthetics is wholly or partially dispensed with4 ,now1 ,i affirm that serious experiments in which ansthetics are wholly or partially dispensed with mean torture pure and simple4 #c4 7,annual ,meeting1 ,st4 ,james's ,hall1 ,may #aija47--;,if this were not enough1 the late ,home ,secretary has told us the facts4 ,i have ,hansard here4 ,on ,july #bdth1 #ahii1 the late ,home ,secretary in his place in ,parliament1 and in his official capacity as ,home ,secretary1 told us that 'serious experiments1 in which the use of ansthetics have been wholly or partially dispensed with1' do take place in ,english laboratories4 ,we know1 therefore1 that torture does take place4 #di ,this should be #ahii4 ,each of the three speakers uses this phrase as a final and irresistible argument4 ,if you are still unconvinced4 ,if you want any further proof4 ,if this were not enough--they all of them play the ,home ,secretary1 as a sure card3 at ,queen's ,hall1 at ,st4 ,james's ,hall1 they produce him as though it were indeed unanswerable4 ,since they are willing to go back to ,july1 let us take them back to ,may4 ,this phrase about serious experiments was spoken on ,july #bdth1 #ahii4 ,on ,may #ith of that year1 a question was put and answered in the ,house4 ,it was put by the same gentleman who put the question in ,july2 it was answered by the same ,home ,secretary2 and it was practically the same question4 ,the ,home ,secretary1 in his answer to it1 said3-- ,the sole use of this ,certificate 7,b7 is to authorise the keeping alive of the animal1 after the influence of the ansthetic has passed off1 for the purpose of observation and study4 ,i should certainly not allow any certificate involving dissections or painful operations without the fresh use of ansthetics4 ,here1 in ,may #ahii1 we have this emphatic statement1 that ,certificate ,b is not allowed for serious operations without ansthetics4 ,why did the ,national ,society stop at ,july8 ,if it had only gone a few weeks further back1 a surprise was in store for it4 ,but at ,july it stuck2 thus it was still able to say all sorts of things about legalised torture4 ,so late as ,may #fth1 #aijb1 at the great annual meeting at ,st4 ,james's ,hall1 the ,rev4 ,reginald ,talbot said3-- ,certificate ,b makes it necessary that the operator should produce complete ansthesia during the initial operation1 but 7please mark this7 after the initial operation is over1 after the animal has returned to the state of semi or complete consciousness1 there is then allowed by this certificate a period of observation upon a semi-sensible or completely sensible animal4 ,the animal is opened1 is disembowelled1 and in that condition his vital organs can be probed and stimulated4 ,now that is something more than pain2 it deserves something more than the name of even severe and prolonged pain4 ,surely this comes within the tract and region of what we may call agony4 ,as for ,certificate ,a1 the inoculations-certificate1 which is used for inoculations only1 and therefore is granted for nine experiments out of every ten1 he said3-- ,there is a ,certificate ,a1 which1 if it were granted1 and when it is granted--and pray you mark my words1 for ,i know what ,i am speaking about1 and ,i want you to know too--would allow major operations to be performed upon animals1 cats1 dogs1 or any other animals1 without the use of any ansthetic at all4 ,i know quite well that that certificate has not been applied for1 or has not been granted this last year1 or1 so far as ,i know1 in any previous year1 but ,i say this1 c4 ,it is impossible to understand these words4 ,certificate ,a is never granted for major operations4 ,it is never granted 7save in conjunction with another certificate7 for any sort or kind of experiment on a cat or a dog1 or a horse1 or an ass1 or a mule4 ,it is more in use than all the other certificates put together2 it covers nine experiments out of every ten4 ,we shall try in vain to guess how this mistake arose in the speaker's mind4 ,but1 at the great annual meeting of the chief of all the anti-vivisection societies1 it is strange indeed that nobody seems to have corrected him4 ,this description of a certificate which does not exist--,i know what ,i am speaking about1 he says1 and ,i want you to know too--was applauded by an audience that filled the whole hall4 ,nobody on the platform put him right4 ,and1 in the next number of its official journal1 the ,national ,society reported every word of his speech1 and said that he had analysed the ,act and its administration in a striking and powerful manner4 ,,curare ,curare1 says ,mr4 ,berdoe1 paralyses the peripheral ends of motor nerves1 even when given in very minute doses4 ,that is to say1 it prevents all voluntary motion4 ,then comes this frank admission1 ,large doses paralyse the vagus nerve and the ends of sensory nerves4 ,that is to say1 it can be pushed1 under artificial respiration1 till it paralyses sensation4 ,with small doses1 the ends of the motor nerves lose touch with the voluntary muscles4 ,with large doses1 under artificial respiration1 the ends of the sensory nerves lose touch with the brain4 ,let us agree with ,mr4 ,berdoe that curare does act in this way2 that it does not heighten sensation1 and has no effect1 save in very large doses1 on sensation1 and then abolishes sensation4 ,only1 of course1 to procure this ansthetic effect1 the animal may have to be subjected to artificial respiration4 7,the evidence as to the action of curare on the sensory nerves rests not on the case of accidental poisoning recorded by ,mr4 ,white1 though that case does point that way1 but on ,schiff's experiments on the local exclusion of the poison from one leg of the frog by ligature of an artery47 ,this1 surely1 is a true definition of curare1 that it is a painless poison1 which in small doses prevents the transmission of motor impulses2 and1 in large doses1 which may necessitate the use of artificial respiration1 prevents the transmission of sensory impulses4 ,mr4 ,berdoe can hardly refuse to accept this definition2 indeed1 it is his own4 ,and1 certainly1 he would be a bold man who said that a small dose of curare has any effect on sensation2 or that the exact strength of any one specimen of curare is standardised as a supply of antitoxin is standardised4 ,now we have a perfect right to take a practical view of curare4 ,at the present time1 and in our own country1 how is it used8 ,the ,act forbids its use as an ansthetic4 ,what evidence does ,mr4 ,berdoe bring that it is so used8 #a4 ,he quotes ,professor ,rutherford's experiments4 ,these were made at least #af or #ag years ago4 #b4 ,he quotes ,dr4 ,porter's paper1 ,on the ,results of ,ligation of the ,coronary ,arteries4 7,journal of ,physiology1 vol4 xv4 #ahid1 p4 #aba47 ,dr4 ,porter speaks of four experiments made under morphia plus curare4 ,these experiments were made at ,berlin1 #ad years ago1 by the ,professor of ,physiology at ,harvard1 ,u4,s4,a4 #c4 ,he refers to ,professor ,stewart's papers1 in the same volume of the ,journal of ,physiology4 ,the one experiment which he quotes at some length was made at ,strasburg1 #ad years ago or more4 ,but we want to know what is done now and here under the ,act1 not what was done at ,berlin or ,strasburg #ad or more years ago4 ,still1 the experiments by ,professor ,stewart have been in constant use1 among the opponents of all experiments on animals4 ,in ,may #aijj1 at the great annual meeting of the ,national ,society1 at ,queen's ,hall1 ,dr4 ,reinhardt said3-- ,i will pass on to prove to you1 by a few conclusive evidences1 for which ,i can give you chapter and verse1 that torture is inflicted on animals by ,british vivisectors to-day4 ,now1 if you buy the #aeth volume of the ,journal of ,physiology1 and look at page #hf1 you will find there1 etc4 ,to prove that animals are tortured in ,england to-day1 he quotes one experiment made at ,strasburg ever so long ago4 ,and1 in #aija1 ,mr4 ,coleridge wrote1 in the ,morning ,leader1 saying3 ,it is with curare1 which paralyses motion and leaves sensation intact1 that all the most shocking vivisections are performed4 ,and1 the same year1 ,mr4 ,stephen ,smith1 a ,medical ,patron of the ,london ,society1 wrote3 ,i state emphatically that when curare is used1 proper ansthesia is out of the question4444 ,curare is used daily throughout ,england4 ,mention of an ansthetic in a report is no guarantee that the animal was ansthetised4 ,i cannot find1 in all the anti-vivisection literature which ,i have read1 any shadow of evidence that any experiment of any sort or kind has been made in this country1 on any sort or kind of animal1 under curare alone1 for the last sixteen or seventeen years4 ,i believe that ,i might go further back than that4 ,but surely that is far enough4 ,certainly1 so long as any curare is used 7not as an ansthetic1 but in conjunction with an ansthetic7 in any experiments on animals in this country1 the societies will not trouble to inquire how much of it is used4 ,i wrote1 therefore1 to the ,professors of ,physiology at ,edinburgh1 ,cambridge1 and ,oxford1 and asked them to tell me how much curare was used in their laboratories throughout #aijc1 and what ansthetics were given with it4 ,some opponents of experiments on animals seem to think that curare is used very often4 ,one of them says that it is used daily throughout ,england4 ,so ,i wrote to these ,professors at our ,universities1 and they kindly sent the following answers3-- #a4 ,your question re curare is easily answered4 ,we did no experiments with it during the past year4 ,indeed1 ,i have given it up almost entirely for years1 chiefly because it is very difficult to get a preparation which--,i suppose from impurities--does not seriously affect the heart4 ,there might still be occasions during which it is necessary to use it--if1 e4g4 the least muscular movement would vitiate the results of an experiment4 ,but ,i find it possible in nearly all cases to get such absolute quiescence with morphia or chloral 7besides ether and chloroform7 that to all intents and purposes ,i have long given up the use of curare4 ,of course1 if ,i had occasion to use it1 an ansthetic would be administered at the same time4 #b4 ,i have asked those who worked in the physiological laboratories in #aijc to give me a return of the number of experiments done and of the number in which curare was used4 ,including my own experiments1 ,i find that #afj in all were made under the ,license and ,certificates ,b1 ,,ee1 ,c4 ,curare was given in four cases2 in two of these the ,a4,c4,e4 mixture was the ansthetic1 in the other two ether4 #c4 ,at the third laboratory1 during #aijc1 curare was given to seven frogs deprived of their brains before it was given1 and to one rabbit under ether4 ,that was the whole use of curare1 during a whole year1 in three great ,universities3 at one1 seven inanimate frogs1 and one rabbit under ether2 at another1 four animals1 under ,a4,c4,e4 or ether2 at another1 nothing4 ,,incomplete ,,an,,sthesia ,it sometimes happens1 at an operation1 that the patient moves4 ,mostly1 this movement is at the moment of the first incision through the skin2 but it may be at some later period during the operation4 ,he does not remember1 after the operation1 that he moved1 or that he felt anything4 ,that is incomplete ansthesia1 or light ansthesia4 ,the corneal reflex may be abolished1 and still the patient may move4 ,seven years ago some experiments were made in this country by an ,american surgeon4 ,in the published account of them1 it was said that one of the animals was1 at one time1 under incomplete ansthesia1 and that1 in the case of another animal1 the ansthesia was at one time overlooked4 ,this latter phrase meant not that the ansthetic had been left off1 but that it had been given in excess1 so that the blood-pressure suddenly fell4 ,the character of the experiments1 and the occurrence of these two phrases about the ansthesia1 roused some criticism1 and the ,home ,office instituted an inquiry into the matter4 ,that inquiry1 it said1 ,october #aath1 #ahii1 resulted in showing no evidence whatever that the animals experimented on by ,dr4 ,crile felt pain4 ,on the contrary1 all the evidence shows they did not4 ,the ,act does not go into questions of corneal reflex1 and unconscious muscular movements1 and all the undefinable shades between incomplete ansthesia and complete ansthesia and profound ansthesia4 ,the only substantial question1 says the ,home ,office1 is whether or no the animal has been during the operation under the influence of an ansthetic of sufficient power to prevent it feeling pain4 ,this is the requirement of the law4 ,we cannot refuse to call morphia and chloral ansthetics1 for there are deaths every year from an over-dose of them4 ,and we cannot admit that an animal under an ansthetic1 because it makes a movement1 is in pain or is conscious2 for we know that a patient under operation may move yet feel nothing4 ,every hospital surgeon1 and every ansthetist1 who has seen a whole legion of patients go under chloroform or ether and come out of it1 and everybody who has been under these ansthetics1 they all know that incomplete ansthesia is not sham ansthesia1 and that movements1 even purposive movements1 may occur without consciousness1 without pain1 alike in men and in animals4 ,,one ,,animal ,,and ,,one ,,experiment ,when the ,home ,office allows a licensee to make a certain number of experiments1 it means that he may experiment on that number of animals and no more4 ,the ,home ,office1 having heard what the experiments are to be1 where they are to be made1 on what kind of animals1 and for what purpose1 and having taken advice about them1 allows him to make a fixed number1 and adds any restrictions that it likes1 e4g4 that he must send in a preliminary report when he has made half that number4 ,and one thing is certain1 that one experiment one animal1 and that #aj experiments #aj animals1 and no more4 ,everybody knows that1 who knows anything at all about the administration of the ,act4 ,now take a false statement1 which has been made again and again during many years1 that one experiment any number of animals1 and observe how it spread4 #a4 ,in the ,house of ,commons1 on ,march #abth1 #ahig1 ,mr4 ,mac,neill asked whether any record were kept of the number of animals used in experiments during #ahie1 and said that #bjj or #cjj animals are sometimes used in a single experiment1 and that #hj or #ij is a common number4 ,the ,home ,secretary answered3 ,the honourable member is under an entire misapprehension4 ,the number of animals used does not exceed the number of experiments given in the return4 #b4 ,a year later1 ,may #ahth1 #ahih1 at the ,annual ,meeting of the ,national ,society1 ,mr4 ,mac,neill said again3 ,any one casually reading that report 7the ,inspector's report to ,government7 would imagine that each experiment was on the body of a single animal4 ,it is nothing of the kind4 ,an experiment is a series of investigations in some particular branch1 and sometimes #bj1 #cj1 or #dj animals are sacrificed in the one experiment4 ,the ,national ,society published this speech in its official journal4 #c4 ,a few weeks later1 an anonymous letter in the ,bradford ,observer said1 ,any one casually reading the report would imagine that each experiment was on the body of a single animal4 ,it is nothing of the kind4 ,an experiment is a series of investigations in some particular branch1 and sometimes #bj1 #cj1 or #dj animals are sacrificed in the one experiment4 #d4 ,on ,august #ast1 #ahih1 the ,national ,society published this letter in its official journal1 under the heading1 ,our ,cause in the ,press4 #e4 ,on ,october #bast1 #aijb1 a letter in a provincial paper said that one experiment means not one animal1 but a series of operations on many animals4 #f4 ,in ,january #aijc1 the ,national ,society admitted that its action in #ahih 7see #d7 was unfortunate4 #g4 ,on ,june #be1 #aijc1 in ,parliament1 ,mr4 ,mac,neill again said that an experiment did not mean one operation1 but a series of researches1 often performed by persons who had no more skill than the children who broke up a watch4 #h4 ,about this time1 the same false statement was made by an ,anti-vivisection ,society at ,manchester4 #i4 ,a little later1 it was made by the ,national ,canine ,defence ,league1 in these words1 ,each experiment may include any number of dogs4 ,there is no limit fixed by law4 ,on ,january #aath1 #aijd1 in the ,times1 the leaflet containing this and other grossly false and misleading statements was vehemently denounced by the ,national ,society4 ,it would be hard to find a better instance of the spreading of a false report4 ,an experiment8 ,oh1 it is any number of animals--#bj of them1 #cj of them2 #bjj1 #cjj of them2 hecatombs1 and triple hecatombs2 any young doctor can get leave to cut them up4 ,,certificates ,e ,,and ,,ee ,for all inoculations and similar proceedings1 ,certificate ,a is necessary4 ,for all experiments where the animal is allowed to recover from the ansthetic1 ,certificate ,b is necessary4 ,but these certificates do not extend to the dog1 the cat1 the horse1 the mule1 or the ass4 ,the three latter animals are also scheduled under ,certificate ,f2 the dog and the cat under ,certificates ,e and ,,ee4 ,that is to say1 to inoculate a dog1 e4g4 for the study of the preventive treatment against distemper1 it is necessary to hold a ,license1 plus ,certificate ,a1 plus ,certificate ,e2 to operate on a dog1 and let him recover1 it is necessary to hold a ,license1 plus ,certificate ,b1 plus ,certificate ,,ee4 ,and it is certain that the ,home ,office does enforce and emphasise here the spirit of the ,act2 and that it does guard and restrict and tie up ,certificate ,,ee with its own hands4 ,now let us take an instance1 which shows in a very unfavourable light the methods of the ,national ,canine ,defence ,league4 ,three years ago1 certain experiments were made on dogs1 for the purpose of finding the best way of resuscitating persons apparently drowned4 ,the ,home ,secretary was asked whether he knew that certain of these experiments were to be made without ansthetics2 and he answered1 ,in view of the great importance of the subject in connection with the saving of human life1 and of the strong recommendations received in support of the experiments1 ,i have not felt justified in disallowing the certificates4 ,a great outcry was raised against these experiments by the ,national ,anti-vivisection ,society and the ,canine ,defence ,league4 ,the ,national ,society1 in its official journal1 ,august #aijc1 said that it was now proved1 that in ,england to-day experiments are performed without ansthetics which involve inconceivable agony to dogs1 and this with the deliberate permission of the ,home ,secretary4 ,mr4 ,coleridge made a public appeal to all humane societies1 to go down with all their strength into ,kent1 on that not far distant day when the ,home ,secretary would have to face his constituents1 and turn him out of ,parliament4 ,the ,canine ,defence ,league sent two memorials to the ,home ,office1 circulated a petition1 and issued leaflets1 entitled ,a ,national ,scandal1 ,scientific ,torture1 ,a ,peep behind the ,scenes1 and so forth4 ,we must consider one of these leaflets at some length2 but first let us see what is the truth about these experiments4 ,they were made by the ,professor of ,physiology at ,edinburgh2 and he has kindly written to me about them4 ,in every experiment1 except two1 the animal was1 throughout the whole experiment1 under complete ansthesia with chloroform or ether4 ,in two cases1 and in two only1 a small preliminary operation1 under ansthesia1 having been performed1 the animal was allowed to recover from the ansthetic1 or almost to recover from it1 and was then and there submerged and drowned1 at once and completely1 to death2 no attempt at resuscitation was made2 it became unconscious in a little more than a minute4 ,in the face of these facts1 what is to be said of the outcry raised by the ,canine ,defence ,league8 ,they presented two memorials to the ,home ,secretary3 they got up a monster petition with thousands of signatures2 and they issued the following leaflet3--- ,,sign ,,the ,,nation',s ,,petition ,,to ,,parliament ,,against ,,the ,,dissection ,,of ,,live ,,dogs ,in ,medical ,laboratories 99_/ #a4 ,dogs1 on account of their docility and obedience to the word of command1 are the animals chiefly selected for torture4 #b4 ,thousands of dogs are tortured yearly by licensed experimenters4 #c4 ,the total number of experiments performed in #aijb was #ad1ijf1 #ab1ggf of which were without ansthetics4 #d4 ,the ,home ,secretary stated in ,parliament on ,july #bbnd1 #aijc1 that neither the starving of animals to death nor the forced over-feeding of animals were included in these returns4 #e4 ,nor does the number #ad1ijf give the number of dogs used1 for each experiment may include any number of dogs--there is no limit fixed by law4 #f4 ,the ,home ,secretary stated in ,parliament on ,may #aath1 #aijc1 that at one laboratory alone in ,london #bcb dogs were used for vivisectional experiments last year4 #g4 ,there are now laboratories scattered over the whole of the ,united ,kingdom4 #h4 ,the ,home ,secretary stated in ,parliament on #ajth ,july #aijc1 that one dog may be used again and again for vivisectional experiment or demonstration--and this without ansthetics4 ,think of the condition of the poor dog between each living-dissection4 ,has not the time come for the nation to rise as one man and say-- ,this shall not be8 ,it is no wonder that even the ,national ,anti-vivisection ,society1 in a letter to the ,times1 ,december #aath1 #aijc1 denounced this leaflet4 ,the wonder is1 that ,mr4 ,pirkis1 ,r4,n41 the chairman of the ,canine ,league1 tried to defend it4 ,this deplorable leaflet1 said the ,national ,society3 ,it contains a series of grossly false and misleading statements4 ,let us take it paragraph by paragraph4 ,the first two paragraphs are grossly false4 ,the third suppresses the truth4 ,the fourth is grossly false2 the ,home ,secretary said that neither the starving of animals to death nor the forced over-feeding of animals was included among the experiments authorised or performed4 ,paragraph five is grossly false4 ,so is paragraph six3 not one word was said about any experiments1 either by the ,home ,secretary or by anybody else4 ,the entire number of all dogs and cats together1 under ,certificates ,a1 ,b1 ,e1 and ,,ee1 throughout the whole kingdom1 that year1 was #cdd4 ,paragraph eight is grossly false4 99 99 99 99 99 ,for want of space1 it is impossible to consider all the special arguments of the anti-vivisection societies4 ,of course1 among these special arguments1 there are a few which have something in them4 ,how could they all of them be utterly false8 ,they go back over thirty years2 they are drawn from all parts of the world4 ,this incessant rummaging of medical books and journals1 ,british and foreign2 and all this everlasting espionage2 the whole elaborate system of a sort of secret service--these methods1 year in year out1 are bound to find1 now and again1 a fault somewhere4 ,but ,i do say1 having read and re-read a vast quantity of the publications of these societies1 that they are1 taken as a whole1 a standing disgrace to the cause2 that they are tainted through and through with brutal language1 imbecile jokes1 and innumerable falsehoods2 that they have neither the honesty1 nor the common decency1 which should justify them4 ,still1 here it is that the money goes4 ,there is money in the business2 there is milk in the cocoa-nut2 and twopence more1 and up goes the donkey4 ,these are the phrases used1 by the ,national ,anti-vivisection ,society1 of the bacteriologists1 and the men who are working at cancer4 ,but these societies1 that spend thousands every year1 what have they got to show for it all8 ,they have1 with much else of the same kind1 the ,zoophilist4 ,truly1 a fine result2 a high-class official journal1 the recognised organ of the anti-vivisection movement in ,england4 ,take1 for a final instance1 one or two of the things said about ansthetics4 ,on ,june #abth1 #ahig1 in the ,echo1 ,mr4 ,berdoe said that certain experiments1 involving severe operations1 had been made on dogs under morphia and curare4 ,he based this assertion on the account of the experiments in the ,journal of ,physiology4 ,on ,june #ahth1 ,mr4 ,weir1 in the ,house of ,commons1 called attention to this assertion2 and the ,home ,secretary promised to inquire into the matter4 ,on ,july #ahth1 ,mr4 ,weir asked whether this inquiry had been made2 and the ,home ,secretary answered3-- ,yes1 ,i have made full inquiry into the allegations contained in the letter and statement which the honourable member forwarded to me1 and find that they are absolutely baseless4 ,the experiments referred to were performed on animals under full chloroform ansthesia2 the morphia1 to which alone allusion was made in the published account of the experiments1 being used in addition4 ,curare was used1 but not as an ansthetic4 ,it is simple enough4 ,the gentlemen who made the experiments did not know that the ,national ,society buys and ransacks the ,journal of ,physiology2 or did not care4 ,but the ,national ,society called this answer a ,fruitless ,official ,denial2 and ,mr4 ,coleridge sent an explanatory letter to the ,london daily papers1 accusing all the experimenters of amending their published record so as to make it fit in with the ,government report4 ,in #ahii1 the ,national ,society published that sentence1 which has already been quoted1 about the ,nine ,circles1 and the whiff of chloroform possibly administered4 ,in #aijj1 it said1 ,the chloroformists of the physiological laboratories are doubtless common porters1 with no technical knowledge of their work4 ,in #aija1 it said1 ,our readers will remember that ,mr4 ,coleridge has had more than one battle with the ,home ,office on the question of complete and incomplete ansthesia4 ,we need hardly say that the victory on each occasion rested with our ,honorary ,secretary4 ,and again1 ,by many turns of the anti-vivisection screw we have at last extracted 7from the ,home ,office7 the admission that pain is not unknown in the laboratories4 ,in #aijb1 it said1 ,the blessed word ansthesia warns off the profane anti-vivisectionist who would rob the altars of science of their victims4 ,take later instances4 ,in #aijc1 we find ,mr4 ,wood saying that we may be sure the narcosis becomes profound when the inspectors knock at the door of the laboratory2 ,dr4 ,brand1 saying that in all experiments1 other than inoculations1 it is probable that only a whiff of chloroform is given1 to satisfy the experimenter's conscience1 and to enable him to make humane statements to the public2 and ,mr4 ,berdoe1 saying that vivisectors1 where they use anything except curare1 employ sham ansthetics4 ,beside such statements as these1 there is the argument from the very rare action of morphia as a stimulant 7see ,british ,medical ,journal1 ,january #adth1 #ahii72 but this argument is not in question4 ,the real argument is1 that a man who makes experiments on animals is likely enough to tell lies about them4 ,as ,mr4 ,berdoe says1 of a very explicit statement about ansthetics1 made by the late ,professor ,roy1 ,it is and must be absolutely untrue4 ,read again that sentence about the whiff of chloroform4 ,the phrase is thirty years old2 but1 like ,sir ,william ,fergusson's evidence in #ahge1 it is still in use4 ,or take that one phrase--where they use anything but curare4 ,it affords1 in six words1 a perfect instance of the anti-vivisectionist at his worst4 ,,iv4 ,,our ,,cause ,,in ,,parliament ,under this heading the official journal of the ,national ,society reports questions asked in ,parliament1 and the answers given to them4 ,this aspect of the work of the anti-vivisection societies1 and the part taken by them in elections1 and their plans to amend or abolish the ,act1 must be noted here4 ,in one year1 the ,national ,society spent #hhh1 #acs4 #b;d4 on purely electoral work4 ,that is a very large sum1 when we think of the grave injury done to the cause of mercy by the deplorable waste of money spent in perfectly unnecessary offices and salaries4 ,the ,society's journal tells us something of this electoral work3-- #ahii4--,the ,parliamentary ,league has again been successful in its work at bye-elections4 ,at ---- the two candidates were approached1 and both gave more or less satisfactory answers4 ,sir ----'s reply was thought to be the more satisfactory one1 and consequently our supporters gave him their votes4 ,as our readers are aware1 he was returned4 7,in a later number1 the ,zoophilist hints that further pressure may be applied to this gentleman in ,parliament47 #aijj4--,the efforts of the ,society will not be confined to forwarding the interests of any one candidate or any one party4 ,as soon as the names of candidates were announced1 ,mr4 ,coleridge issued to all of them a circular letter demanding their views on the vivisection question4 ,the numerous replies which have already arrived1 and are still arriving1 afford results more gratifying than we for a moment anticipated1 and show clearly that we are now recognised throughout ,great ,britain to be a power that cannot be ignored4444 ,volunteer workers are also being despatched from headquarters to various places4 ,readers who have votes or who will help in any way are invited to communicate immediately to the head office1 when information about the views of their candidates will be at once sent to them4 ,the ,london ,society also1 like the ,national ,society1 desires to have a representative in ,parliament2 and this desire is stated in emphatic words in one of its reports4 ,the general tone of that report has already been noted4 ,it loves big black headlines1 ,,no ,,surrender1 ,,the ,,awakening ,,churches1 ,a ,,truculent ,,science1 ,,the ,,sinews ,,of ,,war1 ,,the ,,appeal ,,to ,,the ,,people4 ,they had better ensure the return of that opponent of vaccination who says that you can bring any member of ,parliament to your knees4 ,and1 of course1 these societies follow the successful candidates on their subsequent careers4 ,in ,parliament1 says the ,london ,society1 the ,society's work is carried on as occasion permits4 ,members of ,parliament are written to or are personally seen at the ,house of ,commons4 ,questions are drafted for them to submit to the ,home ,secretary1 and one or more officers of the ,society are in constant attendance at the ,house of ,commons when the question of vivisection is likely to be raised4 ,and the ,national ,society says1 ,in order to stimulate attention 7to ,mr4 ,coleridge's ,bill7 our lecturer has been assiduous in his attendance in the lobby of the ,house during the present session1 and by personal interviews has been able to arouse a good deal of interest in it on both sides of the ,house4 ,it is evident that ,our ,cause in ,parliament is urged with diligence1 and is not left to stand or fall according to the unsolicited conscience of what the ,london ,society calls the average lay member4 ,take1 for example1 the system of drafting questions to be put to the ,home ,secretary4 ,it may or may not take off the edge of sincerity2 anyhow1 the question should be drafted with great care4 ,on ,february #bfth1 #aijj1 a question was asked as to certain observations which were alleged to have been made on living animals1 but in fact had been made on their organs removed after death4 ,the ,national ,society said of this mistake3-- ,we wish our readers to know that the question was not prompted by any communication from our ,society1 and we think it unfortunate that members of ,parliament should be asked to put questions in the ,house by persons who do not realise that questions based on inaccurate premises can do nothing but harm to our cause4 ,it is hard that the whole anti-vivisection movement should suffer through the carelessness and indolence of those who will neither be at the pains to avoid inaccuracy by their own study and investigation1 nor by consulting the ,national ,society's officers4 ,these careless1 indolent1 inaccurate persons1 who think so lightly of the ,national ,society's officers1 and draft a question so silly that the whole cause is damaged1 bring us back to the point whence we started3 the want of unity between the societies1 the frequent jarring of one with another4 ,we have still to see something of the dealings of the ,national ,society with ,government4 ,it is at its best1 doubtless1 in the formal letters from ,mr4 ,coleridge to the ,home ,office2 but these1 after all1 are his own work1 and the ,society cannot take the credit of them4 ,per contra1 we may credit to the ,society1 and not to ,mr4 ,coleridge1 certain threats to ,ministers in #ahih3-- 444 ,should we be so unfortunate as to be left by you without such an open assurance1 we shall feel it our duty to employ the strength and resources of this ,society in an endeavour to prevent your return to ,parliament at the next election4 ,we know of a large and increasing number of your constituents who are ready1 in the unfortunate event of your being unable to reassure them as to your attitude in the matter of endowing torture1 to place humanity above party politics4 444 ,this ,society will feel it to be its duty to use every means in its power to prevent your return to ,parliament at the next election4 444 ,we beg leave to inform you that at the next election the forces of this ,society will be used with the utmost vigour to prevent your return to ,parliament4 ,we know of many1 and shall no doubt soon secure more of your constituents1 pledged to place humanity above party and vote against you on the next occasion that you present yourself4 ,what are we to think of these three letters8 ,the resources of the ,society1 given with some vague hope of keeping animals out of pain1 are to be used for keeping ,ministers out of ,parliament4 ,note the bullying tone of the letters4 ,it is the same thing1 two years later1 at the ,general ,election1 with the heckling of candidates3 ,we are now recognised throughout ,great ,britain to be a power that cannot be ignored4 ,a ,society that bullies ,ministers of ,state1 what will it not do to the average lay member8 ,v4 ,a ,,historical ,,parallel ,it is a long way1 from the plain duty to take care of animals1 to the arguments and general behaviour of these societies4 ,of course1 we have seen them here from the most unfavourable point of view4 ,from that point of view1 apart from any more favourable aspect1 they have their parallel in history4 ,the two instances are1 in some ways1 very unlike3 but the parallelism is worthy of note4 ,the historical instance is more than fifty years old3 we have what was said1 in #ahea1 against his worst opponents1 by a man who had an unpopular cause to defend4 ,newman1 in #ahea1 gave a set of lectures on ,the ,present ,position of ,catholics in ,england3 and his sayings1 some of them1 seem apt to our present subject4 ,take the following examples4 ,only1 here and there1 a word is altered1 or a phrase left out1 that all offence may be avoided3-- 444 ,we should have cause to congratulate ourselves1 though we were able to proceed no further than to persuade our opponents to argue out one point before going on to another4 ,it would be much even to get them to give up what they could not defend1 and to promise that they would not return to it4 ,it would be much to succeed in hindering them from making a great deal of an objection till it is refuted1 and then suddenly considering it so small that it is not worth withdrawing4 ,it would be much to hinder them from eluding a defeat on one point by digressing upon three or four others1 and then presently running back to the first1 and then to and fro1 to second1 third1 and fourth1 and treating each in turn as if quite a fresh subject on which not a word had yet been said4 444 ,no evidence against us is too little3 no infliction too great4 ,statement without proof1 though inadmissible in every other case1 is all fair when we are concerned4 ,an opponent is at liberty to bring a charge against us1 and challenge us to refute1 not any proof he brings1 for he brings none1 but his simple assumption or assertion4 ,and perhaps we accept his challenge1 and then we find we have to deal with matters so vague or so minute1 so general or so particular1 that we are at our wits' end to know how to grapple with them4 444 ,for myself1 ,i never should have been surprised1 if1 in the course of the last nine months of persecution1 some scandal in this or that part of our cause had been brought to light and circulated through the country to our great prejudice4 ,no such calamity has occurred3 but oh6 what would not our enemies have paid for only one real and live sin to mock us withal4 ,their fierce and unblushing effort to fix such charges where they were impossible1 shows how many eyes were fastened on us all over the country1 and how deep and fervent was the aspiration that some among us might turn out to be a brute or a villain4 444 ,we are dressed up like a scarecrow to gratify1 on a large scale1 the passions of curiosity1 fright1 and hatred4 ,something or other men must fear1 men must loathe1 men must suspect1 even if it be to turn away their minds from their own inward miseries4444 ,a calumny against us first appeared in #ahcf1 it still thrives and flourishes in #ahea4 ,i have made inquiries1 and ,i am told ,i may safely say that in the course of the fifteen years that it has lasted1 from #bjj1jjj to #bej1jjj copies have been put into circulation in ,america and ,england4 ,a vast number of copies has been sold at a cheap rate1 and given away by persons who ought to have known that it was a mere fiction4 ,i hear rumours concerning some of the distributors1 which1 from the respect which ,i wish to entertain towards their names1 ,i do not know how to credit4 444 ,the perpetual talk against us does not become truer because it is incessant2 but it continually deepens the impression1 in the minds of those who hear it1 that we are impostors4 ,there is no increase of logical cogency2 a lie is a lie just as much the tenth time it is told as the first2 or rather more1 it is ten lies instead of one2 but it gains in rhetorical influence4444 ,thus the meetings and preachings which are ever going on against us on all sides1 though they may have no argumentative force whatever1 are still immense factories for the creation of prejudice4 444 ,the ,prejudiced ,man takes it for granted that we1 who differ from him1 are universally impostors1 tyrants1 hypocrites1 cowards1 and slaves4 ,if he meets with any story against us1 on any or no authority1 which does but fall in with this notion of us1 he eagerly catches at it4 ,authority goes for nothing2 likelihood1 as he considers it1 does instead of testimony2 what he is now told is just what he expected4 ,perhaps it is a random report1 put into circulation merely because it had a chance of succeeding1 or thrown like a straw to the wind2 perhaps it is a mere publisher's speculation1 who thinks that a narrative of horrors will pay well for the printing3 it matters not1 he is equally convinced of its truth3 he knows all about it beforehand2 it is just what he always has said2 it is the old tale over again a hundred times4 ,accordingly he buys it by the thousand1 and sends it about with all speed in every direction1 to his circle of friends and acquaintance1 to the newspapers1 to the great speakers at public meetings4444 ,next comes an absolute1 explicit1 total denial or refutation of the precious calumny1 whatever it may be1 on unimpeachable authority4 ,the ,prejudiced ,man simply discredits this denial1 and puts it aside1 not receiving any impression from it at all1 or paying it the slightest attention4 ,this1 if he can3 if he cannot1 if it is urged upon him by some friend1 or brought up against him by some opponent1 he draws himself up1 looks sternly at the objector1 and then says the very same thing as before1 only with a louder voice and more confident manner4 ,he becomes more intensely and enthusiastically positive1 by way of making up for the interruption1 of braving the confutation1 and of showing the world that nothing whatever in the universe will ever make him think one hair-breadth more favourably than he does think1 than he ever has thought1 and than his family ever thought before him4 ,about our state of mind1 our views of things1 our ends and objects1 our doctrines1 our defence of them1 he absolutely refuses to be enlightened4444 ,the most overwhelming refutations of the calumnies brought against us do us no good at all4 ,we were tempted1 perhaps1 to say to ourselves1 ',what will they have to say in answer to this8 ,now at last the falsehood is put down for ever1 it will never show its face again4' ,vain hope6 ,such is the virtue of prejudice--it is ever reproductive2 future story-tellers and wonder-mongers1 as yet unknown to fame1 are below the horizon1 and will unfold their tale of horror1 each in his day1 in long succession4 444 ,perhaps it is wrong to compare sin with sin1 but ,i declare to you1 the more ,i think of it1 the more intimately does this ,prejudice seem to me to corrupt the soul1 even beyond those sins which are commonly called more deadly4 ,and why8 because it argues so astonishing a want of mere natural charity or love of our kind4 ,they can be considerate in all matters of this life1 friendly in social intercourse1 charitable to the poor and outcast1 merciful towards criminals1 nay1 kind towards the inferior creation1 towards their cows1 and horses1 and swine2 yet1 as regards us1 who bear the same form1 speak the same tongue1 breathe the same air1 and walk the same streets1 ruthless1 relentless1 believing ill of us1 and wishing to believe it4 ,they are tenacious of what they believe1 they are impatient of being argued with1 they are angry at being contradicted1 they are disappointed when a point is cleared up2 they had rather that we should be guilty than they mistaken2 they have no wish at all we should not be unprincipled rogues and bloodthirsty demons4 ,they are kinder even to their dogs and their cats than to us4 ,is it not true8 can it be denied8 is it not portentous8 does it not argue an incompleteness or hiatus in the very structure of their moral nature8 has not something1 in their case1 dropped out of the list of natural qualities proper to man8 99 99 99 99 99 ,these sentences1 many of them1 might be used now to describe ,anti-vivisection at its lowest level4 ,it might keep a higher level3 but we have seen that the literature1 arguments1 and general methods of the ,anti-vivisection ,societies fail to do that4 ,the ,parliamentary interviewer1 the itinerant lecturer1 and the letter-writer1 are not1 after all1 of much help to any cause3 and surely it is time1 after all this waste of huge sums of money1 that a ,royal ,commission should inquire1 not only into experiments on animals1 but also into ,anti-vivisection4 ,,index ,a ,a1 ,certificate1 #bfh1 #bhf ,abolitionist1 the1 #cjb ,absorbable ligature1 the1 #bfd ,act #ci #dj ,vict4 c4 #gg1 #bfg-bic ,actinomycosis1 #bdf ,adrenalin1 #bfc ,aga ,khan1 ,sir1 #agi ,air1 compressed1 #ga ,algeria1 malaria in1 #bcj ,america1 diphtheria in1 #aji2 tetanus in1 #acc1 #ace2 yellow fever in1 #bcb-bdj ,amoy1 plague in1 #aid ,amyl nitrite1 #bed2 false argument1 #cde ,anaemia1 #ga2 pernicious1 #bfc ,ansthesia1 grades of1 #ceg2 false statements1 #cff ,ansthetics1 discovery and study of1 #ee1 #bef2 use under the ,act1 #bha ,anderson1 ,mr41 #aij ,andrews1 ,staff-,surgeon1 #bfc ,anglo-,indians and ,anglo-,africans1 #bbh ,animal heat1 #fh ,animals1 protective inoculation of1 #hi-ie1 #aac2 action of drugs on1 #bee ,annett1 ,dr41 #bbc ,anopheles and ,culex1 #bad-bdb ,anthrax1 #gf1 #hg-ie ,antiseptics1 #gh-hf2 use of under the ,act1 #bhe ,antitoxins1 testing of1 #bgj2 false arguments against1 #cch-cdb4 ,see also ,diphtheria1 ,tetanus1 c4 ,anti-vivisection ,societies1 #big sqq42 dissensions1 #bii-cjb2 expenditure1 #cjd-cjf1 #ccd1 #cfg2 acceptance of all advantages from past discoveries1 #cjg2 attitude toward sport1 #cjh2 toward doctors and hospitals1 #caj2 literature1 #cac-cbd2 method of espionage1 #cbg2 general arguments1 #cbf-ccd2 special arguments1 #cce-cfg2 electoral and parliamentary tactics1 #cfg-cga ,aphasia1 #fb ,arguments1 anti-vivisection1 #cbf-cfg ,aristotle1 #c1 #dd1 #bdc ,arloing and ,courmont1 #ajj ,artificial respiration1 #bfd ,asellius1 #ai ,assam-,burmah railway1 cholera on1 #afb ,athens1 ,pasteur ,institute at1 #adc ,aubertin1 #fb ,b ,b1 ,certificate1 #bfh1 #cdi4 ,see also ,experiments ,baccelli1 ,prof41 #acc ,bacteriology1 #gg sqq42 not before the #ahge ,commission1 #ge2 the foundation of ,lister's work1 #he2 hardly recognised in the wording of the ,act1 #bfg2 the cause of more than #ij per cent1 of all experiments1 #bib2 false statements1 #caf1 #cdj ,baginsky1 ,prof41 #aje ,bagshawe1 ,bishop1 #cbi ,bainbridge1 ,surgeon-,general1 #afi ,baker1 ,major1 #agb ,bang1 ,prof41 #ii ,bannerman1 ,major1 #agc1 #age1 #agh ,barbadoes1 filariasis in1 #bdj ,barry1 ,bishop1 #cdc ,battipaglia-,reggio railway1 and malaria1 #bba ,bazan1 ,dr41 #db 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#ccg ,spontaneous generation1 #bdd ,sport1 attitude of anti-vivisection societies toward1 #cjh ,sphygmometer1 the1 #ag ,spurious hydrophobia1 #cdg ,stanley1 ,mr41 #db ,starling1 ,prof41 #ci1 #fi ,staten ,island1 #bdb ,steenstrup1 on entozoa1 #bdd ,sternberg1 #abh1 #bca ,stoker1 ,sir ,w4 ,t41 #bia ,stone1 ,dr41 #bfc ,streptococci1 #hc ,strophanthus1 #bee ,strychnine1 study of1 #bec ,subdural inoculations1 #acc1 #ach1 #bga ,suppuration1 #hd ,swammerdam1 #bdd ,syme1 #db1 #gh ,sympathetic system1 #fi ,t ,tabes mesenterica1 #ih ,talbot1 ,rev4 ,r41 #ceb ,terzi1 ,signor1 experiment on self1 #bbj ,tetanus1 #abh-acf ,tew1 ,dr41 on typhoid1 #aig ,thane1 ,mr4 ,g4 ,d41 #bij ,thompson ,yates laboratories1 #bbc ,thoracic duct1 the1 #ba ,thuillier1 #hi ,thyroid extract1 use of1 #bej2 false argument1 #cdd ,tiedemann1 #bg ,tooth1 ,dr41 #bjb ,torsion of arteries1 #bfd ,tracheotomy in diphtheria1 #aad-abj ,transfusion of saline fluid1 #bfd ,transplantation of bone1 #bfd ,treves1 ,sir ,frederick1 #cba ,trichiniasis1 #bdd ,trotter1 ,mr4 ,w4 ,b4 ,l41 #bhh ,tubercle1 #if-aja ,tuberculin1 #ih ,typhoid fever1 #aif-baa ,u ,umarkhadi jail1 plague in1 #agg ,undhera1 plague in1 #agh ,v ,valentin1 #ch ,valisnieri1 #be ,vallry ,radot1 #acg ,vaso-motor system1 #ef1 #fi ,vaughan1 ,surg4-,capt41 #aee ,venesection1 #bfd ,venoms1 relative strength of1 #bfj ,veratria1 #bee ,veterinary operations1 #bha1 #bic ,vierordt1 #ag ,villemin1 #if ,virchow1 ,prof41 #ge1 #bde ,virulence1 grades of1 #hi1 #aci1 #bfj ,virus fixe1 #aci ,w ,wall1 ,dr4 ,a41 #cej ,waller1 #gh ,war ,office1 experiments for1 #bhh ,washbourn1 ,dr41 #bjh ,wassermann1 #aec ,west1 ,lieut4 ,j4 ,w41 #bji ,west ,africa1 malaria in1 #bbd1 #bbf ,wharton ,jones1 #gg ,widal's reaction1 #baj1 #baa ,wilberforce1 ,archdeacon1 #cai1 #cbh ,willis1 #ei ,winburg1 typhoid in1 #bji ,winmarleigh1 ,lord1 #bfg ,wolff1 #bdf ,wood1 ,mr4 ,somerville1 #cci-cdd ,woodhead1 ,prof41 #aag1 #abd1 #bga ,woolsorters' disease1 #hg ,wright1 ,sir ,almroth1 #aja1 #agj1 #aif ,y ,yellow fever1 #bca-bdj ,yersin1 #afi1 #aid ,z ,zoophilist1 the1 #cad-cbj ,zrich1 diphtheria in1 #ajd ,transcriber's note3 ,in footnote #ah the sentence ,es mssen vor allen ,dingen die ,quellen1 aus denen der ,infections-stoff fliesst1 so weit es in menschlichen ,macht liegt1 verschlossen werden4 was changed to read3 ,es mssen vor allen ,dingen die ,quellen1 aus denen der ,infektionsstoff fliesst1 so weit es in menschlicher ,macht liegt1 verschlossen werden4 ,three overwide tables have been split into two parts4 ,in each the first row of the original table has been repeated in the split off table in order to make the table more readable4 ,these three tables appear in3 ,,part ,,ii-,,experiments ,,in ,,pathology1 ,,materia ,,medica1 ,,and ,,therapeutics4 ,,vaccination ,,against ,,charbon 7,,france74 ,sheep4 ,,vaccination ,,against ,,charbon 7,,france74 ,cattle4 ,,vaccination ,,against ,,rouget 7,,france74