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FURTHER. RESEARCHES BYPROFESSOR KOCH.

IMPORTANT STATEMENT BY SIR JOSEPHLISTER.

Sir JOSEPH LISTER has returned from a visit of a few I

days to Berlin, where he has had the opportunity of wit-nessing the action of Koch’s treatment of tuberculosis ; andon Wednesday in King’s College Hospital he related hisimpressions regarding it. He spoke of the effects producedby this treatment upon tubercular disease as simplyastounding, both in its curative effect and its diagnosticvalue. He combated the statements which had appeared’from time to time in certain publications, to the effect thatit was impossible for the dead portions of tissue resultingfrom the treatment to be got rid of by other than sur-gical means ; he stated that provided these portions oftissue were preserved from septic agency, they need notnecessarily be separated from the living body, as theywere eliminated by absorption in the same manner as acatgut ligature. There was no reason to suppose that thefact of this tubercular tissue being destroyed would make ’,it incapable of absorption. He compared the action of IKoch’s fluid with that used by Pasteur in the case ofanthrax, an injection of which gave complete immunityfrom this disease, and he hoped that Koch’s futureresearches would result in showing the remedy capable ofacting on human beings so as to give them completeimmunity from tuberculosis.There was another line of research from which be hoped

for good results in the direction of immunity. Throughthe kindness of Professor Koch he had the opportunity ofvisiting the Hygienic Institute of Berlin, and of seeing mostbeautiful researches being carried on in that institution, ofwhich he was the inspiring genius. Those researches werenow going on, and fresh facts were accumulating day byday. They had not yet been published, and he was not atliberty to mention any details, but there could be no harmin saying that he saw, in the case of two of the most virulentinfectious diseases to which man is liable, that the injectionunder the skin of a small quantity of a material, perfectly con-stant in character-an inorganic chemical substance as easilyobtained as any other article in the materia medica-cutshort these two formidable diseases in the animals in whichthey were performed. These same animals were rendered in-capable of taking the disease underthe test of the most potentinoculations. He suspected that before many weeks werepassed, if it should be found that the same results could be Iproduced on man-though experience of what was known ofthe different behaviour of Koch’s fluid in guinea-pigs and inman makes this a matter of uncertainty until tested byexperiment,-the world would be startled by the mag-nificence of these researches, which would be recognisedon every hand.

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IMMUNITY AGAINST DIPHTHERIA ANDTETANUS.

(BY TELEGRAM FROM OUR SPECIAL COMMISSIONER.)

THE nature of the researches which have lately beenaoing on in the Hygienic Institute of Berlin has givenrise to much speculation. Professor Carl Fraenkel hast length published the result of his investigations ondiphtheria as a result of experiments on animals. In de-

scribing the agent, he says that the not yet chemically defined.class of proteid bodies called toxalbumins somewhat re-sembles, but ditfers in essential points from, ferments, inas-much as the quantity of the ferment does not govern theresult of its action, whereas the action of toxalbuminis altogether dependent upon the quantity used. He statesfurther, that immunity from diphtheria is secured, first,by the use of attenuated virus prepared by Pasteur’s method,And, in the second place, by injecting the bacillary productsfound in-such cases.The bacillus can be attenuated, but its cultivation cannot

be carried to any great length, and it soon recovers in amysterious manner its former normal virulence. Inocula-tion with the attenuated bacillus aftbrds a partial pro-tection only, and serves to postpone the fatal issue. Butthe method of attenuating the bacillus of diphtheria byheating or culture in antiseptic media has producedunsatisfactory results. Experiments with bacilli which havebeen attenuated by culture in unsuitable media, like agar-agar, have hitherto produced only negative results, andthose conducted with dried toxalbumin were also unsatis-factory. Inoculation with the culture lluid which had beenheated to 131° F., and filtered through Chamberlain’s filter,had the power of rendering the body more resistant to theinfection, but did not insure immunity. Animals whichwere inoculated with one-tenth of a cubic centimetre diedin from three to nine days, while control animals died infrom thirty to thirty-six hours. Better results were ob-tained with large and dilute doses than with concentratedones, which are more dangerous to use. Perfect immunitywas obtained by inoculating from 10 cc. to 20 cc. of thebouillon culture, which had been kept for three weeks,and attenuated by heating to a temperature of 149° or

158° F’., but the test is a virulent one, and inoculationmust be postponed for at least fourteen days. It is alsoshown that the diphtheritic virus and the protective agentare dinerent substances, inasmuch as immunity is obtainedby small injections of the culture products : when injected.in large doses there was no evidence of direct infection. Atthe Institute of Hygiene in Berlin, of which Dr. Koch ishead, Dr. Behring and Kitasato have succeeded incuring animals which have been infected with tetanusor diphtheria. Moreover, by inoculations with a per-fectly constant fluid of inorganic character they had suc-ceeded in rendering healthy animals refractory to thesediseases. They maintain that the immunity thus obtainedof rabbits and mice to tetanus is due to an alteration in theactive property of blood serum, which has the effect of render-ing harmless the toxic, tetanus-producing substances. Theirexperiments go to prove, in the first place, that the blood ofrabbits, which possess immunity from tetanus, will destroythe tetanus virus ; secondly, that the property is possessedby shed blood and its serum when freed from corpuscles;thirdly, such blood and serum has the power of actingtherapeutically on other animals. Their experimentsappear to show conclusively that the blood of those animalswhich do not possess this immunity from tetanus does notdestroy in any way the tetanus virus, and that therefore thisvirus can be found in animals susceptible to tetanus whichhave been killed by the disease. They have succeeded inprotecting rabbits against living tetanus bacilli, as wellas against the tetanus virus. No mouse or rabbit in itsnatural condition is found refractory to the influence ofthe tetanus poison.

THE HOSPITAL SUNDAY FUND.

A MEETING of the Council of this Fund was held on the29th ult. at the Mansion House, under the presidency ofthe Lord Mayor.The report was laid "in proof on the table. For the

year there had been collected £42,814, being E1070 3s. 10d.more than had been raised in any previous year. Of this,£38,823 was received from congregations, while from

legacies and special donations f3991 had been received.Notice is taken in the report that from the congregationunder the pastoral care of the Rev. Prebendary Forrest thesum of E1258 3s. 3d. was obtained, being the largest amountever raised by any one congregation. Awards to 169 insti-tutions were made, which was an increase of eight over lastyear. After allowing for liabilities and the current ex-

penses, there was left £41,061, and of this £39,101 wasrecommended to be paid to 113 hospitals and 56 dispensaries.Five per cent.-viz., £2140-was set apart for the purchaseof surgical appliances. The Council called special attentionto the increase of f551 in the amount collected from con-gregations over that of the previous year. One anonymousdonation of i500 was again reported. There was specialattention called to the following sentence in the report:, :," Gratifying as this improvement undoubtedly is, theCouncil still feel that the total amount collected must be

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much larger, if the hospital managers are to be placed in aposition to utilise the large number of beds now empty forwant of funds."Sir S. H. Waterlow, in moving the adoption of the report,.congratulated the Council upon the large increase in thereceipts upon those of former years; yet they had only re-ceived one legacy this year to the amount of f:1003. Betweenthe years 1880 and 1890 the total had increased by nearly40 per cent. (Applause.) With regard to the money allottedfor surgical appliances, they found it quite insufficient tomeet the largely increasing demands made upon them inthat department. There would, therefore, be a necessityfor discussing at no distant date whether there should be anincrease in the sum voted for that object. The fund, hewas glad to say, was worked at a cost ot only 3 per cent.Sir Owen Roberts seconded the motion, which was

carried.The Ven. Archdeacon Sinclair proposed the addition of

certain names to the Council for 1891. He suggested thatif the Royal College of Surgeons and nurses made a point tof attending the service at St. Paul’s Cathedral, theymight induce the Bishop of London to select a specialpreacher for hospitals, and the result would be more satis-factory from a pecuniary point of view.The resolution was seconded by Mr. Bonsor, M.P., and

passed. ’,It was decided to recommend to the general meeting that

Sunday, May 31st, 1891, be fixed for the annual collection.Mr. H. N. Custance (the secretary) read a letter from the

Metropolitan and National Nursing Association, pressingthe claims of that body upon a share of the collections.Sir Owen Roberts proposed that so important a requestshould be referred to the General Purposes Committee forconsideration, seconded by Sir S. Waterlow, who remarkedthat such a reauest would throw an immense additionalMsponsibility upon the resources of the Fund. The resolu-tion was carried.The meeting terminated by a vote of thanks to the Lord

Mayor for presiding.We understand that it has been referred to the Committee

of Distribution " to confer with the Lord Mayor with theview of calling a meeting of managers of the leading hos-pitals to consider the possibility of arranging some uniformsystem of accounts to be presented to their subscribers andlaid before the Committee of Distribution." The preliminarymeeting will be held on Dec. 8th at the Mansion House fortuembers of the Committee of Distribution only.

THE LONDON HOSPITAL.

ON Wednesday last the quarterly meeting of the

governors of this hospital was held, when the report of theHouse Committee was presented. Mr. J. H. Buxton,treasurer of the hospital, occupied the chair. The report<dealt chiefly with the charges which had been made againstthe London Hospital before the Select Committee of theHouse of Lords. The allegations were to the effect: (1) That,too much power is entrusted to the matron with regard tothe dismissal of probationers for inefficiency; (2) that withregard to the private nursing institution, insufficientlytrained nurses are withdrawn from the wards and sent outas thoroughly trained nurses ; (3) that the nurses’ food isinsufficient and unsuitable; (4) that the staff is insufficient,’that too great responsibility is thrown upon nurses notthoroughly trained, and that there are too many payingprobationers; (5) that too much menial work is castupon the nurses, that the hours are too long, andgenerally that the nurses are overworked. Each ofthese charges was denied emphatically. Reference was

also made to the case of the girl Nicholls, who hadJecently complained of having been criminally assaulted at’the hospital. It was presumed that the assault had been’committed by a student now missing. Every assistanceshad been given to the police in the matter.The Chairman, in moving the adoption of the report,

said those who were present must acknowledge that theirdefence to the allegations made against the management ofthe hospital was singularly complete, and he would alsopoint out that it was the report ot a body of men who gavetheir energies, time, and money to the hospital, andwho had had many years’ experience in hospital work.

The members of the committee always encouraged sug-gestions, for they were well aware that in a large insti-tution like theirs there must be room for improvementsomewhere. But they did not like, when once serious allega-tions had been met and disproved, that these charges shouldbe renewed as if they had never received denial. If theyonly knew what the nursing had been ten years before,nothing would be said against the nursing that now existed.The change in that time for the better had been enormous.All round they had received the very warmest expressionsof approval from sisters, nurses, and probationers who hadgone from the London Hospital to other places. He feltmore than anyone else, being treasurer, the vital harmwhich had been done to that greatest of all East London,charities by a few persons-not more than two or three,-harm from which it would not recover for a quarter of acentury.Mr. Cobb seconded the motion.Mrs. R. Hunter addressed the meeting at considerable

length, reiterating the charges made against the hospitalnursing arrangements. She was continually interrupted,and was not allowed to complete all she desired to say.

Sir E. H. Currie deplored the fact that the charges shouldhave been made, and further that they should have beenmade by a governor of only four months’ standing, awak-ing the press, and doing almost incalculable harm. Heaverred that for some trumpery reason one of the greatestcharities in England had been brought into disrepute. Thecharges touched a lady who had given ten years of her lifeto the work of the hospital. She was charged with unjustlydischarging nurses, whereas, out of 599 nurses who had beenin the hospital only eight had been dismissed by her for in-competency. What,too, became of the charge of neglectingthe health of the nurses when it had been clearly provedthat in ten years, out of 1166 workers in the hospital, onlysixteen had died ? Sir E. Currie closed his speech with theremark, which was received with great cheering, "that thesecret of the charges was that one woman wanted to get herknife into another woman."Mr. H. G. Yatman proposed and Mr. R. Hunter

seconded an amendment to the effect "that this meeting,while adopting the report of the House Committee, earnestlytrusts that the committee will take steps for improving thenursing arrangements of the hospital." Mr. Yatman vainly-attempted to address the meeting, standing for some timeamidst uproar and cries of "Divide!" The amendmenthaving been lost, the report was unanimously adopted.Mr. J. Hall stated that he had been interested in the

hospital for years, and proceeded to make further remarksamidst great interruption.After electing the officers for the ensuing year, the

meeting separated. __

DENTAL HOSPITAL OF LONDON.

THE annual dinner of the past and present students of theDental Hospital of London was held on Nov. 29th at theHolborn Restaurant, Dr. Joseph Walker presiding. In pro-posing the toast of the evening he remarked that there wasno portal through which to enter the dental profession exceptthe L. D. S. The small number of sixteen dental surgeons hadthe power of admitting or refusing candidates. The GeneralMedical Council had the power of keeping up the standardof the examination, and he hoped they would continue to doso. He was glad to say that the number of stndents was in-creasing. The flourishing condition of the school was largelydue to the teaching of the staff. He hoped shortly to seeoperations going on all day long instead of only in themorning. Dr. Samuel Wilks said that he had always had agreat objection to specialism, but dentistry had been longerand more differentiated than other specialties. Formerly ifanything was the matter with a tooth it simply meant pullingit out; now dentists went in for conservative dentistry, and,further, this was within the reach of the poorer classes, thanksto the Dental Hospitals. Mr. Sibley remarked that theDental Hospital was healthy and robust, and doing goodwork, but was capable of doing very much more. Beforethe Dental Hospital was founded, authorities were consultedin order to enable general hospitals to establish dental depart-ments where conservative treatment might be carried out;but this being found impracticable, the special hospitals