1353PATHOLOGY AT CAMBRIDGE.

In all these writings the main plank in the anti-tuberculosis campaign is held to be the immunisationof the people-especially the infant population-with a specific prophylactic vaccine. Opinionnaturally differs almost as widely as do the claimsof the inventors as to the value of this or that vaccine.Doubtless the proposition is a fascinating one to all

sociologists. The future is in the hands of the children,and if the world can be made safe for the cominggeneration by protection against such diseases as

tuberculosis we have advanced one long stage on theroad towards a happy future.Wide publicity has been given during the past week

to the announcement, made in another column by ourParis correspondent, that Dr. A. CALMETTE and sixcolleagues have reported to the Academy of Medicinein Paris the preliminary results of prophylacticvaccination against tuberculosis made in two

series of cases of infants under one year of age. Thebasis of Dr. CALMETTE’S work is to be found inresearches made by him, over a long period of years,on a culture-medium containing ox-gall, by the useof which non-virulent strains of bacilli capable of

producing antibodies in laboratory animals havebeen obtained. The ape and the calf have also beenfound to resist infection with this strain. There are,of course, not a few of such strains in experimentaluse in various laboratories of different countries,and some of them, at least, on careful investigationhave proved to be avian strains of the tuberclebacillus of very low virulence. (In passing we maynote that a very interesting and illuminating articleon these strains has recently been written by Dr.A. STANLEY GRIFFITH in the June number ofTubercle.) ) The Calmette vaccine is administered

by the mouth in a spoonful of milk every 48 hoursfrom the third to the tenth day after birth. Theauthor states that this method is without dangerand " its efficacy is beyond all doubt." Two series ofcases have been published. The first is a series of178 infants treated in 1922. A certain number ofthese cases appear not to have been traced, but it

I.

is stated that 94 are known to be quite well and thatno deaths from tuberculosis are known to haveoccurred. The second series consists of 137 infantstreated during 1924. These were all from familiesin which tuberculosis was known to have occurred.The mortality amongst Paris infants born in such anenvironment is stated to be 32 per cent. if leftuntreated, while in the series of 137 cases treatedthere have been, so far, no deaths. These statisticsare remarkable and we await further details withmuch interest. Do the reports, for instance, statewhether or not these last children were left in theirtuberculous environment and whether this immunitycan be attributed to any other precautions of theantituberculosis campaign, notably removal from theinfected homes as is done in France under the famousGrancher system 1 We ask because a mortality of32 per cent. among untreated children strikes us as

remarkably high, and we do not know on what groundsthis figure is suggested. -

In conclusion, this experiment in prophylaxisagainst tuberculosis in infants raises questions whichare of fundamental importance to our present viewson the wholesale immunisation of a people. In allthese large-scale experiments at least two essentialdesiderata are required. In the first place the bacterio-logical details of the vaccine must be firmly estab-lished, and in view of the doubts cast upon so manyof these non-virulent strains of tubercle bacilli wemust be quite sure that the strain is a human one.Dr. GRIFFITH’S work has shown that this point is

by no means a purely theoretical one. Prophylacticvaccine with avian strains might well fail in its

purpose. In the second place the sociological conditionsfor the experiment must be made non-variable as faras possible. Untreated and treated groups of infantsmust be under the same hygienic conditions, withthe same welfare organisation details. Only byso stabilising the bacteriological and sociologicalconditions can any such experiments be reallycrucial. These difficulties have been emphasisedat some length, as the question of prophylaxis againstinfective disease is notoriously hard to answer. Wehave only to follow the discussion which has beengoing on for some weeks in the Times on small-poxprophylaxis to realise how far we are yet from attaininga sociological crucial experiment free from all mannerof variable factors.

PATHOLOGY AT CAMBRIDGE.

IN the class lists of the Natural Sciences Triposissued in Cambridge on June 19th the names of fourmen and two women appear as having taken Part II.in pathology. It is no new thing that pathologyshould be theoretically, and occasionally in practice,available as a science subject as well as an item in themedical curriculum. But it is a departure full ofsignificance of progress already made, and full of hopefor more progress to come, that the subject shouldreach the position it deserves as a discipline worthy ofindependent study in one of our ancient universities,where it can be pursued along these lines to suchexceptional advantage. The School of Physiology atCambridge was an infant in the arms of MichaelFoster not so many years ago ; it has risen to a positionwhich is nowhere surpassed and in few places rivalled,and in its academic devotion to the progress of

knowledge has made contributions to practicalmedicine of the most real and solid kind. We hopethat with its new position in the curriculum and itsnew buildings which are imminent, Prof. H. R. Deanwill see the School of Pathology grow and progress tothe same distinguished position ; medicine is sometimes

best served by those who do not go to the bedside.WIRELESS INJURY TO HEALTH.

IN the early days of the application of the Hertzianwaves a close look-out was naturally kept to see ifthey had any harmful influence on the operators, andin 1909 Dr. P. Bellile, a French naval surgeon on boarda vessel engaged in the Morocco campaign, found thata number of wireless operators developed eczema alongwith conjunctivitis and even keratitis, presumed to bethe result of exposure to electric currents. One mancomplained of painful palpitation, and Dr. Bellile wasdisposed to think that neurasthenia, then becomingrather common among naval men, might be due totheir work in wireless telegraphy. During the 16 yearswhich have since elapsed, in which every large shipand almost every up-to-date household has installedwireless transmitters or receivers, little or nothingfurther has been heard of injury to health. A recenttragic occurrence in which a wireless operator waselectrocuted in the air was shown to have beendue to a leakage of current from the magneto. Thereport just received from New Jersey of the deathof six women in a wireless testing departmentfrom nervous collapse followed by fever and uncon-sciousness will not therefore be debited to the actionof long wave currents until exact information isreceived. Happily it seems that the human body hasno apparatus able to respond to very long electricwaves.

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1354 DETERMINATION OF SEX.

Annotations.teNe quidnimis."

LONDON SCHOOL OF HYGIENE AND

TROPICAL MEDICINE.

THE munificent Rockefeller gift of$2,000,000 doesnot come to full fruition until the London School ofHygiene and Tropical Medicine is both built andequipped. This will not be for another two yearsor so, although the decision will shortly be takenregarding the five excellent series of competitiveplans submitted to the Advisory Committee. Withcharacteristic generosity the Rockefeller Foundation,however, has guaranteed the sterling value of thegift as from the date when the offer was made. The

undertaking of the British Treasury to provide funds i

for the upkeep of the school also does not comeinto force until the fabric is complete. In the mean-time, however, thanks to an interim grant from theFoundation, the new directorate has taken over theLondon School of Tropical Medicine and Dr. AndrewBalfour has been busy remodelling the curriculumas far as ways and means permit.The diploma course in tropical medicine has been

extended by the addition of lectures on biochemistry,by giving much more attention to tropical hygieneand by the introduction of tutorial weeks. Twocourses of study, each lasting five months, now occupythe academic year ; one course begins in Octoberand terminates in February, the other in Marchterminating in July. More clinical demonstrationswill be given in the wards and opportunity offeredfor the study of minor forms of tropical disease atthe Albert Dock Hospital and on ships adjacentthereto. Research is to be put in the forefront ofthe programme and a number of studentships havebeen instituted, carrying an income of 2250 perannum. Holders of these research studentships willgive help as demonstrators in the diploma courses,but will have a large part of their time free forindependent research. The demand at present forskilled workers in protozoology and entomology byColonial Governments is greater than the supply.That these Governments are themselves awakeningto the value of research was indicated in recentreplies (summarised on p. 1381) by Mr. Amery in theHouse of Commons, although the proportion ofexpenditure on this head to the total cost of medicaland sanitary services is as yet conspicuously small.

The London School is now proposing to utiliseoverseas laboratories on a concerted basis ratherthan to continue the policy of research by expedition,as has been the practice in the past. Within the lastfew days a proposal has been made to develop theNatural History Museum at Nairobi into a centre fortropical research as a memorial to the late Sir RobertCoryndon, and a Rockefeller gift of =644,000 to theSingapore College of Medicine has been announcedfor the endowment of chairs of bacteriology andbiochemistry. The aims of the London School aretypified in its new seal, of which an impression ishere given. The design, executed by Mr. AllanWyon, owes its inspiration to a coin of ancient Sicilv.where with little doubt the allusion is to the deliveranceof the city of Selinus from a pestilence caused by thestagnation of the waters of the river. Apollo andArtemis are proceeding slowly in their chariot, Artemisdriving while her brother, the sun-god, dischargesarrows from his bow. The arrows are the healingrays of the sun, which drive away the malaria mists ;and Artemis is beside him as the goddess who easesthe pains of women labouring with child. The palmtree and the snake have been added to the Siciliandesign.

, ." "

The arrangements here described concern theteaching of tropical medicine for its special diploma,rather than the more general work on public healthteaching which will be taken over by the school whencompleted. The requirements of public healthstudents are being met in London at present at

University College, King’s College, Middlesex HospitalMedical School, and the Royal Institute of PublicHealth, with a special course on sanitary law andadministration at St. Bartholomew’s Hospital MedicalSchool. It is proposed to develop the teaching ofapplied physics, physiology, and principles of hygiene,for which at present facilities simply do not exist, andpublic health students will also attend a course inparasitology to be given at 23, Endsleigh-gardens byColonel A. Alcock, Prof. R. T. Leiper, and Dr. J. G.Thomson. At the same time opportunity will betaken of collecting a graphic museum of public health,something on the lines of the Ministry of Healthexhibit now showing at Wembley, which will not beallowed to be disbanded when the Exhibition closes.

DETERMINATION OF SEX.

WE had occasion recently to point out 1 that theassociation of male and female with the right andleft sides of the body respectively is a general beliefin some form or other among all nations and peoples.Mrs. Monteith Erskine’s book,2 which we had notthen received, confirms this statement. Mrg.Erskine now writes :

" The theory which I have set forth and elaborated inmy book Sex at Choice’ is no untried recruit to thedomain of biological hypothesis, but a hardy veteranwho has stood the fire of 25 years’ intensive practice andconstant operation. It is in the workings of the left ovaryas distinct from the right, and in the contention that bothboys and girls may be conceived in the same month, leavingthe alternate one completely fruitless, that the essence ofmy theory consists. For its substantiation I have utilisedto the full the personal opportunities afforded by my ownsex and maternity, probing to their depths the mysteries ot

pregnancy in its every phase. Furthermore, by sifting theresearches of many medical and lay friends, by exhaustingthe contents of nearly every treatise of sex-determinationfrom Hippocrates’downward, by penetrating into the homesand confidence of women of every class of society, andfinally by gathering from thousands of cases, where myformula was used, an accumulation of data undisturbed Lyany vestige of contrary evidence, I have secured the assurancenecessary to lay my theory before the bar of public opinion.It is for time alone to pronounce judgment."We have no desire to deny the possible truth of

the views set forth by the late Dr. Rumley Dawsonor of those now advanced bv Mrs. Erskine. It i"a priori likely that a belief so universal as that which

1 THE LANCET, April 25th, p. 878.2 Sex at Choice. London : Christophers. Pp. 154. 7s. 6d.