The President's Address. By G. S. Wood-head. 211 



kept in the recumbent position, with the limbs slightly raised ; 

 gentle massage, very gradually increased, should be applied, 

 followed, as improvement occurs, by gentle and carefully graduated 

 exercise. The condition of the tissues, as revealed under the 

 Microscope, bears out the contention of the veterinarian that here 

 we have altered nutrition due to imperfect circulation and accumu- 

 lation of fluid in the connection tissue spaces. 



Both of these problems are strictly micro-biological, but they 

 are problems that have a tremendous bearing on surgical practice. 



Splendid work, then, is being done at the front, whilst at home 

 contributions have been made to the common fund of knowledge 

 to be drawn upon for the better preservation of the health of our 

 troops, and I propose to give a short account of a method devised 

 for the testing and sterilization of water on a large scale, a method 

 based on microscopical research, but one in which the Microscope, 

 having served its purpose, is no longer necessary. 



Nowadays, most of those who have worked at infective diseases 

 are convinced that, although the accumulation of waste products in 

 the tissues, resulting from fatigue or overfeeding, the lowering of 

 vitality of the tissues by cold, wet, and bad ventilation, are un- 

 doubtedly predisposing or accessory causes of these diseases, specific 

 micro-organisms, each reproducing its kind, are the exciting factors 

 in the production of infective diseases. It is recognized, almost 

 universally, that cholera, typhoid fever, dysentery and certain 

 forms of epidemic diarrhoea are induced by specific bacteria which, 

 adherent to particles in food and in water, and carried by flies, may 

 be transported from place to place, and finally may attack suscep- 

 tible individuals. Although none of these bacilli flourish and 

 multiply in water as they do in milk and other organic media, they 

 may retain their vitality in it for some time. A medium so 

 readily infected is often a source of grave danger, sometimes giving 

 rise to explosive outbreaks, especially of cholera and typhoid fever ; 

 and since hygiene became a science, one of the subjects to which 

 hygienists have turned, again and again, is the production and 

 maintenance of a water-supply free from the infective organisms 

 that produce the above-mentioned diseases. Charcoal filters were 

 tried and found wanting ; indeed they often proved to be breeding 

 grounds for the bacteria they were supposed to eliminate. Heating, 

 sedimentation, filtration through Berkefeld and Chamberland- 

 Pasteur filters were also tried in turn, and, under ideal conditions, 

 each has given good results, though, under the rough conditions 

 that obtain in the field, they have not been so satisfactory. There 

 has been a lack of fuel, or the heating apparatus has not been 

 available when it was most urgently required. Sedimentation 

 has failed because sterilization can be obtained by this method 

 only after a long period of settlement, and even then complete 

 sterilization does not always result. 



