216 BEVIEW — TROPICAL MEDICINE, ETC. 



Typhus fevor, evidently closely allied to typhus, amongst the Japanese troops in the Russo-Japanese 



Fever— war. From the stools, and in some cases from the urine, he isolated an organism, the 



coHiinued Bacilhts febris exanthematieus mandschiirici, which he regards as the cause of the disease, 



and which resembles organisms of the paratyphoid group, and whose cultural characteristics 



he describes in detail. 



Rogers^ gives statistics to show that true typhus still occurs in India, but it is now rarely 

 seen, owing to the improved sanitation of gaols in that country. 



Newsholme- discusses at length the relation of poverty to typhus in Ireland. He says 

 of the operative causes of typhus, specific infection is admitted generally to be indispensable. 

 Malnutrition has not always been associated with epidemics of this disease, and there has 

 been no constant association of epidemics with exceptional overcrowding, or cessation of 

 epidemics when overcrowding has been enormously reduced. Vagrancy is the one factor 

 which has always accompanied specific infection, and in the absence of which epidemics 

 have failed to occur even in the vicinity of infected populations. 



He also points out that the suppression of typhus in Ireland had been due chiefly to the 

 efBcient immobilisation of infection by means not intended expressly for that purpose. 



M'VaiP has an interesting account of typhus, chiefly as regards its occurrence in 

 Glasgow. He mentions its association with fleas, which have been suggested by Matthew 

 Hay as carriers of the infection. He gives a plan of a useful type of reception-house. 



Vaccination. In the Tropics small-pox spreads with a rapidity and attains a 

 severity which is rarely seen at home, and, as most tropical countries are beyond the pale 

 of the " Conscientious Objector," one has opportunities of noticing the good results from 

 vaccination, while in some parts even the mind of the ignorant and prejudiced native is 

 impressed by its eflicacy when an epidemic presents itself in his village. 



Fink* supplies some striking and interesting evidence in favour of vaccination in 

 Burmah. He noted that it was a common experience where small-pox is epidemic to 

 find the local medicine man inoculating all children, who have not been protected by a 

 previous attack of the disease. The method consisted in selecting a mild case, removing 

 the scabs off the pustules, grinding these scabs down to a fine powder, mixing with water, 

 and injecting some of this mixture into the forearm or rubbing it into open abrasions. 



In a village in the Pakokku district in Burmah, where small-pox had broken out, 

 59 persons had been attacked : 22 of these, mainly children, had got the disease by 

 infection, and the rest, viz., 37, by inoculation. Four deaths occurred among the children 

 who had not been inoculated. 



After personal experience of each child vaccinated in 1900 and 1901, and also of all 

 those inoculated, Fink observed that not a single child successfully vaccinated a year or 

 two previously got small-pox, either by infection or by inoculation. His figures are worth 

 quoting : — 



Number of children successfully vaccinated in 1900 and 1901 — 144. 



Number successfully vaccinated, inoculated without result — 123. 



Number successfully vaccinated and have resisted infection, but were not inoculated — 21. 



Nield Cook,'' in an excellent paper, describes the method employed by him in the 

 cultivation and preservation of calf lymph in Calcutta. 



Climatic difficulties occur in the Tropics in connection with the cultivation and 

 preservation of calf lymph. 



Blaxall and Fremlin's'' observations go to show that a vaccine is rendered inert by 

 exposure to a temperature of 37° C. for twenty-four hours, but it will stand a temperature 

 of 180° C. for several weeks without deterioration, and can be kept for a year or more in 

 cold storage at a temperature of a few degrees below zero centigrade without any loss of 



' Eogers, L. (London, 1908), " Fevers in the Tropics." 



^ Newsholme, A. (November, 1907), " Poverty and Disease, as illustrated by the course of Typhus Fever and 

 Phthisis in Ireland." Proc. Roy. Soc. Med. Epid. Sect., Vol. I., No. 1. 



=> M'Vail, J. C. (London, 1907). " The Prevention of Infectious Diseases." 



•• Pink, L. (July 16th, 1904), " The Efficacy of Vaccination tested by Inoculation and Small-Pox." British 

 Medical Journal. 



' Nield Cook, J. (May, 1907), " The Cultivation and Preservation of Calf Lymph." Lidian Medical GazctU. 



« Blaxall, F., and Fremlin, H. (August 9th, 1906), " Glycerinatcd Calf Lymph." Lancet, p. 669. 



