MEDICINE 169 



necessary to do is to dip the right hand and left foot into a couple of pots or pans contain- 

 ing salt-solution, from which wires lead off to the two ends of the galvanometer. I did this 

 some twenty years ago, and I remember, as if of yesterday, the keen pleasure with which I 

 first witnessed the electrical pulsations of my own heart." 



Malta fever. As in Malta, so in Gibraltar, Malta fever it is called " Rock fever " 

 in Gibraltar has been stamped out from the British garrison by prohibition of the 

 goats' milk which was the source of infection. More recently, it has been stamped out 

 at Port Said: all imported goats were tested for the disease, and those which showed 

 signs of infection were slaughtered. (Ross, Journ. R.A.M.C., 1911, p. 618). The 

 fever is very widely distributed; thus, it is not uncommon in South Africa (Garrow, 

 S. African Med. Journal, 1911, p. 51) ; and a little group of cases was lately found, under 

 the usual conditions of occurrence, in south-west Texas (Ferenbaugh, Journ. Amer. 

 Med. Ass., 1911, ii, 730). Sir David Bruce, at the annual meeting, 1910, of the Research 

 Defence Society, described the discovery of Malta fever in the district of Ankole, on the 

 eastern shore of Lake Albert Edward. The native name for the fever, in this part of 

 Uganda, was " muhinyo." He examined some 50 cases of the disease. The symptoms 

 were those of Malta fever; the micrococcus Melitensis was found in the blood of two of 

 the cases; the tests and reactions were those of Malta fever, and the usual evidence of 

 infection was found among the goats of the district (See also Journ. R.A.M.C., 1910, p. 



52?)- 



Meningitis, Epidemic Cerebro-spinal. In this terrible disease, the use of a serum 

 treatment is by this time generally recognised as the best possible method. The first 

 use of Flexner's serum it is his work at the Rockefeller Institute which founded the 

 present understanding of the nature of epidemic meningitis and the present 

 treatment was in 1905; the earlier results of the serum treatment (New York, 

 Belfast) are already noted in E. B. xviii, 13 ib. Later results, in France, were published 

 in the Annales de Vlnstitut Pasteur, February 1910. Of 402 cases with a serum treat- 

 ment, 66 died =16.4 percent. The ordinary death-rate from the disease, under other 

 methods of treatment, is 70 per cent. Figures collected far and wide, from many con- 

 tributors, are sometimes viewed with distrust. But, with cerebro-spinal meningitis^ 

 we have that best of all object-lessons, the continuous experience of a good hospital. 

 In the Children's Hospital, Boston, U.S.A., the death-rate in cases of epidemic menin- 

 gitis, year after year, without the serum treatment had ranged between 60 and 80 per 

 cent. In 1908, with the serum treatment, it came down with a run to 20 per cent. 



For recent facts in Great Britain, see Reports to the Local Government Board on Public 

 Health and Medical Subjects, new series, No. 61 (Brit. Med. Journ., 1912, i, 383). 



As with diphtheria, so with this cerebro-spinal fever, much attention has lately been 

 given to the subject of " carriers." By long study and experiment, it has been found 

 certain that persons who have been in close association with cases of the disease, or 

 have themselves suffered from an "abortive attack," may be able to spread the infec- 

 tion: and there seems to be valid evidence that the number of carriers, in time of an 

 outbreak of the disease, may be as high as 20 or even 30 per cent of the persons bacterio- 

 logically examined: it may be even higher, among members of a family in which there 

 has been a case. The spread of the knowledge of these facts will doubtless make people 

 careful to take precautions, and to submit themselves for bacteriological examination, 

 if there is any reason to think that they may be carrying the germs. 



Mental Disorders (Neuropathology). It may sound old-fashioned, and unscientific, 

 to use the phrase " mental disorders," seeing the magnificent work which is being done 

 on the chemical, physical, structural changes which attend diseases of the brain, and 

 the steady advance towards a comprehensive statement of these diseases in terms of 

 general pathology. The researches of Dr. F. W. Mott and others hardly leave room for 

 doubt that the best work, henceforth, will be done on these lines. Still, the work of the 

 psychologists has a distinctive value of its own: and the full time has not yet come for 

 chemistry and bacteriology to administer the new kingdom which they appear to be 

 entering. 



