further series of problems: and his Huxley Lecture (Brit. Med. Journ., Nov. 9, 1912) is 

 likely to be one of the classics of medical literature. No excuse is needed for quoting 



from it: 



"Polio-myelitis has been endemic in northern Europe for many years, but it is only five 

 years since it started on that unique, and as yet unexplained movement that has carried 

 it around the globe. Some significance attaches to the fact, that the first two foci of the 

 present epidemic I say present, because since 1907 the disease has prevailed severely each 

 summer and autumn at some places in the United States and Canada arose in the Atlantic 

 Coast cities and in the State of Minnesota in the middle West, The former receive the mass 

 of emigrant population from Europe, and the latter, secondarily, the large contingent of 

 Scandinavian emigrants. . . 



"Five years ago the mystery of the disease was wholly unfathomed. The outlook was 

 suddenly brightened when Landsteiner and Popper, in 1909, announced the successful 

 transmission of polio-myelitis to monkeys; but the high hopes raised were as quickly damped 

 by the failure to propagate the experimental disease beyond the first generation. This 

 obstacle was immediately removed when intracerebral was substituted for intraperitoneal 

 inoculation, as was done by Lewis and myself, and by Landsteiner and Levaditi. By this 

 means the disease could be, and has been, transmitted through an indefinite number of 

 monkeys. . . . 



"The virus of polio-myelitis passes readily through the more coarse and slightly through 

 the finest filters. It is highly resistent to drying, heat, and chemical action. In dust, 

 especially within protein matter, it survives weeks and months; in diffuse daylight indef- 

 initely, and resists the action of pure glycerine and carbolic acid in one-half per cent solution 

 for many months. When animal tissues containing the virus suffer softening and disin- 

 tegration or disorganisation by mould, the virus survives. Recovery from polio-myelitis 

 in man and monkey is attended and produced by an immunisation of the body. During 

 this process microbicidal substances appear in the blood that are capable of neutralising 

 the active virus. . . . " 



Dr. Flexner goes on to give the evidence that the nasal mucous membrane is the usual 

 way alike of ingress and of egress of the virus in cases of the disease. He discusses also 

 the question of insect carriers, and of human carriers; the possibility of "reservoirs "of 

 the virus among domestic animals, and the present position of treatment. 



Relapsing Fever. The infecting agent of relapsing fever (famine fever), the " spiril- 

 lum Obermeieri," is conveyed from man to man, like the infecting agents of many, other 

 fevers, by the bite of insects. The fever is thus akin to other forms of spirillum infec- 

 tion, or " spirochaetosis," such as the spirochaetosis of fowls. Mackie, in India, first 

 showed that body-lice are capable of conveying relapsing fever; and Bousfield (Jour. 

 R.A.M.C. 1910, ii, 444) has published evidence of a similar way of infection in the 

 Sudan. Other observations, e.g. in Hussia, tend to prove that bugs convey the disease. 

 And in the Western States of America, e.g., Montana, California, Idaho, there seems to 

 be some evidence that it may be conveyed by cattle-ticks. Major Marjoribanks, I. M.S., 

 speaking of the transmission of the fever by body-lice, puts the matter well: 



"What is the practical use of this discovery? Simply this, that the subject of relapsing 

 fever has been lifted from the sphere of curative medicine into the far higher sphere of 

 preventive medicine. Formerly, all we could do was to send our native assistants into in- 

 fected villages with febrifuges and other paraphernalia of curative medicine. But now we 

 can strike at the disease at the root, and, by destroying the lice on the bodies of patients, 

 prevent its spread. The details of the campaign have still to be worked out. My own 

 suggestion to village officers so far has been that a cauldron should be set up in each infected 

 village, and the clothes of the patient boiled in it to destroy the lice. Other methods will 

 suggest themselves as we gain experience: this is a bit of preventive medicine in the making." 



Sleeping-Sickness. Dr. Sandwith, in his Gresham Lectures for 191 2, 1 has told the 

 whole story of Sleeping-Sickness, from the time of Livingstone till now. Under " Pres- 

 ent Research Work," he writes as follows: 



"Important investigations are being carried out under the re-constituted Sleeping-Sickness 

 Commission in Central Africa appointed by the Royal Society, consisting of Sir David and 

 Lady Bruce, Captain A. E, Hamerton, D.S.O., and Major D. Harvey, to find out the 

 reason why, although man and his domestic animals have been removed from the shores 

 of the Lake Victoria Nyanza for some three years, Glossina palpalis, caught on the north 

 shores of the lake, still continues to infect susceptible animals when allowed to feed on them 

 for experimental purposes. Their prime object is to investigate the part played by African 

 fauna in the maintenance and spread of sleeping-sickness. 



1 Sleeping-Sickness, by F. M. Sandwith, M.D., F.R.C.P. Macmillans, 1912. 



