i 7 6 MEDICINE 



and from man to mammals. (3) Tuberculosis is transmissible to man in the milk or the 

 meat (pork or beef) of tuberculous animals. The risk of infection from birds (avian 

 tuberculosis) is negligible. (4) There are three types of the bacillus of tubercle: human, 

 bovine, and avian. (5) The bacillus of lupus is of the bovine order, but is of a modified 

 type, and is not identical with bovine tuberculosis. (6) Strict supervision of the meat- 

 trade and the milk-trade is of the utmost concern to the public health, especially in 

 regard to infants and young children; and no relaxation of the present restrictions is 

 permissible. 



On January i, 1912, pulmonary tuberculosis (consumption) was made one of the 

 compulsorily notifiable diseases in England. The preliminary steps towards this meas- 

 ure are of interest. The municipal system of voluntary notification, with partial isola- 

 tion, introduced by Dr. Newsholme in Brighton, gave encouragement toward further 

 action. In 1908, the Local Government Board, taking advantage of its powers under 

 the Public Health Act, issued the Public Health (Tuberculosis) Regulations, 1908, 

 making the notification of consumption compulsory in all Poor-law cases of the disease, 

 whether institutional or district. In 1911, it issued similar Regulations for all in- 

 patients and out-patients of Hospitals and Dispensaries other than Poor-law institu- 

 tions. Having thus covered two-thirds of all cases, it covered the remaining third on 

 January i, 1912. 



In the last few years, great attention has been given to the use of "auto-inocula- 

 tion " as a factor in the treatment of tuberculous disease; and to the relation of graduated 

 exercises to auto-inoculation. Much work has also been done on the efficacy of bovine 

 tuberculin for the treatment of tuberculosis of human origin, and the efficacy of 

 human tuberculin for the treatment of tuberculosis of bovine origin. Along 

 these lines, a notable advance has been made, in Germany and in the United 

 States, toward the saving of calves born of tuberculous cows. The principle of the 

 method has been stated as follows: "If a calf is born of a tuberculous cow and left 

 with its mother, the calf dies. If the calf is inoculated with small doses of bovine 

 tuberculin the calf will also die. But if that calf is taken away from its mother and 

 inoculated with small doses of human tuberculin, the calf will live and will be able to 

 return to the herd from which it came." 1 



Typhoid Fever. During 1910-12, the house-fly has been marked down as an im- 

 portant agent in the spread of typhoid fever, and, probably, of other infections. The 

 fly does not act as an intermediate host of the bacillus typhosus: it does not afford such 

 opportunities to these germs as the Anopheles mosquito affords to the protozoa of 

 malaria: it simply conveys the germs, on its feet, from infective substances to our food. 

 A full account of the subject will be found in Dr. L. O. Howard's book, The House Fly, 

 Disease Carrier (Murray, 1912). The use of a protective vaccine against typhoid 

 fever is steadily gaining ground, and there is no longer any room to doubt its validity. 

 We have only to hope that it may be made, by further work, more efficient and more 

 lasting. Meanwhile, we have reason to be glad of the good results which have already 

 been obtained. Two sets of figures come to be noted here: they are concerned with the 

 British Army in India, and with the Army of the United States. 



(a) Sir William Leishman, in his address to the Glasgow Medico-Chirurgical Society 

 on " Anti-typhoid Inoculation " (Brit. Med. Journ., Feb. 17, 1912), said that "for 17 

 years prior to 1907 the annual number of admissions had averaged 1406, with an 

 average of 353 deaths. In 1905, anti-typhoid inoculation was introduced as a volun- 

 tary measure; and, while at first not largely utilised, was by 1907 being taken advantage 

 of by the troops in increasing numbers. Since that date, the admissions from enteric 

 had fallen steadily, till in 1910 they numbered only 296, with 45 deaths." Col. Firth, 

 in his paper on " Recent Facts as to Enteric Inoculation and the Incidence of Enteric 

 and Paratyphoid Fevers in India " (Journ. R.A.M.C., Aug. 1912) says that the whole 

 scries of facts indicates " that against enteric fever the value of inoculation as now 



1 See Major Cummin's paper on "Primitive Tribes and- Tuberculosis, ' with discussion: 

 Trans. Soc. Trap. Med. and llyg., June 1912. 



