28 



NATURE 



[November 2, 191 1 



fortified by a liberal dietary, by the use of cod-liver oil and 

 by diinatic treatment. 



Dr. Theodore Williams, at the express wish of the presi- 

 dent of the college, proceeded to sketch the evolution of 

 the treatment of consumption as it had come under his 

 own cognisance during his nearly fifty years of professional 

 experience. He spoke of the effects of climate, and especi- 

 ally of that of high altitudes ; then of the open-air life 

 which had first been advocated in England by Bodington 

 and Henry MacCormac, and was now accepted as essential 

 in cases of tubercular disease. Dr. Williams had personally 

 studied the climates most advantageous for the treatment 

 of consumption in the New and the Old Worlds, and had 

 given a full trial to mountain climates, having recorded 

 their effects on more than 400 of his private patients, .and 

 studied the results of the diminished barometric pres*ui>\ 

 of the diathermancy of the air, and of the asepticity, or 

 freedom from pathogenic germs, which are characteristic 

 of high-altitude climates. 



He found the effects on selected cases of chronic tubercu- 

 losis remarkable : many symptoms vanished, and muscular 

 power increased largely, while the local improvement was 

 even more striking, and in many early cases of consolida- 

 tion the disappearance of physical signs was so complete 

 that the physician had to refer to his notes to discover 

 which lung was originally attacked ! In fact, the high- 

 altitude cases yielded the most favourable results of all 

 his statistics, and, what is more important, the fewest 

 relapses. 



He then noticed the establishment and spread of sana- 

 toria all over the world, and said that in Germany alone the 

 insurance societies now maintain more than 16,000 beds 

 for the working classes ; and he directed attention to the 

 methods pursued, including rest, with or without Liege- 

 halle, good feeding, graduated exercise, and labour super- 

 vised to meet individual requirements, which have all been 

 tried at different sanatoria, giving the results achieved 

 thereby. He described the system pursued at some of the 

 best English institutions, where the patients with limited 

 tuberculous pulmonary lesions, when removed to thoroughly 

 hygienic surroundings and compelled to lead a healthy life, 

 their food, exercise, and rests being under minute skilled 

 direction, may slowly and gradually recover, and, losing 

 symptoms, be able to return home to active working life, 

 ready and able to instruct those around them in the gospel 

 of fresh air and wholesome living. 



But Dr. Williams emphasised the need for discovering 

 and treating early cases of the disease, and though agree- 

 ing in the general truth of the curability of consumption, 

 he felt obliged to except the acute cases, which, how- 

 ever, fortunately form a very small percentage of the 

 whole. 



He contended that the pressing need is for more 

 hospitals for consumption — England had been a leader in 

 establishing these, and now it is recognised that the con- 

 sumption hospital is required as a centre from which to 

 draft off cases suitable for sanatoria, as well as for the 

 treatment of more advanced and acute cases, which are 

 thus isolated from the rest of the population and prevented 

 from becoming centres of infection. 



Dr. Theodore Williams spoke of the modern treatment 

 of consumption by anti-tuberculous serums and vaccines, 

 and gave the experience of others and of himself, con- 

 cluding by the remark that everything points to the 

 necessity for further investigation, and that such investiga- 

 tion can be best carried on in hospitals and sanatoria, 

 where trained obsert^ers minutely watch the effect of 

 tuberculin on the patient's system and control the inocula- 

 tions and their results. He summed up with a bird's-eve 

 view of the present state of the crusade against tubercu- 

 losis in this country and our means of pursuing the 

 fight. 



He reminded his audience of what had already been 

 done by the blessed agencies of prevention, such as 

 improved drainage, more cubic space, and less overcrowd- 

 ing, better food and more of it, more air and sunlight, 

 cleanliness of house and person, and increased opportuni- 

 ties for play and exercise, and how, mainly by these means, 

 the phthisis mortality had been reduced two-thirds in fiftv 

 years. 



NO. 2192, VOL- 881 



A good town-planning scheme should prove a ti; 

 weapon in the hands of the combatants. Education of 

 classes, including the children, must be promoted, and tli 

 with the tuberculosis exhibitions and popular lectures an.; 

 tracts which now permeate and enlighten the country, will 

 be found to be trusty armour and show the people h"> 

 they can help themselves. 



Prevention is naturally what is to be aimed at; but I 

 the consumptives who are now among us are needed n- 

 links in the chain : — 



(i) Well-equipped consumption hospitals to receive n 

 isolate acute and advanced cases. 



(2) The dispensary system, introduced by Dr. Philip, :> 

 now at work in several metropolitan boroughs, which, w 

 the out-patient departments of consumption hospitals, < 

 classify the patients, visiting them and contacts in tli 

 own homes, and connecting them with local governnv 

 and philanthropic agencies. 



(3) The sanatorium, and especially those instituti<. 

 which make a feature of preparing the patient by variou- 

 grades of labour for return to a workaday world. 



(4) Labour colonies and exchanges to assist in the r-- 

 habilitation of those who have been smitten with t 

 disease, or may be more liable to reinfection, or m 

 require the safeguard of a changed and more health, 

 occupation. 



The task of further reducing, and finally abolishii 

 tuberculosis is not a hopeless one, but it does not 

 wholly with the doctors. It lies also with those who h;i\ 

 It in their power to remove and lessen the principal caus- - 

 of tuberculosis, viz. the overcrowding of our cities, iIt 

 want of open spaces and of ventilation, the insanitar\ 

 houses, the disgusting habit of spitting, and the lack of 1 

 good supply of water and of pure milk. Philanthropi- 

 together with local government authorities administer; 

 under our Minister of Health, might remedy these defei - 

 and ensure that the number of phthisis cases should be in 

 future comparatively small. 



The great Harvey would smile with pleasure as 

 realised our successive advances in knowledge and t 

 attempts to remedy our deficiencies, and he might w> li 

 receive our laurel crown as the leader who showed the wa\ 

 to those who are now searching out the secrets of nature 

 by way of experiment. 



UNIVERSITY EDUCATION IN ENGLAND AND 

 WALES. 



A TTENTION has been directed already (Nature, 

 ■^ September 21, vol. Ixxxvii., p. 407) to the Blue-book 

 containing the reports for the year 1909-10 from those 

 universities and university colleges in Great Britain which 

 participate in the Parliamentary grant for university 

 colleges. In the notes referred to, information was given 

 as to the amount of the Treasury grant, particulars con- 

 cerning the incomes of the various colleges, and similar 

 data. 



.\n introductory report by the Board of Education, v. 

 which the volume opens, contains much that deser\ 

 careful study by all who are interested in the progress 

 higher education. A number of extracts from this pi' 

 fatory memorandum are subjoined. 



The weakness of the appeal which university education 

 makes in the present day to the imagination of the wealth\ 

 finds its counterpart in the apathy of the public at lar. 

 and this apathy is only too frequently reflected in the n 

 tude of the local authorities. Some of the most importa: 

 of these give far less than their proper share of support t 

 the universities, and in one or two instances the mainten- 

 ance at their present level of the grants made by local 

 education authorities has been endangered. On the oth^'- 

 hand, in two instances there has been a notable increase 

 the amount of the support received from this source. A-; 

 the result of representations made by the Right Hon. 

 Joseph Chamberlain, M.P., the Chancellor of the U^ni- 

 versity, the City of Birmingham has promised to increase 



