September 23, 1920] 



NATURE 



129 



tions which are made above are anything but assump- 

 tions. But. so far as the evidence available at the 

 present time can teach any lesson, that lesson is 

 this : The only way of dealing satisfactorily with the 

 anoxic type of anoxaemia is to abolish it by in some 

 way supplying the blood with oxygen at a pressure 

 sutricient to saturate it to the normal level. 



It has been maintained strenuously by the Oxford 

 school of physiologists that Nature actually did this ; 

 that when the partial pressure in the air-cells of the 

 lung was low, the cellular covering of that organ 

 could clutch at the oxygen and force it into the blood 

 at an unnatural pressure, creating a sort of forced 

 draught. This theory, as a theory, has much to 

 recommend it. I am sorry to say, however, that I 

 cannot agree with it on the present evidence. I will 

 onlv make a passing allusion to the experiment which 

 I performed in order to test the theory, living for six 

 days m a glass respiration-chamber in which the 

 partial pressure of oxygen was gradually reduced 

 until it was at its lowest— «bout 45 mm. Such a 



?ressure, if the lung was incapable of creating what 

 have termed a forced draught, would mean an 

 oxygen pressure of 38-40 mm. of mercury in the 

 blootl, a change sufficient to make the arterial blood 



?|uite dark in colour, whereas, did any considerable 

 orctd draught exist, the blood in the arteries would 

 be quite bright in colour. Could we but see the 

 blood in the arteries, its appearance alone would 

 almost give the answer as to whether or no oxygen 

 was forced, or, in technical language, secreted, 

 through the lung-wall. .\nd, of course, we could see 

 the blood in the arteries by the simple process of 

 cutting one of them open and shedding a little into 

 - loscd glass tube. To the surgeon this is not a 

 ■ult matter, and it was, of course, done. The 

 . >. Mt showed that the blood was dark, and the most 

 careful analyses failed to discover any evidence that 

 tho body can force oxvgcn into the blood in order 

 to rompensate for a deficiency of that gas in th« air. 

 V"'t the body is not quite powerless. It can, by 

 breathing more deeply, by increasing the ventilation 

 of the lungs, bring the pressure of oxygon in the air- 

 ' closer to that in the atmosphere breathed than 

 ■ild otherwi.se be the case. 1 said just now that 

 till- oxvgon in my lungs dropped to a minimal pres- 

 Mir<- of 48 mm.; but it did not remain at that level. 

 \\ h n I bestirred myself a little it rose, as the result 



of increased ventilation of the lung, to 56 mm., and 

 at one time, when 1 was breathing through valves, it 

 reached 68 mm. Nature will do something, but what 

 Nature does not do should be done by artifice. 

 Exploration of the condition of the arterial blood is 

 only in its infancy, yet many cases have been 

 recorded in which in illness the arterial blood has 

 lacked oxygen as much as, or more than, my own 

 did in the respiration-chamber when I was lying on 

 the last day, with occasional vomiting, racked with 

 headache, and at times able to see clearly only as an 

 effort of concentration. A sick man, if his blood is 

 as anoxic as mine was, cannot be expected to fare 

 better as the result, and so he may be expected to 

 have all my troubles in addition to the graver ones 

 which are, f>erhaps, attributable to some toxic cause. 

 Can he be spared the anoxaemia? The result of our 

 calculations so far points to the fact that the efficient 

 way of combating the anoxic condition is to give 

 oxygen. During the war it was given with success in 

 the field in cases of gas poisoning, and also special 

 wards were formed on a small scale in this country 

 in which the level of oxygen in the atmosphere was 

 kept up to about 40 per cent., with great benefit to a 

 large percentage of the cases. The practice then 

 inaugurated is being tested at Guy's Hospital by 

 Dr. Hunt, who administered the treatment during 

 the war. 



Nor are the advantages of oxygen respiration con- 

 fined to pathological cases. One of the most direct 

 victims of anoxic anoxaemia is the airman who flies 

 at great heights. Everything in this paper tends to 

 show that to counteract the loss of oxygen which he 

 sustains at high altitudes there is but one policy, 

 namely, to provide him with an oxygen equipment 

 which is at once as light and as efficient as possible — 

 a consummation for which Dr. Haldanc has striven 

 unremittingly. And here I come to the personal note 

 on which I should like to conclude. In the pages 

 which I have read view^s have been expressed which 

 differ from those which he holds in matters of detail 

 — perhaps in matters of important detail. But Dr. 

 Haldane's teaching transcends mere detail. He has 

 always taught that the physiology of fo-dnv is the 

 medicine of to-morrow. The more gladly, therefore, 

 do I take this opportunitv of saying how much I 

 owe, and how much I think medicine owes and will 

 owe, to the inspiration of Dr. Haldane's teaching. 



The University Problem in London. 



A REUNION of the Old Students' Association of 

 the Ro)al College of Science was held on 

 >dav evening. September 14, at the Imperial 

 • ge Union, South Kensington. The president 

 Richard Gregory) was in the chair, and the 

 nipal feature wa» an address by Prof. H. E. 

 strong ent*itlo<l " Pre-KensinRton History of the 

 al College of Science and the University Problem 

 !'in." The address was devoted largely to an 

 taphical sketch of Prof. .Armstrong's early 

 ■ : ' ' - .it the Royal College of Science, dating 

 I' 111' '.ummrr term of 1865, when he became 

 ' Ml of its forerunner, the Royal Collece of 

 : V, then situate in Oxford Street. Prof. 

 -....iig's reminiscences of Hofmann, Mcr.eod, 

 Inll, Huxley, Frankland, and others were all 

 ;htful to listen to, but especially of th«' first- 

 '•d did h<- evidently cherish an affectionate 

 lory. \ discussion followed, in which the chairtnan, 

 i .M.' O. Forster, Prof. Whitehead, Prof. Morgan, 



NO. 2656, VOL. 106] 



Prof. E. \V. Skeats, Dr. G. T. Moody, and Mr. S. \V. 

 Hunt took part. Some remarks of the lecturer 

 referring to e.xamin.ttions seemed to be regarded as a 

 polemic against this feature of university life, and 

 called forth a certain amount of timid npologv and 

 some vigorous defence. Prof. .Armstrong, briefly 

 replying, explained that he did not object to examina- 

 tions, but to the London system ; what he was anxious 

 to see was a. series of institutions established in 

 London which would make education effective. It 

 was for each one to consider what was the best 

 system, but so long as each school attempted to do 

 everything there could not be success. The part of 

 the address referring to this subject is subjoined. 



I have now fifty years' direct experience of the 

 London University system. Tt'if.n.'li.ini thi« period 

 the talk has ever been of e\ iv, never of 



learning — London has been with' • aional ideals. 

 Under the •yttem methods of teaching haw been 



